Is It Anxiety or a Heart Attack? Learn to Spot the Difference

Symptoms like chest pain, shortness of breath, rapid heartbeat and sweating can be worrisome, but they don't always mean you're having a heart attack. These problems can be symptoms of an anxiety attack, too.

Knowing how to spot the differences can change how you respond. An anxiety attack is uncomfortable and upsetting. A heart attack is a life-threatening medical emergency that requires care right away.

But it can be tricky to tell the difference between the two. If you're not sure, it's always better to take your symptoms seriously, says Dr. Ali Rizvi, a cardiologist at Houston Methodist.

"Don't ignore any symptoms, even if you think it might just be stress," he says. "It's better to be on the safe side."

What causes an anxiety attack?

Worries are a part of life. When your worries become severe or intense, you could be having an anxiety attack, sometimes known as a panic attack. Anxiety attacks that happen often can be a mental health condition. Talk with your doctor if you have intense worries that won't go away. (Related: When Overthinking Becomes a Problem & What You Can Do About It)

Anxiety attacks can be caused by your experiences, personality, brain chemistry and even your genetics. Both acute stress, such as the death of a loved one, or chronic stress, such as money problems, can trigger an attack.

They can also come out of nowhere and might not be related to a particular stressor. Anxiety disorders are the most common mental health condition in the U.S., afflicting more than 40 million adults, or about 19% of people.

Symptoms of an anxiety attack

Symptoms of an anxiety attack include:

• A sense of impending doom or loss of control
• Dizziness
• Rapid heartbeat
• Shortness of breath
• Sweating
• Temporary chest discomfort, or even pain

These symptoms can be severe enough to resemble a heart attack.

What causes a heart attack?

Heart attack, also called myocardial infarction, is a medical emergency. If you think you might be having a heart attack, call 911 right away.

A heart attack happens when blood flow to the heart is suddenly blocked, and the heart can't get the oxygen it needs to pump blood to the body. Blockages are often caused when plaque, a waxy substance that builds up on the walls of your arteries. This is called atherosclerosis and can lead to coronary artery disease. This plaque can become unstable over time, breaking loose and blocking blood flow to the heart.

More than 800,000 people have a heart attack each year in the U.S., and heart disease is the leading cause of death in the nation.

Symptoms of a heart attack

Knowing the main symptoms of a heart attack can help you know when to seek medical care. These include:

• Chest pain that lasts more than a few minutes or goes away and returns
• Feelings of lightheadedness, weakness or a cold sweat
• Pain or discomfort that radiates to the jaw, neck or back
• Pain or discomfort in your arms or shoulders
• Shortness of breath

Some other symptoms of heart attack are less common in men and more common in women. These include fatigue and nausea or vomiting. If you have heart disease, Dr. Rizvi says it's also important to pay attention to changes in your normal symptoms.

"Don't ignore anything that's out of the ordinary," he says. "If there's any change in your symptoms, that's sometimes more important than the symptom itself."

Key differences to know

Anxiety attack and heart attack have different risk factors.

The risk factors for heart problems include smoking, high blood pressure, diabetes or a family history of heart disease. Understanding your risk factors and health history can help doctors determine which tests to order. (Related: 5 Commonly Ordered Heart Tests & What They Show)

"We do different testing for someone who's 80 years old with diabetes versus someone who's 30 years old and is an active runner with no symptoms," Dr. Rizvi says. "That's because their likelihood of having something significant is different."

Other ways to tell the difference between heart attack and anxiety symptoms include understanding the source of pain, what it feels like and how long it lasts.

Onset and triggers

Anxiety attacks can be triggered by stress or specific events. Common triggers for anxiety can include:

• Caffeine overconsumption
• Chronic health conditions
• Financial problems
• Interpersonal conflict
• Certain medications
• Other sources of stress
• Personal traumas or triggers
• Public performances or social events
• Skipping meals

(Related: What Are Heart Palpitations & When to Worry)

Heart attacks are most often due to coronary artery disease and typically happen during physical activity. Blood pressure can go up when you're exercising or otherwise working hard, which can increase the risk for a heart attack during these times.

Different types of pain

Both heart attacks and anxiety attacks can cause pain in your chest, but there are some signs that can help you tell the two apart.

Pain from a heart attack feels heavy. Usually, this crushing, squeezing or burning pain radiates to the arm, jaw or back. An anxiety attack may cause pain that feels sharp or stabbing. It stays in the chest and doesn't move to other parts of the body.

A heart attack doesn't always happen like you see in the movies. In many cases, especially for women, there isn't a sudden, chest-clutching moment. But a heart attack can still be fatal, so it's important to seek health care.

How long symptoms last

Anxiety attacks start quickly, but their intensity generally peaks within 10 minutes and most symptoms go away within 30 minutes.

Heart attacks can be sudden, but often they start slowly with mild discomfort that gets worse. These symptoms won't disappear over time.

When to seek medical help

Dr. Rizvi emphasized that if you think you might be having a heart attack you should call 911 right away. It's especially important if you're having shortness of breath, nausea, sweating or radiating pain, which are not anxiety symptoms.

"People have a tendency to ignore symptoms — maybe they don't want to trouble people, or they think they need to tough it out," he said. "It's better to come to the hospital and be told it's not your heart than to stay home when you're having a heart attack."