Heart attack or panic attack? How to tell the difference

David McNeely, MD

Cardiology

Chest pain, shortness of breath, sweating. These are all symptoms of a heart attack and also of a panic attack. But how do you tell the difference? Prisma Health cardiologist David McNeely, MD, offered some insight and advice.

First, don’t ignore your symptoms. “When new symptoms or feelings arise, it can be hard to know what’s causing them,” said Dr. McNeely. “This can cause uncertainty and lead to brushing off symptoms as stress or nerves. It’s important not to ignore new or unfamiliar symptoms, because they may signify a serious health problem.”

A heart attack occurs when the heart muscle is not getting enough blood flow, which is usually caused by a blockage in the artery supplying the heart with blood. This can cause you to experience these symptoms:

• Chest, arm or jaw pain
• Shortness of breath
• Nausea
• Palpitations/heart racing
• Feeling of dread
• Sweating

Unfortunately, many of these symptoms may also arise from a panic attack. It can be difficult to distinguish between the two, but here are some differences:

• Heart attack symptoms generally begin after a period of stress on the heart, such as physical activity, but may also occur during times of emotional stress or at rest.
• Symptoms due to heart attack are typically worse with physical activity; whereas, panic attack symptoms may improve with exercise.

There are also risk factors that can lead to heart disease and increase your risk for a heart attack. They include:

• Smoking
• High blood pressure
• High cholesterol
• Lack of physical activity
• Family history of heart disease

“Regardless of risk factors, any new symptoms you are experiencing that make you think it could be a heart attack should be evaluated by a healthcare professional,” said Dr. McNeely. “While there are no good tests to identify a panic attack, your doctor may perform an ECG or blood tests to help ensure you’re not having a heart attack.”