Heart Attack or Panic Attack - which is which? – Dr Wendy Davis ND

Heart Attack or Panic Attack - which is which?

What may look and feel like an apparent heart attack may actually be a panic attack, and knowing the difference is very important.

When a heart attack starts, blood flow to your heart has suddenly become blocked and the muscle can't get oxygen. If not treated quickly, the muscle fails to pump and begins to die.

A panic attack typically comes on abruptly, producing intense anxiety, fear and a sense of impending doom that is typically disproportionate to the situation at hand. Panic attacks tend to peak within 10 minutes, and most subside within 30 minutes.

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 minutes. 

The pain associated with a panic attack tends to be sharp and stabbing in the center of the chest, localized to one small area, typically lasting only up to 10 seconds.

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. It can also manifest as nausea.

Symptoms of a Heart Attack:

  • Chest pain or discomfort - Upper body discomfort - Nausea
  • Shortness of breath - Breaking out in a cold sweat - Sudden dizziness
  • Anxiety - Hot flashes - Sensation of a lump in the throat - Heart burn
  • Unusually tired - Lightheadedness

Symptoms of a Panic Attack:

  • Hyperventilation - Chest pain - Heart palpitations
  • Trembling - Sweating - Nausea - Dizziness

Although the two may seem completely different, research has shown that there are several reasons to consider that a relationship between panic disorder and coronary artery disease (CAD) might exist.

First, panic disorder has been linked to other forms of cardiac disease. Second, the most likely source of the chest pain during panic attacks is ischemia. Finally, there is evidence that panic disorder may be associated with cardiovascular risk factors, such as hypertension, hyperlipidemia, and smoking.

Not that I want to add to your stress, BUT overall, patients with panic disorder were between 80% and 91% more likely to also have coronary heart disease. Patients diagnosed with both panic disorder and depression were, on average, 260% more likely to develop coronary heart disease than patients without those mental health problems.

On the flip side, research published in 2017 also points out that "Anxiety and its associated disorders are common in patients with cardiovascular disease and may significantly influence cardiac health.

A breathing exercise that can help quell anxiety and panic attacks helps retain and gently accumulate carbon dioxide (CO2), leading to calmer breathing and reduced anxiety. In other words, the urge to breathe will decline as you go into a more relaxed state (a modern method similar to breathing into a paper bag).

Take a small breath into your nose, a small breath out; hold your nose for five seconds in order to hold your breath, and then release to resume breathing.

Breathe normally for 10 seconds.

Repeat the sequence several more times: small breath in through your nose, small breath out; hold your breath for five seconds, then let go and breathe normally for 10 seconds.

As for heart attacks, your best course of action is to take proactive measures to prevent them. According to a 2015 study, more than 70% of heart attacks could be prevented by implementing:

  • A healthy diet (and no seed oils)
  • Normal body mass index (ideally under 30)
  • Getting at least 2.5 hours of exercise each week and reducing screen time to less than 7 hours per week
  • Avoiding smoking and limiting alcohol to one drink or less per day
  • And 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 as can Magnesium deficiency.