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The Differences Between a Heart Attack and a Panic Attack

Thomas Togioka';

By Thomas Togioka

Posted on February 12th, 2021 in Cardiology

Pressure in the chest, shortness of breath, racing heartbeat, and tingling sensations can all be signs of a panic attack or a heart attack. The two can feel very similar.

What's dangerous is that patients could:

  • confuse one for the other
  • ignore the symptoms 
  • not seek medical attention

Hospitals have amazing techniques to treat heart attacks, but they are most effective if patients come in right away.

It's preferable that doctors see a patient with chest pain who turns out not to have a serious medical issue than they see a patient who comes in hours or days later when the opportunity for treatment has passed.

It's very important to rule out a heart condition before pursuing the diagnosis of a panic disorder. Women have a higher rate of panic attacks as do the younger patients, but it is a myth to think that the elderly are immune or do not have panic attacks; they can also have them.

Heart Attack and Panic Attack Shared Symptoms

Unfortunately, physically, a panic attack and a heart attack may feel similar, but heart attacks can be fatal without a physician's assessment, testing, and if left untreated. 

Panic disorder is a clinical term used for repeated episodes of fear and anxiety which can occur out of the blue or can be related to specific situations or even places. However, while panic attacks are not life-threatening, although they are intensely uncomfortable. 

Keep an eye out for some of these symptoms that could be related to either a heart attack or panic attack:

  • chest pain
  • shortness of breath
  • passing out
  • tingling
  • dizziness
  • sweating
  • a sensation of impending doom

Other serious conditions may also share the similarities between a heart attack and a panic attack, for example:

  • blood clots
  • lung infection or collapse
  • tear in the large blood vessels of the chest

Heart Attack and Panic Attack Exclusive Symptoms

When a person has never experienced the symptoms of a panic attack and a heart attack before, it's difficult to know the difference between them. Yet, a person can weigh several factors, including:

  • characteristics of the pain: during a panic attack, chest pain is usually sharp or stabbing and localized in the middle of the chest while chest pain from a heart attack may resemble pressure or a squeezing sensation and can radiate in both arms, the jaw, back, shoulders, neck, or upper stomach
  • onset: although both conditions can develop suddenly and without warning, some heart attacks come on because of physical exertion, such as climbing the stairs.
  • duration: most panic attacks are over in several minutes, though they can last longer but during a heart attack, symptoms last longer and get worse. 

The best predictor of whether symptoms are due to panic versus heart attack are:

  • the patient’s age: people younger than 40 years of age, especially those who have had previous panic attacks and are healthy, are more likely to go through a panic attack
  • previous history of panic attacks: older patients and those without a prior history of panic attacks are less likely to experience one

Heart Attack and Panic Attack: Should Patients Go to Urgent Care?

Patients who have a diagnosed panic attack disorder can try deep breathing or other relaxation techniques to see if their symptoms improve. But they should not delay long. Patients can also use medications provided to them by their physician for home use. 

People with recurrent panic attacks benefit from seeing a therapist or psychologist who can help them with anxiety disorders. When experiencing new-onset or prolonged symptoms of panic attacks, young patients can get evaluated in urgent care.

Patients who have risk factors or known heart disease should come to the ER when:

  • their symptoms do not go away quickly
  • if their symptoms differ from what they have experienced with other panic attacks

Heart Attack: Potentially Serious Symptoms

It's very important to treat heart attacks immediately as delays in diagnosing and treating heart attacks can cause permanent damage to the muscle of the heart, physical disability, or death.

When patients experience the following symptoms, they should immediately go to the emergency department:

  • new-onset chest pain (tightness, squeezing, heaviness)
  • shortness of breath
  • sweating
  • lightheadedness
  • pain radiating to the arm or jaw
  • ripping sensation in the chest or back

Heart attacks tend to occur in the following groups, who should also go to the ER right away: 

  • middle-aged people and older age groups
  • patients with pre-existing coronary artery disease 
  • patients with hypertension, diabetes, obesity, high cholesterol, or a history of smoking, risk factors associated with coronary artery disease

Anybody that has chest pain would be best advised to seek immediate medical attention. At Cedars-Sinai Marina Del Rey Hospital's emergency department, we can perform several tests to distinguish whether patients are having a panic attack or a heart attack. These tests include an EKG, blood tests, and some type of stress test.