How to Tell the Difference Between a Panic Attack and a Heart Attack

Feb 16, 2021 | Panic, Mental Health

Both a panic attack and a heart attack share certain symptomologies. However, both conditions have distinct signs that can help you tell them apart. Perhaps understanding how both conditions occur will demystify the confusion between both ailments.

Panic Attack

A panic attack is an abrupt rush of intense fear that interferes with your psychological and physical functioning. The manifestations occur abruptly without any stimulus or apparent warning. The suddenness is the reason the attack is confused with myocardial infarction.

A panic attack begins in the fear center of the brain called the amygdala. It is part of your brain responsible for interpreting neuron transmission from the senses. The amygdala falsely interprets internal and external cues from your sensory nerves as impending danger or threats.

Information from the amygdala stimulates activities in the sympathetic nervous system in preparation for fight or flight. The sympathetic nervous system stimulates the adrenal glands, which release biochemicals called catecholamines. The most notable of these is adrenaline. The adrenaline rush you feel when you sense danger is an effect of these biochemicals.

Catecholamine’s overall effect is to generate energy to prepare your body for fight or flight.

  • Their action in the heart raises your heartbeat – that is why you get heart palpitations during a panic attack. The heart pumps blood rapidly to increase your blood pressure to get oxygen to your muscles as part of the fight or flight preparation.
  • The biochemicals also raise your breathing rate to increase the oxygen supply to the muscles. Your body switches to shallow inhalation to increase oxygen intake. However, rapid shallow breathing does not utilize the full capacity of your lungs. The quick short breaths interfere with exhaling. Thus, the release of carbon dioxide in the lungs slows down, and its concentration builds up in your blood. The impact of this effect is your chest feels like it is tightening up from pressure build-up. You also get the feeling like you cannot breathe – a condition known as hyperventilation. The sensation is also synonymous with choking, smothering, or suffocation. It can easily be confused with a heart attack.
  • Your muscles tend to tremble and twitch during a panic attack.
  • In your digestive system, the hormones and neurons work to empty the gut to relieve it of any work during the fight or flight period. The energy (normally) used here is channeled to the muscles. As a result, you can get the sudden urge to empty your bowels and nausea.

The panic attack peeks at 10 minutes and may take close to half an hour to clear out.

Heart Attack

A heart attack occurs when blood flow in the arteries is interrupted. For the most part, a heart attack develops gradually. However, there are cases of instantaneous and sudden attacks. The symptoms can be mild or severe from the onset. Additionally, heart attack symptoms dominate the upper side of the body.

Signs of a heart attack include

  • Discomforts in the central or left side of the chest are also called angina. The most common symptom is chest discomfort. During the attack, a lot of tension builds up in your chest. It may be accompanied by pain. The pressure may last for a few minutes or occur intermittently.
  • Pain extends to your jaw, arms, neck, upper back, and sometimes the upper stomach.
  • Shortness of breath and unusual tiredness sometimes lasting for days.
  • Nausea and vomiting
  • Dizziness
  • Cold sweat.
  • Heart palpitations or slow heart rate

Women are more likely to experience shortness of breath, lethargy, and weakness. Chronic fatigue may last days after the attack. Similarly, diabetics and elderly adults may experience lightheadedness and shortness of breath.

Susceptibility to A Heart Attack

Once you have a heart attack, you are at a higher risk of developing a second attack. The most common cause of a heart attack is coronary heart disease. The condition occurs due to the deposition of plaque in the wall of your arteries.

Plaque increases in your arterial walls because of cholesterol deposits. In diabetes, excess sugar is converted to fat and stored under your artery walls. Contributing factors include sedentary living, obesity, poor nutrition, smoking, and mechanical injury from high blood pressure.

Comparing and Contrasting the Two Conditions

There is a world of difference between a heart attack and a panic attack.

  • A panic attack occurs suddenly, and a heart attack – for the most part – takes place gradually.
  • You can manage the tension resulting from hyperventilation in a panic attack with controlled breathing. However, in a heart attack, angina is difficult to relieve without specific interventions or medications because it is a consequence of cardiovascular irregularities, and not breathing.
  • A panic attack involves your entire body: restlessness, muscle spasms, tingling and tension, and discomfort in the gut. The symptoms of a heart attack tend to occur in the upper body.
  • Chest pains tend to occur in the center and left side of the chest where the heart is located for a heart attack. On the other hand, discomfort is often felt in the entire chest region during a panic attack.
  • For a heart attack, your heart rate increases or decreases depending on the physiological issues caused by the heart attack. For a panic attack, heart palpitations are always present and tend to be related to the feeling of fear.
  • For a heart attack, you can have pain in your jaw, arms, back, and above your belly button. There tends to be no such pain in a panic attack.

Noteworthy, a heart attack can trigger a panic attack. In this case, all these symptoms will be experienced simultaneously. Therefore, when you begin to experience these signs, contact your emergency services immediately.

New Dimensions Can Help!

If you or someone you know is experiencing any of the above symptoms or problems, New Dimensions can help. Our team of experienced therapists and psychiatrists can help you overcome these challenges and help you develop the skills you need to thrive. To schedule a complementary assessment or to find out more about our programs, contact us at 1-800-685-9796.

Our affiliate, MHThrive, provides Individual Therapy, Couples and Marriage Counseling, and Family Therapy at our locations in Katy, The Woodlands, and the Clear Lake area of Houston, Texas. We also provide telehealth therapy for anyone who resides within the State of Texas. To schedule an appointment with one of the MHThrive therapists, contact us at 713-477-0333 or visit to learn more.