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The difference between a panic attack and a heart attack

The symptoms of a panic attack and heart attack can be terrifyingly similar. How can you know the difference? Bailee Blackburn, M.D., a Piedmont primary care physician, shares the symptoms and triggers to watch for as well as when to seek medical care.

What is a panic attack?

“A panic attack is a sudden episode of intense fear or anxiety with associated physical symptoms that can last for several minutes up to an hour,” Dr. Blackburn says.

Panic attack symptoms can vary from person to person, but common symptoms include:

  • Chest pain

  • Being suddenly deeply fearful or anxious

  • Feeling a sense of impending doom

  • Pounding or racing heart

  • Shortness of breath

  • Trembling

  • Sweating

  • Stomach pain

  • Nausea

  • Chills

  • Numb or tingling hands

  • Feeling like you’re outside your body

What are the symptoms of a heart attack?

Heart attack symptoms include:

  • Chest pain or tightness, usually in the left side of your chest or under your breastbone

  • Shortness of breath

  • Jaw pain

  • Sweating

  • Arm pain

  • Nausea

  • Feeling a sense of impending doom

“As you can see, heart attacks and panic attacks can share a lot of commonalities in how they present, particularly when chest pain or shortness of breath is involved,” Dr. Blackburn says.

How to tell the difference between a heart attack and a panic attack

While it can be challenging to differentiate between a panic attack and a heart attack, here are a few things to watch for, particularly if you’ve experienced panic attacks in the past.

“Often, the chest pain with heart attacks is more of a pressure or squeezing, whereas a lot of people describe their chest pain in panic attacks as more of a sharp or shooting pain,” Dr. Blackburn says. “Also, the chest pain in a panic attack will completely go away in a few minutes once the attack passes. If you’re having a heart attack, the pain may change in intensity, but it usually won’t let up.”

Also, consider the potential trigger.

“Panic attacks usually have an emotional stress trigger, while heart attacks are often triggered by physical exertion,” she says.

When to seek medical care

“I would definitely seek medical care if you start developing any of these symptoms, particularly for the first time,” Dr. Blackburn says. “It can be difficult even for medical providers to tell the difference just on hearing your symptoms, so additional cardiac or lab testing is usually indicated to make sure we get the correct diagnosis and ultimately, treatment.”

She adds, “Don’t ever write off symptoms where your heart is concerned. Talk to your provider to make sure you are getting the care you need.”

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