Panic attack or a heart attack?

For women especially, the difference could be subtle. Know the signs.

It comes on out of nowhere: a terrible feeling of dread. You feel a sharp, stabbing pain in your chest. You feel like you can’t breathe and you start shaking. Your heart feels like it’s running a mile a minute.

Panic attacks can be terrifying. You may feel like you’re dying, even though you’re not in any real danger. If you’ve never had a panic attack, or even if you have, how do you know it’s not a heart attack?

Panic attacks can happen at any time, which makes them especially scary for people who experience panic disorder.

“Heart attacks and panic attacks have some symptom similarities,” said Janet Smith, M.D., cardiologist with Norton Heart & Vascular Institute. “Especially for women.”

Women, panic attacks and heart disease

Women are twice as likely as men to have a panic attack. Women also are more prone to migraines than men. One study found most women who have panic attacks suffer from migraines as well. Women who experience both had more frequent and longer-lasting panic attacks. Women over age 50 who have heart disease are more likely to have panic attacks as well.

As with panic attacks, women experience different heart attack symptoms than men. Because of this, women may not even know that anything is wrong. Women often explain away heart attack symptoms as acid reflux, the flu or aging, even though heart disease is the No. 1 killer of women in the U.S. Panic attacks can be another reason a woman may delay getting care.

Know the signs

Panic attack symptoms include:

  • Sense of dread or danger
  • Feeling like you’re losing control or might die
  • Rapid heart rate
  • Sharp or stabbing chest pain that lasts only 5 to 10 seconds
  • Shortness of breath
  • Pain that is localized to one small area
  • Pain after a significant stressor, anxiety or while you are resting
  • Pain that can be produced or worsened by pressing over the area of pain
  • Hot flashes
  • Chills
  • Trembling or shaking

Heart attack symptoms include:

  • Chest discomfort with heaviness, pressure, aching, burning, fullness or squeezing pain
  • Pain or discomfort in one or both arms, left shoulder, neck, back, throat, jaw or stomach
  • Shortness of breath
  • Sudden fatigue, weakness or lightheadedness
  • Nausea or vomiting
  • Cold sweat or perspiration
  • Unexplained anxiety
  • Heart palpitations or increased heart rate

If you experience panic attacks and have a risk for heart disease, talk to your doctor about what symptoms should immediately trigger a trip to the emergency department.

If you’ve never had a panic attack and you’re not sure? It’s better to be evaluated immediately — don’t explain away symptoms. Call 911 and be transported to the hospital via ambulance. That way, emergency medical responders can monitor you and provide important information to your emergency doctors. Every minute matters with a heart attack — time saved is heart muscle saved.


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