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by Reid Wilson, PhD, and Mark Pollack, MD
Panic attack or heart attack

Updated October 2020

Panic attacks and heart attacks can feel frighteningly similar: shortness of breath, palpitations, chest pain, dizziness, vertigo, feelings of unreality, numbness of hands and feet, sweating, fainting, and trembling. Some people describe this experience as feeling as if they’re losing control or going to die.

A panic attack occurs spontaneously or a stressful event can trigger it, but it poses no immediate danger. A heart attack is dangerous, and it requires prompt medical attention. In women, though, heart disease symptoms are sometimes mistaken for a panic attack.
Panic disorder is diagnosed in people who experience panic attacks and are preoccupied with the fear of a recurring attack. Like all anxiety disorders, this one is treatable.

Dr. Wilson offers this advice: For someone who has had a heart attack and also has panic attacks, together we identify, along with their physician, the symptoms that should trigger an immediate trip to the emergency room. Whether it turns out to be another panic attack or not, this person should treat those symptoms as a possible heart attack. He or she is to treat all other symptoms as signs of anxiety or a panic attack, even though they may feel like a heart attack.

Those who have never had a heart attack—but have been diagnosed with panic disorder and are fearful of a heart attack—should get a thorough physical evaluation to determine their heart health. If they are not at risk of a heart attack, then we begin the psychological work: They must be willing to be uncertain whether they are having a panic attack or a heart attack.

Their first goal is to respond to their typical anxiety or panic symptoms as anxiety or panic. Their position should be to say, ‘I want to recover from panic disorder strongly enough that I am willing to have a heart attack and miss it.’ That is how they will confront their need to be 100 percent certain.

Recent research suggests that people who have received a diagnosis of panic attacks or panic disorder under age 50 have an increased risk of developing heart disease or suffering a heart attack. The conclusions in this study are not definitive, and reasons for the increase in heart disease and heart attack were not established. More studies must be conducted to find out whether panic disorder is a risk factor for developing heart disease.

Dr. Pollack says the findings of this research offer some value. The study does suggest the possibility that, like other modifiable cardiac risk factors such as poor diet, sedentary lifestyle, or hypertension, treatment of panic and anxiety may have a beneficial effect on reducing the likelihood of developing heart disease.”
 
Whenever you’re in doubt about your symptoms, seek care without delay. Only medical tests can rule out the possibility of a heart attack. Once a heart attack is ruled out, seek effective treatment such as talk therapy and medication.


About the Authors

Reid Wilson, PhD and Mark H. Pollack, MD are both ADAA Clinical Fellows. 

Reid Wilson Ph.D. is Director of the Anxiety Disorders Treatment Center and is an international expert in the treatment of anxiety disorders, with books translated into nine languages. He is author of Stopping the Noise in Your Head: The New Way to Overcome Anxiety and Worry and Don't Panic: Taking Control of Anxiety Attacks (Harper) and Facing Panic: Self-Help for People with Panic Attacks (ADAA), is co-author, with Dr. Edna Foa, of Stop Obsessing! How to Overcome Your Obsessions and Compulsions (Bantam), is co-author, with Lynn Lyons, LICSW, of Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous & Independent Children (HCI Books) and of Playing with Anxiety: Casey’s Guide for Teens and Kids. He is co-author of Achieving Comfortable Flight, a self-help package for the fearful flier.  He designed and served as lead psychologist for American Airlines' first national program for the fearful flier. He serves as the Expert for WebMD’s Anxiety and Panic Community. His free self-help website – www.anxieties.com – serves 500,000 visitors per year. Television appearances include The Oprah Winfrey Show, The Katie Show, Good Morning America, and CNN. He has served as psychologist in an episode of A&E’s Hoarders. In 2014 he was honored with the highest award given by the Anxiety and Depression Association of America, and he was presented the 2019 Service Award by the International OCD Foundation.

Mark H. Pollack, MD, is the Chairman of the Psychiatry Department at Rush University Medical Center in Chicago, Illinois. He is a former President of the ADAA Board of Directors. Dr. Pollack’s areas of clinical and research interest include the acute and long-term course, pathophysiology, and treatment of patients with anxiety disorders and associated comorbidities, development of novel pharmacologic agents for mood and anxiety disorders, uses of combined cognitive-behavioral and pharmacologic therapies for treatment refractory patients, presentation and treatment of anxiety in the medical setting, and the pathophysiology and treatment of substance abuse.

I’m 26 years old I live in Homestead Florida my name is Kiara Cabrera I experienced a panic attack when I was smaller but now that I’m growing up I experience another type of Exide he attack that I had to call the ambulance I didn’t know what was going on I need help base on that the medicine that they gave me does not work how can I reach out to you for help

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