Distinguishing Panic Attacks from Heart Conditions

Heart conditions, including chest pains and short breaths often march hand-in-hand with panic attack signs, which are dizziness and heart palpitations. And this is scary because both situations can become fatal. What makes diagnosing medical illnesses even more troublesome is that the symptom sets overlap so considerably. This can be very fatal as urgent cardiac care can be delayed or unwarranted anxiety treatments are applied. There must be differences between them, which the medical personnel and the patients should be aware of. 

Heart Conditions: 

Heart conditions can range from angina, arrhythmias, and heart attacks resulting from impairments of the cardiovascular system due to physical problems. Common heart  conditions include: 

Pain or feeling tightness in the chest. Most patients who suffer from it say that the feeling is more of a pressure. 

• Trouble in breathing 
• Irregular heartbeats 
• Dizziness or lightheadedness 
• Nausea, sweating 

These symptoms of potentially fatal heart diseases are usually misdiagnosed as panic attacks when they may not be; this is particularly hazardous in emergency settings wherein diagnoses need to be done quickly enough for treatment. 

Panic Attacks:  

Panic attacks are intense episodes of fear or anxiety with characteristic physical symptoms including: 

• Racing or pounding heart 
• Chest pain that stabs or pierces 
• Hyperventilation, dyspnea 
• Heavy perspiration, shakiness
• Dizziness, sense of impending doom 

Anxiety attacks are not diseases of the heart, which can kill. Attacks last for 10–20 minutes and symptoms resolve spontaneously. Even though symptoms are quite severe in many patients, most are afraid they are having an attack. 

The Challenge of Differential Diagnosis 

Panic attacks and heart conditions such as heart attacks have the same symptoms, which can include chest pain, shortness of breath, palpitations, dizziness, and sweating. What varies is the cause. 

• Panic Attacks: They are due to the generation of the fight-or-flight response in the body, usually because of stress or anxiety. These are acute conditions, sudden, peaking in minutes, and associated with a feeling of impending doom. 
• Heart Attacks: Due to blockage of coronary arteries; decreased blood supply to the heart. It only worsens with time if not treated appropriately. 
• Chest Pain: In anxiety, pains are usually sharp because of hyperventilation. Heart attacks usually cause a squeezing or pressure-type sensation because of decreased blood flow. 
• Palpitations: Both conditions may cause the patient to complain of a racing heart;  etiologies would be different. 

Read More: A Guide to Handling Panic Attacks, According to Psychologist

Differences in Signs and Symptoms 

1. Chest Pain 

Chest pain differs significantly between panic attacks and heart attacks, which is a crucial factor in distinguishing the two. During a panic attack, the pain is typically sharp, stabbing, or transitory and does not usually radiate to other parts of the body. In contrast, chest pain associated with a heart attack is often described as pressure-like, squeezing, or heavy, and it frequently radiates to other areas such as the arm, neck, jaw, or back. Understanding these distinctions can be essential for timely and accurate diagnosis.

2. Duration 

Panic attacks typically resolve within 20-30 minutes without requiring medical intervention, while heart attacks involve symptoms that evolve and persist, necessitating emergency treatment in a hospital setting.

3. Cause 

The cause of a panic attack can occur at rest, during stressful situations, or sometimes even without any apparent reason. In contrast, a heart attack typically occurs during or shortly after physical exertion, especially in individuals who have predisposing risk factors for heart disease.

4. Accompanying Symptoms 

A panic attack is typically associated with tingling in the hands or feet, depersonalization, and an overwhelming sense of fear. In contrast, heart attack symptoms may include vomiting, nausea, and fatigue. Women, in particular, may experience atypical symptoms, such as unexplained tiredness and mild pressure in the chest.

Read More: What are Nocturnal Panic Attacks?

Problems with Diagnosis 

Common Mechanisms 

Anxiety causes elevated blood pressure and stress hormones. This temporarily disturbs the normal functioning of the heart. The presence of anxiety caused by heart conditions  also makes diagnosis complicated. 

Bias in Diagnostic Practices 

In the younger patients and women with or without a history of anxiety disorders,  symptoms often are blamed on panic attacks where heart problems may still exist. 

Emergency Stress 

Included, in the acute medical differential, would be fatal conditions such as MI. In such  a case the exclusion of preliminary work-up appearing normal often include ECGs or  routine blood work mean symptoms may improperly have been contributed to anxiety.

• Unnecessary tests: Patients get subjected to costlier invasive procedures. 
• Misdiagnosis: Symptoms are attached and, subsequently, delay mental health without  seeking treatment. 
• Pushed off/Not being treated seriously: Patients and therefore will not be seeing  doctors anytime soon 
• Delayed Treatment: Anxiety symptoms diagnosed that could be lethal for a heart  condition 
• Increased Anxiety: Extended symptoms of not knowing and not clear about one’s health  raise the emotional suffering of a patient.

Read More: What is the Difference Between Panic & Anxiety?

How to Differentiate 

1. Clinical Assessment 

The duration of symptoms differs between a panic attack and a heart attack. A panic attack typically worsens and then improves within minutes, while a heart attack’s symptoms may continue to worsen over time, requiring urgent medical attention. The type of chest pain also varies: heart-related pain often radiates to the arm, neck, or jaw and is described as a sharp, stabbing sensation, while chest pain from an anxiety attack tends to be localized. Anxiety attacks are usually triggered by tension or emotional stress, whereas heart attacks are typically triggered by physical exertion, especially in individuals with risk factors for heart disease.

2. Diagnostic Tools  

Electrocardiograms (ECGs) are used to identify conditions that may affect the heart, such as arrhythmias. Troponin levels are elevated when the heart muscle is damaged, helping diagnose heart-related issues. Stress tests evaluate how the heart functions under physical stress, providing insight into its performance during exertion. These diagnostic tools are crucial for distinguishing between heart-related conditions and other issues that might cause chest pain or discomfort.

Overcoming Misdiagnosis 

1. For Health Professionals

In-depth Training: It’s essential to provide mental health professionals with comprehensive training on diagnosing panic disorders. This training should include recognizing the signs and symptoms, understanding the causes, and being familiar with the most effective diagnostic tools. A well-trained professional will be more equipped to accurately diagnose and treat individuals suffering from panic disorders.

Stringent Evaluation: When evaluating a patient for panic disorders, it is crucial to rule out any underlying somatic (physical) conditions that may mimic or contribute to the symptoms. A careful and thorough assessment of psychogenic (mental or emotional) factors will help differentiate panic disorders from other potential medical conditions.

Emotional Expression in Communication: When interacting with patients, it is important to reassure them and create an open and trusting environment. Clear communication about the diagnostic process, including any assessments, tests, or treatments, will help reduce anxiety and confusion. A compassionate, empathetic approach can also ease the emotional burden on the patient, making them feel supported throughout the diagnosis and treatment process.

2. For Patients 

Self-Learning: It’s important to educate yourself about the symptoms and triggers of panic attacks. Understanding the warning signs, such as rapid heart rate, difficulty breathing, or feelings of impending doom, can help in recognizing a panic attack early. Additionally, identifying triggers—such as stressful situations, specific phobias, or certain environmental factors—can empower individuals to manage and avoid potential attacks.

Advocacy: If symptoms persist or worsen, it is crucial to seek another opinion from a healthcare professional. Getting a second opinion ensures a more comprehensive understanding of the condition and can provide alternative treatment options if the current approach is ineffective. Advocacy for oneself is key to finding the most appropriate care and support.

Counseling: Providing access to a qualified counselor who specializes in anxiety and panic disorders is essential for long-term management. Counseling can offer strategies for coping with anxiety, identifying irrational fears, and developing healthy thought patterns. Regular sessions can help individuals gain better control over their emotions, reduce the frequency of panic attacks, and prevent them from reoccurring. 

Effects of Misdiagnosis over Time 

Misdiagnosis may create very profound physical and psychological impacts: 

On Panic Disorders: Persistent checking of the heart may generate even more anxiety,  which is vicious. 

For Heart Conditions: He may be charged with the costs or even death owing to the time  wastage in undertaking the life- saving treatment over his heart attack because of his  wrong diagnosis about suffering from an anxiety attack. 

Panic Disorders Treatment 

If panic attacks are diagnosed then the above treatment can prevent and avoid relapses: 

Therapy: CBT through the physician informs the patients with the thought procedure that  leads him to anxiety. 

Lifestyle Changes: Exercise, diet, and sleep ward off anxiety.

Stress Management: Meditation, yoga, and deep breaths calm the individual down. 

When Anxiety Accompanies Heart Disease 

Chronic anxiety is harmful to the heart disease that already exists. So, the treatment of  both has to be concurrent. Stress hormones, such as cortisol, elevate blood pressure and  strain the heart gradually. In this scenario, cardiologists and mental health practitioners need to be involved in a multidisciplinary manner. 

Conclusion 

This is such an overlap between panic attacks and heart conditions that it poses  diagnostic challenges of major proportions for profound implications on the health and  well-being of the patient. The major challenge would be the risk of delayed treatment, undue testing, and emotional  distress from a misdiagnosis. Improvement of diagnostic accuracy would be possible in  a team approach between cardiologists, psychologists, and the physicians. Educating the  patient with knowledge regarding their symptoms and encouraging better awareness  among the healthcare professionals can offer timely and proper care. Distinguishing panic  attacks from heart conditions is a step toward more compassionate and comprehensive  healthcare. 

FAQs 

1. What is the sign that the chest pain I experience is a panic attack or heart  condition? 

Panic Attack: Painful or constricting, along with an anxiety attack, racing heart, or  sweating. This lasts for between 10-30 minutes and tends to abate. 

The chest pain, typically, can be described as heavy, crushing, or quite tight and, possibly  radiates into the arm, neck, or jaw but isn’t exacerbated by rest alone but rather  aggravated on exertion by the patient. 

2. Can an attack burn my heart permanently?

Most of the times, attacks actually cause no kind of injury on the heart, but increase its  rate and the elevation of the blood pressure. Stress and chronic anxiety contribute in the  long haul to heart diseases. 

3. What is panic attack and what is an episode of a heart condition?

Panic Attack: Stress, anxiety, or phobias; or being in an overwhelming situation.  Heart condition: Physical exercise, hypertension, bad dieting, or underlying heart  problems. 

4. Does anxiety eventually lead to heart disease? 

Unless managed properly, chronic anxiety or repeated attacks can lead to hypertension,  arrhythmias, and even the development of heart diseases. 

5. What do I do during an attack to calm myself? 

Deep breathing: Breathe in for 4 seconds, hold for 4 seconds, breathe out for 4 seconds. 

Grounding: Concentrate on the grounding technique by writing down what is within your  environment. 

Remember it is temporary and not fatal. 

6. Can a panic attack coincide with a heart condition? 

Yes. The chance of a panic attack happens when someone with a heart condition is  distressed or frustrated so that diagnosis and treatment can be complicated. 

7. What lifestyle changes are likely to be preventative for both panic attacks and  heart conditions?

All of the above may improve the overall health of the heart, thereby indirectly lowering  anxiety: regular exercise, healthy diet, stress management, such as yoga and meditation,  adequate sleep, smoking avoidance, alcoholism or use, etc.