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Panic Attack vs. Heart Attack: Differences in Signs, Pain, & Risk Factors

Published: January 12, 2023 Updated: January 26, 2023
Published: 01/12/2023 Updated: 01/26/2023
Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD
  • Why Panic Attacks & Heart Attacks Feel SimilarWhy They Feel Similar
  • Symptoms of a Heart AttackHeart Attack Symptoms
  • Symptoms of a Panic AttackPanic Attack Symptoms
  • Heart Attack vs. Panic Attack: 5 Key DifferencesKey Differences
  • Risk Factors for Panic Attacks & Heart AttacksRisk Factors
  • Can a Panic Attack Cause a Heart Attack?Panic Attack Causing Heart Attack
  • When Should You Seek Medical Attention?Get Help
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Panic Attack vs Heart Attack InfographicsInfographics
Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD

A heart attack is an emergency that requires immediate medical attention, and a panic attack is a mental health issue that triggers powerful physical effects. Heart attacks are dangerous, and panic attacks are discomfort that one perceives as danger. Understanding the subtle differences between the two can prepare people for future episodes. Of course, when in doubt, never hesitate to seek emergency medical assistance.

A therapist can help you overcome your panic attacks. BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $60 per week. Complete a brief questionnaire and get matched with the right therapist for you.

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Why Panic Attacks & Heart Attacks Feel Similar

Panic attacks and heart attacks feel similar because they have a noteworthy overlap of symptoms and experiences. Whether symptoms are from panic or cardiovascular issues, someone may feel chest pain, shortness of breath, and an overall sensation of fear and distress. These two conditions display the powerful connection between physical health and mental health.

Symptoms of a Heart Attack

A heart attack is usually the result of heart disease involving a buildup of plaque inside a person’s arteries. These areas of plaque buildup can break open inside the blood vessel and form blood clots that block blood flow. When part of the heart does not get enough oxygen, a heart attack occurs.1,2

Although all heart attacks are dangerous, they can range in effects from very mild to extremely intense. Symptoms of a heart attack include:1,2

  • Chest pain and discomfort
  • Feeling weak, faint, or light-headed
  • Pain or discomfort in the jaw, neck, or back
  • Pain in the arms or shoulders
  • Shortness of breath, either before or during the chest discomfort
  • Indigestion and heartburn

Many women can have some additional symptoms of heart attack like nausea, vomiting, and unexplained tiredness.2,3

What Does a Heart Attack Feel Like?

Chest pain is the most common symptom of a heart attack, although about 33% of people note no pain at all during heart attacks.1 A heart attack can feel like a sudden discomfort, or it can slowly come and go over the course of several hours. Some people can report “silent heart attacks” that cause no obvious symptoms at all.1

Heart attacks will feel different for each person. Additionally, a person’s second heart attack may feel nothing like their first, so people must always consider their symptoms and experience. A heart attack can also feel differently based on your individual differences and co-occurring health issues. People with diabetes and high blood sugar at the time could report very mild or no symptoms, and women could experience extreme fatigue that lasts for days.1

Symptoms of a Panic Attack

A panic attack is a rush of intense fear and physical discomfort that peaks within a few minutes. It is a mental health event that has the power to greatly impact a person’s physical health. Although panic attacks are intense, shocking, and very scary, they rarely put the person in actual physical danger.4

Symptoms of a panic attack include:4

  • Heart palpitations, quicker heart rate, or pounding heartbeat
  • Sweating
  • Shaking
  • Feeling short of breath or choking
  • Chest pain or discomfort
  • Nausea and stomach pain
  • Feeling dizzy, light-lighted, or faint
  • Feeling chills or very hot
  • Feeling numb or tingly
  • Feeling detached from your body or reality (dissociation)
  • A fear of losing control or going crazy
  • Thoughts of dying

Panic attacks are frequently connected to panic disorder, but the event can occur when linked to other mental health conditions, like generalized anxiety disorder, phobias, and social anxiety disorder.4 Panic attacks may present at unexpected times and without a clear trigger. This aspect can make panic attacks challenging to track and to prevent.4 After panic attacks, people will begin to worry about the next one. They may also engage in a series of unhealthy coping skills in order to prevent future attacks.4

What Does a Panic Attack Feel Like?

Due to the sudden, unexpected, and intensity of a panic attack, it will often feel like an acute medical situation. Especially if someone hasn’t had a panic attack before, they could feel tremendous fear and uncertainty about what is happening to them, and they could assume the worst case scenario is happening.

The person may appear shocked and extremely worried about their state, and due to their shortness of breath, they could struggle to communicate clearly. They could feel like they need to lay down and fear that they are going to pass out or die.4 Panic attacks are awful, but they always have a clear beginning and end. No panic attack lasts forever, even though it may feel like it will.4

A panic attack is terribly draining both physically and emotionally, so the person may need to rest and take a nap following the experience. Once awake, the person may be happy they survived the attack, or they could start worrying about the next one.

What Happens to Your Heart Rate During a Panic Attack?

During a panic attack, cardiovascular effects are quite common. A person could note palpitations, a hard or thumping heartbeat, or a more rapid pace to their heart rate. Many people will see their heart rate increase dramatically. In some cases, it could surpass 200 beats per minute.5

Can a Panic Attack Cause Chest Pain?

One of the most common symptoms of a panic attack is discomfort or pain in the chest. Feeling intense pressure or weight on the chest is typical during a panic attack, and these effects can leave people sore afterwards.

Heart Attack vs. Panic Attack: 5 Key Differences

Heart attacks and panic attacks share many similarities: Both tend to come on suddenly and lead to effects like chest pain, worry, dizziness, and nausea—but focusing on the differences can help keep people informed and safe. The differences between heart attacks and panic attacks include the location of pain, the type of pain, the duration of the pain, and the triggers of the attack.

Here are five key differences between a panic attack vs. a heart attack:

1. Location of Pain

Both heart attacks and panic attacks involve chest pain, but the location of the pain will be slightly different:

  • In panic attacks, the chest pain will start in the center of the chest and stay there for the duration of the episode.
  • In heart attacks, the pain will start in the center of the chest before radiating to other areas. The jaw, neck, shoulders, and arms could be the center of the pain before the heart attack ends.5

2. How the Chest Pain Feels

The sensation of the pain will differ between the two attacks as well:

  • With heart attacks, the pain will resemble an intense pressure in the chest, and the person will often describe it as if an elephant is sitting on their chest. There could also be an achy or burning feeling in the chest.5
  • With a panic attack, the pain will be more sharp and stabbing. The racing heartbeat and pounding rhythm will be hard for many to detail and describe.5

3. Duration of Pain & Consistency

The onset, duration of the attack, and consistency of symptoms will help to separate heart attacks from panic attacks:

  • In panic attacks, episodes begin with a noteworthy surge of fear and discomfort. The symptoms peak after just a few minutes and last for a relatively short time.4
  • Heart attacks, on the other hand, can start slowly and have no notable symptoms, or they can be intense, remit, and then come back over the course of several hours. Panic attacks will not last for hours.1

4. Triggers

The triggers of panic attacks and heart attacks come from different sources:

  • Panic attacks can seemingly arise out of nowhere or be triggered by a source of fear. At times, attacks can occur at night. Nighttime panic attacks usually only happen in people with daytime panic attacks, too.5
  • Heart attacks tend to stem from physical activity or strain. If the episode presents when walking, working in the yard, or exercising, it’s more likely a heart attack.5

5. They Tend to Happen to Different Populations

While anyone could have a panic attack or a heart attack, there are risk factors that make it easier to determine the likelihood of either one:

  • Heart attacks tend to target people with several risk factors, like smoking, being overweight, and high blood pressure.
  • People with panic attacks may have other anxiety disorders, a family history of anxiety, and stressful life experiences.2,4

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Risk Factors for Panic Attacks & Heart Attacks

Risk factors will increase the chances of a panic attack or heart attack occurring. Some of these issues are controllable by the person, while others are completely beyond control. When people recognize the risk factors they can control, they can take steps to adjust their situations and reduce dangers.

Risk Factors of a Panic Attack

Like other conditions, panic attacks have various risk factors that interact to produce a tendency for the episodes to take place.

Risk factors for a panic attack include:4,6

  • Family history of anxiety and panic attacks
  • High levels of sudden or chronic stress
  • Previous traumatic experiences
  • High anxiety or having a diagnosed anxiety disorder, like PTSD or a phobia
  • Experiencing unwanted feelings
  • Cigarette smoking
  • Excessive caffeine consumption
  • History of physical or sexual abuse

In addition, once someone has one panic attack it seems to increase the risk of another one in the future.4

Risk Factors of a Heart Attack

Several lifestyle and physical health issues contribute to the risk of heart attacks. By addressing these changeable situations, someone could greatly reduce their risk.

Risk factors for a heart attack include:1

  • Smoking cigarettes
  • High blood pressure
  • High cholesterol levels
  • Being overweight or obese
  • Eating an unhealthy diet
  • Low levels of physical activity
  • High blood sugar

Other risk factors for heart attacks are outside of the individual’s control. These include:1

  • Age
  • Family history of heart attacks and heart disease
  • Infections
  • Preeclampsia

Having only one of these factors will contribute to increased risk, but when combined, the risk becomes much greater.

What About Heart Palpitations or Skipping Beats?

No matter the attack, the person will focus intently on their heart rate, rhythm, and strength of beat. Palpitations are strongly linked to panic attacks, but rather than having an association with heart attacks, palpitations are closely connected to arrhythmia, a type of heart disease that creates fluttering feelings in the chest.3

It is important to remember that a changing heartbeat could indicate a serious problem, or it could be related to diet, exercise, sleep, or stress. Whenever anyone has a concern about the state of their heart, they should follow up with a healthcare professional.

Can a Panic Attack Cause a Heart Attack?

Panic attacks can put increased strain and pressure on your heart, but this is unlikely to induce a heart attack. Of course, any time a person can take steps to reduce their stress, they lower their risk of either type of attack. When having a panic attack, people generally fear the worst. They worry that they are having a heart attack, that they’ll pass out, or that the panic attack will kill them. While it’s possible for those things to happen, those cases are incredibly rare.5

When Should You Seek Medical Attention?

If you feel uncomfortable, struggle to breathe, feel dizzy, or experience pain in your chest, seek immediate, emergency medical attention. The great news is that medical professionals are able to quickly and accurately diagnose a heart attack with a series of tests.1

Watch for Subtle Signs of a Heart Attack

Heart attacks may appear suddenly and without warning, but in other situations, there are subtle signs of a heart attack of which to be aware. Warning signs of a heart attack include:5

  • A pain in the shoulder
  • Pain in the neck or chest
  • Feeling “off” for a period
  • Increasing frequency or intensity of pain

These pains could be angina, which is a chest pain linked to heart attacks.

What Happens If I Go to the Emergency Room for a Panic Attack?

There is no harm in taking the extra precaution of going to the emergency room for a panic attack. Since people are so easily confused by panic attacks masquerading as heart attacks, emergency professionals become familiar with the issue.

The professionals can offer you education about the differences between the two attacks and offer medication to reduce symptoms. Hopefully during future incidents, you will be better able to discern a panic attack from a heart attack and employ mental health strategies to feel better.

If you need help from a mental health expert, seek out treatment for panic attacks as appropriate.

Final Thoughts

Heart attacks and panic attacks are each serious health episodes. One is dangerous, and the other triggers discomfort, so people should always do their best to learn the differences and follow the best course of action. When in doubt, though, head to the nearest emergency department to get the needed care. Always better to be safe with your health and well-being.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Talk Therapy

Online-Therapy.com – Get support and guidance from a licensed therapist. Online-Therapy.com provides 45 minutes weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get Started

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For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

Panic Attack vs Heart Attack Infographics

Symptoms of a Heart Attack Symptoms of a Panic Attack Heart Attack vs. Panic Attack: Key Differences

When Should You Seek Medical Attention?

6 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • National Heart, Lung, and Blood Institute. (n.d.). Heart Attack. Retrieved from https://www.nhlbi.nih.gov/health-topics/heart-attack.

  • Centers for Disease Control and Prevention. (2021, January 11). Heart Attack Symptoms, Risk, and Recovery. Retrieved from https://www.cdc.gov/heartdisease/heart_attack.htm

  • Centers for Disease Control and Prevention. (2020, January 31). Women and Heart Disease. Retrieved from https://www.cdc.gov/heartdisease/women.htm

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA.

  • Cleveland Clinic.(2021, April 2). How to Tell the Difference Between a Panic Attack and a Heart Attack: An Expert Explains which Signs to Look For. Retrieved from https://health.clevelandclinic.org/the-difference-between-panic-attacks-and-heart-attacks/

  • Mayo Clinic. (2018, May 4).Panic Attacks and Panic Disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021

update history

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

  • Originally Published: October 21, 2021
    Original Author: Eric Patterson, LPC
    Original Reviewer: Benjamin Troy, MD

  • Updated: April 7, 2022
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.

  • Updated: January 12, 2023
    Author: No Change
    Reviewer: No Change
    Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Added “Why Panic Attacks & Heart Attacks Feel Similar”, “What Happens to Your Heart Rate During a Panic Attack?”, “Can a Panic Attack Cause Chest Pain?”, and “Watch for Subtle Signs of a Heart Attack”. Revised “Heart Attack vs. Panic Attack: 5 Key Differences”. New material written by Eric Patterson, LPC, and reviewed by Kristen Fuller, MD.

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Headshot of Eric Patterson, LPC
Written by:

Eric Patterson

LPC
Headshot of Benjamin Troy, MD
Reviewed by:

Benjamin Troy

MD
  • Why Panic Attacks & Heart Attacks Feel SimilarWhy They Feel Similar
  • Symptoms of a Heart AttackHeart Attack Symptoms
  • Symptoms of a Panic AttackPanic Attack Symptoms
  • Heart Attack vs. Panic Attack: 5 Key DifferencesKey Differences
  • Risk Factors for Panic Attacks & Heart AttacksRisk Factors
  • Can a Panic Attack Cause a Heart Attack?Panic Attack Causing Heart Attack
  • When Should You Seek Medical Attention?Get Help
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Panic Attack vs Heart Attack InfographicsInfographics
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