How to Tell the Difference

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A pounding coronary heart. Chest ache. Shallow, quick breath. Dizziness, nausea, and chilly sweats. Having one (or all) of those signs is sufficient to set off some alarm bells in your head. Am I simply anxious, or is that this one thing extra?

The very fact is, it may be onerous to inform the distinction between a panic assault and one thing extra, like a coronary heart assault. “The signs of panic assaults and coronary heart assaults closely overlap, and it is fairly widespread for individuals having panic assaults to worry they’re having a coronary heart assault, particularly if it is their first panic assault,” says Kiki Fehling, PhD, a licensed psychologist in Boston, Massachusetts.

Fehling ought to know. She really had a coronary heart assault that she initially mistook for a panic assault. “I solely knew one thing was significantly unsuitable when my signs didn’t subside even after practising a number of anxiety-reducing coping expertise,” she explains. (Fortunately, she acquired assist in time and was efficiently handled.)

Backside line: If a psychological well being skilled can get the 2 confused, anybody can. Fortuitously, with the data and instruments to reply to each, you possibly can inform the distinction and get the provide help to want.

Right here, be taught extra concerning the distinction between coronary heart assaults vs. panic assaults, and remedy for each.

What are the indicators of a panic assault?

For some individuals, one of many first indicators they’re anxious is a pounding coronary heart and chest ache or discomfort. They could even really feel like their coronary heart is racing. This will trigger fear that there is one thing unsuitable along with your coronary heart, which creates extra worry, and finally ends up making signs worse, says Ileana Piña, MD, a heart specialist with Jefferson Well being in Philadelphia and a member of the American Heart Association’s National Hispanic Latino Cardiovascular Collaborative.

The above are widespread panic attack symptoms. They don’t seem to be life-threatening, and may trigger different signs like the next, per the National Institute of Mental Health (NIMH):

  • Sweating
  • Chills
  • Trembling
  • Bother respiration
  • Dizziness
  • Weak point
  • Numbness or tingling
  • Nausea or abdomen cramps

Many of those signs can strike throughout a coronary heart assault, too, says Dr. Piña. And in that case, they may very well be lethal. “So we at all times suggest that if you happen to’re unsure, the perfect factor to do is to go to the ER,” she provides.

How lengthy do panic assaults sometimes final?

Panic assaults can really feel like a tsunami. They usually hit rapidly with out a lot warning and may ease up virtually as quick. “Bodily signs normally peak and subside inside 10 minutes,” Fehling says.

Chest ache from a coronary heart assault, however, may ease up for a brief interval. But it surely’ll preserve coming again till you are handled, per the American Heart Association (AHA). It additionally tends to worsen as you exert your self.

“Bodily signs of a panic assault normally peak and subside inside 10 minutes.” –Kiki Fehling, PhD, psychologist

What are the indicators of a coronary heart assault?

In line with the AHA, the most typical indicators of a coronary heart assault are:

  • Chest ache that begins within the middle of your chest that may additionally really feel like strain, squeezing, or fullness (“It usually seems like an elephant sitting in your chest,” says Dr. Piña)
  • Ache that radiates out elsewhere, together with one or each arms, your again, neck, jaw, or abdomen
  • Shortness of breath
  • Chilly sweats
  • Nausea
  • Dizziness or lightheadedness

Chest ache is the most typical coronary heart assault symptom for most individuals. However ladies usually tend to produce other crimson flags like nausea or fatigue, which might get chalked as much as one thing else. “Girls’s signs are likely to get written off as being too emotional,” says Dr. Piña. “Their signs additionally typically get attributed to indigestion or a pulled muscle as a substitute,” she provides.

How you can inform the distinction between a coronary heart assault and a panic assault

To be sincere, it is not at all times simple (or totally doable) to inform the distinction between a panic assault and coronary heart assault.”[Both] can overlap a lot that even docs can not inform the distinction with out working medical checks,” Fehling says. “So if somebody has regarding signs it is higher to be protected and get evaluated on the ER.”

That stated, there are clues you possibly can decide up on, per Fehling and Dr. Piña:

  • Severity of chest ache: Chest ache from a coronary heart assault tends to hit tougher and is extra noticeable after you have exerted your self, whereas chest ache from a panic assault is not affected by your bodily exercise degree. “If sitting and doing nothing makes it higher, it may very well be your coronary heart,” says Dr. Piña.
  • Ache location: The place you are feeling the ache can consider, too. Whereas each panic assaults and coronary heart assaults could cause ache within the middle of your chest, it could radiate outwards to your arm, again, shoulder, or jaw throughout a coronary heart assault, per the Cleveland Clinic. That will not occur throughout a panic assault although.
  • Size of time: Remember the fact that you need to begin to really feel higher inside 10 minutes or so after a panic assault strikes, however coronary heart assault signs will not go away (and should worsen) till they’re handled.

One other factor to bear in mind: Whereas emotional stress is extra more likely to set off a panic assault, over time, nervousness and stress can increase your coronary heart assault threat, too. Actually, a February 2023 examine within the Journal of the American Heart Association discovered that folks with melancholy are practically twice as more likely to have a coronary heart assault in comparison with individuals with out melancholy.

Remedy for panic assaults

“Panic assaults are quite common and never harmful,” Fehling says. And if it solely occurs as soon as, you do not essentially have to get remedy. However frequent or regular panic attacks may very well be an indication of a sure sort of tension referred to as panic dysfunction, per the NIMH.

Panic issues can really feel debilitating and intrude along with your on a regular basis life, so it is essential to succeed in out for assist from a licensed psychological well being skilled. Therapists will usually use cognitive behavioral remedy (CBT) because the go-to method.

“CBT helps individuals overcome panic by educating them coping expertise and serving to them higher perceive the connection between their signs, feelings, ideas, and behaviors,” Fehling says. “Most individuals who obtain CBT for panic dysfunction stay panic-free for years after remedy,” she provides. Different varieties of remedy for nervousness might embrace EMDR or a trauma remedy referred to as brainspotting.

There are additionally sure nervousness and antidepressant medicines that could be useful in treating your panic dysfunction, per the Mayo Clinic. Discuss to your physician about these choices and whether or not you would be a very good candidate for them.

When you’re in the course of panic assault? Making an attempt strategies like deep breathing, mindfulness, counting out loud, or reciting optimistic affirmations may also help shorten or cease it.

Remedy for coronary heart assaults

Coronary heart assaults occur when a blockage in a number of of your coronary heart’s arteries reduces or stops blood circulate to the center. This lack of blood circulate deprives your coronary heart of oxygen, which might trigger a part of the center muscle to die, per the Mayo Clinic.

The one option to resolve that is with emergency remedy to take away the blockage and get a daily quantity of blood flowing again to the center. This may be carried out with heart medications to dissolve the clot or by way of surgical procedure, per the AHA.

It is also essential to protect your heart from future coronary heart assaults with quite a lot of way of life modifications, together with the next, per the Mayo Clinic:

  • Consuming a balanced eating regimen stuffed with heart-healthy foods
  • Getting loads of train
  • Quitting smoking and limiting alcohol consumption
  • Decreasing stress
  • Sustaining a wholesome weight on your physique measurement and form
  • Managing underlying circumstances like hypertension and diabetes
  • Taking remedy as prescribed
  • Going to the physician frequently for checkups

What to do in case you have a coronary heart assault

When you or somebody you understand thinks they’re having a coronary heart assault, name 911 instantly and get to the closest ER. “It is so significantly better to get to the hospital the place they may also help differentiate your signs,” says Dr. Piña. “You do not wish to be sitting on a foul occasion that would value you your life,” she provides.

When you’re ready for an ambulance, comply with any directions from the 911 operator, which can embrace taking aspirin or nitroglycerin (if prescribed), and beginning CPR or utilizing a defibrillator, if you happen to referred to as on behalf of somebody having a coronary heart assault, per the Mayo Clinic.

When to see a physician

Though a panic assault will not hurt your bodily well being, having them regularly can take a severe toll in your psychological well being. So it is a good suggestion to provide your physician a heads up, even if you happen to’ve solely had one. Collectively you possibly can determine in case your signs are anxiety-related and resolve if it is price speaking with a psychological well being skilled.

FAQ

Why does your coronary heart race at night time?

Your heart may race at night from stress, nervousness, or melancholy, says Fehling. Some individuals may also get nocturnal panic assaults, which might stir you out of your sleep (and don’t have any apparent set off), per the Mayo Clinic.

Nighttime heart palpitations may also occur from consuming caffeine or alcohol earlier than mattress. In some instances, they may very well be pushed by an underlying well being situation like a thyroid dysfunction or heart disease, per the Cleveland Clinic. So if the issue is occurring frequently, it is a good suggestion to get it checked out.

What are the various kinds of panic assaults?

Psychological well being specialists categorize panic assaults into two essential sorts. Cued panic assaults hit after you have been uncovered to a daunting or triggering state of affairs, based on the American Psychological Association. You might need one, for example, if it’s important to give a speech and are petrified of public talking. Typically simply serious about a set off can cue up a panic assault.

Un-cued or sudden panic assaults, however, really feel like they hit out of the blue and don’t have any identified set off, the APA says. They’ll occur through the day or at night time.

Each sorts will be handled with discuss remedy, remedy, or a mixture of the 2.

How are you going to rule out a coronary heart assault at dwelling?

Sadly, you possibly can’t. Chest ache can have a variety of doable causes, however the one option to affirm that it is not from a coronary heart assault is by going to the hospital. So if you happen to’re unsure what you are coping with, do not take an opportunity. Name 911 and go to the ER as quickly as doable.


Nicely+Good articles reference scientific, dependable, current, strong research to again up the data we share. You’ll be able to belief us alongside your wellness journey.


  1. Kwapong, Yaa A et al. “Affiliation of Despair and Poor Psychological Well being With Cardiovascular Illness and Suboptimal Cardiovascular Well being Amongst Younger Adults in the US.” Journal of the American Coronary heart Affiliation vol. 12,3 (2023): e028332. doi:10.1161/JAHA.122.028332


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