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Published on May 26, 2020

Is this a panic attack or a heart attack?

Panic or Heart Attack?

All of sudden, you’re sweating, feeling short of breath and have pain in your chest.

Could you be having a heart attack or is it a panic attack?

“Both situations are worrisome,” said Megan A. Titas, MD, FACC, a cardiologist who practices at the Cape Cod Healthcare Cardiovascular Centers in Falmouth and Sandwich. “While you’re undergoing these symptoms, it can be difficult to distinguish between the two.”

The two are different in their onset and their duration.

“Panic attack symptoms typically come on when someone is physically at rest,” she said. “Exertional symptoms are more likely to be a heart attack. If somebody I'm seeing tells me ‘I get my symptoms every time I climb a flight of stairs or when I'm walking out to my mailbox,’ that makes me worried.”

Panic attacks usually resolve within 20 minutes, she said. “A heart attack is not going to go away. A myocardial infarction keeps going on and on.”

Heart Attack Symptoms

Typical heart attack symptoms (according to the Mayo Clinic) include:

• Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back

• Nausea, indigestion, heartburn or abdominal pain

• Shortness of breath

• Cold sweat

• Fatigue

• Lightheadedness or sudden dizziness

Panic Attack Symptoms

Anxiety can manifest in a lot of different ways, according to Dr. Titas.

Typical panic attack symptoms (according to the Mayo Clinic) include:

• Sense of impending doom or danger

• Fear of loss of control or death

• Rapid, pounding heart rate

• Sweating

• Trembling or shaking

• Shortness of breath or tightness in your throat

• Chills

• Hot flashes

• Nausea

• Abdominal cramping

• Chest pain

• Headache

• Dizziness, lightheadedness or faintness

• Numbness or tingling sensation

• Feeling of unreality or detachment

“With a heart attack, you get chest discomfort, which can be described in a lot of ways, but typically pressure is something I hear about,” Dr. Titas said. “People who are having a panic attack tell me they have some tingling around their mouth or their fingers and both hands, which is different than what people describe in a heart attack.”

Panic attacks happen when stress hormones trigger a “fight or flight” response in the body. That results in a racing heart, chest pain and shortness of breath.

A blocked coronary artery can lead to similar symptoms.

When in doubt, get it checked out, she said.

“We definitely recommend calling 911 and being evaluated. If there's any doubt at all, then 911 and the emergency room is always the answer.”

If you’re sure it’s a panic attack, there are several things you can do, including deep breathing, self-awareness and talking to your primary care doctor about treatment of stress and anxiety.

“There are pharmacologic and therapeutic ways to treat it,” she said. “Anxiety is a huge problem and is not to be taken lightly. It should be addressed as a medical issue.”