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How To Tell The Difference Between Panic And Heart Attack

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How to Tell the Difference Between Panic Attacks and Heart Attacks

It feels like your heart is getting squeezed. You can’t get a deep breath. You get chest pains. You feel weak. You genuinely feel as though you’re about to die.

Then it all goes away.

What happened? Many people worry they suffered from a heart attack. But what you may have suffered from is a panic attack. Don’t let the name fool you – panic attacks cause very real physical symptoms that mimic those of a heart attack, yet in general, nothing is wrong with your heart.

Why are these anxiety attacks so powerful and how can they be stopped? We’ll explore these anxiety attacks below.

Better Safe Than Sorry

Although treatment including therapy and medication is available for all of these conditions, do not be afraid of requesting tests to determine which condition you are dealing with. With these three medical challenges, the old adage Better safe than sorry definitely applies. Complete Care centers offer a full range of treatment options to provide you with essential medical care for any or all of these conditions. Check out our location page for a center near you.

What Is A Panic Attack

A panic attack causes sudden, brief feelings of fear and strong physical reactions in response to ordinary, nonthreatening situations. When youre having a panic attack, you may sweat a lot, have difficulty breathing and feel like your heart is racing. It may feel as if youre having a heart attack.

Panic disorder can develop when you worry too much about having another panic attack or change behaviors to avoid having a panic attack.

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The Chest Pain Is Different

Although you experience chest pains with both conditions, the characteristics of the pain are different. When youre having a panic attack, the chest pain is sharp or stabbing and is often localized in the middle of the chest.

On the other hand, a heart attack resembles pressure or a squeezing sensation. This pain often starts in the middle of the chest and radiates to the jaw, shoulders, and arms.

Emotions During A Panic Attack

Panic attack vs. heart attack: How to tell the difference ...

What is similar in both men and women during a panic attack is the presence of strong emotions, says Benjamin Hirsh, M.D., a cardiologist at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, NY. While its true that some people may feel chest pain or pressure during a panic attack, neither tends to last more than 30 seconds. What distinguishes other physical symptoms of panic is that they are often accompanied by a sense of a loss of control over feelings and thoughts, he adds. Howeverand this is importantif chest pain leaves and then returns, its time to call 911.

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Panic Or Heart Attack How To Know The Difference

The human body is really good at signaling when something is wrong. Unfortunately, it’s not very good at diagnosing itself. In fact, many of the signals it sends are virtually the same for a wide variety of conditions. And we tend to minimize our symptoms. So, if your body is telegraphing chest pain, shortness of breath, nausea and lightheadedness, you may be inclined to chalk it up to stress or anxiety. Chances are, you’ll rule out anything more serious despite the fact that these can also be symptoms of a heart attack. So how can you tell if you’re having a panic or heart attack? Knowing the difference and acting fast could save your life.

What It Feels Like

Some describe a feeling of burning, squeezing or aching. Generally, men and women experience symptoms differently. Males generally describe the classic “elephant on your chest” symptom. Women often present with vague symptoms and may feel extremely fatigued, dizzy or nauseous. They may experience upper back pain and mistake heart attack symptoms with heartburn or stomach issues. For women, if something just feels “off,” it’s important to get checked out.

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Angina And Heart Attacks

Angina is a syndrome caused by the supply of oxygen-rich blood to the heart becoming restricted.

People with angina can experience similar symptoms to a heart attack, but they usually happen during exercise and pass within a few minutes.

However, occasionally, people with angina can have a heart attack. It’s important to recognise the difference between the symptoms of angina and those of a heart attack. The best way to do this is to remember that the symptoms of angina can be controlled with medicine, but symptoms of a heart attack cannot.

If you have angina, you may have been prescribed medicine that improves your symptoms within 5 minutes. If the first dose does not work, a second dose can be taken after 5 minutes, and a third dose after a further 5 minutes.

If the pain persists, despite taking 3 doses of glyceryl trinitrate over 15 minutes, call 999 and ask for an ambulance.

Page last reviewed: 28 November 2019 Next review due: 28 November 2022

Are You Having An Anxiety Attack Or A Heart Attack

Panic Attack vs Heart Attack: How To Tell The Difference

People who suffer from panic attacks often say their acute anxiety feels like a heart attack, as many of the symptoms can seem the same. Both conditions can be accompanied by shortness of breath, tightness in the chest, sweating, a pounding heartbeat, dizziness, and even physical weakness or temporary paralysis.

Perhaps most powerful, though, is the sense of dread that overshadows both events. The fear itself can lead to an increase in these symptoms.

To learn more about living a heart-healthy lifestyle and what to do when anxiety feels like a heart attack, contact UPMCs Heart and Vascular Institute today.

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Why Panic Attacks Seem Like Heart Attacks

Panic attacks manifest themselves in many different ways, and can literally cause you to feel anything. Many people think that the symptoms are âin their headâ or otherwise imagined and nothing could be further from the truth. The symptoms are real, but they are usually not caused by what is feared. This is the case when you fear a heart attack during a panic attack. With a panic attack you might feel the following symptoms that are similar to a heart attack:

  • Chest Pains
  • Tingling in the Extremities, Face, or Body
  • Sense of Impending Doom
  • Dizziness

All of these things are remarkably similar to the symptoms of a heart attack. When you really get out your microscope, however, you can see some clear differences.

What Causes A Panic Attack

A panic attack is an intense feeling of anxiety and fear, which occurs suddenly without any warning. When youre experiencing a panic attack, you may feel like youre losing control, dying, or having a heart attack.

The causes of a panic attack remain unknown. However, certain factors may play a role.These include:

  • Major stress
  • Changes in brain function

In the early stages, panic attacks may happen without warning. However, over time, theyre often triggered by something.

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Should I Seek Emergency Care

If you experience the shared symptoms of heart and panic attacks, and are worried that you may be having a heart attack, it’s important to seek emergency medical attention. This means, in the UK, calling 999, regardless of your age or medical history.

Only after a full examination can a heart attack be ruled out, and a quick response from medical professionals can be the difference between life and death.

The exception is if you have experienced panic attacks before and are getting identical symptoms, which settle when you use techniques you’ve been taught .

Can A Panic Attack Cause A Heart Attack

Chest Pain Anxiety Attack Symptoms

A panic attack is unlikely to cause a heart attack, but its possible. Emotional stress plays a role in both conditions. Both panic attacks and heart attacks can occur during or after a stressful situation, says Dr. Miller. But most of the time, people have a panic attack rather than a heart attack in response to emotional stress.

People who have anxiety, depression or chronic stress may have a higher risk of heart problems. Chronic stress can lead to high blood pressure, which raises the risk of heart attack and stroke.

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Panic Attacks On The Other Hand Include Increased Heart Rate

Unlike heart attacks, panic attack symptoms dont generally differ according to gender. Panic attacks tend to last about 20 to 30 minutes, with the peak of severe symptoms occurring at about 10 minutes, Leibowitz says. If someone is describing chest pain that lasted half an hour and was then resolved, its usually not a heart attack, though this isnt always 100% true.

Panic attack chest pain does not move away from the torso. The chest pain of a panic attack is more of a centralized upper-stomach/middle-chest pain that doesnt radiate through the body, she says. Other symptoms of panic attacks include an increased heart rate, and pain that happens in conjunction with feelings of anxiety.

Relieve Anxiety Reduce Afib

Anxiety and AFib play off each other, and thats no good for your body or your mind. If you know that anxiety triggers your AFib, make it a priority to get the stressors in your life under control as you craft a more heart-healthy routine.

If anxiety is too much to bear, dont suffer alone talk to your doctor about adding anxiety medication to your health management. You may not need to take it every day, only when things get very bad, but knowing that you have something on hand for emergencies can go far to reassuring yourself that youll get through the panic should it strike again.

Next, add exercise. Workouts dont need to be strenuous, but they do need to be regular: youll see more positive physical and psychological results when you commit to exercising several times a week. If youre not sure where to start, you may first want to meet with your doctor and a trainer to measure your current level of fitness, so you can choose an appropriate workout that respects your limits.

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Characteristics Of The Pain

Although chest pain is common to both a panic attack and a heart attack, the characteristics of the pain often differ.

During a panic attack, chest pain is usually sharp or stabbing and localized in the middle of the chest.

Chest pain from a heart attack may resemble pressure or a squeezing sensation.

Chest pain that occurs due to a heart attack may also start in the center of the chest, but can then radiate from the chest to the arm, jaw, or shoulder blades.

How Can I Be Sure Im Not Having A Heart Attack

Panic Attack vs Heart Attack | How to tell the differences

Well, first of all, if you dont have a history of panic attacks, and you do have some of the risk factors for heart attack, and youre worried about it go see a doctor, says McLaughlin, because theyre the only ones who can tell you for certain.

But in general, a heart attack is much more likely to accompany exertion, says McLaughlin, whereas a panic attack can occur when youre sitting and even seemingly relaxed. A heart attack is less likely to happen out of the blue than to happen to someone whos shoveling snow, or running up a flight of stars, for example, she says. Exertion, especially in someone not used to exercise, can increase blood pressure, which McLaughlin says can push people with an impending heart attack over the edge.

So without that kind of recent or current exertion, says McLaughlin, an out-of-the-blue pain in the chest, lasting less than ten minutes, is really less likely to be a heart attack. But even ten minutes can feel like ages, so here are some things you can do when youre hit with sudden chest pain or fluttering.

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The Effect Of Anxiety On The Heart

When someone is anxious, their body reacts in ways that can put an extra strain on their heart. The physical symptoms of anxiety can be especially damaging among individuals with existing cardiac disease.

Anxiety may have an association with the following heart disorders and cardiac risk factors:

  • Rapid heart rate In serious cases, can interfere with normal heart function and increase the risk of sudden cardiac arrest.
  • Increased blood pressure If chronic, can lead to coronary disease, weakening of the heart muscle, and heart failure.
  • May result in higher incidence of death after an acute heart attack.

Medical History Provides Clues

Your medical history may offer hints as to whether you’re experiencing a panic attack or afib. Often panic attacks are precipitated by some anxiety or depression or another psychiatric difficulty. Also, whether you’ve had a panic attack in the past could be a clue. Dr. Sobel said the presence of one panic attack increases the likelihood of another. Likewise, he said, a family history of cardiac disease and arrhythmias may point in a different direction.

Women may have atypical symptoms of a heart attack or other heart condition, such as a burning sensation in the upper abdomen, an upset stomach, or sweating. Doctors don’t always consider a heart attack or heart arrhythmia when women come to the ER with those symptoms, said Michelle B. Riba, MD, a professor and associate chair for integrated medical and psychiatric services at the University of Michigan.

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The Difference Between Panic Attacks And Heart Attacks

Because the symptoms of panic attacks and heart attacks present so similarly, doctors often use the process of elimination along with their knowledge of heart conditions to discover a true diagnosis.

It is important to note is that a hidden heart problem for a person who is relatively healthy is uncommon. While it may occur in very rare cases, most individuals who are 40 and younger will not suffer a heart attack.

This means, if a person who has significant anxiety and no pre-diagnosed heart problem experiences the symptoms that match both a panic attack and a heart attack, the likelihood of it actually being a heart attack is very low.

Unfortunately, panic attacks still come with some difficult health and/or physical symptoms, which can cause people to continuously worry about an undiagnosed health condition. And while the physical effects can look similar, there are subtle ways to tell the difference between panic attacks and heart attacks.

Panic Attacks Vs Heart Attack

Linnea Hanold Baker on Twitter: " The difference between ...

According to, the pain of a heart attack usually presents as a crushing pain that feels like someone is standing on your chest. With other causes, such as panic attacks, the pain is usually much more variable in nature. Panic attacks will present as a sharp or stabbing sensation. The pain with a heart attack also tends to be centrally located in the chest, and then can move to the left arm, back, shoulders or neck. Panic attacks usually involve pain that lingers over the heart, though it can mimic the movement into the arm, back and neck as well. Cardiac pain usually lasts longer than pain from a panic attack, as panic attack pain will often disappear after 15 minutes or so.

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How Are Panic Attacks Managed Or Treated

Psychotherapy, medications or a combination are very effective at stopping panic attacks. How long youll need treatment depends on the severity of your problem and how well you respond to treatment. Options include:

  • Psychotherapy:Cognitive behavioral therapy is a type of psychotherapy, or talk therapy. You discuss your thoughts and emotions with a mental health professional, such as a licensed counselor or psychologist. This specialist helps identify panic attack triggers so you can change your thinking, behaviors and reactions. As you start to respond differently to triggers, the attacks decrease and ultimately stop.
  • Antidepressants: Certain antidepressant medications can make panic attacks less frequent or less severe. Providers may prescribe serotonin selective reuptake inhibitors , serotonin-norepinephrine reuptake inhibitors or tricyclic antidepressants . SSRIs include fluoxetine and paroxetine . SNRIs include duloxetine and venlafaxine . TCAs include amitriptyline and doxepin .
  • Anti-anxiety medications: Benzodiazepines are the most commonly prescribed anti-anxiety medication to treat and prevent panic attacks. They help with anxiety but have risks of addiction or dependence. These medications include alprazolam and lorazepam .

What Questions Should I Ask My Doctor

If you have panic attacks, you may want to ask your healthcare provider:

  • Why am I having panic attacks?
  • What is the best treatment for panic attacks?
  • How long will I need therapy?
  • How long do I need to take medications?
  • Should I look out for medication side effects?

A note from Cleveland Clinic

Panic attacks can be extremely uncomfortable. Although theyre not physically harmful, they can take a toll on your mental health and stop you from doing the things you love. Dont be embarrassed to tell your healthcare provider that you have panic attacks. Your provider can help you overcome fears and anxieties that trigger attacks. You can get better with treatments like psychotherapy and medications.

Last reviewed by a Cleveland Clinic medical professional on 08/12/2020.


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Bottom Line: Always Listen To Your Body

I always tell both men and women to listen to their bodies, Sicular says. If youre not feeling like yourself and something feels off, especially in your chest, theres no harm in going to the emergency room and getting an EKG and a medical evaluation. Thats especially true if you have risk factors for cardiovascular disease.

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