Is it a panic attack or a heart attack? How to tell them apart
What are their characteristic symptoms?
How long do they last and what applies to crises that occur at night?
When should you seek medical help immediately?
The symptoms suddenly appeared: you felt a tightness in your chest, your heart started beating like crazy and you started sweating profusely. Your mind immediately goes to the heart attack.
Or is it a panic attack, the frequency of which has skyrocketed in the middle of the pandemic caused by the new coronavirus?
Distinguishing the two situations is not always easy and this increases the anxiety and stress of the sufferers. But both are serious, so it is important to immediately understand what is happening so that you can ask for the appropriate help.
Cardiologist Dr. Mistyann-Blue Miller, from the Department of Cardiovascular Medicine at Cleveland Clinic, Ohio, explains what infarction has in common with panic attack and how they differ.
The symptoms of a heart attack
Myocardial infarction occurs when a part of the heart is not supplied with enough blood. This is usually because some of the coronary arteries of the heart are blocked.
The most common symptoms of a heart attack are:
- Chest pain or pressure
- Strong or fast heartbeats
- Feeling dizzy or fainting
- Sweating (especially cold sweat)
- Pain or discomfort in the upper body (eg jaw, neck, arm, shoulder, back)
- Dyspnoea
- Nausea or vomiting
- Feeling of impending doom
A heart attack can threaten life. So you shouldn't wait to see if the symptoms go away. As soon as someone feels them, they should go to the doctor.
How the panic attack manifests itself
A panic attack is the sudden development of extreme fear or anxiety. These crises do not threaten life. But they can negatively affect the quality of life and mental well-being.
Those who have regular or frequent panic attacks may suffer from panic disorder, a type of anxiety disorder. However, everyone can have a single panic attack, especially in the difficult times we are going through due to the coronavirus.
Symptoms of panic attack include:
- Sudden feeling of anxiety and fear
- Chest pain
- Difficulty breathing
- Feeling of impending doom
- Strong or fast heartbeats
- Sweating
- Terror (shaking) of the body
- Weakness or dizziness
- Stomach pain or nausea
Differences in symptoms
The symptoms of these two conditions seem very disturbing.
However Dr. Miller says they're not exactly the same, but there are main differences on a few key points:
In place of pain: The two conditions cause chest pain. However «when a person has a heart attack, their pain reflects on other parts of the trunk. It can e.g. also affect the corresponding arm, jaw or neck», says Dr. Miller. «If it is a panic attack, the pain is usually limited to the chest».
In the sensation of pain: A heart attack causes pain that looks like pressure on the chest, as if something heavy has sat on you. It can also cause a heartburn sensation (a burn behind the sternum). Conversely, panic attacks often cause a sharp, stab-like pain (this pain is not typical for a heart attack). In addition, patients with panic attacks feel a discomfort in the chest or the way their heart beats frantically, which they cannot easily describe.
...and in the causes
Myocardial infarction often occurs after exercise or other physical exertion. But this is not the case with a panic attack. «A person who climbs e.g. many stairs, can have a heart attack», explains Dr. Miller. «But he will not have a panic attack if there is no emotional cause».
But what happens when the two situations happen at night? It is a fact that both can happen during sleep. But the difference is that people with nocturnal panic attacks usually manifest them during the day. Therefore, these are not people with isolated crisis but rather with panic disorder.
Therefore, if you experience chest pain at night and/or some other of the aforementioned symptoms, but have no history of panic attacks, you may have a heart attack, adds the expert. So you should go to the doctor immediately.
The duration is also important
The symptoms of panic attack usually last from a few minutes to an hour. Then they disappear and the sufferer feels much better. However, this is not the case with a heart attack.
Pain and other symptoms of heart attack usually manifest in waves, with flare-ups and remissions. «Infarctions can cause excruciating pain, intensity 9 or 10 on the pain scale», explains the specialist. «But then the pain can be reduced to 3 or 4, before it gets worse again. So the pain can change, but it doesn't go away».
The heart attack may also look like it appeared «out of nowhere, but many times there have been episodes of angina. Angina is chest pain due to heart disease, which manifests itself for days or even weeks before the heart attack.
«You may sporadically feel a skewer or some pain in the shoulder and chest that soon subsides, so you think it's something else. These symptoms usually manifest after exercise, great stress or a rich meal. But at some point the pain reappears more intense or you feel that something is wrong. And then the infarction» manifests itself, says Dr. Miller.
Better than safe
A heart attack is an emergency. The panic attack does not. But since their symptoms overlap, it's safer not to take risks. If you experience chest pain or other symptoms suspected of a heart attack, seek medical attention immediately, the specialist recommends.