Panic attacks and heart attacks can feel almost the same, and even experts say the two are hard to tell apart. If you have chest pain or aren’t sure what’s happening – call 911 and let professionals check. A heart attack is an emergency. Medcanvas Psychiatry helps with panic once your heart is cleared.
It’s late at night. You wake up with your heart pounding so hard you can feel it in your throat.
Your chest is tight. Your hands are tingling. You can’t catch your breath, and there’s this awful feeling that something is very, very wrong.
Is it your heart? Is it anxiety? You’ve had panic attacks before. Or maybe you haven’t, and that’s what makes this so scary.
Here’s the honest answer up front. You can’t reliably tell from the inside. Doctors have trouble telling them apart without tests. So if you’re ever in doubt, treat it as an emergency.
At Medcanvas Psychiatry in Minot, North Dakota, we help people with panic disorder every day. But the first rule is simple: rule out the heart. Let’s walk through how these two overlap, how they differ, and what to do next.
Why Do They Feel So Similar?
Because the body’s alarm system looks the same from the inside.
Cleveland Clinic lists chest pain or pressure, a pounding or racing heart, sweating, shortness of breath, nausea, and a feeling of impending doom as symptoms that show up in both. The article says they “can feel similar,” and that it “can often be difficult to tell the difference.”
Nebraska Medicine explains the cause. A heart attack happens when blood flow to part of the heart is blocked. A panic attack is the body’s fight-or-flight response switching on when there’s no real danger.
Two very different things. One scary set of sensations.
How Can They Differ?
There are patterns. But please read these as clues, not a test you can run on yourself.
| Heart Attack | Panic Attack | |
| Chest pain | Pressure, squeezing, or aching; may feel like heartburn | Often sharp or stabbing; sometimes hard to describe |
| Where it spreads | Can reach the arm, jaw, neck, shoulders, or back | Usually stays in the chest |
| How long | Doesn’t resolve; may ease and return in waves | Often a few minutes, up to about an hour |
| What sets it off | Often physical exertion; sometimes preceded by days or weeks of warning chest pain | Usually emotional stress |
| Breathing | Shortness of breath | Trouble breathing |
| Sweating and nausea | Cold sweats, nausea or vomiting | Sweating, stomach pain, or nausea |
Source for the table: Cleveland Clinic.
Nebraska Medicine adds that panic attacks come on suddenly and peak in about five minutes. Heart attack symptoms generally worsen over time, though some start suddenly and severe. And they note that heart attack symptoms typically last until treated, while panic symptoms can last from a few minutes to several hours.
Panic attacks can also bring shaking, trembling, weakness, and dizziness. Heart attacks can bring lightheadedness or faintness.
Notice how many of those overlap. That’s the point. Even the “differences” have exceptions.
What About Women?
Worth a mention. Nebraska Medicine says women often have vaguer heart attack symptoms, like extreme fatigue, dizziness, nausea, and upper back pain. They may mistake these for heartburn or a stomach problem.
Its advice: if something just feels “off,” get checked.
It also notes that women report panic attacks more than twice as often as men do.
So, What Should You Do?
Short answer: don’t gamble.
Cleveland Clinic puts it plainly. “A heart attack is a medical emergency. A panic attack isn’t.” Its advice is to seek immediate medical care if you have heart attack signs or aren’t sure which you’re having. And: “Don’t take chances.”
Nebraska Medicine says to seek emergency care right away for chest pain or other unusual symptoms with no clear cause. It also says to call 911 rather than driving yourself, so emergency crews can start treatment on the way.
So here’s the plan:
- If it’s chest pain or you’re unsure, call 911.
- Don’t drive yourself.
- Don’t wait to see if it passes.
- Tell them about any past panic attacks, heart history, and medications.
If it turns out to be a panic attack, you’ve lost an afternoon. If it was your heart, you may have saved your life. That’s a trade worth making.
And a history of panic attacks doesn’t mean this time can’t be your heart. Always check.
What If It Was Panic?
Then you’ve got a real condition that deserves care, not a shrug.
Cleveland Clinic says panic attacks aren’t life-threatening, but they interfere with your quality of life and mental well-being. It also says that if a racing heart during panic happens regularly, it’s worth getting medical care.
You might also notice:
- You’re afraid of the next attack
- You avoid places or activities because of it
- You can’t relax in your own body
- You’ve gone to the ER more than once
- Panic is hurting work, school, or relationships
When attacks keep coming and fear of them starts shaping your days, that can point to panic disorder, which is treatable. (This is general information and isn’t a diagnosis.)
Can Panic Be Treated?
Yes. Nebraska Medicine says treatment can teach you to recognize an oncoming attack and use skills to ease it. It may not prevent every attack but it can reduce their severity, frequency and duration.
It also suggests self-talk during an attack: remind yourself you’re having a panic attack, it will pass, and you’re okay. That works best when you’ve been medically cleared and know what your episodes look like. If you’re not sure, go back to the plan above.
Care can include therapy, medication or both, depending on you.
When Should You See Someone?
Consider reaching out if:
- You’ve had repeated panic attacks
- You’ve been cleared by a doctor but still fear the next one
- You’re avoiding things you used to do
- Your sleep, work, or relationships are suffering
- You feel on edge most days
- You’re using alcohol or other substances to cope
If you’re ever thinking about harming yourself, call or text 988 any time. For chest pain or any possible heart emergency, call 911.
How Medcanvas Psychiatry Can Help
At Medcanvas Psychiatry, we treat anxiety, panic disorder, depression, PTSD, social anxiety, and generalized anxiety, for patients ages 6 to 70.
We don’t replace emergency care or a cardiology workup. If you’re having chest pain, call 911. But once your heart’s been checked, we can help you understand panic and build a plan. Because we coordinate with other providers, we can work alongside your primary care doctor or other clinicians.
Learn more about us, see our services, look at the conditions we treat, or read more on our blog.
FAQs
How can I tell the difference?
There are clues, like pain spreading to the arm or jaw, or onset after exertion, but they overlap. Don’t rely on them alone.
How long does a panic attack last?
Often a few minutes, up to about an hour, though it can feel longer.
Can panic disorder be treated?
Yes. Treatment can reduce how severe, how frequent, and how long attacks are.
Is a panic attack dangerous?
Cleveland Clinic says panic attacks aren’t life-threatening, but they can seriously affect your life.
Are You Ready to Talk About Panic?
If your heart has been checked and the attacks keep coming, we’re here.
- Book an appointment
- Call 701-963-6917
- Email contact-us@medcanvaspsychiatry.com
- Visit 104 20th Ave. SW, Suite 4, Minot, ND 58701
- Telehealth available
