Panic attack or heart problems? How to distinguish one from the other and how to treat it

Updated 2 years ago on April 03, 2023

Panic attacks have long been uncommon: they lead among the reasons for treatment, psychotherapists admit. What does it look like? A person is seized by a sudden uncontrollable fear for life without any real threat to life: you begin to pant, your heart rate increases, you feel nauseous, nauseous, your legs are sluggish, you are about to faint, and it seems that you will die. How to distinguish panic attacks from heart problems and other illnesses that the attack masquerades as, and - most importantly - exercises to stop panic attacks.

What is a panic attack

Panic attacks can occur in a perfectly healthy person- healthy both physically and mentally. However, when the symptom appears, the sufferer is terrified that he or she is seriously ill and will either die of cardiac arrest/choking, etc., or go insane. Let's say right off the bat: neither of these things will happen.

A panic attack is an intense fear that results in an increased production of adrenaline. We have already written more about the causes of panic attacks.

A typical scenario is that during the first anxiety attack the person calls an ambulance, then the attacks recur, he is examined, but finds no somatic diseases. In a favorable scenario, one of the doctors examining the patient refers him to a psychotherapist, and the person finally learns that he is not alone, he has panic attacks, quite a common problem. Worse, if the attacks have become regular, and the person began to limit themselves in activities or movements to avoid repeated attacks (some are afraid to ride the subway, some even leave the apartment). Panic disorder affects up to 5% of the population.

Signs of a panic attack

To begin with, it is important to understand what happens in the body during a panic attack.

The distinguishing feature of PA from the disease is its unpredictability, an avalanche-like increase. In addition to the physiological symptoms, there are psychological ones:

  • Confusion or constriction of consciousness.
  • A "lump in the throat" feeling.
  • Derealization: the feeling that everything around seems unreal or occurs somewhere far away from the person.
  • Depersonalization: the patient's own actions are perceived as if "from outside.
  • Fear of death.
  • Fear of going crazy or committing an inappropriate act (screaming, fainting, throwing oneself at a person, wetting oneself, etc.)
  • Intrusive thoughts. After the attack a person thinks about the danger for a long time, does not part with disturbing thoughts.

Most often, patients suffering from panic attacks are taken to cardiologists - with suspected heart or vascular problems.

Age. Patients under 30 years of age are very rarely exposed to acute coronary events (myocardial infarction, stroke, aortic rupture (aneurysm), thromboembolism). Yes, it can happen at a young age, but as a rule, there are prerequisites for it (previously established diagnoses). Panic attacks, on the other hand, occur without prior diagnoses.

Gender. Panic attacks occur 2-4 times more often in women than in men. And mostly in young women. At the same time, arrhythmia is rarely common in women before menopause (more often men suffer from arrhythmia), if again, she has no history of a history of arrhythmia.

Blood pressure. During a panic attack, your blood pressure is usually elevated. But if anxiety and fear are accompanied by a sharp drop in blood pressure below the normal range (the accepted norm is 120 over 80, but the figures may be individually higher or lower), this is an alarming signal. In this case, there may be more serious problems than a panic attack.

Stroke. Many people are afraid of a stroke during a panic attack. But we should not forget that with a stroke there are clear neurological symptoms: a person moves his tongue and cannot say anything, one half of the body or face goes numb, an intolerable headache, which does not cause any doubt about the need for an ambulance. In a panic attack, the hands may be slightly (!) numb, the feet may be cold and sweaty, and if the headache seems unbearable, it is only from excitement, in fact it is not.

Pain in the heart. Not all people know that when the stabbing in the left subcostal area is most often not heart pain, but intercostal neuralgia. True heart pain is diffuse, its localization is difficult to determine, as a rule, it is behind the sternum. But in this place above the solar plexus, where the heart is actually located, it can hurt more than just the heart: it can hurt there in diseases of the stomach, cholecystitis, esophagitis, thromboembolism, or spinal diseases. In any case, the pain syndrome is a reason to see a doctor, but not a sign of impending death or a reason to panic.

Choking. If you feel like you can't breathe in, you need to look at your face. In true hypoxia, the lips turn blue, the upper part of the face turns significantly pale. In a panic attack, there may only be a slight pallor, but not bruising. Choking can also be an attack of bronchial asthma, but in this case you can clearly hear wheezing and cannot breathe out - this is not the case with a panic attack. You can use a paper bag to monitor your breathing: that way you can see if you are okay with the amount of air you breathe in and out.

Sedation. If you give a patient a sedative during a panic attack, the attack gradually ends, even without the sedative the patient gradually gets better. On average, an attack lasts from 20 minutes to 2 hours. A patient with arrhythmia will not get better over time, even with sedatives, but will get worse.

Treatment of panic attacks

Some people, realizing that there is no real danger to their health, cease to feel fear. Others realize what is happening, but still cannot control the process. Then it is necessary to see a psychotherapist.

Exercises to stop a panic attack

To stop a panic attack, you must stop hyperventilating your lungs. You don't need to frantically open a window or run out onto a balcony. On the contrary, you have to hold your breath.

Breathing techniques can be different:

  • five counts of inhalation, five counts of exhalation, five counts of delay.
  • "square breathing": 5 counts of inhalation, 5 counts of delay, 5 counts of exhalation, 5 counts of delay.
  • You can slow down your breathing and stretch the exhalation: 5 breaths, 7 breaths (gradually stretching the exhalation to 10 counts).

The most important thing is to understand that you are not dying or crazy at all, you are not in danger, and you are not alone in your problem. Don't give up and go back to a normal full life.

Telehealth is Easy!

Safe, secure video platform for people who need immediate emotional or psychiatric support. 👍

Visits are always HIPAA compliant and can be done almost anywhere.