Panic attack or heart attack? Knowing the difference

Always rule out the heart first

If you have chest pain and are not sure what it is, call your emergency number: 999 in the UK, 112 or 999 in Ireland, 998 or 999 in the UAE, 911 in Canada. Do not rely on an article to tell a heart attack from panic. South Asian people have a higher risk of heart disease, so it is especially important to take chest symptoms seriously.

Signs that suggest a heart problem

Seek urgent help if chest pain:

• feels like pressure, squeezing or heaviness;
• spreads to the arm, jaw, neck, back or stomach;
• comes on with exertion;
• comes with sweating, nausea, breathlessness or feeling very unwell;
• lasts more than a few minutes or keeps coming back.

Signs more typical of panic

Panic attacks often:

• come on suddenly, sometimes at rest or in a stressful moment;
• peak within around ten minutes and then ease;
• include tingling in hands or around the mouth;
• come with a strong fear of dying or losing control;
• happen repeatedly with similar symptoms, after the heart has been checked and found healthy.

There is overlap, which is exactly why medical checks matter.

After you have been checked

Once a doctor has examined you, and tests such as an ECG show your heart is healthy, repeated similar episodes are very likely to be panic. At this point, going to A&E every time can actually keep panic going, because each visit reinforces the belief that the sensations are dangerous.

Talk to your doctor about a plan: which new symptoms should prompt urgent care, and which familiar symptoms are panic you can manage.

Getting treatment for panic

CBT teaches you to understand panic sensations and stop fearing them. Read more in panic disorder. Many people who once rushed to hospital regularly find panic becomes manageable within months.

Questions people ask

How can I tell if it is a panic attack or a heart attack?

You cannot be sure without a medical check. Chest pain that spreads to the arm or jaw, comes with exertion or lasts more than a few minutes needs urgent care.

Should I go to A&E for a panic attack?

If you are unsure, especially the first time or with new chest pain, yes. Once your heart has been checked, agree a plan with your doctor for repeat episodes.

Can panic attacks show on an ECG?

A panic attack may show a fast heart rate but not the changes seen in a heart attack. An ECG helps doctors rule out heart problems.

Are South Asian people at higher risk of heart disease?

Yes, people of South Asian heritage have higher rates of heart disease, which is why chest symptoms should always be taken seriously.

Can anxiety cause chest pain every day?

Ongoing anxiety can cause chest tightness and muscle tension. Have it checked by a doctor first, then treat the anxiety.

What does panic chest pain feel like?

Often sharp or stabbing, or a tight band, sometimes with tingling and breathlessness. But heart pain can vary too, so get checked.

Do panic attacks raise blood pressure?

Blood pressure and heart rate rise temporarily during panic, then settle. This is not the same as long-term high blood pressure.

Can young people have heart attacks?

It is less common but possible. Do not assume chest pain is panic because of your age; seek help if unsure.

Why do I keep going to hospital with chest pain when tests are normal?

Repeated normal tests with similar episodes usually point to panic. Therapy can break this cycle.

What should I tell the doctor about my panic attacks?

Describe the symptoms, how quickly they start and stop, what you were doing, and how often they happen. Ask what signs should prompt urgent care.