The Differences Between an Anxiety Attack and a Heart Attack

A heart attack has nothing to do with an anxiety attack, although they can produce similar sensations. In this article, we'll talk about eight differences between an anxiety attack and a heart attack.

Written and verified by the psychologist Laura Ruiz Mitjana.

Last update: 23 October, 2022

An anxiety attack and a heart attack can produce similar symptoms on a physiological level. However, they shouldn’t be confused. In this article, we’ll talk about eight differences between an anxiety attack and a  heart attack. They’ll help you establish if you might be facing one situation or another.

It’s important to point out, as cardiologists assure us, that not all patients who suffer a heart attack present characteristic symptoms. Nor do all patients who present symptoms of a heart attack suffer from one. The same goes for anxiety attacks.

The symptoms of a heart attack

A heart attack occurs when a part of the heart doesn’t receive enough blood. It usually happens when an artery that supplies blood to the heart is blocked. Common symptoms of a heart attack include:

• Chest pain or pressure.
• Pounding or racing heart.
• Feeling dizzy or faint.
• Sweating, including cold sweats.
• Pain or discomfort in the upper body, such as the jaw, neck, arms, shoulders, or back.
• Difficulty breathing.
• Nausea or vomiting.
• The sensation of imminent death.

A heart attack can be life-threatening, so don’t wait to see if the symptoms go away. In fact, you must seek immediate medical attention if you’re exhibiting signs of a heart attack.

The symptoms of an anxiety attack

An anxiety attack is a sudden attack of overwhelming fear or anxiety. These episodes aren’t life-threatening, but they do interfere with the quality of life and mental well-being. Symptoms of an anxiety attack include:

• Sudden feelings of strong anxiety and fear.
• Chest pain.
• Difficulty breathing.
• The sensation of imminent death.
• Pounding or racing heart.
• Sweating.
• Shakes or tremors.
• Weakness or dizziness.
• Stomach pain or nausea.

People who experience regular or frequent anxiety attacks may be suffering from panic disorder, a type of anxiety disorder. On the other hand, an isolated panic attack can happen to anyone, even without a diagnosis.

The differences between an anxiety attack and a heart attack

What are the differences between an anxiety attack and a heart attack? Here, we’ll talk about the most relevant differences so you’ll be able to make a good differential diagnosis.

That said, if you should find yourself experiencing any of the conditions we describe, you should obtain a proper diagnosis from a medical professional.

1. Type of chest pain

In a heart attack, chest pain is characterized by a feeling of tightness, heaviness, or intense discomfort. Patients often define it as feeling like “a heavy weight on their chest ” or “a pain like they’ve never experienced before”. On the other hand, in anxiety (or in an anxiety attack), the pain is of another type. It’s usually more of a stabbing kind of pain.

2. Location of pain

Another difference between an anxiety attack and a heart attack is the location of the chest pain. In a heart attack, the pain is diffusely localized behind the sternum.

As stated by Dr. Pizarro, it’s a type of pain that radiates to the left shoulder and arm, to the front of the neck, or to the jaw.

In an anxiety attack, the pain is located in a more specific area. In fact, it can be pointed to with a finger. It’s generally in the inframammary area.

3. Duration of pain

Although in each individual case, the duration of the pain can vary a great deal, as a rule, in a heart attack the pain lasts several minutes and can become persistent. According to specialists, this pain is either maintained or increases in intensity.

In contrast, in an anxiety attack, the pain can last from seconds to days. Therefore, it can either be shorter or longer than a heart attack.

4. Pain changes depending on the posture

In a heart attack, no movement can relieve the chest pain. However, in an anxiety attack, it can be relieved with deep breathing techniques.

In an anxiety attack, the pain can also be relieved with certain movements or even with swallowing. Furthermore, the pain is reproduced on palpation.

5. Respiratory disorders

Another of the main differences between an anxiety attack and a heart attack, beyond the type of chest pain, is linked to respiratory disorders or symptoms. In anxiety, this type of symptom frequently appears. It’s a symptom that’s part of the overactivation of the sympathetic autonomic nervous system, typical of anxiety. It manifests itself through a feeling of suffocation or hyperventilation.

In contrast, respiratory disturbances aren’t characteristic of heart problems. Consequently, the person who suffers from them can usually breathe normally. If they do have any difficulty breathing, hyperventilation doesn’t appear, and if it does, it’s a result of anxiety.

6. Feeling of a loss of control

The feeling of loss of control is a characteristic cognitive or psychological symptom of anxiety, especially anxiety attacks.

On the other hand, in a heart attack, this symptom doesn’t usually appear. Thus, unless the heart problem itself causes an anxiety crisis, the symptom won’t occur.

7. Tingling sensation and numbness

Another difference between an anxiety attack and a heart attack is a tingling sensation. This appears frequently in anxiety in the form of numbness and tingling in the arms and legs.

In addition, these sensations are often accompanied by sudden stabs of pain. In contrast, in a heart attack, there’s a uniform numbness, without variations, which usually affects only one part of the body.

8. Other symptoms

In a heart attack, beyond chest pain, nausea, pain in the pit of the stomach, and a burning sensation in the chest also appear. While in an anxiety attack, a tingling sensation in the fingers and tremors typically occur.

Having an anxiety attack is really different from having a heart attack. Although anxiety and heart problems may share common elements (such as subjective discomfort, chest pain or pressure, etc.), they’re far from the same thing.

It’s important to know how to identify the symptoms of each of these disorders. As we’ve explained, they’re different conditions that present different symptoms, especially in relation to the type of chest pain. Finally, we must emphasize the importance of a reliable diagnosis by a medical professional.