Can Anxiety and Panic Attack Cause a Heart Attack?

The heart beats suddenly at an increasing rate, you feel chest pain and shortness of breath. Are you currently experiencing a heart attack or is it an anxiety attack? “Any of these symptoms can be significantly frightening,” explains Dr. Michael Jonash, a senior cardiologist and cardiovascular catheter.

Although the two phenomena often share similar symptoms and feelings, the cause of the event is very different between them, as well as the duration of the symptoms and of course their effect on us. Here are some important things to know about the differences between the two and who is more likely to get one or the other.

1. The cause of the symptoms is different

   One of the main differences between a heart attack and an anxiety attack is the cause of the symptoms. During a heart attack, the blood supply to the heart muscle is impaired. Reduced blood flow causes symptoms such as chest pain and shortness of breath, and over time it can damage the heart muscle. Other common symptoms of a heart attack include nausea, pain radiating to the jaw or back arm and dizziness.

   Although the symptoms of anxiety and panic attack can feel very similar to a heart attack, they are not related to a decrease in blood flow to the heart. In fact, blood flow to the heart is completely normal during a panic attack. Instead, panic attacks are caused by an excessive response of intense fear to things in the environment that would not normally cause such a response. The physiological response results from a rapid and powerful release of specific stress hormones in the body that are supposed to protect us from the stressful event, in the mechanism of “fight or flight” – This basic physical reaction is often accompanied by accelerated heartbeat, chest pain and shortness of breath. Because the symptoms are not due to a decrease in blood flow to the heart, the results of medical tests during a panic attack are usually normal.

2. The duration of symptoms varies

   Another important difference between a heart attack and an anxiety attack is how long the symptoms last. For a heart attack, the symptoms usually last for minutes to several hours. Chest pain from a heart attack may come in rising and falling waves, but are unlikely to occur day after day. In a heart attack when the pain has started with significant exertion, it can improve slightly at rest. Pain from a heart attack that appears at rest in general will get worse over time and will not go away on its own. Anxiety attack symptoms, however, usually last about 10 minutes, but may occur several times a day or for many days in a row. Chest pain in an anxiety attack will usually improve or even go away on its own within about 20 minutes.

3. Different factors in different populations

   A heart attack caused by a decrease in blood flow in the coronary arteries results from the development of atherosclerosis along with a component of a local blood clot in the artery. Atherosclerosis develops gradually over the years, even if the person does not feel the symptoms at all. The first manifestation of developing atherosclerosis over the years can be a sudden and sudden heart attack!

   There are many risk factors for developing atherosclerosis – smoking, diabetes, hypertension, hyperlipidemia, family genetic history and more. Of course, in populations where these risk factors exist, the likelihood of pain resulting from a heart attack is generally higher.

   At the same time, it is important to note that sometimes the person (who has not been tested in advance) is unaware of the development of atherosclerosis in the body, sugar levels, blood lipids and blood pressure, hence a heart attack can certainly appear in a “healthy” person.
   
   An anxiety attack on the other hand can occur at any age in any situation and without any background illnesses.

4. Is there a way to medically distinguish between a heart attack and an anxiety attack?

   “If there is a doubt – no doubt! In any event significant chest pain with accompanying symptoms – should be examined immediately and treated,” explains Dr. Jonash. It is more necessary especially in women as the symptoms of a heart attack can be unconventional (without typical angina) and the manifestation can be more minor and appear as fatigue, nausea, heartburn, etc. Therefore it is necessary to be tested!

   Medical professionals use medical tests designed to test the heart for signs of damage to know if you have had a heart attack or a panic attack. These tests include:

   A. Electrocardiogram, ECG: A heart monitor that monitors your heart rate and can show if you have had a heart attack or have had one in the past
   B. Blood test: Blood tests can show evidence of damage to the heart muscle
   third. Cardiac echo: An ultrasound of the heart that examines the general and regional heart function.
   D. Cardiac catheterization: A test that examines the blood flow to the heart and can show if there are blood vessels in the heart that do not receive a blood supply. If such is found – it is possible to “fix” it immediately and resume blood flow.

5. Can Anxiety and Panic Attack Cause a Heart Attack?

   Although the symptoms of an anxiety attack are not usually due to changes in blood flow to the heart, anxiety can affect blood pressure and heart rate in ways that increase the chance of having a heart attack. This is because panic attacks and anxiety can temporarily increase heart rate and blood pressure, and can cause the heart’s blood vessels to constrict.

   These temporary changes increase the pressure on the heart, which can reduce blood flow to the heart muscle. In someone with heart disease or risk factors for heart disease, these changes in blood flow can lead to a heart attack.

6. To sum up: the symptoms that are important to know

   Below is a list of typical symptoms of a heart attack and anxiety attack. Be sure to seek medical help or consult a treating physician with any questions. It is always important to check early on the question of the development of atherosclerosis and the existence of risk factors for atherosclerosis.

   Heart Attack

• Chest pain, chest tightness, angina
• Sudden onset of pain, sometimes after extreme exertion
• The pain radiates to the left hand, shoulders, back or jaw
• The pain and symptoms are prolonged and worsen over time
• Shortness of breath
• Hyperhidrosis
• Nausea and vomitingpanic attack
• Accelerated and strong pulse
• The pain appears suddenly after mental stress or a stressful event
• The pain passes and improves spontaneously over time
• The pain goes away in about 20 minutes
• Shortness of breath
• Pallor and excessive sweating
• A feeling of circumcision at the tips of the hands and lips*Dr. Michael Yonash, Senior Cardiologist, Specialist in Internal Medicine and Cardiology. Director of Structural Heart Diseases, Cardiac Catheterization, Kaplan Hospital. Senior Lecturer at the Hebrew University. And a senior catheterist at Herzliya Medical Center