Your chest is tight, your heart is racing, you’re sweating and you feel like you’re dying. Is it panic, or your heart? Here’s the honest answer, what to do right now, and what helps afterwards.
You can’t reliably tell a panic attack from a heart attack at home: the symptoms overlap, and even doctors need an ECG and blood tests. If you have chest pain, get emergency help now. Once your heart has been checked, repeated panic attacks can be treated.
Chest pain? Get help now. Call 112, or 767 in Lagos, or have someone take you to the nearest hospital emergency unit. Don’t drive yourself.
Why they’re so easy to confuse
Chest pain, breathlessness, a racing heart, sweating, nausea and dizziness can all come with either. The British Heart Foundation even lists suddenly feeling anxious, like a panic attack, as a less common heart attack symptom.
And heart attacks don’t always cause chest pain. In a large US registry, a third of people having a heart attack arrived at hospital without chest pain. That was more common in women, older people and people with diabetes.
Why there’s no safe home test
Doctors can’t rule out a heart attack from symptoms alone. They need an ECG, blood tests and sometimes more. Popular rules of thumb, such as “if it hurts when you press, it’s a muscle”, “sharp pain isn’t the heart” or “if the pain doesn’t spread, it’s panic”, aren’t safe ways to decide.
Heart attack warning signs
- Chest pain, pressure, tightness or squeezing that doesn’t go away.
- Pain spreading to the arms, neck, jaw, back or stomach.
- Shortness of breath.
- Sweating, feeling sick or light-headed.
- A feeling like bad indigestion.
- Pale or grey skin; on black or brown skin, it’s easier to see on the palms.
Women are more likely than men to have symptoms other than chest pain, such as breathlessness, nausea, back or jaw pain and unusual tiredness.
What to do: call 112, or 767 in Lagos, or get someone to take you to the nearest emergency unit straight away. Don’t drive yourself, and don’t worry about wasting anyone’s time.
What a panic attack is
A panic attack is a sudden surge of intense fear that peaks within minutes. It can bring a pounding heart, chest pain, breathlessness, shaking, sweating, dizziness, tingling, feeling unreal, and a fear of dying or losing control. Most last 5 to 20 minutes. The symptoms are real, caused by adrenaline and the body’s alarm system.
Panic is a common reason for chest pain in emergency departments. In a study at a heart hospital’s emergency department in Canada, about one in four people with chest pain had panic disorder, and almost none were recognised. But 44% of them also had known heart disease. Both can be true at once.
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Why getting checked matters in Nigeria
About one in three Nigerian adults aged 30 to 79 has high blood pressure, and only about one in nine of them has it under control. A national registry found that people having heart attacks in Nigeria are often relatively young city-dwellers, and that many arrive late: only about one in eight reached care within 12 hours. With a heart attack, every hour counts.
After your heart has been checked
If tests find no heart problem, that means the dangerous causes weren’t found. It doesn’t mean your symptoms were imagined: panic causes real physical symptoms. Ask the doctor what to do if it happens again, and get checked again for any new or different chest pain.
Panic attacks are very treatable. Talking therapy, especially cognitive behavioural therapy (CBT), is the recommended treatment, and even brief CBT started soon after an emergency visit has reduced panic in studies. A doctor may also offer medicine.
You can find a therapist who works with anxiety and panic, by video, voice or chat. Read more about panic disorder in Nigeria, anxiety’s physical signs, panic attacks and anxiety.
Frequently asked questions
How can I tell if it’s a panic attack or a heart attack?
You can’t safely tell at home. The symptoms overlap, and doctors need an ECG and blood tests to be sure. If you have chest pain, call 112, or 767 in Lagos, or get to the nearest emergency unit.
Can a panic attack feel like a heart attack?
Yes. Panic can cause chest pain, a racing heart, breathlessness, sweating and a fear of dying. That’s exactly why chest pain should always be checked.
Can anxiety cause chest pain?
Yes, but so can heart problems, and anxiety and heart disease can happen together. Get chest pain checked, especially if it’s new or different.
How long does a panic attack last?
Most panic attacks last 5 to 20 minutes, and some up to an hour. How long it lasts can’t tell you whether it’s panic or your heart.
Should I go to hospital for a panic attack?
Go for chest pain, breathlessness that doesn’t settle, fainting, a first attack, or anything that feels different. Once a doctor has diagnosed panic attacks, agree a plan for future ones.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
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