Cardiophobia: A Growing Fear of Heart Attacks

Cardiophobia is one form of pathophobia, the fear of death from the onset of a deadly and sudden disease. This differs from hypochondria, which I mentioned in a previous post, where I spoke about patients with hypochondria panicking at any sign of fluctuation in their body, which is usually read by the patient as a possible symptom of some potential disease.

With cardiophobia, the patient lives in constant fear of dying from a disease, specifically related to the cardiovascular system. This fear is irrational and persists despite numerous negative medical consultations. Even though medical tests are conducted and have actively excluded organic pathological conditions, we still find this problem persisting in the mind of the patient. In the case of cardiophobia, (thanks to our model of treatment and through meticulous action-research-clinical-intervention), we can identify the main dysfunctional attempted solutions adopted by the patients suffering from this obsessive problem.

Dysfunctional behaviours that cardiophobia patients engage in

1. Specialist medical consultations

In an attempt to control their fear of dying, patients tend to request numerous specialist tests and consultations, usually from a respected specialist if possible. Visits to hospitals and specialist clinics are a regular occurrence, as are ECGs, blood pressure measurements, and continual time on the internet researching DR Google. This continual search for reassurance has little to no effect on reducing the patient's anxiety.

2. Continual monitoring of their heartbeat

The attempt to control their heartbeat often leads patients to the experience of losing control. This solution of obsessively focusing their conscious attention on monitoring their heart to have control over its rhythm finds them worrying about it beating too fast — tachycardia — or beating too slow — bradycardia. They also look for any suspicious or worrying chest pains. As with what happens for most forms of rigid and obsessive control (that eventually lead to a loss of control), even in this case, the cardiophobia paradox is created: While the patient tries to reassure themselves by monitoring their heart, the more they alter their hearts functioning and natural rhythm. This then produces the effect they were worried about discovering (an irregular heartbeat), which subsequently triggers a panic attack.

3. Avoidance of certain situations

In my recent post on phobic mental traps, I wrote about the dangers of avoidance. A cardiophobic person usually avoids any contexts or situations that may cause cardiac stress, such as funerals, exercise, football matches, parties, etc. They gradually reduce to zero any physical activity that might expose their heart to risk. The irony here is that this leads to reduced physical health and more time to feed the obsession with their heart and its functioning.

4. Ongoing conversations

As is typical in phobic and obsessive disorders, there is usually a continual sharing of their fears with others, which produces a paradoxical effect of increasing their fear and obsessive fixation with their heart. Even though the patient receives rational reassurances from those around them, this only feeds their need for reassurance and the belief that something sinister is at hand.

An approach to treatment

Clinicians must be capable of gaining the trust of the patient and communicating effectively to ensure that the patient feels that you take them seriously. Treatment must also involve methods that are not simple, rational explanations because this will only feed the problem further. We have found that effective therapy involves breaking the cycle between the obsession and the usual dysfunctional solutions, to solve their phobia.