The difference between panic attacks and heart attacks

## Panic Attack vs Heart Attack: Know the Difference Both feel terrifying and share symptoms, but knowing the difference can reduce panic and ensure you get appropriate help. ### Shared Symptoms (Why It's Confusing) Both can cause: - Chest pain or pressure - Shortness of breath - Sweating - Nausea - Dizziness - Fear of dying - Arm or jaw discomfort ### Panic Attack Characteristics **Timing:** - Sudden onset (0-10 minutes to peak) - Peaks at 10 minutes - Usually over within 20-30 minutes - Can happen anytime, even during sleep - Often no clear trigger **Chest Sensations:** - Sharp, stabbing pain - Comes and goes - Changes with breathing - Anywhere in chest - Improves with movement/position change **Other Symptoms:** - Tingling in hands/feet - Feeling unreal (derealization) - Hot/cold flashes - Trembling or shaking - Fear of losing control - Hyperventilation **Context Clues:** - History of anxiety - Young age (though can happen any age) - Stress or anxiety trigger - Previous similar episodes - Gets better with calming techniques ### Heart Attack Characteristics **Timing:** - Gradual onset usually - Persists or worsens - Lasts longer than 30 minutes - Often during/after physical exertion - More common early morning **Chest Sensations:** - Crushing, squeezing pressure - "Elephant on chest" - Constant, not fleeting - Center or left side typically - Radiates to arm, jaw, back - Doesn't change with breathing **Other Symptoms:** - Cold, clammy sweat - Extreme fatigue - Shortness of breath at rest - Lightheadedness/fainting - Sense of impending doom - Vomiting (not just nausea) **Context Clues:** - Risk factors present (see below) - Age over 40 (though younger possible) - During physical activity - Doesn't improve with rest - Progressively worsening ### Risk Factors for Heart Attack **Major Risk Factors:** - High blood pressure - High cholesterol - Diabetes - Smoking - Family history of heart disease - Obesity - Sedentary lifestyle - Age (men >45, women >55) **If You Have These**, err on side of caution with chest pain. ### When to Call 911 **Call Immediately If:** - First time experiencing these symptoms - Crushing chest pressure - Pain radiating to arm/jaw - Symptoms persist >20 minutes - Symptoms worsen with activity - You have cardiac risk factors - Fainting or near-fainting - Severe shortness of breath **Better Safe Than Sorry:** - EKG can quickly rule out heart attack - Many people delay seeking help - "Time is muscle" for heart attacks - Embarrassment < Death - ER staff won't judge you ### What to Do During Panic Attack **Immediate Actions:** 1. Sit down safely 2. Remind yourself: "This is panic, not danger" 3. Breathe slowly (longer exhale) 4. Use grounding techniques 5. Don't fight it (makes worse) 6. It WILL pass **DON'T:** - Google symptoms (increases panic) - Check pulse repeatedly - Hyperventilate - Catastrophize - Run to ER repeatedly ### What to Do If Suspecting Heart Attack **Immediate Actions:** 1. Call 911 (don't drive yourself) 2. Chew aspirin if available (325mg) 3. Sit upright 4. Stay calm as possible 5. Unlock door for paramedics **DON'T:** - Wait to see if improves - Drive yourself - Ignore symptoms - Take someone else's medication - Lie flat ### After the Episode **Post-Panic Attack:** - Rest but don't avoid activities - Consider therapy for anxiety - Learn panic management techniques - Track triggers - Consider medication if frequent **Post-Heart Evaluation:** - Follow all medical advice - Cardiac rehabilitation if needed - Lifestyle modifications - Medication compliance - Regular follow-ups ### The Diagnostic Process **At the ER:** - EKG (immediate) - Blood tests (troponin) - Chest X-ray - Medical history - Physical exam **Results:** - Heart attack shows on EKG/blood tests - Panic attack: all tests normal - Sometimes given anxiety resources - Follow-up with primary care ### Living with Uncertainty **Health Anxiety Management:** - One thorough cardiac workup - Trust negative results - Don't seek repeated testing - Address anxiety directly - CBT very effective **Creating Certainty:** - Know your baseline - Track panic patterns - Identify triggers - Have panic plan - Regular check-ups ### The Bottom Line **When Unsure, Seek Help:** - First chest pain = ER - Known panic disorder = use judgment - Risk factors = lower threshold for ER - Peace of mind worth ER visit - Living in fear worse than checking *Many panic attack sufferers fear heart attacks, and many heart attack victims dismiss symptoms as anxiety. When in doubt, get checked. Your life is worth more than avoiding embarrassment.*