Panic Attack or Heart Attack? Understanding the Difference
In a discussion with Dr. Abhishek Shukla, Senior Geriatrician, Dr. Nirupma Jaiswal, MD Psychiatry (KGMC, Lucknow), explained an important medical concern. Many patients arrive at hospitals with complaints of severe chest pain, palpitations, breathlessness, and fear, believing they are having a heart attack. However, after evaluation, some of these episodes are found to be panic attacks rather than cardiac emergencies.
Dr. Jaiswal explained that panic attacks can closely resemble heart attacks, making it difficult for patients to differentiate between the two. A typical panic attack usually reaches its peak within minutes and often subsides within 30–40 minutes. Stressful thoughts, traumatic memories, or perceived threats can activate the amygdala, the brain's alarm center. This activates the hypothalamus, hippocampus, and brainstem, leading to the release of adrenaline and noradrenaline.
These stress hormones prepare the body to respond to danger. As a result, the heart beats faster, breathing becomes rapid, blood pressure may rise, and chest discomfort can occur. Muscles throughout the body become tense, sometimes causing significant pain. Reduced blood flow to the digestive system may lead to nausea, while some individuals experience feelings of unreality or detachment from their surroundings.
Patients experiencing recurrent panic attacks should seek medical evaluation to rule out heart disease and consult a psychiatrist when appropriate. Treatment may include medications such as sertraline, paroxetine, lorazepam, or alprazolam under medical supervision. Deep breathing exercises and relaxation techniques can also help by improving oxygen-carbon dioxide balance and reducing anxiety symptoms.
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