What's the Difference Between a Panic Attack and a Heart Attack?

Symptoms like chest pain, shortness of breath, and a racing heart can be alarming and scary. These symptoms can be caused by various medical issues, including a heart attack, which is a medical emergency. But they can also be caused by a panic attack. While a panic attack can make you feel as though you’re in danger, it’s not a medical emergency. 

Although panic attacks and heart attacks may feel similar, they have different causes and treatments. In this article, we’ll go over panic attack vs heart attack symptoms and provide tips to help tell the two apart.

What Is a Panic Attack?

A panic attack is a sudden, intense episode of fear or anxiety. Panic attacks can cause anxiety symptoms like a sense of doom or a feeling of being out of control. They also cause physical symptoms such as shortness of breath, chest pain, and a rapid heartbeat. While panic attacks can come on out of the blue, they usually subside within 30 minutes.

When you have a panic attack, your fight-flight-freeze response is activated without there being a physical threat. This causes the body to release stress hormones. This response is designed to give your body the energy needed to run from, fight off, or hide from a threat. But when there is no threat, it results in unpleasant symptoms that may mimic the sensation of a heart attack.

What Is a Heart Attack?

A heart attack happens when blood flow to the heart is blocked or severely limited, meaning that part of your heart doesn’t get enough blood.

This blockage usually happens as a result of buildup in the arteries. Sometimes, a piece of this can break off and cause a clot that blocks blood flow. If this blood flow isn’t restored quickly, it can cause damage to part of the heart muscle.

Recognizing the Symptoms of a Panic Attack vs Heart Attack

Panic attacks and heart attacks share symptoms like chest pain and shortness of breath. However, they have some key differences. 

Panic Attack Warning Signs

Panic attacks can come on suddenly. However, some people notice signs beforehand. These can include quickened breathing, a feeling that something bad is about to happen, or an increased awareness of bodily sensations, like feeling your heart beating. Certain situations may also cause anxiety that triggers a panic attack, like being in a crowded location or being far away from home.  

Panic attacks can cause intense physical and emotional symptoms, but they are usually short, lasting from 5 to 20 minutes. Most panic attacks peak at 10 minutes. Physical panic attack symptoms include:

• Chest pain
• Shortness of breath
• Sweating and hot flashes
• Rapid heart rate
• Shaking or trembling
• Chills
• Upset stomach or nausea
• Tingling or numbness
• Dizziness or lightheadedness

Emotional panic attack symptoms include:

• Overwhelming fear
• A sense of doom
• Feeling like things aren’t real (derealization) 
• Feeling detached from yourself, like you are watching yourself from outside your body (depersonalization)
• A fear of losing control or dying

Heart Attack Warning Signs

While heart attack symptoms can come on suddenly, sometimes there are warning signs that can appear in the days or weeks before a heart attack. This might include chest pain that comes and goes, shortness of breath, lightheadedness, and fatigue. 

Classic heart attack signs include:

• Chest pain or pressure that radiates to the left arm or back
• Shortness of breath
• Sweating
• Nausea or vomiting
• Lightheadedness

It’s also important to note that women often experience different or more subtle heart attack symptoms. These include:

• Fatigue
• Indigestion or heartburn
• Neck or jaw pain
• Dizziness
• Cold sweats 

How to Tell Them Apart

The symptoms themselves, as well as their duration and onset, can provide clues to tell the difference between a panic attack and a heart attack.

Location and Type of Pain

Although both panic attacks and heart attacks can cause chest pain, people often provide different descriptions of this pain. Chest pain caused by a panic attack usually feels sharp or stabbing.

It may also be described as a fluttering sensation in the chest, like your heart is beating too quickly or skipping a beat. With a heart attack, the pain is often experienced as a crushing or squeezing sensation, like an elephant is sitting on your chest. Some people even find that it is similar to heartburn.

The location where the pain can be felt can also help to differentiate between a panic attack and a heart attack. Chest pain caused by a panic attack is usually localized to a particular area, often in the center of the chest. With a heart attack, the pain often spreads, radiating to the left arm, jaw, or upper back.

Duration and Onset

Panic attacks usually come on quickly or “out of the blue.”  Symptoms usually peak within 10 minutes and subside within 30 minutes. While you might experience some lingering anxiety, it’s not as intense.

With a heart attack, symptoms often develop more slowly and worsen over time, lasting for hours if left untreated. Some people also say that their heart attack symptoms come and go in waves, reducing and increasing in intensity, but never completely disappearing.

What you are doing when symptoms come on might help you distinguish between heart attack and panic attack symptoms. Heart attacks usually happen during physical activities like climbing stairs or shoveling snow. Panic attacks, on the other hand, can happen even when you are resting.

Accompanying Signs

Both panic attacks and heart attacks can cause shortness of breath, but the way this feeling presents can differ. With a panic attack, you’re more likely to hyperventilate, meaning that you are breathing quickly.

This can make it feel like you’re not getting in enough air or like you can’t catch your breath. You might also feel like you are choking or being smothered. With a heart attack, it might feel like you can’t get enough air in because of chest pain or tightness. This kind of shortness of breath won’t improve with calming breathing exercises. 

Symptoms can also help to tell the difference between a heart attack and a panic attack. A feeling of impending doom is associated with both heart attacks and panic attacks, but some people say that this feeling is different with a heart attack than when they are experiencing anxiety, because they don’t feel as panicked about it. On the other hand, panic attacks come with strong feelings of fear and anxiety.

They might cause specific fears, such as a fear of losing control, or sensations as though things aren’t real. 

When to Seek Emergency Care

It’s best to seek emergency care if you or a loved one is experiencing new or worsening chest pain. While it can be difficult to know if a heart attack is causing chest pain, it's always best to err on the side of caution.

Early treatment can help to ensure the best outcomes after a heart attack, and medical professionals would much rather send someone home who isn’t in immediate danger than have you not come in when you are experiencing a medical emergency. It’s recommended to call 911 rather than having someone else take you to the hospital, because an ambulance can provide treatment more quickly, while you are on the way to the hospital. 

If you call 911, stay on the line until the dispatcher tells you to hang up. This ensures that they have the correct information, and they can also provide you with first aid instructions. While you are waiting for help:

1. Move into a comfortable position to sit or lie down. Loosen any restrictive clothing or jewelry, especially around the chest and neck.
2. Unless you are allergic or otherwise advised by a doctor, chew two 81 mg Aspirin tablets.
3. Take nitroglycerin if prescribed.
4. If you are with someone having a possible heart attack, monitor their symptoms so that you can inform paramedics. If it is safe to do so, gather any medications that the person takes to inform healthcare professionals.
5. If the person loses consciousness or stops breathing, begin CPR. If you are not trained in CPR, use hands-only CPR.
6. If an automated external defibrillator (AED) is available, turn it on and follow the instructions to apply the pads. The machine will have voice prompts that guide you through how to use it. 

Getting Professional Help

It can be difficult to know if you are having a panic attack or a heart attack, so any new or worsening chest pain warrants a visit with a healthcare professional. Because a heart attack is an emergency medical situation, it’s important to discuss your risk with your doctor. They can help you identify and manage risk factors like high cholesterol, high blood pressure, smoking, and diabetes.

If panic attacks are the cause of your chest pain and other symptoms, you’re not alone. Up to 11% of people in the United States experience a panic attack each year. While they’re scary to experience, treatment can help reduce their frequency and intensity.

Medication or psychotherapy - or a combination of both - can be used to treat panic attacks. Healthy lifestyle changes like eating a balanced diet, participating in regular exercise, getting enough quality sleep, and managing stress are also important. 

References

Bayer Inc. (n.d.). What to do during a suspected heart attack. In Surviving a heart attack (Aspirin® Canada). Retrieved August 23, 2025, from https://www.aspirin.ca/en/surviving-a-heart-attack/what-to-do-during-heart-attack/

Beth Israel Deaconess Medical Center. (2020, February 1). Panic attack vs. heart attack: How to tell the difference. Wellness Insights. https://www.bidmc.org/about-bidmc/wellness-insights/heart-health/2020/01/panic-attack-vs-heart-attack

Cleveland Clinic. (2023, February 12). Panic attacks & panic disorder: Causes, symptoms & treatment. Cleveland Clinic. Retrieved August 23, 2025, from https://my.clevelandclinic.org/health/diseases/4451-panic-attack-panic-disorder

Cleveland Clinic. (2024, January 26). The difference between panic attacks and heart attacks. Health Essentials. https://health.clevelandclinic.org/the-difference-between-panic-attacks-and-heart-attacks

Mayo Clinic. (2024, May 9). Heart attack: First aid – basics. Mayo Clinic. https://www.mayoclinic.org/first-aid/first-aid-heart-attack/basics/art-20056679

Merschel, M. (2025, April 15). Call 911 for heart attack or stroke symptoms, or just drive to the ER? What doctors say you should do. American Heart Association News. Retrieved August 23, 2025, from https://www.heart.org/en/news/2025/04/15/call-911-for-heart-attack-or-stroke-symptoms-or-just-drive-to-the-er

Williams, C. S. (2022, July 13). How to tell the difference between a heart attack and panic attack. American Heart Association News. https://www.heart.org/en/news/2022/07/13/how-to-tell-the-difference-between-a-heart-attack-and-panic-attack