Key takeaways: 

  • Heart attacks and panic attacks have a lot in common, but they are different conditions.
  • Some of the risk factors are the same.
  • Medical tests can help determine what is causing your symptoms.
  • It is important to get emergency medical care for serious symptoms, like chest pain or shortness of breath, even if you think it may not be a heart attack.

It can be difficult to tell the difference between a panic attack and a heart attack because they have many symptoms in common. They also have similar risk factors, although some people are more likely to have a heart attack, while others are more likely to have panic attacks. We’ll go over what is the same, what is different, and what to do if you aren’t sure about your symptoms.

What do heart attacks and panic attacks have in common?

Heart attacks and panic attacks are two very different conditions that can seem similar. This is because they can both cause symptoms like:

  • Chest pain
  • Shortness of breath
  • Nausea
  • A sense of impending doom — a strong feeling that something awful is about to happen

In some cases, the symptoms can be so similar that it can be hard to tell whether you are having a panic attack or a heart attack.

Both heart attacks and panic attacks can have some of the same risk factors. For example, stress can cause both heart attacks and panic attacks. Anxiety is very common in people who have panic attacks and people with certain risk factors for a heart attack, such as heart disease.

What are the differences between a heart attack and a panic attack?

There are a few important differences between a heart attack and a panic attack: the cause of symptoms, the duration (or how long symptoms last), and who is more likely to have one or the other.

The cause of the symptoms is different

One of the major differences between a heart attack and a panic attack is the cause of the symptoms, or what actually happens in your body to trigger the attack. During a heart attack, there isn’t enough blood flowing to your heart. This strains the heart muscle and can lead to permanent damage. The reduced blood flow causes symptoms like chest pain and shortness of breath, and, with time, it can damage the heart muscle. Other common symptoms of a heart attack include nausea, pain in the left arm or jaw, and lightheadedness.

There are medical tests and procedures that can look at your heart to determine whether you are having a heart attack and whether your heart muscle has been damaged.

Although the symptoms of a panic attack can feel very similar to a heart attack, they are not related to decreased blood flow to the heart. In fact, the blood flow to your heart may be completely normal during a panic attack. Instead, panic attacks are caused by an exaggerated response of intense fear to things in the environment that would not normally cause that kind of reaction. Because the symptoms are not due to decreased blood flow to the heart, the results of medical tests during a panic attack are typically normal.

The symptom duration is different

Another important difference between a heart attack and a panic attack is how long the symptoms last. For a heart attack, the symptoms often last only minutes to a couple of hours. Chest pain from a heart attack may come and go, but is unlikely to happen day after day. Panic attack symptoms, on the other hand, usually last about 10 minutes, but may happen several times a day or for many days in a row. Some people deal with daily panic attacks; others have symptoms only a couple of times each year.

They tend to happen to different groups of people, but this isn’t an exact science

Heart attacks and panic attacks can affect anyone at any age, but some patterns hold true for everyone. Men and older people are more likely to have a heart attack, whereas women and younger people are more likely to have a panic attack.

That said, it depends on the individual. A person who has a mental health condition, like anxiety, depression, or post-traumatic stress disorder, is more likely to have panic attacks than is someone without one. But it is possible to have panic attacks and have heart disease. Likewise, a person can have a heart attack out of the blue, without having any known risk factors.

Is there a way to tell medically between a heart attack and a panic attack?

Medical professionals can sometimes use medical tests designed to check the heart for signs of damage to tell whether you’ve had a heart attack or a panic attack. These tests include:

  • Electrocardiogram (ECG): a heart monitor that examines the rhythm of your heart and can show if you are having heart attack or have had one in the past
  • Blood work: blood tests can show evidence of heart muscle damage
  • Echocardiogram: an ultrasound of your heart that looks at how well your heart muscle functions
  • Stress test: an exercise test that can show how your heart responds to stress
  • Cardiac catheterization: a test that looks at the blood flow to your heart and that can show if there is a part of your heart that is not getting enough blood flow

If someone has the common symptoms of a heart attack, but all of these tests are normal, it is likely that a panic attack caused the symptoms.

Can a panic attack cause a heart attack?

Although the symptoms of a panic attack usually are not due to changes in blood flow to the heart, anxiety can affect your blood pressure and heart rate in ways that increase your chance of having a heart attack. This is because panic attacks can temporarily increase your heart rate and blood pressure, and can cause your heart’s blood vessels to spasm. These temporary changes increase stress on the heart, which can reduce blood flow to the heart muscle. In someone with heart disease or risk factors for heart disease, these changes in blood flow could lead to a heart attack.

Common risk factors that might put someone at risk for a heart attack from a panic attack or other stressful situation include:

As we mentioned earlier, some of the risk factors for heart attacks and panic attacks are similar. Some studies have shown that people with frequent panic attacks, or a panic disorder, are more likely to have heart problems. This does not mean that panic attacks cause heart problems. It just means that there is a lot of overlap between the risk factors and symptoms of both conditions. People who are likely to have panic attacks are also likely to have heart problems, and vice versa.

What triggers a panic attack?

Nobody really knows the exact reason why some people get panic attacks. A panic attack happens when a person’s brain has an abnormal response to their environment, and the triggers that cause the reaction can be different for different people.

Some common triggers for panic attacks include:

Some people frequently get panic attacks. After experiencing several attacks, these people may eventually come to recognize and predict their triggers. For others, a panic attack can randomly happen only once or twice, without a known trigger.

Sometimes, medical conditions, medications, or substance use can trigger panic attacks. Medical conditions that can trigger a panic attack include:

  • Overactive thyroid
  • Low blood sugar
  • Post-traumatic stress disorder
  • Depression or another mental health condition
  • Inflammation of the inner ear, called labyrinthitis
  • A tumor, known as a pheochromocytoma, that causes increased stress hormones in your body

Medications that may trigger a panic attack include those used to treat asthma and some heart conditions. In some people, certain substances can trigger panic attacks. These include:

  • Caffeine
  • Alcohol
  • Nicotine
  • Illegal drugs

How to stop a panic attack

If you recognize that you are having a panic attack, there are a few things that you can do. First, try to get out of the situation that triggered the attack. Then, take slow deep breaths and try to calm down. Sometimes, talking to a trusted friend helps.

For repeat or frequent panic attacks, self-coping strategies, like meditation and mindfulness, can help you handle the attack. Mindfulness means recognizing your physical reaction and reminding yourself that there is no real danger. Talk therapy and anti-anxiety medications, or medications that help slow your heart rate, may help decrease the frequency of attacks.

When should you go to the ER for a panic attack?

If you have chest pain or shortness of breath, and this is the first time you have ever had these symptoms, you should go to the emergency room right away. The symptoms could be a panic attack, but they could also be a sign of several other serious medical problems, like a heart attack, an asthma attack, or a blood clot in the lungs. If you have never had a panic attack before, it is not safe to assume that these symptoms are from a panic attack. You should have an urgent medical evaluation to make sure that your symptoms are not from a life-threatening condition.

If you have had panic attacks in the past, but your symptoms seem different or more severe, you should also get emergency care. It is possible for a panic attack to lead to a heart attack or other serious heart problems. Emergency evaluation could help determine the cause of your symptoms, and your provider may be able to treat them so you feel better faster.

How to treat a heart attack

A heart attack is an emergency. If you think you or someone near you may be having a heart attack, call 911 right away. If not treated quickly, a heart attack can cause serious heart damage, cardiac arrest, or death. The sooner you get to a hospital, the sooner medical professionals can evaluate you and start lifesaving treatment if necessary.

The bottom line 

It can be difficult to tell the difference between a panic attack and a heart attack because many symptoms and risk factors are similar. Sometimes, how often symptoms happen and how long they last may suggest which condition is more likely — but not always. Heart attacks tend to be more common in men and older people, whereas panic attacks are more common in women and younger people, but both can happen to anyone at any age. In some people, panic attacks can lead to a heart attack, so it is always important to get emergency medical care for chest pain or shortness of breath.