A panic attack can be frightening and resembles a heart attack. Chest pain is a common symptom of both, so sometimes it gets confusing to differentiate between the two. It is important to understand that these two are very different conditions. If you compare the panic attack and heart attack carefully, you can still find many differences.

 Panic Attack vs. Heart Attack

1. Definition

• Panic attacks are caused by extreme anxiety, fear or apprehension. Bodily or cognitive symptoms are common, including palpitations, dizziness and shortness of breath. These symptoms can vary in severity and can last from minutes to hours. A panic attack is not dangerous or life threatening.
• Heart attack or myocardial infarction can be life threatening if not detected and treated urgently. In this condition, the heart muscle dies due to blockage in any of the arteries supplying blood to heart muscles.

2. Symptoms

Symptoms of panic attack:

• Fast pulse and increased heart rate
• Very sharp chest pain lasting for less than ten seconds
• The chest pain is localized and confined to a small area
• The area of chest pain can be tender to touch
• The chest pain usually occurs at rest
• The pain gets better by itself and changes its intensity with changing posture
• A feeling of extreme anxiety

Symptoms of heart attack:

• Sudden chest pain which increases in severity and does not get better on its own
• The pain can be felt as heaviness or pressure inside the chest
• The pain can be experienced in shoulders, arm, jaw, neck or abdomen
• The pain gets severe by exertion
• The person can experience shortness of breath

3. Causes

Here is a comparison of the causes of panic attack vs. heart attack

• Causes of panic attack: The exact cause of panic attacks is not very well understood. Some people are more prone to get this condition in stressful situation as compared to others. This can be familial. Many major changes or stress in life can also lead to a panic attack. These individuals are also more likely to have depression and are at a greater risk of developing addictions or committing suicide.

• Causes of heart attack: The blood flowing to heart is supplied by coronary arteries. Blood clot, cholesterol plaques or other reasons that lead to poor blood supply can block the arteries, which will result in muscle damage or destruction, leading to a heart attack.

4. Treatment

When it comes to panic attack vs. heart attack, it is important to know their difference in treatments.

Treatment for panic attack:

• The panic attack can be prevented and the symptoms can be controlled effectively with the help of medication. Other effective treatment options include psychotherapy, cognitive behavioral therapy and meditation. These relaxation techniques work by reducing the anxiety and stress level.
• If the panic attack starts, taking anti-anxiety medicines immediately can control the symptoms and can reduce the severity of symptoms as well. These medicines include Xanax, Ativan and Clonopin, and they are usually prescribed for short term use.
• Certain antidepressants, especially the selective serotonin reuptake inhibitors (SSRIs) such as Prozac, Lexapro, Paxil and Celexa, are prescribed to control severe anxiety and these can prevent the recurrence of panic attacks. 

Treatment for heart attack:

If you or anyone close to you is having severe chest pain, contact the emergency services immediately. The treatment for heart attack comprises of:

• Antiplatelet medicines which prevent the clot formation.
• Blood thinners or anti-coagulation medicines to prevent the clots.
• A coronary angiography is performed to visualize the arteries and other required interventions like stenting can be done simultaneously to open the blocked arteries.
• Medicines which dissolve the clots and restore the vessel patency are also used.
• Oxygen is given along with medicines to supply oxygen for heart muscles.
• It is essential to keep the heart rhythm regular, so medicines to regulate the heart rate and rhythm are also given.
• Cardiac surgery is another option. The main goal of treatment in case of a heart attack is to open the blocked blood vessels as quickly as possible and to minimize the damage to heart muscles. If the blockage is cleared early and the blood flow is restored, there are better chances of preserving the functionality of the heart.

What to Do If You Have Chest Pain?

Any chest pain should be evaluated in a hospital or emergency setting. The difference in chest pain of panic attack vs. heart attack is sometimes very little. The best thing is to get evaluation by a doctor.

• The first thing which gives a clear indication about the cause of chest pain is an echocardiogram. To do this, electrodes are placed on the chest and a tracing of the electrical activity of the heart is obtained. This gives a very clear picture of what might be the reason of chest pain and which area of the heart is affected.
• Blood tests will be done and the levels of troponin are measured. Tropnin is a protein found in heart muscles and the levels increase in case of heart muscles damage. 

Depending on the history, physical examination and results of these tests, further course of action will be decided.