Panic Attack vs Heart Attack - Know And Tell The Difference

Pain in the chest. One is sharp and stabbing, and the other is squeezing pain with pressure. Both are enough to send you scrambling for medical attention—and religious intervention. One induces panic; the other one can kill you.

Yes, ladies and gentlemen. We’re talking about heart attacks and panic attacks. Ever felt one? Then you’d know what I’m talking about. Having a heart attack can cause someone to panic, which might mess things up even more. If someone thinks that they may be having a heart attack, it’s time to seek emergency medical attention.

To learn the difference between panic attacks and heart attacks, we could learn what each is first.

What Is a Panic Attack?

Panic attacks are sudden bouts of intense feelings of fear.

A panic attack happens without notice. Symptoms normally peak within 10 minutes after it starts and then vanish soon after. Physical symptoms of a panic attack are

• Chest pain.

• Racing heart

• Breathing issues and hyperventilation

• Trembling or shaking

• Chills

• Nausea

• Sweating

• Tingling or numbness in the extremities.

You might also feel

• As if you’re choking or being smothered.

• Fear of losing control.

• Like you are going to die.

• De-realisation (feelings of unreality), or depersonalisation (feeling detached from yourself).

Panic attacks are downright unpleasant and can be very disconcerting. If you have had symptoms of a panic attack, it is vital to see a healthcare provider. They can give you an official diagnosis and ensure no underlying physical cause.

How Long Does a Panic Attack Normally Last?

Panic attacks usually last five to 20 minutes. However, some people have reported attacks that last an hour.

Experts remain confused as to why some people experience panic attacks or develop a panic disorder. Your brain and nervous system play important roles in perceiving and handling fear and anxiety.

Researchers think dysfunction of the amygdala - the brain segment that processes fear and other emotions - might cause these conditions. They also believe chemical imbalances in gamma-aminobutyric acid (GABA), cortisol and serotonin might play an important role.

You are at risk of having a panic disorder, if you have

Family History

Anxiety disorders, including panic disorders, often run in families. You are at 40% increased risk of developing panic disorder if one of your first-degree relatives (biological siblings, children or parents) have this condition.

Mental Health Conditions

People suffering from anxiety disorders, depression or other mental health ailments are more prone to panic attacks.

ACE - Adverse Childhood Experiences

ACEs refer to negative experiences that occur between the ages of 1 and 17. These experiences are primarily traumatic events. ACEs could contribute to the development of panic attacks and panic disorder.

What Triggers Panic Attacks?

Usually, panic attacks have no specific trigger. However, people who have a phobia can experience phobia-related triggers that could lead to a panic attack. For example, someone with trypanophobia (intense fear of needles) could undergo a panic attack if they have to get their blood drawn for a medical test. For some unfortunate folks, the fear of having a panic attack is enough to trigger one.

Your healthcare provider will enquire about your symptoms and medical history. They might run tests to rule out medical conditions that result in similar symptoms like panic attacks, such as heart disease, thyroid disease and respiratory (breathing) problems.

For the lack of an underlying physical cause, your provider could make a diagnosis depending on the symptoms and risk factors.

Persistent worry about further panic attacks or their consequences. Altering your behaviour to avoid situations that you think could trigger panic attacks.

In addition, the attacks cannot be because of the direct effects of a substance or general medical condition. And they can’t be better accounted for by another mental health ailment, like a phobia or PTSD.

Psychotherapy, medications, or a combination of both are straight up effective in treating panic attacks and panic disorders. How long you will require treatment, depends on the severity of the condition and how well you respond to treatment.

Psychotherapy

Psychotherapy (talk therapy) is a term that describes a range of treatment techniques that look to help a person identify and change unhealthy emotions, thoughts and behaviours.

Specific varieties of psychotherapy that can assist with panic attacks and panic disorder are

Cognitive Behavioural Therapy

In this variety of therapy, you discuss thoughts and emotions with a mental health professional, like a licensed counselor or psychologist. This specialist picks and identifies panic attack triggers, so you can change your thinking, behaviours and reactions. As you begin to respond differently to triggers, the attacks might decrease and stop, ultimately.

Exposure therapy

This involves exposure to whatever triggers a panic attack. Over time you learn to become comfortable with the situation, instead of it causing anxiety and panic. You will learn relaxation techniques, like breathing exercises, to manage your anxiety throughout the process.

Medications that can help treat panic attacks and panic disorders include

Antidepressants

Particular antidepressant medications can make panic attacks more frequent or less severe. Healthcare providers might prescribe serotonin-selective reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs could be fluoxetine (Prozac) and paroxetine (Paxil). SNRIs could be duloxetine (Cymbalta) and venlafaxine (Effexor).

Antianxiety medications

Providers mostly recommend benzodiazepines to treat and prevent panic attacks. They can assist with anxiety, but you can get hooked on them, so be careful. These medications include alprazolam (Xanax) and lorazepam (Ativan).

Your doctor can help you identify triggers which cause panic attacks. During psychotherapy, you learn strategies to manage triggering events and prevent an attack. You may also take such actions to lower your risk of having a panic attack.

• Stop smoking, drinking and coffee.

• Exercise regularly, to manage stress, relieve tension and boost mood.

• Eat healthy.

• Manage stress healthily.

Speak to your provider about herbal supplements or OTC medications. Be careful though. Some substances can boost anxiety.

Heart attacks

Heart attacks (myocardial infarction) refers to a medical emergency where the heart muscle starts dying because of lack of blood flow. An arterial blockage causes this. If your healthcare provider can’t restore blood flow quickly enough, a heart attack can result in permanent heart damage and death.

Heart attacks are dangerous - let’s get that out of the way. They happen because of lack of blood flow - something related to a blockage in one or more of your heart’s arteries.

Without blood, the impacted heart muscle starts to die. If blood flow isn’t resumed quickly, a heart attack can result in permanent damage or death.

When a heart attack happens, blood flow to a part of the heart stops or is far below normal, resulting in injury or death to that part of the cardiac muscle. When a part of the heart is unable to pump because it is dying from lack of blood flow, it can throw a spanner in the works of the pumping function of the heart. This can bring down or stop blood flow to the rest of the body - deadly, if not stopped soon enough.

Usually, heart attacks happen because of blockages in one of the blood vessels supplying the heart. Usually, this happens because of plaque - a sticky substance that can accumulate in the insides of the arteries. This is known as atherosclerosis. When there’s too much atherosclerotic buildup in the blood vessels to the heart, it is known as coronary artery disease.

Usually plaque deposits inside the coronary (heart) arteries can break open or rupture, and a blood clot could get stuck at the place of this rupture. If the clot blocks the artery, this can deprive the heart muscle of blood, resulting in a heart attack.

Heart attacks are possible without ruptured plaque, however this is rare and only accounts for 5% of all heart attacks. This type of heart attack can happen because of

• Coronary artery spasm

• Rare medical conditions, like any disease that results in the unusual narrowing of blood vessels.

• Trauma that results in tears or ruptures in the coronary arteries.

• Obstructions that happen somewhere else in the body like a blood clot or an air bubble that ends up in a coronary artery.

• Eating disorders which, over time can damage the heart and result in a heart attack.

• Anomalous coronary arteries (heart issues that happen at birth, where the coronary arteries are in abnormal positions)

• Other conditions that can cause the heart not to receive as much blood as it should for a prolonged period of time, especially when blood pressure is low, oxygen is low or your heart rate is too fast.

There are many risk factors for a heart attack. They are

Age and sex

Your risk of heart attack increases as we age. Your sex influences when your risk of a heart attack begins to increase. For males, the risk increases at age 45. For females, the risk increases at age 50 or post menopause.

Family history of heart disease

If you have a parent or sibling with a history of heart disease or heart attack, especially when they’re younger, your risk increases manifold because your genetics are similar to theirs. Your risk goes up if a first-degree relative (biological sibling or parent) has a heart disease diagnosis at age 55 or younger, if they’re female or at age 65 or younger, if they’re male.

Lifestyle

Lifestyle choices you make that are not good for your heart can increase your risk of having a heart attack. This includes factors like smoking, consuming high-fat foods, lack of physical activity, and too much alcohol or drug use.

Certain health conditions

Some health conditions lay stress on the heart, and increase your risk of heart attack. Such conditions include diabetes, obesity, high blood pressure, high cholesterol, eating disorders or a history of preeclampsia.

How do I know if I have had a heart attack?

Doctors usually diagnose heart attacks in an emergency room setting. If you have symptoms, you should undergo a physical examination. A doctor will check your pulse, blood oxygen levels, blood pressure, and listen to your heart and lung sounds. They’ll ask you about the symptoms you faced.

Blood tests

This remains one of the most reliable ways to check for a heart attack - checking for cardiac troponin in the blood. During a heart attack, the damage to the heart muscle cells always causes this chemical marker to show up in the bloodstream.

Electrocardiogram (EKG or ECG)

This is one of the primary tests you get when you come to an ER with heart attack symptoms. Your heart’s electrical signals can help tell if an injury is happening, as well as if there are rhythm abnormalities.

Echocardiogram

Using ultrasound (high-frequency sound waves), an echocardiogram generates a photo of the inside and outside of the heart. It can show how well the heart is squeezing, and whether the valves are working.

Coronary angiogram

Also known as heart catheterization. This procedure uses X-rays and contrast dye to show the blood vessels to the heart and can find blockages.

Heart-computed tomography (CT) scan

This creates a highly detailed scan of the heart and blood vessels to check for narrowing or hardening of the major coronary arteries.

Heart MRI

This test uses a powerful magnetic field and computer processing to create an image of the heart. It can show blood flow problems in the arteries.

Exercise stress test

This test uses an ECG, echocardiogram or nuclear scans while you are physically active, to help show you if your heart is receiving enough blood.

Nuclear heart scans

Using a radioactive dye, a provider injects into the blood and computer enhanced methods like computed tomography (CT) to find areas of the heart that are not receiving as much blood or are injured. These scans might be single-photon emission computed tomography (SPECT) scans, or positron emission tomography (PET) scans.

How is a heart attack treated?

Treatment of a heart attack means restoring blood flow to the impacted heart muscle as soon as possible. This can happen in many ways, through medication or surgery. Treatment includes many of the following methods.

Supplementary oxygen

People having issues breathing or with low blood oxygen levels often receive supplementary oxygen together with other heart attack treatments. This oxygen can be taken through a tube which sits below the nose, or a mask that fits over the nose and mouth. This increases the amount of oxygen circulating in the blood, reducing the strain on the heart.

Such medicines could include -

Anti-clotting medication

This includes aspirin and other blood-thinning medicines.

Nitroglycerin

This medicine relieves chest pain, causing blood vessels to widen so blood can flow easily.

Thrombolytic (clot busting) medications

Providers use these only within the first 12 hours following a heart attack.

Antiarrhythmia medications

Heart attacks can cause malfunctions in the heart’s normal beating rhythm, known as arrhythmias, which can be life-threatening. Medications to stop or prevent these malfunctions exist.

Pain medications

The most common pain medication people receive during heart attack care is morphine. This can help bring down chest pain.

Beta Blockers

These medications help slow down the heart rate, so the heart can recover from the injury of a heart attack.

Antihypertensives

These medicines bring down your blood pressure, and help the heart recover from the injury of a heart attack.

Statins

These medicines help stabilize the plaque in the blood vessels, so they don’t rupture. They also help bring down cholesterol, and the chances of having another heart attack.

Percutaneous coronary intervention

Providers restore circulation to the affected heart muscles, with this procedure, also known as angioplasty. It is important to open the artery with a catheter to restore blood flow. The faster this happens, the better the chances of a favourable outcome. Providers depend on a metric called “door to balloon time” to measure their ability to treat a cardiac arrest. This is the average time it takes folks to undergo PCI, after their first visit to the emergency room. If you receive PCI, your provider might put a stent where the blockage is. This helps keep the artery open, so other blockage can’t occur in the same spot.

Coronary artery bypass grafting

People with severe blockages of the coronary artery might undergo coronary artery bypass grafting (CABG). Doctors call this an open-heart surgery or bypass surgery. During CABG, a blood vessel from elsewhere in the body is used to construct a detour for blood. This reroutes blood around one or more blocked artery sections and brings blood to the heart muscle.

A panic attack is a sudden episode of intense fear or discomfort. Think Raoul Duke in Fear and Loathing in Las Vegas (1998). There are physical symptoms like a racing heart, shortness of breath or dizziness - which can feel overwhelming, even though there might not actually be any real danger.

Panic attacks are sudden, intense feelings of fear which can result in physical symptoms that can make you feel real uncomfortable. A large section of those who experience panic attacks develop panic disorder, a type of anxiety disorder. Therapy and medications are the way to go, for the treatment of panic attacks and panic disorder.

When you have a panic attack, you have sudden, temporary feelings of fear, and strong physical reactions. In response to what? Something rather ordinary and nonthreatening. A panic attack might cause you to sweat, cause breathing issues and a racing heart. It can feel like you’re having a heart attack.

Panic attacks are the main feature of panic disorder. However, they can be comorbid with

• Anxiety disorders.

• Phobias

• Mood disorders.

• Substance use disorders

• Psychotic disorders.

• Trauma and stressor-related disorders.

• Certain medical conditions.

Panic attacks aren’t dangerous and they don’t harm you in any way. However, frequent attacks can reduce your quality of life and cause other issues.

Although they share a bunch of similarities, the two conditions result from different disease processes. Panic attacks occur when stress hormones trigger the body’s “flight or fight” response, which results in a racing heart, chest pain and shortness of breath.

In case of a heart attack a coronary artery blockage might result in the same symptoms. One key distinction between the two is that a heart attack develops during physical exertion, while a panic attack can occur at rest.

A heart attack is more likely to occur when the work load of the heart increases - for instance while a person is mowing the lawn or running up the stairs - especially when people aren’t regular with physical activity.

Another difference between them lies in the duration - panic attacks usually subside and resolve on their own in around 20 minutes. A heart attack will continue and get worse over time.

In women the symptoms of a heart attack are milder - it could include unusual fatigue and chest discomfort, not chest pain. Don’t overlook symptoms. Call a doctor.

If the symptoms point towards a panic attack, there are a number of treatment options. An example could be integrated therapies - that focus on stress management and relaxation via meditation, acupuncture, and yoga.

To conclude, while panic attacks and heart attacks can have similar symptoms, like chest pain and shortness of breath, they are separate conditions requiring different approaches to treatment. A panic attack is usually triggered by stress or anxiety, and although distressing, isn’t life-threatening. Conversely, a heart attack is a medical emergency demanding immediate attention. Understanding the nuances between the two can help you recognise the signs and seek appropriate care. If you are unsure about your symptoms, consult a healthcare professional. Taking care of your mental and physical health is important to lead a balanced, healthy life.

How can I tell if I'm having a panic attack or a heart attack?

Panic attacks often involve a sudden sense of fear or anxiety, rapid heartbeat, chest tightness, and shortness of breath. Heart attacks usually come with chest pain, pressure, or discomfort that may radiate to the arm, neck, or jaw, and are often accompanied by nausea, sweating, or dizziness.

Can panic attacks cause chest pain like a heart attack?

Yes, panic attacks can cause chest pain, which is often sharp or stabbing. However, this pain is typically not related to the heart and usually resolves once the panic attack subsides. Heart attack chest pain is more likely to feel like pressure or tightness and persists until treated.

What should I do if I think I'm having a heart attack?

If you suspect you're having a heart attack, call emergency services right away. Early intervention is crucial, as heart attacks can lead to serious complications.

Can stress or anxiety trigger a heart attack?

While stress and anxiety don't directly cause heart attacks, they can contribute to risk factors such as high blood pressure, poor lifestyle habits, and an increased risk of heart disease.

Are panic attacks dangerous?

While panic attacks are not life-threatening, they can be incredibly distressing and affect your quality of life. If panic attacks occur frequently, it may be helpful to seek therapy or treatment to manage them effectively.