Your heart is racing and you’ve been feeling chest pain. You’re having trouble breathing, you’re stressed and you have heart palpitations.

How do you know if what you’re feeling is the beginning of a panic attack or a heart attack?

Q. How can you tell the difference between a heart attack and a panic attack?

A. A panic attack and a heart attack are very similar in terms of symptoms. With both, you can experience chest pain. Chest pain from a heart attack, however, tends to radiate to the arms, neck or jaw. You can also have heart palpitations and heart fluttering, neither or which get better or worse if you stop or start moving. With a panic attack, on the other hand, these symptoms usually improve when you stop moving, sit down, use breathing techniques and relax. 

Q. Is there a difference in the intensity of symptoms in a panic attack or heart attack, based on the individual?

A. Symptom intensity, and actual symptoms, can vary from patient to patient. For example, patients who are female or who have diabetes often don’t have chest pain or experience it to a lesser degree. Sometimes they have abdominal discomfort, nausea or sweating instead of chest pain. 

Q. Does anyone know why there’s a difference in the way women and men experience heart attacks?

A. We don’t quite know that. What we do know is there’s a difference in symptoms for men and women, so we need to educate our patients appropriately so that they know when to seek medical attention.

Q. If I’ve suffered panic attacks in the past, and I think I might be having another one, should I automatically assume it’s a panic attack and not a heart attack?

A. If you’ve had panic attacks in the past, and know that the symptoms you’re experiencing are similar and get better with techniques like meditation and breathing exercises, you can assume it’s another panic attack. If, however, you’ve never had a panic attack before and your symptoms aren’t improving with breathing or meditation, you should seek medical attention as you may be having a heart attack.

Q. As a cardiologist, have you ever seen a patient who didn’t know whether they were experiencing a panic attack or heart attack?

A. We see it all the time. It’s very common for a patient to come into the ER or the hospital with a panic attack. Even as a trained physician, it can be difficult to tell until you get a proper history and have tests run. Plus, often patients actually have a panic attack while they’re having a heart attack, making it even more difficult to differentiate between the two.

Q. If I’m not sure, when should I seek medical help?

A. If you aren’t sure, you need to seek medical help right away. If you feel like you may be having a heart attack, call 911 – do not drive yourself to the hospital.

Femi Showole, D.O., is a cardiologist at MidMichigan Health.

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