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How to Tell the Difference Between a Panic Attack and a Heart Attack

A sharp pain in the chest. Shortness of breath. Tingling in the arms or hands. Nausea, sweating, shaking and a racing heartbeat. Is it a heart attack? It might well be. But it could also be a panic attack. The two conditions have some similarities, and it can be tricky to tell them apart sometimes.

What Is a Heart Attack?

Dr. Tamara B. Horwich, associate clinical professor of medicine, cardiology/cardiovascular disease at the David Geffen School of Medicine at UCLA, says “a typical heart attack occurs when one of the coronary arteries, which are arteries that supply blood to the heart muscle, becomes blocked or obstructed. This leads to a decrease in blood supply to the heart muscle.” A heart attack is also sometimes referred to as a myocardial infarction.

Typical signs and symptoms of a heart attack include:

  • Chest discomfort that may feel like pressure, squeezing or pain.
  • Pain in the upper body, particularly in one or both arms, the neck, back, jaw or stomach.
  • A feeling of fullness in the chest.
  • A feeling of severe indigestion.
  • Shortness of breath.
  • Palpitations or a pounding heart.
  • Nausea or cold sweats.
  • Lightheadedness.
  • Flu-like symptoms.
  • Paleness in the face or looking unwell.
  • A sense of doom.

What Is a Panic Attack?

“A panic attack occurs when a person experiences a rapid surge of intense fear or discomfort that reaches a peak within minutes,” Horwich says. They may be triggered by a stressful event, such as just before a big presentation or after getting fired. But in some people, there’s no obvious reason for the panic attack to develop. Other symptoms may include:

  • Chest pain.
  • Pounding heart.
  • Sweating.
  • Fear of dying.
  • Fear of “going crazy” and losing control.
  • Dizziness.
  • Nausea.
  • Chills.
  • Paresthesia (a feeling numbness or tingling).

Horwich says women are more likely than men to experience them. “Panic attacks are most likely to occur between the ages of 18 and 25.” They can be a one-off or seldom occurrence for some people, while for others, they happen regularly. “Persons with panic disorder experience multiple panic attacks and live in fear of having another one,” she says.

Where They Overlap

Having a heart attack or panic attack are decidedly unpleasant experiences for anyone. And in some people, having a heart attack could trigger a sense of panic. “It’s not a usual occurrence for a panic attack and heart attack to happen at the same time to a single person,” Horwich says, “but it certainly is a possibility.” While “panic attacks are not a known trigger for heart attacks,” both may have a stress connection. “Chronic stress over time certainly does raise the risk of having a heart attack.”

And because the symptoms can be so similar, it can be difficult to distinguish one from the other in the moment, Horwich adds. “Both panic and heart attacks can be associated with chest pain or chest discomfort, sweating, palpitations and dizziness.”

Seek Help

It’s important to seek help if you or a loved one may be having a heart attack. “If you think you are having a heart attack or if you are unsure if your symptoms are indicative of a panic attack or heart attack, it’s imperative that you seek medical help ASAP,” Horwich says. Seeking appropriate treatment as quickly as possible can literally save your life in the event of a heart attack. “Diagnosing and treating a heart attack as soon as possible can protect your heart from irreparable damage and lead to a longer and higher quality of life.” If in doubt, get checked out.

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