How to tell difference between anxiety and heart attack

The symptoms of a panic attack and heart attack can be terrifyingly similar. How can you know the difference? Bailee Blackburn, M.D., a Piedmont primary care physician, shares the symptoms and triggers to watch for as well as when to seek medical care.

What is a panic attack?

“A panic attack is a sudden episode of intense fear or anxiety with associated physical symptoms that can last for several minutes up to an hour,” says Dr. Blackburn.

Panic attack symptoms can vary from person to person, but common symptoms include:

  • Chest pain

  • Being suddenly deeply fearful or anxious

  • Feeling a sense of impending doom

  • Pounding or racing heart

  • Shortness of breath

  • Trembling

  • Sweating

  • Stomach pain

  • Nausea

  • Chills

  • Numb or tingling hands

  • Feeling like you’re outside your body

What are the symptoms of a heart attack?

Heart attack symptoms include:

  • Chest pain or tightness, usually in the left side of your chest or under your breastbone

  • Shortness of breath

  • Jaw pain

  • Sweating

  • Arm pain

  • Nausea

  • Feeling a sense of impending doom

“As you can see, heart attacks and panic attacks can share a lot of commonalities in how they present, particularly when chest pain or shortness of breath is involved,” says Dr. Blackburn.

How to tell the difference between a heart attack and a panic attack

While it can be challenging to differentiate between a panic attack and a heart attack, here are a few things to watch for, particularly if you’ve experienced panic attacks in the past.

“Often, the chest pain with heart attacks is more of a pressure or squeezing, whereas a lot of people describe their chest pain in panic attacks as more of a sharp or shooting pain,” says Dr. Blackburn. “Also, the chest pain in a panic attack will completely go away in a few minutes once the attack passes. If you’re having a heart attack, the pain may change in intensity, but it usually won’t let up.”

Also, consider the potential trigger.

“Panic attacks usually have an emotional stress trigger, while heart attacks often are triggered by physical exertion,” she says.

When to seek medical care

“I would definitely seek medical care if you start developing any of these symptoms, particularly for the first time,” says Dr. Blackburn. “It can be difficult even for medical providers to tell the difference just on hearing your symptoms, so additional cardiac or lab testing is usually indicated to make sure we get the correct diagnosis and ultimately, treatment.”

She adds, “Don’t ever write off symptoms where your heart is concerned. Talk to your provider to make sure you are getting the care you need.”

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Are You Having An Anxiety Attack or A Heart Attack?

People who suffer from panic attacks often say their acute anxiety feels like a heart attack, as many of the symptoms can seem the same. Both conditions can be accompanied by shortness of breath, tightness in the chest, sweating, a pounding heartbeat, dizziness, and even physical weakness or temporary paralysis.

Perhaps most powerful, though, is the sense of dread that overshadows both events. The fear itself can lead to an increase in these symptoms.

Know the Difference Between Anxiety and Heart Attack

If you’re experiencing symptoms, call 911 immediately. While there are ways to determine the difference between a panic attack and a heart attack, a medical diagnosis is the only way to be sure.

What does a heart attack feel like?

Pay special attention to an episode that includes:

  • Chest pain or pressure.
  • Burning esophageal discomfort resembling indigestion.
  • Shooting or aching pain that moves down the arm.
  • Pain that travels into the jaw area.
  • Discomfort between the shoulder blades.
  • Vomiting.

These physical indicators can more clearly signal a heart attack.

It is especially important to be aware of your own heart attack risk factors. For example, if you’re a smoker with a family history of heart disease and have high blood pressure, you’re more likely to experience a heart attack.

What does anxiety chest pain feel like?

If, on the other hand, you experience chronic stress, suffered a recent traumatic event, or are having trouble coping with life’s ups and downs, you may be dealing with anxiety.

Symptoms of severe anxiety and panic often resemble a heart attack, which can worsen your distress. When anxiety feels like a heart attack, the panic can feel overwhelming. Luckily, when stressors go away, the symptoms usually do, too.

The effects of anxiety are different for everyone, and our response to anxiety can be situational. Here are some signs to look out for if you are experiencing anxiety chest pain symptoms:

  • Persistent dull aching.
  • Sharp, shooting, or stabbing pain.
  • Tightness, tension, or pressure.
  • Twitching spasms.
  • Numbness in certain areas.

Know the Correlation Between the Two Conditions

According to the American Heart Association, many mental health issues can affect your heart health. When your body is under stress, it produces higher levels of glucose, adrenaline, and cortisol. Repetitive or prolonged distress overworks your adrenal glands, heart, and arteries.

Unhealthy coping mechanisms, such as smoking cigarettes or eating fatty foods, can contribute to the negative cycle. If left unchecked, an unhealthy mental state can become another risk factor for heart attack.

Additionally, up to a third of all heart attack survivors experience depression. Anxiety and chest pain can trigger more panic, resulting in a potentially destructive cycle. Healthy mental and physical habits reduce the chances of anxiety and heart attacks.

Editor's Note: This gallery was originally published on February 16, 2018, and was last reviewed on September 2, 2022.

How do I know if its heart problem or anxiety?

The difference is that, when extra heartbeats in the upper and lower chambers are the cause of abnormal rhythm, symptoms may feel like an initial skip or hard thumping beat followed by a racing heart. When anxiety is the trigger, heart rate typically increases steadily rather than suddenly.

Can you confuse anxiety with heart attack?

Different Types of Anxiety Disorder Panic disorder – can be associated with cardiac disease or mistaken for heart attack. Feelings of extreme agitation and terror are often accompanied by dizziness, chest pains, stomach discomfort, shortness of breath, and rapid heart rate.

How can you rule out a heart attack at home?

Signs of a heart attack include: - Pain or discomfort in one or both arms, the back, neck, jaw or stomach. - Shortness of breath with or without chest discomfort. - Other signs such as breaking out in a cold sweat, nausea or lightheadedness. (If you're experiencing any of these symptoms, call 9-1-1 immediately.)

What is the difference between a heart attack and an anxiety attack?

Often, the chest pain with heart attacks is more of a pressure or squeezing, whereas a lot of people describe their chest pain in panic attacks as more of a sharp or shooting pain,” says Dr. Blackburn. “Also, the chest pain in a panic attack will completely go away in a few minutes once the attack passes.