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

The symptoms of a panic attack and a heart attack can be very similar, making it difficult to tell the difference.

Also, having a heart attack can cause someone to panic, which may make the situation more confusing. If someone thinks they may be having a heart attack, they should seek emergency medical attention.

Every year, about 2 to 3 percent of people in the United States experience panic disorder. Symptoms of a panic attack can include:

  • sharp pain in the chest
  • tingling in the hands
  • shortness of breath
  • racing heart
  • sweating
  • shaking

Every year, about 735,000 people in the United States have a heart attack. Symptoms of a heart attack can include:

  • chest pain
  • shortness of breath
  • nausea
  • vomiting
  • sweating

While the symptoms of these two conditions overlap, knowing how to tell the difference can be lifesaving.

Image credit: Stephen Kelly, 2019

How to tell the difference

Knowing the difference between a panic attack vs. heart attack can be difficult, especially if a person has never experienced the symptoms of either before.

Distinguishing between the two conditions can be made easier by several factors, including:

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 to 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.

Onset

The onset of symptoms may also help a person know if they are having a panic attack or heart attack.

Although both conditions can develop suddenly and without warning, there may still be some differences.

Sometimes heart attacks come on due to physical exertion, such as climbing the stairs.

Duration

The duration of symptoms might also help distinguish between a heart attack and panic attack.

Although it can vary, most panic attacks are over in 20 to 30 minutes.

During a heart attack, symptoms tend to last longer and get worse over time. For example, chest pain may be mild at the onset of a heart attack but become severe after several minutes.

Can a panic attack cause a heart attack?

A panic attack will not cause a heart attack. A blockage in one or more of the blood vessels to the heart, which leads to an interruption of vital blood flow, causes a heart attack.

Although a panic attack will not cause a heart attack, stress and anxiety might play a role in the development of coronary artery disease.

Panic attacks can occur as isolated events or as part of an anxiety disorder.

Some research indicates that people with anxiety disorders may have an increased risk of developing heart disease due to low heart rate variability (HRV).

HRV is the time between each heartbeat. The autonomic nervous system controls the heart rate. The heart rate is meant to vary throughout the day, depending on a person’s activities and emotions.

A high HRV indicates that a person’s heart rate shifts efficiently throughout the day, based on what they are doing. It is also a sign that their autonomic nervous system is working well.

A low HRV means a person’s heart does not switch gears as efficiently. Some studies associate a low HRV with an increased risk of heart disease.

In the researchers’ analysis of studies looking at HRV in people who were diagnosed with various types of anxiety disorder, including panic disorder, the results indicated the participants had a lower HRV than those without an anxiety disorder.

It is crucial to understand that having a panic attack or panic disorder does not mean someone will have a heart attack. Additional research is needed to say if having panic disorder increases the risk of developing heart disease, definitively.

When to see a doctor

A doctor at a desk showing tablet to patient

A doctor may use a cardiogram to accurately diagnose heart disease.

As the symptoms of panic attacks and heart attacks are similar, it is always best to seek immediate medical attention when in doubt.

It is vital to seek emergency medical treatment if any of the following symptoms develop:

  • sudden severe chest pain
  • pressure in the chest, lasting more than 2 or 3 minutes
  • chest pain, radiating down the arm or into the jaw

According to the Woman’s Heart Foundation, doctors may mistake heart disease for panic attacks in women. Medical tests, such as an electrocardiogram and blood tests, can help a doctor make an accurate diagnosis.

A person’s outlook and recovery can improve when they receive prompt treatment for a heart attack. Even if symptoms are not due to a heart attack, a person can also receive medical treatment for a panic attack.

Outlook

The outlook will vary, depending on whether a person has experienced a heart attack or a panic attack.

Although a panic attack may feel very uncomfortable, it is not life-threatening. Panic attacks can interfere with a person’s quality of life, so they should seek appropriate treatment.

A doctor can help treat anxiety and panic attacks with various techniques, including lifestyle modifications, medication, and counseling.

In some cases, a heart attack can be life-threatening. With prompt treatment, many people survive a heart attack. Following a heart attack, a person will also need to take steps to manage the underlying heart disease.

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