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Am I Having a Panic or Heart Attack?

For people who have never had a panic disorder, the first panic attack can be very frightening. Often, it is difficult to tell the difference between a heart attack and a panic attack, especially if there has been no prior history of either. In fact, one in five people who go to the emergency room for chest pain end up being diagnosed with a panic attack.1

Both panic and heart attacks can result in numbness of the hands and feet, sweating, dizziness, shortness of breath, and fainting. So what distinction can be made between the two?

Panic attacks and panic disorders

Chances are, you know someone who either has a panic disorder or experiences panic attacks. One in three people has a panic attack at some point in their life.1 Panic attacks are much more common than panic disorders. Panic attacks start off as a sudden, discrete feeling of intense fear and last for a few minutes, and in some cases, an hour. On the other hand, panic disorder is defined by recurrent panic attacks, in addition to intense fears of having subsequent attacks.

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The median age for the first panic attacks is 24 years old, which differs from the average age of a heart attack which is approximately 65 years old.2 Panic attacks are twice as common in women as they are in men. This is the opposite of heart attacks, where men have twice the risk compared to women.

Differences

The symptoms of a panic attack can overlap with those of a heart attack, but there are differentiators between the two.3

Chest pain

Chest pain is a common complaint for people who experience panic attacks. Hyperventilation during an attack results in chest pain, and sometimes even EKG changes. However, in panic attacks, the pain is often sharp and stabbing. In a heart attack, the pain is more of a squeezing-type pain with pressure.

Duration

In a panic attack, symptoms typically resolve within a few minutes, or at most 1 hour. On the other hand, with a heart attack, the pain gets progressively worse and can radiate to the jaw, shoulder, and arm.

Activity

Heart attacks can develop when someone is physically exerting themselves, such as going up a flight of stairs. On the other hand, panic attacks typically occur at rest.

The role of stress

Can you get a heart attack from a panic attack? The short answer is not directly. However, anxiety can increase the risk of heart attacks in the long run. This is because anxiety results in an increase in the stress hormone cortisol.

For example, one study in the United States followed 34,000 males with healthcare careers over a 2 year period. The men were between the age of 42-77 years old and had no heart disease at the beginning. By the end of the study, it was found that the risk of fatal heart disease was three times higher in those who reported anxiety compared to those with low levels of anxiety.4

Do you experience panic attacks? If so, were you able to distinguish your first panic attack from a heart attack? Share your experiences below!

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