The physical sensations of a panic attack and a heart attack are often difficult to distinguish, as both events involve symptoms like chest pain, a racing heart, and shortness of breath. This similarity creates confusion and fear, making rapid differentiation challenging. Understanding the specific markers for each condition is important for knowing when to seek immediate medical help for a cardiac event versus managing a psychological episode.
Key Symptom Differences
The nature of the chest pain is the most significant difference between the two events. Heart attack pain is frequently described as a crushing pressure, fullness, or squeezing sensation, centralized in the chest and lasting for more than a few minutes. This discomfort often radiates outward to the left arm, shoulder blades, neck, jaw, or back.
Panic attack chest pain, in contrast, is typically sharp, stabbing, or shooting, and is often localized to the middle of the chest. While both can cause nausea and sweating, cardiac symptoms often include cold sweats, lightheadedness, or extreme fatigue. A panic attack is more likely to feature sensory symptoms, such as tingling or numbness in the hands (paresthesia), and a feeling of unreality or detachment from one’s surroundings.
Progression and Timeline of Events
How the symptoms start and resolve provides another important distinction. A panic attack is characterized by a rapid onset of intense fear, with symptoms usually peaking within 10 minutes. The entire episode generally resolves quickly, with symptoms subsiding completely within 20 to 30 minutes, although they can occasionally last up to an hour.
Heart attack symptoms can begin slowly, building up over hours or days, particularly in women, or they can come on suddenly. The pain and discomfort associated with a heart attack do not resolve quickly or completely on their own, often continuing or worsening until medical intervention is received. While a panic attack can occur at rest or during stress, a heart attack is more likely to develop during or immediately following physical exertion, as the heart’s workload increases.
Emergency Response Guidelines
When confronting symptoms that could be either a panic attack or a heart attack, the safest course of action is to assume the most serious possibility. If the chest discomfort is prolonged, is accompanied by cold sweats, or radiates to the jaw or arm, call emergency services immediately. Do not attempt to drive yourself to the hospital, as this delays definitive care and puts others at risk.
While waiting for help, the individual should sit down, rest, and try to remain calm; any tight clothing should be loosened. If a heart attack is suspected and the person is not allergic to aspirin, they may be instructed to chew and swallow a 325 mg aspirin, which helps reduce blood clotting. If the symptoms are determined to be a panic attack, self-management techniques, such as controlled diaphragmatic breathing or grounding, can help the body exit the fight-or-flight response.