How you can tell if it’s a heart attack or anxiety

February 24, 2017 Allison Milionis

If your heart races and your palms get sweaty before a job interview or first date, your nerves are probably the culprit. But if an anxiety or panic attack produces symptoms that mirror those of a heart attack, take it seriously.

“Unfortunately it’s not clear cut for patients to decide for themselves if their symptoms are anxiety-related or not,” says Rachel J. Le, M.D., cardiologist at Providence Spokane Cardiology.

For that reason, it’s important that you talk to your provider if you regularly have anxiety or panic attacks.

What symptoms do heart attack and anxiety share?

  • Palpitations, pounding heart or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sense of shortness of breath or smothering
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Dizziness, unsteadiness, lightheadedness or faintness
  • Numbness or tingling sensations
  • Sudden fatigue

There can be subtle differences in symptoms. During an anxiety attack, you may feel:

  • A stabbing, needlelike pain
  • Pain and discomfort toward the center of your chest
  • A sense of dread or fear of dying

During a heart attack, you’re likely to feel:

  • Pain that is dull with heavy pressure
  • Pain in the center of your chest that may also radiate to your upper body (arms, shoulders or jaw)

Dr. Le adds that a racing heart brought on by anxiety tends to be a temporary condition. “The heart can race in response to specific triggers, like exercise or emotional stress. But with rest, heart rates should return to normal,” she says.

Be aware if you’re at risk

If you’re at risk for heart disease, don’t disregard new symptoms even if you think the symptoms could be related to anxiety or panic attacks, Dr. Le advises.  

If you’re not sure what the risk factors are for heart disease, the American Heart Association has a lot of helpful information.  

When it’s time to call 911

Don’t wait to get help if your heart starts racing or if you have a hard time breathing while you’re resting. Some heart attacks are sudden and intense. Others start slowly with mild pain or discomfort.

Call 911 if you feel:

  • Chest discomfort. It can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath. Trouble catching your breath can come with or without chest discomfort.
  • Other signs. These can include breaking out in a cold sweat, nausea or lightheadedness.

Rule of thumb: If you’re experiencing the symptoms of a heart attack, call 911. Don’t drive yourself or have a friend or family member drive you to the emergency department. The paramedics on an ambulance team will provide the best care. During a heart attack, every minute counts. If your heart stops on the way to the emergency department, paramedics are trained to revive you.

Symptoms same for women?

As with men, the most common heart attack symptom women have is chest pain or discomfort. Women, however, are more likely than men to experience other common symptoms, such as shortness of breath, nausea or vomiting, and back or jaw pain.

We wrote about heart attack warning signs in women in a recent post. The article includes an engaging “Go Red for Women” campaign video, featuring Elizabeth Banks.

The take away

If you’re not sure whether it’s anxiety or a heart attack, don’t waste time trying to figure it out yourself. Call 911. Time is critical when it comes to matters of the heart.

Don’t hesitate to talk to your provider if you’re having anxiety or if you have questions about your heart health.


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