Is it heart attack or panic attack? Experts on how to differentiate | Health

World Heart Day 2022: A panic attack can sometimes seem like a heart attack as it shares some of its symptoms with a heart attack, be it chest pain, increased heart rate or shortness of breath. However, one can distinguish between the two by considering the location of the pain and the duration of the symptoms. Experts say the patient needs immediate medical attention because you can never be sure if it isn’t a heart attack. (Also read: World Heart Day 2022: Foods to Eat and Avoid for Better Heart Health)

Heart attack and panic attack cases are on the rise amid the Covid pandemic as heart muscle weakness and post-Covid anxiety become more common. In such situations, symptoms such as shortness of breath, chest pain, nausea, palpitations can confuse one if one is suffering from a heart attack or a panic attack.

“We all agree as doctors that you shouldn’t take any chances that it’s not a heart attack. And the reason is simple: Sometimes it can be difficult to tell the difference,” says Dr. Atul Mathur, Executive Director – Interventional Cardiology & Head of Cath Lab, Fortis Escorts Heart Institute, Okhla Road, New Delhi.

“Panic attacks occur when stress hormones trigger the body’s ‘fight-or-flight’ response, often resulting in rapid heartbeats, chest tightness, chest pain and breathlessness. In the event of a heart attack, a blockage in a coronary artery can show the same thing. Chest pain, rapid heartbeat, and shortness of breath can result from insufficient blood reaching the heart muscle, says Dr. Dhaval Naik, Heart Transplant Surgeon, Marengo CIMS Hospital.

“A patient with panic attacks may have some factors like anxiety or stress related to family/work, where heart attack patients don’t typically have that type of stress, they are more common in panic attacks,” says Dr. Sunil Kumar Wadhwa. Chief Physician Cardiology, Max Hospital Gurugram.


dr Atul Mathur says heart attacks can be sudden and intense, but most often start slowly, with mild chest pain or discomfort that progressively worsens over a few minutes. dr Mathur says these episodes can come and go multiple times before an actual intense heart attack occurs.

“When blood flow to the heart muscle is severely reduced or completely obstructed, heart attack occurs. The typical symptoms are chest discomfort below the sternum, discomfort that radiates into the throat, jaw or upper arm, shortness of breath, drowsiness, tiredness, a feeling of dying or dying, nausea, tachycardia and sweating. Risk factors for a heart attack are diabetes mellitus, high blood pressure, high cholesterol and lack of exercise,” says Dr. Mathur.


dr Mathur says that if the medical exam shows you have a healthy heart, you may experience a panic attack — this is especially the case if the person is experiencing severe anxiety, which is the hallmark symptom.

“Panic attacks are escape or startle reactions, an alarm system gone haywire. These attacks come on quickly, generally peaking in intensity after about 10 minutes. Also, the attacks are triggered by traumatic events or major stresses in life, under certain conditions it can happen for no apparent reason,” says Dr. Mathur.

“Symptoms may include intense anxiety and racing thoughts, feeling out of control, fear of death, feeling disconnected from your surroundings, heart racing or palpitations, chest discomfort, choking sensation, nausea, shortness of breath or rapid breathing, numbness or tingling, feeling hot or cold, dizziness or drowsiness,” adds the cardiologist.

Difference between heart attack and panic attack

In the case of a heart attack, the pain is traditionally felt as a dull pressure below the breastbone. It can radiate to the neck and jaw, or to the left arm.

“It’s a vague pain and you can’t pinpoint it specifically with your fingertip. If you can locate the pain with your finger, it’s unlikely it’s coming from the heart.

Panic attacks, on the other hand, can cause chest pain with a sharp or stabbing sensation, or a choking feeling in the throat. However, one should “never ignore chest pain,” says Dr. mahur.

dr Wadhwa says that both the patients with panic attacks and heart attacks can have difficulty breathing, but it is seen that patients with panic attacks overbreath while patients with heart attacks do not.

“Panic attack sufferers may have cold sweats, such as sweating on the palms of their hands or soles of their feet, which is less common in heart attack sufferers. Panic attack patients may have shaky hands because they are under constant stress,” adds Dr. Wadhwa.

“One of the key differences between these two conditions is that a heart attack often develops during physical exertion, while a panic attack can occur at rest. A heart attack is more likely to develop when the heart’s workload increases, such as while a person is exercising or exercising or walking up the stairs, more likely in people not engaging in daily physical exertion. Panic attacks can start randomly or be triggered by psychological stress. For example, some people experience panic attacks suddenly, others may experience panic attack symptoms when confronted with a phobia such as claustrophobia or fear of heights, or when a person is deeply shocked by something,” says Dr Naik.

Here are more differences between heart attack and panic attack according to Dr. mahur:


Heart attacks may also be accompanied by fatigue, fainting, or loss of consciousness. Panic attacks, on the other hand, are characterized by racing heart, racing thoughts, shaking, tingling or numbness, and a feeling of suffocation.


Heart pain lasts more than a few minutes and can come and go. It can be caused or aggravated by physical exertion. During a panic attack, on the other hand, the symptoms usually peak after about 10 minutes and subside after half an hour.


Any chest discomfort induced by exertion should not be taken lightly and immediate medical consultation should be screened out. Panic attacks can start randomly or be triggered by psychological stress. For example, some people experience panic attacks out of the blue and others may have panic attack symptoms when confronted with a phobia such as claustrophobia or fear of heights.


dr Ashish Jai Kishan, Consultant, Interventional Cardiology, Fortis Escorts Heart Institute shares tips on preventing heart attacks and panic attacks.

Preventing heart attacks includes controlling risk factors such as high blood pressure and high cholesterol, avoiding cigarette smoking and alcohol, eating a healthy diet, and leading an active lifestyle.

Prevention of panic attacks includes controlling stress and anxiety, introducing exercise and medication. Mental health needs attention.

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