Johns Hopkins Health Alerts | Heart Health | Differences Between a Panic or Anxiety Attack and a Heart Attack

Roger S. Blumenthal, M.D., medical editor of The Johns Hopkins Heart Bulletin, explains the importance difference between a panic attack and a heart attack.

Q. I had the shock of my life last week when I found my 58-year-old husband slumped over in his chair shortly after dinner. He had chest pain, a rapid heartbeat, shortness of breath, and he was sweating through his shirt. I called 911 and went with him to the hospital. The good news is that everything checked out OK. The strange news is that the doctor said he had suffered a panic attack, not a heart attack. What could be the problem? Our children are doing well in college, my husband owns his own business, and our lives are better than ever before. What kind of medical workup should he get so he can take steps to prevent another panic attack?

A. An acute anxiety attack, or panic attack, is a terrifying ordeal to experience. During a panic attack, a surge of fear overcomes the individual, often without any clear provocation. Many patients truly believe they are going to die, and some experience syncope, or fainting, as a reaction to this stressor.

The signs and symptoms of a panic attack are quite similar to those of a heart attack: palpitations, difficulty breathing, a sense of doom, lightheadedness, nausea, chest pain, and sudden chills. Unlike a heart attack, however, a panic attack is not medically dangerous.

Anyone diagnosed with panic attacks should be seen and evaluated by a psychiatrist who treats panic attack patients. Fortunately, panic or anxiety disorder is highly treatable. A type of therapy called "cognitive restructuring" helps people understand the nature of their symptoms, and many are greatly helped by understanding the diagnosis and learning to replace their maladaptive response with a clear recognition of what is happening to them. Cognitive therapy can help identify triggers, and can potentially lead to reduction in the frequency of panic attacks. Behavioral modification therapy and relaxation techniques are also used. In addition, anti-anxiety medications have been used with success.

Johns Hopkins Health Alerts | Heart Health | Differences Between a Panic or Anxiety Attack and a Heart Attack