If chest pain hits, you probably feel a bit scared and confused. You might not know if it’s a panic attack or a heart attack that’s causing your symptoms. The two conditions can feel very similar but knowing the differences may help you stay calm and get the care you need.
At Banner Health, we want you to understand the warning signs of both conditions, so you know when to call for emergency help and when it may be related to anxiety.
Why panic attacks and heart attacks feel similar
Both panic attacks and heart attacks can cause chest discomfort, a racing heartbeat and shortness of breath.
“The overlap comes down to how our bodies react to stress,” said Ankur Panchal, MD, a cardiologist with Banner Health. “A panic attack triggers your fight-or-flight response and a sudden surge of adrenaline. This leads to sweating, a racing heart, shortness of breath or chest discomfort.”
A heart attack also causes chest pain, shortness of breath and sweating, but in that case it’s because blood flow to the heart muscle is blocked. “Since the body only has so many ways to signal distress, the symptoms can feel very alike,” Dr. Panchal said.
Signs of a panic attack
“A panic attack usually comes on out of the blue, peaks quickly and then fades,” Dr. Panchal said. It could start even when there’s no clear danger.
Common panic attack symptoms include:
- Intense fear, sense of doom or even a fear of dying
- Chest tightness or sharp pain (but not usually crushing)
- Rapid breathing or hyperventilation
- Sweating
- Trembling or shaking
- Dizziness or lightheadedness
- Tingling or numbness in the hands, face or lips
- Pounding or rapid heartbeat
A panic attack usually peaks within 10 to 20 minutes and then improves without treatment. “Panic attacks aren’t life-threatening, but they can be very distressing,” Dr. Panchal said.
You might recognize when you’re about to have a panic attack, especially if you’ve had one before.
Signs of a heart attack
Heart attacks happen when blood flow to the heart is blocked. Symptoms can start gradually or strike suddenly.
Heart attack symptoms can include:
- Pressure, heaviness, squeezing or crushing chest pain
- Pain that spreads to the arm, neck, jaw or back
- Shortness of breath, even when you’re resting
- Nausea or vomiting
- Breaking out in a cold sweat
Fatigue or unusual tiredness and indigestion may also be heart attack symptoms, especially in women and people with diabetes.
“Heart attack symptoms don’t just last a few minutes. They can fluctuate but they linger,” Dr. Panchal said. Unlike panic attacks, they don’t go away with rest or calming techniques.
Panic attack vs. heart attack: Key differences
This quick comparison chart can help you spot the differences between panic attacks and heart attacks:
Onset
Panic attack: Sudden; often during stress but not always
Heart attack: Gradual or sudden, often with exertion
Pain
Panic attack: Sharp or stabbing; chest tightness
Heart attack: Pressure, squeezing or heaviness
Duration
Panic attack: Peaks within 10 to 20 minutes
Heart attack: Lasts longer; doesn’t fully ease
Other clues
Panic attack: Fear, anxiety, tingling or trembling
Heart attack: Radiating pain, nausea or cold sweat
When to seek medical help
“If you’re not sure, don’t try to sort it out on your own. Heart attacks can’t wait. Get emergency help if chest pain is new, persistent or different from what you’ve felt before, especially if it spreads to other areas or is paired with shortness of breath, sweating or lightheadedness,” Dr. Panchal said.
If you’re not sure, call 911 right away. It’s always safer to treat chest pain as an emergency until a health care provider rules out a heart attack.
“Panic attacks and heart attacks can closely resemble each other. Even doctors sometimes need testing to sort it out,” Dr. Panchal said. “Doctors would always rather see someone in the ER and find it’s a panic attack than have someone stay home with a real heart attack.”
Doctors may use tests like an EKG or blood work to check your heart. If your heart is fine, your provider may talk with you about panic disorder or anxiety treatment options like therapy, breathing exercises and medication.
Caring for your physical and mental health
Both your mental health and heart health matter. “The healthy lifestyle basics really do help both,” Dr. Panchal said.
You can lower your risks by:
- Exercising regularly
- Getting enough sleep
- Choosing a balanced diet
- Practicing relaxation or breathing exercises
- Avoiding tobacco and limiting alcohol
- Managing your blood pressure, cholesterol and blood sugar levels
- Following up with your health care provider
If you have panic attacks often, therapy and medication can help. If you’re at risk for heart disease, your doctor may recommend lifestyle changes, medicine or testing. “Both conditions are treatable,” Dr. Panchal said.
“Mental health and heart health are strongly linked. Managing stress, getting good sleep and taking care of your emotional well-being can lower the risk for problems with both,” Dr. Panchal said.
Why choose Banner Health
At Banner Health, we offer expert care for both your mind and your heart. Our emergency teams, cardiologists and behavioral health specialists work together to give you quality care and peace of mind.
Whether you need emergency treatment, ongoing heart care or help managing anxiety, we’re here for you. Reach out to connect with a heart care or behavioral health expert at Banner Health.
