Panic or Heart Attack? What You Need to Know

Author’s note: This article is summarized from various sources, and attributions are linked within.

Man having a panic attackPhoto bySander SammyonUnsplash

If you’ve ever had a panic attack, you may have though it was a heart attack. And some minor heart attacks could be dismissed by an individual if they routinely have panic attacks. So what’s the difference and when should you worry?

There are a lot of symptoms that are the same for both heart attacks and panic attacks. These include: “heart palpitations, trouble breathing dizziness, nausea, and a feeling of impending doom.”

Doctors state it can be tough to tell the difference in the conditions without tests. Andrew Klein, M.D., a cardiologist at Piedmont Heart Institute in Atlanta says the symptoms can be hard to distinguish to point to a root case.

“When you’re having any kind of chest pain, trouble breathing, or other alarming symptoms, it’s always good to err on the side of caution and head to the emergency room. Physicians there will evaluate and treat you, and might refer you to a cardiologist.”

Often a racing heart is what brings a patient to the emergency room. If tests don’t point to a heart issue, they use the "diagnosis of exclusion” before diagnosing it as anxiety.

Conversely, those with “a history of panic attacks or an anxiety disorder diagnosis might see their doctor about dizziness or heart palpitations and find out they have a heart condition, such as an arrhythmia, Dr. Flaherty says.”

Though the symptoms may feel similar, there are subtle differences. In a heart attack, blood flow to the heart muscle is blocked or reduced due to plaque. Pain can be sudden and severe, or start with mild pain that comes and goes, or gradually worsens.

Cardiac arrest is when your heart stops. It can be caused by an arrhythmia or other conditions and would not be confused with a panic attack.

A true panic attack is unrelated to your heart and instead is caused when your fight or flight response goes into overdrive from a real or imagined fear. Having a panic attack with chest pain, pounding or racing heart, lightheadedness, dizziness and sweating can lead to more panic if you think it’s a heart attack.

Both can cause chest pain but a heart attack will also often have pressure and the feeling of your chest being squeezed. Pain in your chest may be only a panic attack but if you have “discomfort in the jaw, neck, arms, back, or shoulders” it’s more likely to be a heart attack.

Keep in mind, even if something is “only” a panic attack it can lead to a heart attack in some cases. High blood pressure caused by stress increases risk for a heart attack.

A major stressor, like the loss of a loved one can cause stress cardiomyopathy, also called broken heart or takosubo syndrome. This can cause abrupt changes in the heart and weakness in the muscle.

Bottom line, if you’re having any symptoms like the ones mentioned above, it’s a good idea to get checked out by a doctor. “A routine heart exam might include performing an EKG and blood tests to check for cardiac enzymes and can rule out a heart problem.”