It can happen at any time: A sudden onset of an intense feeling of fear accompanied by scary physical symptoms like a racing heart, trembling, or trouble breathing. You could be in the grip of a panic attack, which many people experience at some point, but you might wonder if you’re having a heart attack instead.
Dr. Samantha Kapp-hahn, an Interventional Cardiologist with ThedaCare Cardiovascular Care, said it’s the right question to ask.
“Never second-guess chest pain or other symptoms of heart attack,” said Dr. Kapphahn. “It’s can be challenging to tell the difference, so you should seek immediate care if you are having certain symptoms. “While some people can be hesitant to seek care, avoiding immediate care can potentially translate into more serious health consequences if you are having a heart attack.”
Symptoms of a panic attack might include:
•Sudden, strong feelings of anxiety, fear or doom
•A feeling of detachment from reality
•Trouble breathing, a pounding/racing heart, and/or sweating
•Shaking, trembling, dizziness or lightheadedness
•Abdominal pain, nausea, and/or headache
•Hot flashes or chills
•Chest pain
Panic attacks may happen frequently for people who suffer from anxiety-related disorders. They also can just happen suddenly to anyone.
Heart attacks occur when part of the heart isn’t getting enough oxygen, usually because of a blocked artery, preventing or slowing blood flow to the heart.
Heart attacks share many symptoms with panic attacks. Some may include:
•Chest pain or pressure
•Trouble breathing/shortness of breath
•A pounding/racing heart
•A feeling of impending doom
•Sweating/cold sweats
•Shaking and trembling
•Lightheadedness and dizziness
•Nausea or vomiting
•Pain or discomfort in the upper body, particularly arms, shoulders, back, jaw or neck
While it can be difficult to differentiate between the two, for some people there can be differences between heart attacks and panic attacks: Chest pain that accompanies a panic attack typically remains in the chest, while chest pain that comes with a heart attack can often radiate to other areas, such as down the arms, shoulders, neck, or jaw, Dr. Kapphahn said.
“Additionally, heart attack pain can be often described as deep pressure — the proverbial ‘elephant sitting on your chest’ feeling, or it can be described as feeling like heartburn, or even as a generalized discomfort in the chest,” she said. “Pain with a panic attack is often described as sharp or piercing.”
Never wait to see if symptoms go away, Dr. Kapphahn said. Seek medical attention if you have any signs of heart attack, even if you think it may be a panic attack. ThedaCare hospitals are staffed 24 hours a day by teams who specialize in emergency medicine, offering a full range of emergency care options and support. For additional information about where to go for medical symptoms and conditions, please visit: thedacare.org/get-care-now/.
“Women in particular should be aware that they may experience symptoms that appear different on occasion,” Dr. Kapphahn said.
Heart attacks can manifest differently in women, who are more likely to not feel the typical chest pressure that accompanies a heart attack. They are more likely to experience pain in other areas of the body, such as the back or abdomen, and they may feel other symptoms common to both panic and heart attacks, such as shortness of breath or lightheadedness.
Both panic attacks and heart attacks can often happen for no apparent reason, but often each has its own triggers. Heart attacks can occur following a period of physical exertion or strain, such with people who are normally sedentary and then shovel heavy snow, for example. Heart attacks also can occur after intense emotional events. Panic attacks may occur in people who have certain types of anxiety disorders, or they can occur in isolated situations to anyone, sometimes brought on by a period of emotional stress, such as a divorce or a death in the family. They may not always occur right at the moment of highest emotional experience.
“Those who have anxiety or depression may also be at higher risk of heart problems,” Dr. Kapphahn said. “Chronic stress can contribute to higher blood pressure, increasing the risk of heart attack.”
People who have had panic attacks should talk to their provider about additional screening to help prevent heart disease, as well as to help prevent more frequent or stronger panic attacks.
“The takeaway is that we truly want people to understand and recognize the warning signs of serious heart events, she said. “Heart attacks are life-threatening, and we want people to feel empowered to seek immediate help.”
