What may look and feel like a heart attack may actually be a panic attack, and according to researchers, the cost of misdiagnosing non-cardiac chest pain is high.
An investigation published in Y 1996 found that 25% of ER (emergency room) patients presenting with chest pain met the DSM-III-R criteria for panic disorder, yet attending emergency department cardiologists failed to recognize patients having a panic attack 98% of the time.
As noted by the authors: “Panic disorder is a significantly distressful condition highly prevalent in ER chest pain patients that is rarely recognized by physicians. Nonrecognition may lead to mismanagement of a significant group of distressed patients with or without coronary artery disease.”
The Big Q: How do you tell the two apart?
Before we get into the details, let us take a look at the common signs and symptoms associated with each.
Symptoms of Panic Attack
Symptoms of Heart Attack
When a heart attack starts, blood flow to the heart has suddenly become blocked and the muscle cannot get oxygen. If not treated quickly, the muscle fails to pump and begins to die.
While often a result of coronary heart disease, a heart attack can also be caused by a blood clot blocking an artery.
Some of the most common symptoms of a heart attack include:
|Chest pain or discomfort||Upper body discomfort|
|Shortness of breath||Breaking out in a cold sweat|
|Feeling unusually tired||Lightheadedness|
Telling Them Apart
While it can be very difficult to tell a panic attack from a heart attack, some generalizations can be made that can help tell them apart.
- Pain onset: The chest pain associated with a heart attack will typically start as a feeling of pressure, fullness or aching that escalates, reaching maximum severity after a few mins, whereas the pain associated with a panic attack tends to be sharp and stabbing in the center of the chest, typically lasting only 5 to 10 secs.
- Pain location: The location of the pain also tends to differ between the 2. Whereas panic-associated pain is localized in one small area of the chest, heart attack symptoms typically include pain or discomfort that radiates from the chest into other areas, such as one or both arms, abdomen, back, shoulders, neck, throat or jaw.
Don’t Ignore Your Symptoms
When in doubt, seek immediate medical attention. It’s better to be safe than sorry, as sudden death is the most common symptom of a heart attack.
As noted by Dr. Sam Torbati, Medical Director of the Ruth and Harry Roman Emergency Department in an interview for Cedars-Sinai Medical Center:
“Unfortunately, there is great crossover between the symptoms of panic attack and heart attack, making it very challenging to discern between the two without a physician assessment and testing, such as an EKG.
Common symptoms that may affect patients with either a panic or heart attack include chest pain, shortness of breath, dizziness, sweating, passing out, tingling, or a sensation of impending doom.
These shared symptoms of heart and panic attack may also be caused by other serious conditions such as blood clots, lung infection or collapse, or tear in the large vessels of the chest for patients with certain pre-existing risk factors. So when in doubt, seek immediate medical attention …
The best predictor as to whether symptoms are due to panic versus heart attack is the patient’s age and previous history of panic attacks … Patients should immediately go to the ER if they have new onset chest pain (tightness, squeezing, heaviness), shortness of breath, sweating, lightheadedness, pain that radiates to the jaw or arm, or a ripping sensation in their chest or back.
Heart attacks tend to occur in middle-aged people and older age groups, so the older the person is, the lower a threshold they should have for coming to the ER right away.
Patients with pre-existing coronary artery disease and those with risk factors associated with coronary artery disease should also be evaluated immediately, including those with hypertension, diabetes, obesity, high cholesterol, or a history of smoking.”
Breathe Right to Quell Panic Attacks
When it comes to panic attacks, familiarizing yourself with the function of your fight-or-flight response can be helpful to guide you toward self-help strategies that work for your unique situation.
For example, contrary to popular belief, taking deep breaths can actually worsen a panic attack, as explained by Buteyko Breathing expert Patrick McKeown. A breathing exercise that can help quell anxiety and panic attacks is summarized below.
This sequence helps retain and gently accumulate CO2, carbon dioxide , leading to calmer breathing and reduced anxiety. In other words, the urge to breathe will decline as you go into a more relaxed state.
- Take a small breath into your nose, a small breath out; hold your nose for 5 secs in order to hold your breath, and then release to resume breathing.
- Breathe normally for 10 secs.
- Repeat the sequence several more times: small breath in through your nose, small breath out; hold your breath for 5 secs, then let go and breathe normally for 10 secs.
Mr. McKeown has also written a book specifically aimed at the treatment of anxiety through optimal breathing, called “Anxiety Free: Stop Worrying and Quieten Your Mind — Featuring the Buteyko Breathing Method and Mindfulness.”
Heart Attack Prevention
As for heart attacks, the best course of action is to take proactive measures to prevent them.
According to a Y 2015 study, more than 70% of heart attacks could be prevented by implementing:
- A healthy diet
- Normal body mass index
- Getting at least 2.5 hrs of exercise each week and watching television 7 or fewer hours per week
- No smoking
- Limiting alcohol to 1 drink or less per day
To this experts recommend that maintaining a healthy iron level is important for your heart, as various studies show that both iron deficiency and iron overload can be a significant risk factor for heart attack.
For example, a Scandinavian study found elevated ferritin levels raised men’s risk of heart attack 2-31X. Another found elevated ferritin raised the risk of a fatal heart attack by 218% in men, while women with high levels were 5.53X more likely to have a fatal heart attack.
Also, Magnesium insufficiency has also been implicated in heart attacks, so you want to make sure you are getting enough magnesium from your diet and/or supplements.
Take the steps you need take to lower your risk.
Eat healthy, Be healthy, Live lively