Inform the Distinction

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 laborious 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 folks 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 incorrect when my signs didn’t subside even after practising a number of anxiety-reducing coping expertise,” she explains. (Fortunately, she obtained assist in time and was efficiently handled.)

Backside line: If a psychological well being skilled can get the 2 confused, anybody can. Happily, with the information and instruments to answer each, you may inform the distinction and get the assist you want.

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

What are the indicators of a panic assault?

For some folks, one of many first indicators they’re anxious is a pounding coronary heart and chest ache or discomfort. They might even really feel like their coronary heart is racing. This could trigger fear that there is one thing incorrect 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 Coronary heart Affiliation’s Nationwide Hispanic Latino Cardiovascular Collaborative.

The above are widespread panic assault signs. They don’t seem to be life-threatening, and may trigger different signs like the next, per the Nationwide Institute of Psychological Well being (NIMH):

  • Sweating
  • Chills
  • Trembling
  • Hassle respiratory
  • 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 could possibly be lethal. “So we all the time advocate that when you’re unsure, the most effective factor to do is to go to the ER,” she provides.

How lengthy do panic assaults usually final?

Panic assaults can really feel like a tsunami. They usually hit shortly 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. Nevertheless it’ll maintain coming again till you are handled, per the American Coronary heart Affiliation (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 accordance with the AHA, the most typical indicators of a coronary heart assault are:

  • Chest ache that begins within the heart of your chest that may additionally really feel like strain, squeezing, or fullness (“It usually appears 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 girls usually tend to produce other pink flags like nausea or fatigue, which may 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.

inform the distinction between a coronary heart assault and a panic assault

To be trustworthy, it is not all the time straightforward (or completely potential) 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 assessments,” Fehling says. “So if somebody has regarding signs it is higher to be secure and get evaluated on the ER.”

That mentioned, there are clues you may choose 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 stage. “If sitting and doing nothing makes it higher, it could possibly be your coronary heart,” says Dr. Piña.
  • Ache location: The place you’re feeling the ache can think about, too. Whereas each panic assaults and coronary heart assaults could cause ache within the heart of your chest, it might 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 it is best 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 prone to set off a panic assault, over time, anxiousness and stress can elevate your coronary heart assault danger, too. In reality, a February 2023 examine within the Journal of the American Coronary heart Affiliation discovered that folks with melancholy are almost twice as prone to have a coronary heart assault in comparison with folks with out melancholy.

Therapy 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 must get therapy. However frequent or common panic assaults could possibly be an indication of a sure sort of hysteria referred to as panic dysfunction, per the NIMH.

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

“CBT helps folks 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 forms of remedy for anxiousness may embrace EMDR or a trauma remedy referred to as brainspotting.

There are additionally sure anxiousness and antidepressant medicines which may be useful in treating your panic dysfunction, per the Mayo Clinic. Speak to your physician about these choices and whether or not you would be a superb candidate for them.

If you happen to’re in the midst of panic assault? Attempting strategies like deep respiratory, mindfulness, counting out loud, or reciting constructive affirmations can assist shorten or cease it.

Therapy 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 move to the guts. This lack of blood move deprives your coronary heart of oxygen, which might trigger a part of the guts muscle to die, per the Mayo Clinic.

The one technique to resolve that is with emergency therapy to take away the blockage and get a daily quantity of blood flowing again to the guts. This may be completed with coronary heart medicines to dissolve the clot or through surgical procedure, per the AHA.

It is also essential to guard your coronary heart from future coronary heart assaults with quite a lot of life-style adjustments, together with the next, per the Mayo Clinic:

  • Consuming a balanced weight loss plan stuffed with heart-healthy meals
  • Getting loads of train
  • Quitting smoking and limiting alcohol consumption
  • Lowering stress
  • Sustaining a wholesome weight in your physique measurement and form
  • Managing underlying circumstances like hypertension and diabetes
  • Taking treatment as prescribed
  • Going to the physician frequently for checkups

What to do when you’ve got a coronary heart assault

If you happen to or somebody you recognize 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 can assist 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, when you referred to as on behalf of somebody having a coronary heart assault, per the Mayo Clinic.

When to see a health care provider

Although a panic assault will not hurt your bodily well being, having them ceaselessly can take a critical toll in your psychological well being. So it is a good suggestion to present your physician a heads up, even when you’ve solely had one. Collectively you may work out in case your signs are anxiety-related and resolve if it is value speaking with a psychological well being skilled.

FAQ

Why does your coronary heart race at night time?

Your coronary heart might race at night time from stress, anxiousness, or melancholy, says Fehling. Some folks 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 coronary heart palpitations may also occur from ingesting caffeine or alcohol earlier than mattress. In some instances, they could possibly be pushed by an underlying well being situation like a thyroid dysfunction or coronary heart illness, per the Cleveland Clinic. So if the issue is going on frequently, it is a good suggestion to get it checked out.

What are the several types of panic assaults?

Psychological well being specialists categorize panic assaults into two most important varieties. Cued panic assaults hit after you have been uncovered to a daunting or triggering scenario, based on the American Psychological Affiliation. You might need one, as an illustration, if you need to give a speech and are fearful of public talking. Generally 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 will occur through the day or at night time.

Each varieties may be handled with speak remedy, treatment, or a mix of the 2.

How will you rule out a coronary heart assault at residence?

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


Nicely+Good articles reference scientific, dependable, current, strong research to again up the data we share. You possibly can 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 USA.” Journal of the American Coronary heart Affiliation vol. 12,3 (2023): e028332. doi:10.1161/JAHA.122.028332


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