Heart attack or panic attack? Holidays can trigger both

Will you know the difference?

heart panic blog

Your heart is racing and you feel pain in your chest. Is it a heart attack or panic attack?

Distinguishing between the two can be difficult, especially if you’ve never experienced either, says Dr. William Meurer of the University of Michigan Health System Emergency Department. “There’s an overlap in symptoms associated with heart attack and panic attack.” And, to further complicate things, the stress and anxiety that often cause a panic attack can also lead to a heart attack. “It’s a complicated relationship,” he says.

Holiday influence

According to Dr. Meurer, there’s an increase in both panic attacks and heart attacks around the holidays. “People often blame their symptoms on holiday stress. They minimize versus maximize their symptoms. ‘Maybe I’m OK,’ they tell themselves. People tend to avoid a trip to the hospital ER because they’re with family and friends and don’t want to be a disruption, but their situation may escalate very quickly,” says Dr. Meurer.

“The important thing is to seek medical attention if you’re not sure about your health. Be vigilant and get checked out promptly. If you’re worried that it’s a heart attack, call 911 to get an immediate evaluation.”

If you’re experiencing an episode that is similar to one you’ve had in the past that turned out to be stress-related, Dr. Meurer recommends practicing deep breathing or meditation to see if the symptoms subside. “If they don’t, seek medical help,” he says.

Dr. James Froehlich, U-M Frankel Cardiovascular Center cardiologist, agrees. “Heart attacks are already often missed and we don’t want to discourage anyone who thinks they might be having a heart attack from getting checked out.” He also advises his patients to stay on their regular heart medications through the holidays, “even if you’re feeling good and think you can stop/skip them. Preventive medications are very effective. If you keep up your meds, you may never know about the heart attack you didn’t have.”

What to look for

Heart attack symptoms

  • Escalating chest pain reaching maximum severity after a few minutes
  • Constant pain, pressure, fullness or aching in the chest area
  • Pain or discomfort that travels or radiates from the chest to other areas, such as one or both arms, abdomen, back, shoulders, neck, throat or jaw
  • Pain that is brought on by exertion
  • Shortness of breath

Panic attack symptoms

  • Increased heart rate
  • Sharp or stabbing chest pain that lasts only 5-10 seconds
  • Pain that is localized to one small area
  • Pain that usually occurs at rest
  • Pain that accompanies anxiety
  • Pain that is relieved or worsened when you change positions
  • Pain that can be reproduced or worsened by pressing over the area of pain

The bottom line

“Be vigilant and get checked out promptly,” says Dr. Meurer. “If you think it’s a heart attack, call 911 to get an immediate evaluation. And the added bonus is that ERs aren’t as busy on a holiday, so there’s no reason not to come to the ER if you suspect a heart attack.”

Take the next step:

Frankel-informal-vertical-sigThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is a top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at umcvc.org.

Uric acid and stroke therapy

More research is needed


Portion of CT scan of a brain that has experienced acute ischemic stroke

Portion of CT scan of a brain that has experienced acute ischemic stroke

A Spanish research team has recently found that giving uric acid (UA) with intravenous thrombolytic therapy (tPA) to patients with acute ischemic stroke could help improve outcomes, particularly in women. Emergency Medicine Physician Dr. William J. Meurer talked with us about the study and its implications for stroke treatment and research.

Do the results of the Spanish study mean that hospitals will start supplementing clot-busting tPA with uric acid (UA) when they treat ischemic stroke patients?

No. The main trial didn’t find UA to work when given to everyone. The Spanish researchers have generated an interesting hypothesis by observing that it worked in women. There is not strong enough evidence yet to change practice, but it’s an interesting area for future research.

How did the team conduct the research?

The researchers reexamined the results of their Efficacy Study of Combined Treatment with Uric Acid and rtPA in Acute Ischemia Stroke (URICO-ICTUS) trialContinue reading