Anxiety Attack vs Heart Attack: How to Tell the Difference

Chest pain, racing heartbeat, shortness of breath. When these symptoms strike, it’s natural to feel afraid. But many people ask themselves: Is this an anxiety attack, or could it be a heart attack?

The truth is, anxiety and heart attacks can feel remarkably similar, which makes the situation confusing and frightening. Knowing the differences can save your life or help you find peace of mind if your symptoms are stress-related.

In this guide, we’ll explore the overlap and the distinctions, answering key questions like:

Does anxiety cause chest pain?
What are the differences between anxiety attack vs heart attack symptoms?
How can you tell if it’s anxiety or a heart problem?

If you’re ever unsure, it’s critical to seek emergency medical care immediately.

Table of contents

Anxiety Attack vs Heart Attack: Why They Feel So Similar

An anxiety attack is an intense episode of fear or worry that triggers physical symptoms: chest tightness, rapid heartbeat, dizziness, sweating, or trembling.

A heart attack, on the other hand, happens when blood flow to the heart muscle is blocked, usually by a clot or narrowed arteries. This damages the heart and can be life-threatening.

Why they’re often confused:

Both can cause chest pain, shortness of breath, sweating, dizziness, and palpitations.
The brain struggles to distinguish emotional distress from physical cardiac distress.
Anxiety symptoms come on suddenly and feel overwhelming, while heart attack symptoms can also feel sudden and severe.

Anxiety is usually accompanied by an overwhelming sense of panic or fear, while heart attacks are driven by physical dysfunction in the heart.

Differences Between Chest Pain Anxiety vs Heart Attack Pain

Feature	Anxiety Attack	Heart Attack
Onset	Sudden, often triggered by stress, worry, or panic	Can build gradually or start suddenly, often linked to exertion
Chest Pain	Sharp, stabbing, fleeting; may come and go	Pressure, heaviness, squeezing, lasting minutes or more
Radiation	Usually stays in the chest	Often spreads to shoulder, arm, jaw, or back
Relief	May ease with relaxation or calming techniques	Does not resolve with rest; may worsen with activity
Emotional factor	Fear of losing control, dread	Physical exhaustion, nausea, or collapse

Many patients describe anxiety mimic heart attack scenarios. That’s why it’s so important not to assume; always check with a doctor.

Can Anxiety Cause Chest Pain or Heart Problems?

Yes. Anxiety can trigger real, physical chest pain. Stress hormones (like adrenaline) cause:

Rapid heartbeat and palpitations
Tightened chest muscles
Spikes in blood pressure

Over time, chronic anxiety and stress increase cardiovascular risks by:

Elevating blood pressure
Promoting unhealthy habits (poor sleep, smoking, overeating)
Straining the heart and blood vessels

While anxiety itself doesn’t directly cause a heart attack, long-term stress can increase your risk. Diagnostic tools like a holter monitor can track irregular heart rhythms and help distinguish anxiety-related palpitations from heart problems.

Heart Attack vs Anxiety Attack Symptoms

Anxiety Attack Symptoms

Sudden chest tightness or discomfort
Rapid heartbeat or palpitations
Trembling, shaking
Shortness of breath, choking sensation
Intense fear, doom feeling
Sweating, dizziness

Heart Attack Symptoms

Chest pressure or squeezing that lasts more than a few minutes
Pain radiating to the arm, jaw, shoulder, or back
Shortness of breath without relief
Nausea, indigestion, or vomiting
Cold sweats
Lightheadedness or fainting

If chest pressure lasts longer than a few minutes, spreads to other areas, or feels different from past anxiety episodes, treat it as a heart emergency.

When to Seek Emergency Help

Never take chances with chest pain. Call 911 or your local emergency number if you experience:

Persistent chest pressure or pain
Pain spreading to your arm, neck, jaw, or back
Severe shortness of breath
Fainting, dizziness, or sudden weakness
Symptoms that feel different from your usual anxiety attacks

Even if it turns out to be anxiety, it’s better to be safe than sorry.

Managing Anxiety and Protecting Heart Health

At Cardiology Care NYC, we use advanced diagnostic tools like the electrocardiogram (ECG), echocardiogram, and stress test to determine whether your symptoms are heart-related.

If anxiety is the cause, treatment may include:

Cognitive behavioral therapy (CBT)
Stress management techniques (deep breathing, mindfulness, exercise)
Medications when needed
Lifestyle adjustments: sleep, diet, and exercise

If heart disease is present, early detection through heart health screening or cardiac screening allows for lifesaving interventions from medication to lifestyle changes and specialized cardiology care.

Whether it’s anxiety or heart problems, managing your mental health and getting routine heart screenings can help protect both your mind and your heart.

Conclusion

Anxiety can mimic the terrifying symptoms of a heart attack, but the two conditions have important differences. The safest approach is to never ignore chest pain; seek emergency help if you’re unsure.

At Cardiology Care NYC, our expert team provides comprehensive evaluations to distinguish between anxiety and heart conditions, so you can get clarity, peace of mind, and the right care.

Worried about chest pain or heart health? You can schedule a cardiology consultation today at Cardiology Care NYC.

Frequently Asked Questions

Can dehydration make anxiety or heart attack symptoms worse?

Yes. Dehydration can increase heart rate and trigger dizziness, which may intensify both anxiety episodes and heart strain.

Are nighttime chest pains more likely anxiety or heart-related?

Nighttime anxiety is common, but recurring pain while resting can sometimes indicate heart problems and should be checked.

How does family history affect the likelihood of chest pain being heart-related?

A strong family history of heart disease increases the chance that chest pain may be cardiac in origin, even if it feels like anxiety.

Could digestive issues mimic either anxiety or heart attack symptoms?

Yes. Acid reflux and indigestion often cause chest discomfort that overlaps with both anxiety and heart conditions.

Does exercise help lower the risk of both anxiety attacks and heart attacks?

Regular exercise can reduce anxiety symptoms and strengthen the cardiovascular system, lowering risks for both conditions.

Source

Houston Methodist – Is It Anxiety or a Heart Attack? Learn to Spot the Difference
American Heart Association – Heart Attack or Panic Attack
Very Well Health – Anxiety Attack vs. Heart Attack: How to Differentiate Your Symptoms
Memorial Care – Is It Anxiety or a Heart Attack?

Disclaimer

This blog is for informational & educational purposes only and does not intend to substitute any professional medical advice or consultation. For any health-related concerns, please consult with your physician, or call 911.