Panic Attack vs. Heart Attack: How to Know If You Are Having a Panic Attack or Heart Attack

Panic Attack vs. Heart AttackIt is common for people to mistake panic attacks for heart attacks. Here we’ll take a look at the differences between the two.

The fact is, panic attacks and heart attacks do have some similarities in terms of symptoms, including chest pain. But they otherwise are two distinct medical reactions. Before we look at the specifics of panic attacks vs. heart attacks, let’s define these health issues.

  • Panic attack: A sudden attack of extreme fear that triggers a physical reaction when there isn’t anything physical threat.
  • Heart attack: When blood supply to the heart is suddenly blocked, usually due to a blood clot.


When we talk about the difference between heart attack and panic attack, it should be obvious that one is a medical emergency while the other is not. The problem is that when a panic attack occurs, it can be scary and feel like an emergency.

People who have suffered such attacks report that they feel as if they have lost control and might die. While some people have just one or two panic attacks in their lifetime due to a stressful situation, others experience recurring panic attacks.

Those who suffer from panic attacks and feel frightened or stressed out for long periods of time may be diagnosed with panic disorder. Panic attacks are not life-threatening; however, they can impact the quality of a person’s life in a big way.

Heart attacks are a medical emergency. A lack of blood to the heart can cause serious damage to the heart muscle and it can be life-threatening.

Key Differences between Panic Attacks and Heart Attacks

So how do you know if you’re having a panic attack or a heart attack? Sometimes, it can be hard to tell. The difference between heart attacks and panic attacks can be subtle.

When someone is having a heart attack with chest pain, that pain is usually described as “crushing.” It’s a pain that tends to begin in the middle of the chest but can travel down the left arm and into the back. In some cases of heart attack, the pain even extends into the neck and jaw.

This pain remains for about five minutes and can be accompanied by a tingling sensation in the left arm. It isn’t unusual for someone in the middle of an attack to break into a cold, clammy sweat or feel sick to their stomach and vomit. Anyone who experiences these symptoms should call 911 immediately.

People who are having a panic attack can feel chest pain, shortness of breath, numbness or tingling sensations, nausea, and sweating. These symptoms usually peak after about 10 minutes. It is important to note that the chest pain is not “crushing” like the pain described by heart attack sufferers. Additionally, any tingling or numbness can be felt in both arms, not just the left. Some people even notice these sensations in their legs and toes.

When it comes to panic attack vs. heart attack, those who are having panic episodes focus on their fears, such as losing control, while people having a heart attack usually focus on the “crushing” pain.

Differences in the Causes of Panic Attacks and Heart Attacks

There is no single cause of panic attacks, although there are several factors that we know can contribute to both panic attack causes and panic disorder. Some of those factors are listed below.

  • Major stress
  • Sensitive temperament
  • Genetics
  • Changes in brain functioning

Some studies suggest that panic attacks are connected with the body’s natural “fight-or-flight” response to danger. If you were approached by a threatening animal, such as a bear or crocodile, your heart rate, and breathing would likely speed up as you prepare for the life-threatening situation. These are the same kind of reactions people experience with a panic attack. The only difference is that there is no obvious danger staring at you.

If you have a family history of panic attacks or panic disorder, you’re at a higher risk of panic attacks. Other risk factors include major stress, such as a death or serious illness of a loved one; a traumatic event, like a sexual assault or car accident; and major life changes, including divorce or the arrival of a new baby. Smoking or excessive caffeine intake can also increase the risk of panic attacks.

Heart attacks happen when one or more of the coronary arteries get blocked. This is usually due to fatty deposits. Coronary artery disease can lead to heart attacks. A spasm of the coronary artery that shuts down blood flow to part of the heart can also cause a heart attack.

Here are the most common heart attack risk factors:

  • Age: Men 45 or older and women 55 or older are more likely to have a heart attack.
  • High blood pressure: Over time, high blood pressure can damage arteries.
  • Tobacco use: Smoking as well as exposure to second-hand smoke
  • High blood cholesterol or triglyceride: Bad cholesterol (LDL) can narrow arteries. Good cholesterol (HDL) can lower risk. Triglycerides (blood fat linked to diet) increase risk.
  • Diabetes: Not producing enough insulin or not responding to insulin properly
  • Lack of physical activity: Inactivity can lead to high blood cholesterol levels
  • Obesity: Associated with high LDL, high triglycerides, high blood pressure, and diabetes.
  • Stress: Some people respond to stress in a way that increases the risk of heart issues.
  • Illegal drug use: Stimulants, including cocaine and amphetamines, can cause spasms in the coronary arteries that can lead to a heart attack.
  • History of preeclampsia: A condition that leads to high blood pressure during pregnancy. It increases the lifetime risk of heart disease.
  • History of autoimmune condition: Conditions like rheumatoid arthritis and lupus
  • Family history: If your siblings, parents, or grandparents had early heart attacks, you may be at an increased risk.

Causes of panic attacks and heart attacks do share one factor — stress. If you’re having difficulty coping with stress and panic attacks, it’s important to get help.

How Are Panic Attacks and Heart Attacks Diagnosed?

Usually, panic attack diagnosis starts with a doctor eliminating other conditions that might mimic panic symptoms, including a heart attack.

To help narrow down the diagnosis, a full physical examination will be conducted. Some of the procedures outlined below may also be carried out.

  • Blood tests
  • Electrocardiogram (ECG or EKG)
  • Psychological testing

In most cases, the patient will fill out a psychological questionnaire. It will ask about alcohol or other substance abuse as well as stressful situations like fears or relationship issues.

When it comes to heart attacks, your primary care physician should be screening you for heart issue risk factors during regular physicals. If and when there is a situation where someone shows symptoms of heart attack, he or she will be asked to describe the symptoms. Blood pressure, pulse, and temperature will be taken.

Here are some of the tests that are conducted in cases where a heart attack is suspected:

  • Electrocardiogram (ECG): Records electrical activity of the heart by way of electrodes attached to the person’s skin. A damaged heart doesn’t conduct electrical impulses properly.
  • Blood tests: If a heart is damaged, certain enzymes can leak into the blood
  • Chest X-ray: To check the size of the heart and look for any fluid in the lungs
  • Echocardiogram: Provides video images of the heart, which can show whether or not the heart has been damaged.
  • Coronary catheterization (angiogram): A liquid injection of dye through a thin tube that is fed through an artery makes arteries visible on X-rays, revealing blockages.
  • Cardio computerized tomography (CT): Used to diagnose heart problems and the extent of damage from a heart attack.

Panic Attacks vs. Heart Attacks: Differences in Treatment Methods

As you can imagine, panic attack treatment and heart attack treatment differ. If you have a panic attack or panic disorder, there are two possible forms of treatment: medications or therapy.

In severe cases of a panic attack, a sufferer can head to the emergency room for acute panic attack treatment. Oxygen will likely be administered while vital signs are monitored. During the hospital visit, medication may be given intravenously. The treatment will be explained and the patient will be reassured that everything is okay.

When the panic episode subsides, ongoing treatment may involve psychotherapy. Depending on the severity of the symptoms, medications may also be suggested.

When it comes to heart attack treatment, the sooner the therapy is administered, the more likely you are to have a positive outcome. This is because, following a heart attack, more heart tissue deteriorates with each passing minute. To lower the risk of more damage, blood flow has to be quickly restored.


Heart attack treatment can involve the following:

  • Medications: This includes drugs that reduce blood clotting, dissolves blood clots, or blood thinning medications. Pain relievers may also be administered to bring comfort to the sufferer, as well as beta-blockers, which essentially relax the heart muscle making the heart’s job much easier. There are also medications that can lower blood pressure and reduce stress on the heart.
  • Procedures: Coronary angioplasty and stenting are used to locate blockages. Coronary artery bypass surgery is a procedure that allows a surgeon to sew veins and arteries in place around a blockage to allow blood to flow to the heart.

When signs such as chest pain, shortness of breath, and tingling in the arms arise, it can be very frightening. Often, people who are suffering a heart attack shrug it off as indigestion or a panic attack, while those having a panic attack jump to the conclusion that they’re having a heart attack. Understanding the difference between panic attacks and heart attacks can eliminate the confusion and potentially save your life.



Related Reading:

Silent heart attack (silent ischemia): Symptoms, causes, and treatments

Angina vs. Heart Attack: Differences in Complications, Causes, Symptoms, and Treatments

Heart attack symptoms in women: Risk Factors when at 40, 50, 60