- Anxiety and heart attacks may cause similar symptoms, including chest pain, dizziness, and sweating.
- You're likely dealing with anxiety if you're under age 45 and have a low risk of heart disease.
- If you think you may be having a heart attack, it's best to get emergency care as a precaution.
Your chest hurts, and catching your breath suddenly becomes a struggle. You feel dizzy and hot all over. Your heart begins to pound, almost painfully, and the palms of your hands are slick with sweat. A feeling of doom might wash over you, leaving you convinced something terrible is about to happen.
You know something's wrong — but could the pain and tightness in your chest be a heart attack?
According to Ryan Sheridan, a psychiatric mental health nurse practitioner and former emergency room nurse in private practice, a heart attack can cause these symptoms — and so can anxiety.
Panic attacks, in particular, can closely resemble heart attacks. Many people having a panic attack go to the ER for this reason.
These symptoms can feel terrifying, especially if you don't know whether you're dealing with anxiety or having a heart attack. Below, find out how to tell the difference and what to do next.
Note: Medical experts can diagnose both panic attacks and anxiety, but many don't consider anxiety attacks a medical term. That's why anxiety attack definitions vary between people.
Signs of a heart attack
You can experience a heart attack at any age, but they occur most often in men over 45 and women over 55. If you're younger and don't have any risk factors for heart disease, you're more likely experiencing a panic attack.
That said, if you experience sudden shortness of breath, tightness or pain in your chest or shoulder, or dizziness for no apparent reason, head to the ER right away. With symptoms of a heart attack, it's always best to err on the side of caution.
The most common heart attack symptoms include:
- Chest pain: People often say this pain feels like tightness, pressure, or aching. You may also notice recurring chest pain weeks before an attack.
- Sudden soreness or pain elsewhere in your body: This pain may seem to move into your shoulder, back, arm, jaw, or teeth
- Trouble breathing: You may find it difficult to catch your breath.
- Nausea or vomiting
These symptoms may come on suddenly, or more slowly over a period of several hours.
Heart attacks can involve other symptoms, too. Women are more likely to experience atypical heart attack symptoms, which can include:
- Feeling short of breath or exhausted out of nowhere, like you've climbed several flights of stairs
- Sudden upper back or shoulder pain, like a crushing, too-tight hug
- Feeling lightheaded or dizzy
Signs of anxiety
Anxiety disorders like panic disorder and agoraphobia may also cause difficulty breathing, dizziness, nausea, and heart palpitations.
Other symptoms of both panic attacks and anxiety include:
- Chest pain
- Sweating
- Shaking
- A sensation of choking
- Feeling an intense sense of doom or like you might die
- Tingling and numbness in your hands and feet
These symptoms can mimic heart attack symptoms, with one key difference. They usually show up after you face an anxiety trigger.
For instance, if you barely avoided a car accident because a car cut you off, you may feel on edge for a while and notice symptoms like sweating, shaking, or lightheadedness.
Panic attacks may start suddenly — with or without an apparent trigger.
Note: Anxiety attacks might last for several hours, while panic attack symptoms usually peak in under 10 minutes and fade soon after.
Anxiety vs. heart attacks
During a heart attack, a blocked coronary artery can cause the same symptoms you'd get from fight-or-flight, says Dr. Sanul Corrielus, a board-certified cardiologist in private practice.
If your body can't get enough blood to your heart, this can trigger the symptoms of a heart attack. Reduced blood flow strains your heart and can severely damage the muscle.
To contrast, during an anxiety attack, your heart may race, but your heart muscle and blood flow function as they should. In short, your brain is to blame for your symptoms, not your muscles.
Experts theorize that an overactivation of your brain's fight-or-flight response triggers the release of stress chemicals to protect you. These chemicals help prepare you to move at a moment's notice, but they also may cause anxiety.
What to do next
"It's important not to minimize your symptoms, as this situation can escalate quickly. Don't hesitate to call 911," Corrielus says.
Even if you think your symptoms relate to anxiety, it's always wise to get checked out by a healthcare professional. Doctors at your nearest hospital can run tests to help diagnose your symptoms and recommend the right treatment.
Commonly used tests include:
- Electrocardiogram (ECG): An ECG analyzes your heart's rhythm to tell if you're experiencing a heart attack or if you've had one before.
- Echocardiogram: This ultrasound shows your doctor whether your heart is pumping blood effectively.
- Cardiac catheterization: This test involves placing a long, thin tube into your artery to examine your heart and look for limited blood flow.
- Blood test: Blood work can identify any heart damage and your future risk of heart attacks.
- Stress test: A stress test shows your practitioner how your heart functions during physical activity. Your doctor will have you wait to take this test until your symptoms improve.
As you wait for the ambulance or your ride to the ER, try slow, deep breathing to feel calmer and more in control, Sheridan says.
Quick tip: It's also a good idea to create a list of your current medications, recent major life events, and family history of heart disease, hypertension, or diabetes. If you're not feeling up to making the list yourself, consider asking a loved one for help.
Insider's takeaway
Anxiety conditions, including panic attacks, can often cause physical symptoms that resemble a heart attack.
If you're under age 45 and have no risk factors for heart disease, you're most likely dealing with anxiety — but it's always best to call 911 if you have any doubts at all.
Your symptoms may be due to anxiety, but a trained healthcare professional can make the right diagnosis and recommend the most helpful treatment.
Cassandra Miasnikov Cassandra Miasnikov is a writer specializing in positive psychology and women's health. Her work has been featured in publications including NAMI, Thrive Global, and the International Bipolar Foundation. Cassandra received her Bachelor's in Literature and New Media at UC Santa Barbara and studies Clinical Psychology at the graduate level at Pepperdine University.Cassandra has earned the 20 Under 40 Award in Washington, Oregon, and Idaho. She is a Lead Presenter for NAMI's Ending the Silence campaign, where she teaches middle and high schoolers about mental health.Cassandra is the founder of Selene Marketing, crafting content and websites that help socially conscious entrepreneurs build a brighter tomorrow. She lives in the Pacific Northwest, where she spends her free time playing electric guitar, reading too much high fantasy, and info dumping about Marvel comics. You can connect with Cassandra on LinkedIn. Read more Read lessncG1vNJzZmivp6x7o8HSoqWeq6Oeu7S1w56pZ5ufonyowcidnKxnmJqurcDHaJqoppSewaq7zaxkrLGdpcGwudJomKewmZrBunnVrGShnZGnwW6t062YnKM%3D