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How do I know if it’s anxiety or heart attack

How do I know if it’s anxiety or heart attack?

There is great crossover in the complaints of panic attack and heart attack making it challenging to differentiate between the two without full medical examination and special test like ECG and blood test (Troponin I).

What are the symptoms occur in both panic attack and heart attack?

It includes chest pain, shortness of breath, dizziness, sweating, shakiness, syncope, tingling or a sensation of impending doom.

There is some difference between the two cases:

Panic attack

  • Sharp stabbing pain in the middle of the chest.
  • Sudden onset or follow stressful event.
  • Pain that get better over time.
  • Symptoms that resolve in 20-30 minutes.
  • Shortness of breath.
  • Shakiness.
  • Hands tingling and palpitation.

Heart attack

  • Squeezing pain and pressure on the Chest, the pain radiating to arms, jaw and shoulder blades.
  • Sudden onset or onset during physical exertion as climbing stairs.
  • Pain that gets worse over time.
  • Longer lasting symptoms.
  • Shortness of breath.
  • Profound sweating.
  • Nausea and vomiting.

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The best predictor if the symptoms due to panic attack or heart attack are two:

  • The age, under 40.
  • The previous history of panic attacks.

Though if the patient is under 40 and has previous history of panic disorder is more likely to have panic attack than older people without history of panic attacks.

Heart attacks usually occur in middle-aged person and old age group, especially if they have coronary artery disease or they have risk factors such as hypertension, diabetes, obesity, hyperlipidemia or history of smoking.

If there is any suspicion, the patient should go to emergency to rule out heart attack because “time is muscle” in cardiology. If it is heart attack, the treatment will rescue the patient from catastrophic result in both short and long term.We could not deny the negative effect of stress on the heart because it produces high level of adrenaline, glucose and cortisol.

There is some correlation between severe stress and heart attack e.g. Takotsubo Cardiomyopathy. Anxiety and chest pain may trigger more panic attack and about one third of heart attack patients suffer from depression for some time. To reduce anxiety and heart attack, you should follow healthy mental and physical habits.

Patient with recurrent panic attacks should see a psychologist who can help them to overcome their anxiety and learn how they could relax and breath in good manner.

Know more about ischemic heart disease 


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