Panic Attack vs Heart Attack: Understanding the Differences

When experiencing intense chest pain, sweating, and shortness of breath, it’s natural to fear the worst. For many, these symptoms immediately bring to mind a heart attack. However, they can also be indicative of a panic attack, a condition that, while not life-threatening, can be equally terrifying.

Distinguishing between a panic attack vs heart attack is crucial, not only for peace of mind but also for appropriate medical attention. This article delves into the differences between these two conditions, their symptoms, causes, treatment options, and when to seek medical care.

Understanding Panic Attacks

A panic attack is a sudden episode of intense fear that triggers severe physical symptoms when there is no real danger or apparent cause. They can be frightening and may feel like you’re losing control, having a heart attack, or even dying.

Many people will experience one or two panic attacks in their lifetime, and the problem goes away when the stressful situation ends. However, if you’ve had recurrent, unexpected panic attacks and spent long periods in constant fear of another attack, you may have a condition called panic disorder.

Symptoms of Panic Attacks

The symptoms of panic attacks can be severe and may include:

  • Chest Pain: Often mistaken for heart attack pain, but usually sharper and localized.
  • Palpitations: A feeling of rapid, pounding, or racing heartbeats.
  • Shortness of Breath: Feeling as though you can’t catch your breath.
  • Sweating: Profuse sweating without physical exertion.
  • Trembling or Shaking: Uncontrollable physical shaking.
  • Nausea: Feeling queasy or nauseated.
  • Dizziness: Light-headedness or feeling faint.
  • Chills or Hot Flashes: Sudden chills or waves of heat.
  • Numbness or Tingling: Especially in the hands and feet.
  • Feelings of Unreality: Feeling detached from reality (derealization) or oneself (depersonalization).
  • Fear of Dying: Intense fear that you might die.

Causes of Panic Attacks

Panic attacks can be triggered by a variety of factors, including:

  • Genetics: A family history of panic attacks or panic disorder.
  • Major Stress: Such as the death of a loved one, divorce, or job loss.
  • Temperament: More sensitive to stress or prone to negative emotions.
  • Changes in Brain Function: Neurobiological changes may play a role.
  • Substance Abuse: Excessive use of alcohol, caffeine, or drugs can trigger panic attacks.

Additional Context for Panic Attack Symptoms

While experiencing a panic attack, individuals often feel as though they are having a heart attack due to the similarity in physical symptoms like chest discomfort, shortness of breath, and heart palpitations.

These panic attack symptoms can be incredibly intense and alarming, leading to immediate medical attention. However, it’s crucial to tell the difference between a panic attack vs heart attack to avoid unnecessary emergency room visits and to seek appropriate treatment.

Understanding Heart Attacks

A heart attack, medically known as a myocardial infarction, occurs when the flow of oxygen-rich blood to a section of the heart muscle suddenly becomes blocked. If blood flow isn’t restored quickly, the section of the heart muscle begins to die.

Heart attacks are often the result of coronary artery disease (CAD), a condition where the coronary arteries become clogged with fatty, calcified plaques.

Symptoms of Heart Attacks

The symptoms of heart attacks can vary widely, but common signs include:

  • Chest Pain or Discomfort: A feeling of pressure, tightness, pain, or squeezing in the center of your chest that lasts for more than a few minutes, or goes away and comes back.
  • Shortness of Breath: Often comes along with chest discomfort but can occur before chest discomfort.
  • Nausea and Vomiting: Feeling sick to your stomach or actually vomiting.
  • Pain in Other Areas: Pain may spread to shoulders, arms, back, neck, jaw, or stomach.
  • Cold Sweat: Breaking out in a cold sweat.
  • Lightheadedness: Feeling dizzy or lightheaded.
  • Fatigue: Unusual or unexplained tiredness.

Causes of Heart Attacks

Heart attacks are usually caused by a combination of lifestyle and genetic factors, including:

  • Coronary Artery Disease (CAD): The primary cause of heart attacks, where the arteries become narrowed by fatty deposits.
  • High Blood Pressure: Can damage arteries over time, making them more susceptible to narrowing and blockage.
  • High Cholesterol: Contributes to the buildup of plaques in the arteries.
  • Smoking: Damages the lining of your arteries.
  • Diabetes: Increases the risk of heart disease.
  • Sedentary Lifestyle: Lack of physical activity is a significant risk factor.
  • Obesity: Excess weight increases the risk of heart disease.
  • Stress: Chronic stress can increase heart disease risk.
  • Family History: Genetic predisposition to heart disease.

Additional Context for Heart Attack Symptoms

Recognizing the symptoms of a heart attack is crucial for seeking immediate medical attention. Chest pain, which is often described as an “elephant sitting” on the chest, is a hallmark symptom. Pain can radiate to the shoulder blades, arms, or upper abdomen.

These symptoms are often more severe and persistent compared to panic attack symptoms. In contrast to the fleeting nature of panic attacks or anxiety attacks, the discomfort from a heart attack usually doesn’t go away with relaxation techniques or rest.

Key Differences Between Panic Attacks and Heart Attacks

man, heartache, chest pain

While panic attacks and heart attacks share some similar symptoms, there are key differences that can help distinguish between the two.


  • Panic Attack: Typically starts suddenly and peaks within 10 minutes. Panic attacks happen unexpectedly or can be triggered by stress or fear.
  • Heart Attack: Symptoms usually develop more gradually over several minutes and can last longer. Heart attacks often occur after physical exertion or stress, but can also occur at rest.

Pain Characteristics

  • Panic Attack: Chest pain is usually sharp, stabbing, and localized. People often describe this as a stabbing pain or a racing heart.
  • Heart Attack: Chest pain is often described as a pressure or squeezing sensation that may radiate to other parts of the body, such as the arm, jaw, or shoulder blades. This pain can feel like an “elephant sitting” on the chest and is often accompanied by heart palpitations.

Associated Symptoms

  • Panic Attack: Symptoms like fear of losing control or dying, trembling, and tingling are more common. Panic attack symptoms also include shortness of breath, fast heartbeat, and trouble breathing. There is often a strong flight response and feelings of impending doom.
  • Heart Attack: Symptoms like pain radiating to the arm or jaw, cold sweats, and nausea are more common. Common heart attack symptoms also include shortness of breath, unusual fatigue, and pain in the left side or upper abdomen. These symptoms indicate the heart muscle is not getting enough blood.


  • Panic Attack: Usually subsides within 20-30 minutes. Daytime panic attacks and repeated panic attacks can cause prolonged fear, but each episode is relatively short-lived.
  • Heart Attack: Symptoms persist longer and do not improve with rest. This prolonged discomfort requires immediate medical attention as it is a medical emergency.

Diagnosing Panic Attacks and Heart Attacks

A photo showing a cardiology equipment at Midtown Avicenna Cardiology clinic.

Because the symptoms can overlap, it’s important to get a proper diagnosis to ensure the correct treatment.

Diagnosing a Panic Attack

Diagnosis typically involves:

  • Medical History: A thorough review of your medical history and symptoms. This helps to identify panic attack symptoms and distinguish them from other conditions.
  • Physical Examination: To rule out other conditions that could cause similar physical symptoms. This step is crucial to differentiate between panic attacks and heart attacks.
  • Psychological Evaluation: To assess for panic disorder or other anxiety disorders. This evaluation helps in understanding whether the panic attacks are part of a broader anxiety disorder.

Diagnosing a Heart Attack

Diagnosis typically involves:

  • Electrocardiogram (ECG): Measures the electrical activity of your heart. This test helps identify abnormalities that are common heart attack symptoms.
  • Blood Tests: Check for certain heart enzymes that are released when the heart muscle is damaged. Elevated levels of these enzymes can confirm a heart attack.
  • Chest X-ray: This can help visualize the condition of your heart and lungs. This imaging helps in identifying issues like chest discomfort and shortness of breath linked to heart disease.
  • Echocardiogram: Uses sound waves to create images of your heart. This test shows how well the heart is functioning and can reveal damage caused by a heart attack.
  • Coronary Angiography: Uses a special dye and X-rays to see how blood flows through your coronary arteries. This procedure can identify blockages that are typical in heart attacks.

Treatment Options

Treatment approaches differ significantly for panic attacks and heart attacks.

Treating Panic Attacks

Treatment for panic attacks may include:

  • Psychotherapy: Cognitive-behavioral therapy (CBT) is particularly effective.
  • Medications: Antidepressants and anti-anxiety medications can be helpful.
  • Lifestyle Changes: Regular exercise, healthy eating, and stress management techniques.
  • Relaxation Techniques: Such as deep breathing exercises, yoga, and meditation.

Treating Heart Attacks

Immediate treatment for heart attacks often involves:

  • Medications: Aspirin to reduce blood clotting, thrombolytics to dissolve clots, nitroglycerin to reduce chest pain, and beta blockers to decrease the heart’s workload.
  • Surgery: Angioplasty to open blocked arteries, or coronary artery bypass surgery (CABG) in more severe cases.
  • Lifestyle Changes: Eating a heart-healthy diet, regular exercise, quitting smoking, and managing stress.

When to Seek Medical Help

stethoscope, medical, health

It’s crucial to know when to seek medical help, as timely intervention can be lifesaving.

For Panic Attacks

Seek help if you:

  • Experience frequent or severe panic attacks.
  • Have difficulty managing daily life due to panic attacks.
  • Have persistent worry about having another attack.

For Heart Attacks

Seek immediate help if you:

  • Experience chest pain or discomfort lasting more than a few minutes.
  • Have chest pain accompanied by shortness of breath, sweating, nausea, or pain spreading to the arm, neck, or jaw.
  • Suspect you are having a heart attack, call emergency services immediately.

Preventing Panic Attacks and Heart Attacks

Both panic attacks and heart attacks can be managed and prevented to some extent through lifestyle changes and medical interventions. Understanding the key differences in symptoms and causes can help in taking appropriate steps for prevention and treatment.

Preventing Panic Attacks

  • Regular Exercise: Helps reduce anxiety and stress, which can contribute to preventing frequent panic attacks.
  • Healthy Diet: Avoid excessive caffeine and alcohol, which can exacerbate anxiety disorders and trigger panic attacks.
  • Stress Management: Techniques such as mindfulness and relaxation exercises can help manage anxiety disorder symptoms and reduce the likelihood of panic attacks.
  • Professional Help: Counseling or therapy can be crucial for those with panic disorder or anxiety disorders, providing strategies to manage stress and anxiety.

Preventing Heart Attacks

  • Healthy Diet: Low in saturated fats, trans fats, and cholesterol helps prevent heart disease and maintain healthy blood flow.
  • Regular Exercise: Helps maintain a healthy weight, reduces blood pressure, and lowers the risk of heart attacks.
  • No Smoking: Smoking cessation significantly reduces the risk of heart disease and heart attack symptoms.
  • Regular Health Check-ups: Monitor blood pressure, cholesterol levels, and manage diabetes if present to prevent underlying heart disease.

Understanding Symptoms: Panic Attack vs Heart Attack

Knowing how to tell the difference between a panic attack and a heart attack is essential.

  • Panic Attack Symptoms: Include severe chest pain, shortness of breath, pounding or racing heart, and a sense of impending doom. These physical symptoms are often mistaken for a heart attack, especially during a panic attack vs heart attack confusion.
  • Heart Attack Symptoms: Common heart attack symptoms include chest pain that may radiate to the arm, jaw, or back, shortness of breath, nausea, and sweating. Immediate medical attention is required for heart attack symptoms as they are life-threatening.


Understanding the differences between panic attacks and heart attacks is essential for effective treatment and management. Both conditions can present with similar symptoms, but they have distinct causes, treatments, and implications for your health. Through appropriate interventions and lifestyle changes, both panic attacks and heart attacks can be managed, leading to a healthier, more balanced life.

Remember, while panic attacks are not life-threatening, they can significantly impact your quality of life, and heart attacks, though potentially fatal, can often be prevented with the right measures. Stay informed, stay healthy, and always prioritize your well-being.

Take Control of Your Heart Health Today!

Avicenna Cardiology

At Avicenna Cardiology, we understand the importance of distinguishing between panic attacks and heart attacks. Our team of expert cardiologists is dedicated to providing comprehensive care to ensure your heart is in the best possible hands.

Frequently Asked Questions: Panic Attack vs Heart Attack

Panic attack symptoms include chest pain, shortness of breath, pounding or racing heart, sweating, trembling, nausea, dizziness, chills or hot flashes, numbness or tingling, feelings of unreality, and fear of dying. These physical sensations can be severe and often lead to a fear of impending doom.

Common heart attack symptoms include chest discomfort or pain, shortness of breath, nausea, pain spreading to the arm, neck, jaw, or back, cold sweat, lightheadedness, and unusual fatigue. Unlike panic attacks, heart attack symptoms persist and require immediate medical attention.

To tell the difference, consider the nature and duration of the symptoms. Panic attacks often feature sharp, stabbing pain and last around 20-30 minutes. Heart attacks involve prolonged, squeezing chest pain and additional symptoms like nausea and pain in the left side or upper abdomen. Consulting with a primary care provider or visiting the emergency room can help differentiate the two.

Panic attacks can be triggered by emotional stress, anxiety disorders, or physical exertion. Factors such as genetics, major stress, changes in brain function, and substance abuse can also contribute to frequent panic attacks or panic disorder.

About the Author

Azadeh Beheshtian

Azadeh Beheshtian is board certified in cardiovascular disease and internal medicine by the American Board of Internal Medicine. She specializes in interventional cardiology and peripheral artery disease, with a focus on women’s heart health.