Is it a panic attack or a heart attack?

When your heart suddenly starts racing or you feel tightness in your chest, it’s natural to worry something serious is happening. Panic attacks and heart attacks can share many of the same symptoms, and in the moment it can be difficult — even impossible — to know which one you’re experiencing.

According to Dr. Seemal Mumtaz, a cardiothoracic surgeon with Sharp Community Medical Group and affiliated with Sharp Grossmont Hospital, understanding the patterns of each can help you know when to seek emergency care.

“Both conditions can feel overwhelming,” Dr. Mumtaz says. “The key difference is that a heart attack is caused by a physical blockage in the heart’s blood supply, while a panic attack stems from the body’s stress response. But if you’re ever unsure, it’s always safest to get checked because if it is a heart attack, time is of the essence to open up that blocked artery as quickly as possible”

What a panic attack feels like

A panic attack is a sudden surge of fear or discomfort that peaks quickly. Symptoms often include:

• Heart palpitations

• A racing heart

• Shakiness

• Shortness of breath

• Feeling disoriented

• Abdominal discomfort

“These symptoms can be powerful and very real,” Dr. Mumtaz says. “People often say they feel like something was terribly wrong with their heart, even though the heart itself is healthy.”

Panic attacks tend to come on abruptly, last for a short amount of time, and ease without treatment. While not dangerous, they can be frightening and may recur in times of stress.

What a heart attack feels like

A heart attack happens when blood flow to part of the heart becomes blocked. This is a medical emergency.

Common symptoms include:

• Chest pain and pressure

• Shortness of breath

• Nausea

• Cold sweats

• Shoulder or arm discomfort

• Pain in the upper abdomen

“A heart attack can have gradual onset of symptoms or the symptoms can develop suddenly,” Dr. Mumtaz explains. “But unlike a panic attack, the discomfort usually doesn’t fade quickly, and it usually worsens over time.”

Women in particular may experience less typical symptoms, such as fatigue, indigestion or back discomfort.

Key differences — and why they matter

Because panic attacks and heart attacks can share many of the same sensations, noticing how symptoms begin and how long they last can sometimes provide helpful context. Panic attacks often come on suddenly, feel intense right away and tend to pass within a short period. Heart attack symptoms may build more gradually and last longer, with chest discomfort that feels more like pressure or heaviness than sharp or fleeting pain.

Still, Dr. Mumtaz cautions that these general patterns aren’t reliable enough to make assumptions. “It can be very difficult to tell the difference based on symptoms alone,” she says. “If something feels new, severe or concerning, it’s important to seek medical care so you can be properly evaluated.”

What to do if you’re not sure

If you’re experiencing chest pain, significant shortness of breath, fainting or symptoms that don’t improve quickly, call 911 right away rather than driving yourself to the hospital. Stay as calm as possible and wait for emergency responders to arrive so you can be evaluated safely.

If your symptoms ease and you’ve previously been diagnosed with panic attacks, follow up with your doctor to talk through long-term management options, such as therapy, stress-reduction techniques or medication, if appropriate, to help lower the chance of similar symptoms returning.

Dr. Mumtaz says “Women’s heart attacks are much more likely to be mistaken for a panic attack, it is of utmost importance that women seek immediate care if they are having symptoms and have never had a panic attack before.”

Panic attacks and heart attacks can feel similar, but one is emotionally driven and the other is a true medical emergency. If you’re ever uncertain, it’s always safest to err on the side of caution.

“Your heart is too important to take chances with,” Dr. Mumtaz says. “If something doesn’t feel right, we would much rather see you, evaluate you and reassure you, than have you wait at home with symptoms that turn out to be serious.”

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