Panic Attack or Heart Attack? How to tell the Difference

You’re having chest pain and trouble breathing. You’re thinking, “Am I having a heart attack?” Surprisingly, an experience of extreme anxiety, also called a panic attack, can mimic some of the symptoms of a heart attack, although there are differences, some of them subtle. 

People with anxiety disorders may suffer panic attacks. Medication and therapy can help reduce their severity and frequency. If you don’t normally have anxiety and have never suffered a panic attack, you wouldn’t necessarily be able to distinguish between it and a heart attack if you have a panic attack for the first time. 

Dr. David Bolon, integrative cardiologist in New York City, New York, explains the differences between a panic attack and a heart attack. 

What is a panic attack? 

A panic attack is your body’s response to a feeling of extreme fear when there’s no outward cause to be fearful. You might experience a panic attack anywhere — at the grocery store, in the car, or at home. 

What causes a panic attack? 

A number of factors can make a panic attack more likely. For example, have you recently gone through an extremely stressful event in your life such as a divorce or loss of a significant other or close family member? 

Adult trauma such as sexual assault or childhood trauma such as physical or sexual abuse can result in panic attacks years after the event. Even major positive changes such as having a baby can cause a panic attack. You may be overwhelmed with a feeling of responsibility or insecurity. Any of these experiences and others can cause a panic attack. 

Similarity of heart attack and panic attack symptoms 

Some panic attack symptoms are very similar to those of a heart attack. Following are signs of both heart attacks and panic attacks: 

• Chest pain
• Difficulty getting enough breath 
• Racing heart rate 
• Sweating
• Trembling 
• Feeling lightheaded 
• Nausea

Differences between heart attack and panic attack symptoms

If many of the symptoms are so similar, how can you tell the difference between the two events? Here are helpful tips.

Pain that radiates

If you’re having a heart attack, the pain can extend to the arm, jaw, shoulder, or neck. With a panic attack, the pain is localized to the chest. 

Type of pain 

If your chest feels under pressure, with the sensation of something heavy on it, you’re likely having a heart attack. Your heart may also feel like it’s being squeezed in a vise when you’re having a heart attack, whereas pain from a panic attack is usually a sharp, stabbing pain. 

Length of pain 

Pain with a panic attack is usually limited to anywhere from a few minutes to up to an hour. Heart attack pain can be unrelenting or come in waves. You might feel severe pain followed by less pain, but then it becomes intense again. 

Heart attacks in women

Some doctors can initially mistake heart disease for a panic attack in women, according to the Women’s Heart Foundation. Heart attack symptoms in women may present differently than in men. Women may experience jaw pain, nausea, and shortness of breath. If you’re a woman and are having these symptoms, call our office immediately. 

When to call 911

If you have any of the following symptoms, you need to call emergency medical services: 

• Extreme chest pain 
• Pressure in your chest lasting more than a few minutes
• Chest pain that extends into your arm, neck, jaw, or shoulder 

For problems with chest discomfort or any of the associated symptoms of a heart attack, don’t hesitate to call Dr. David Bolon. For non-emergency concerns, call or book an appointment online.