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Panic vs. heart attack: How to tell the difference


Panic vs. heart attack: How to tell the difference

Every year, one in 10 Americans experiences a panic attack, which can cause symptoms similar to a heart attack. So how can you tell the two apart?
“It can be very difficult to determine which is which, especially if you’ve never experienced the symptoms before,” says Tidelands Health cardiologist Dr. Nitesh Ainani, who practices at The Market Common, Murrells Inlet and Pawleys Island locations of Tidelands Health Cardiology. “One of the biggest differences is that panic attacks usually happen to people who have previous anxiety issues or are being treated for anxiety. Symptoms typically resolve within 30 minutes, and they start to feel better.
“But with a heart attack, symptoms usually get worse, and people can’t get comfortable at all. That is one of the signals that something very concerning is happening and needs immediate attention.”


Heart attacks can be life threatening and occur when blood flow to the heart becomes severely reduced or blocked. Panic attacks are a sudden sensation of overwhelming anxiety or fear that can significantly diminish quality of life.
Understanding what panic attacks and heart attacks have in common – and how they’re different – is important when determining the treatment you may need, Dr. Ainani says.
Common overlapping symptoms of heart and panic attacks include:

  • Chest pain
  • Trouble breathing
  • Dizziness or feeling faint
  • Sweating

Panic attacks can also include intense worry and fear, shivering or shaking, an elevated heart rate and feelings of impending doom and depersonalization (an out-of-body sensation). Panic attacks are often triggered by stress, depression or fear.

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Unlike panic attacks, heart attacks often – although not always – occur during or after physical exertion. Symptoms may include shortness of breath, persistent chest pain, fatigue or weakness. When someone is having a heart attack, symptoms may ebb and flow, but they don’t resolve and may worsen over time.
During a heart attack, chest pain often radiates to the jaw, arm or neck. By contrast, during a panic attack, chest pain tends to remain isolated to the chest and often feels sharper than the squeezing sensation that tends to accompany a heart attack.
“If symptoms are not resolving or you suspect you may be experiencing a medical emergency, the best thing to do is seek medical attention right away,” Dr. Ainani says.
In the ER, your care team can administer tests to determine the cause of your symptoms and provide the treatment you need, he says.
“If you’re young, the chances of having a heart attack are low,” he says. “But if you have severe symptoms and you can’t be sure of the cause, it’s best to seek medical care to rule out something serious like a cardiac event. Prompt care can save your life.”

Dr. Nitesh Ainani, who is accepting new patients, is a fellowship-trained cardiologist who practices at The Market Common, Murrells Inlet and Pawleys Island locations of Tidelands Health Cardiology.

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