When faced with an individual in acute distress, a first aider often encounters a challenging scenario: discerning whether the person is experiencing a panic attack or a heart attack. Both conditions can present with similar symptoms, making accurate assessment difficult. Understanding the nuances of each presentation guides appropriate initial actions. This article clarifies these distinctions, providing guidance for first aiders on how to respond effectively when symptoms overlap.
Understanding Panic Attack Symptoms
Panic attacks are sudden, intense episodes of fear that trigger physical reactions without an apparent cause. These episodes manifest with a rapid or pounding heart rate, shortness of breath, and chest tightness.
Other physical sensations include:
Dizziness
Lightheadedness
Excessive sweating
Trembling or shaking
Nausea
Abdominal distress
Chills
Hot flashes
Beyond physical sensations, panic attacks involve profound psychological distress. A person may feel an overwhelming sense of impending doom, a fear of losing control, or even a fear of dying. These feelings can contribute to a sense of unreality or detachment from their surroundings. While distressing, these symptoms are a manifestation of the body’s fight-or-flight response, not a cardiac event.
Understanding Heart Attack Symptoms
A heart attack, or myocardial infarction, occurs when the blood supply to a part of the heart muscle is suddenly blocked, often by a blood clot. The most common symptom is chest pain, often described as pressure, heaviness, tightness, squeezing, or aching across the chest. This discomfort can last for minutes or may go away and return. The pain can also radiate to other areas of the body, including one or both arms (commonly the left), the back, neck, jaw, or stomach.
Beyond chest pain, a heart attack can present with other symptoms:
Shortness of breath (with or without chest discomfort)
Cold sweat
Nausea or vomiting
Lightheadedness or sudden dizziness
It is important to note that symptoms can vary, and some individuals, particularly women, the elderly, or those with diabetes, may experience more subtle or atypical signs without severe chest pain.
Distinguishing Key Differences and Overlaps
The challenge for a first aider lies in the significant overlap of symptoms between panic attacks and heart attacks, as both can involve chest pain, shortness of breath, sweating, and a racing heart. However, certain characteristics may offer clues, though these are not definitive diagnostic tools. Panic attack chest pain is often described as sharp or stabbing and may be localized to one area, sometimes feeling like a tight band around the chest. In contrast, heart attack pain is typically described as a deep, crushing, or squeezing pressure that may spread to the arm, shoulder, or jaw.
The onset and duration of symptoms can also differ. Panic attacks often come on suddenly, peaking within 10 to 20 minutes, and typically subside within an hour, though residual anxiety may linger. Heart attack symptoms, however, can start slowly and gradually worsen, lasting for several minutes to hours, and do not improve over time. While panic attacks can occur at any time, a heart attack can sometimes be triggered by physical exertion. A first aider cannot definitively diagnose either condition; professional medical evaluation is necessary to determine the cause of symptoms.
Essential First Aid Response
Given the considerable overlap in symptoms and the life-threatening nature of a heart attack, a first aider should always assume the more serious condition when in doubt. The immediate step is to call emergency services without delay. Fast action significantly increases the chances of survival and recovery for a heart attack. Do not wait to see if symptoms resolve.
While awaiting professional medical help, several supportive measures can be taken. Encourage the person to sit down or lie in a comfortable position and loosen any tight clothing around their neck or chest. Remain calm and offer reassurance, as anxiety can worsen symptoms for both conditions. If the individual is conscious and not allergic, and if advised by emergency services, they may be instructed to chew aspirin, which can help prevent blood clotting during a heart attack. A first aider’s role is to provide immediate support and ensure professional medical assessment is obtained promptly, not to attempt diagnosis or administer complex medical interventions.