Telling the Difference Between a Panic Attack and Heart Attack

You’re in the middle of your day when your heart rate and blood pressure start to rise. You start to breathe more quickly and you feel a tightness in your chest.

At this point, you might be asking yourself, “Am I having a heart attack?” Many people experience these symptoms and ending up being treated for cardiac arrest. However, others end up experiencing a panic attack.

How does someone tell the difference between a panic attack and a heart attack? Qiu Tong, MD, is a cardiologist in Batavia and shares his insight into the differences your body is going through during a panic attack vs. a heart attack, and when you should head to the emergency department.

Symptoms of heart attacks

When someone experiences a heart attack, the first hint of something being wrong may be one or more of the following symptoms:

• chest discomfort or pain (angina)
• shortness of breath
• profuse sweating
• jaw or arm pain
• abdominal pain
• back pain

Symptoms of panic attacks

During a panic attack, the body’s stress response is very similar to a heart attack. This might include:

• increased blood pressure
• increased heart rate
• rapid breathing
• fight or flight feelings
• chest discomfort

“In a panic attack, your body is secreting hormones called catecholamines, which cause those symptoms as part of a stress response,” Dr. Tong said. “Usually panic attacks don’t lead to serious health outcomes, but they are still very real and scary. It is important to keep in mind that when someone is having an acute cardiovascular event such as a heart attack or even symptoms from stable heart disease, there is a very similar physiologic response, which is why so many of the symptoms can overlap.”

Telling the difference between a panic attack or heart attack

Unfortunately, there is not a simple, clear-cut answer on how to tell the difference. Both panic attacks and heart attacks can look different for everyone and the signs of each one are very similar.

“Even how long the episode lasts can vary,” Dr. Tong said. “Some heart attacks may last for a long time, while others might be short. The same can be said for panic attacks.”

However, there are two indicators that may point slightly more toward someone experiencing a panic attack over a heart attack: health history and environment.

People who have a documented history of anxiety in the past or are currently living with generalized anxiety disorder are more likely to experience panic attacks. If someone is in a location or situation that has brought on anxiety in the past, they are more likely to experience a similar reaction if they are back in that situation.

According to Dr. Tong, heart attacks are more likely to occur for people who are physically exerting themselves in some way – walking up steep flights of stairs, shoveling snow, etc.

What to do if you think you are having a panic attack or heart attack

Because so many of the symptoms of heart attacks and panic attacks are similar, it can be risky to assume that an episode might be “just” a panic attack.

If someone is having chest or jaw pain, Dr. Tong would strongly encourage them to visit their closest emergency department.

Even if you think you are having a panic attack instead of a heart attack, that can still be scary – and a good reason to talk with a provider.

 “For people who suffer from panic attacks, they have tangible consequences and can feel awful – sometimes making them feel like they are going to die,” Dr. Tong said. “Finding a medical professional who can ask the right questions and determine if they need more testing, imaging, or bloodwork is very important.”