is-it-a heart-attack-or-a-panic-attack-here’s-how-to-tell

We live in a fast paced world where we are bombarded with information and news on a daily basis, most of them trivial, but they still steal our attention and cause, at least in some individuals, psychological and emotional distress. Some are better at managing anxiety, while others might experience symptoms of far more serious medical condition.

Anxiety disorders are one of the most prevalent mental disorders with an estimated 3.6 % of global population affected by them [1]. Additionally, some are more afflicted than others. Female individuals are far more likely to have nearly any type of anxiety disorder (sans social anxiety disorder, which has a similar prevalence between genders) than males and they are more disabling (greater illness burden, more likely to have more than one anxiety disorder etc.) in them than in males [2].

Differences don’t stop there as even a specific anxiety disorders can manifest in a wide variety of symptoms, some more severe than others and with greater possibility of mistaking them for symptoms of other medical conditions.

We will single out panic attacks as they are the topic of this blog post and can often be mistaken for symptoms of a myocardial infarction (heart attack), leading sufferers to seek emergency medical assistance. Their fears are, from a rational perspective, quite sound, as cardiovascular diseases (CVDs), particularly coronary artery disease (CAD), which is also the primary cause of heart attacks, are the leading cause of mortality worldwide [3, 4].

Panic attacks on the other hand are sudden, intense periods of fear accompanied by physical sensations that are disproportionate to the situation that may have triggered it (panic attacks also occur completely spontaneously) and usually completely harmless physically, but can cause significant psychological and emotional suffering to the patient. They are a part of the panic disorder, an anxiety disorder characterised by reoccurring panic attacks of unknown cause (there are several proposed biologically-based mechanism at play) [5].

Knowing the difference

Symptoms of both panic attacks and heart attacks can vary greatly between different individuals, but there are some significant differences, which are worth highlighting.

Typical symptoms of a panic attack:

  • Weakness
  • Sweating
  • Tingling sensation
  • Nausea
  • Dizziness
  • Shortness of breath
  • Heart palpitations (sensations of fluttering in the chest, pounding or heart beating irregularly)
  • Short duration (usually no more than 10 minutes)

Typical symptoms of a heart attack:

  • Heart palpitations
  • Feeling of tightness in the chest
  • Sweating
  • Pain or pressure in the chest
  • Loss of consciousness*
  • Dizziness*
  • Shortness of breath*
  • Pain that radiates to the jaw or arm*
  • Pain in abdomen*
  • Extreme fatigue*

*Note: These symptoms are usually more common in females than males, but can affect both.

The main differences between the two are duration of the attack, triggers and risk factors. Panic attacks are usually brief (less than 10 minutes), while symptoms of an actual heart attack will come and go over a longer period of time. Triggers or the lack of them: heart attacks are usually triggered by physical exertion, sudden changes in temperature or a big meal in contrast with panic attack, which can occur anytime (even in a relaxed state). Lastly, the risk factors. Younger (under 60 years of age) patients and those not in risk groups for cardiovascular diseases (e.g. individuals who smoke, are obese, diabetic or/and have hypertension or dyslipidemia or a family history of CVDs) are less likely to have a heart attack.

Please note that this blog post on the topic of differentiating between panic attacks and heart attacks does NOT constitute medical advice. Patients should seek professional medical help if they experience symptoms associated with myocardial infarction. Subsequent diagnosis should be followed up by a consultation with a personal physician about cardiovascular risk factors, maintaining good cardiovascular health, inclusion of the patient in the risk group(s) and (if diagnosed) panic disorder treatment and management options.

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