In recent years, anxiety and panic attacks have been on the rise, particularly following the COVID-19 pandemic. Last week, the former Scottish First Minister died of a suspected heart attack shortly after giving a speech in North Macedonia. The politician and the leader of the Alba party collapsed and died hours after appearing at the Institute for Cultural Diplomacy Forum in Ohrid.

He was believed to have suffered a heart attack. Reports say that this is a medical emergency, occurring when blood flow to the heart is abruptly blocked, often by a clot.

While chest pain is commonly recognised as a crucial symptom, panic attacks and anxiety disorders are becoming increasingly common, but when symptoms mimic those of a heart attack, it can be challenging to distinguish between the two.

Understanding the relationship between anxiety, panic attacks, and heart health is crucial for both mental and physical well-being. By recognising the symptoms and knowing when to seek help, individuals can take the necessary steps to manage their anxiety and protect their heart health.

We speak with two experts in the field—Dr Kunal Bahrani, Clinical Director & HOD-Neurology at Marengo Asia Hospitals Faridabad, and Dr Geetesh Govil, Consultant Cardiologist at Manipal Hospital, Ghaziabad—about the critical overlap between these conditions and the importance of timely medical attention.

According to Dr Kunal Bahrani, chronic anxiety and panic attacks are leading contributors to rising heart attack cases. He explains, “Stressful life events and repeated anxiety episodes activate the body’s ‘fight or flight’ response, elevating heart rate and blood pressure.” Over time, this can strain the cardiovascular system and increase the risk of heart issues.

Dr Geetesh Govil says that while anxiety does not directly cause heart attacks, it can exacerbate existing heart conditions by weakening the heart muscle, increasing blood pressure, and constricting blood vessels. Repeated episodes of vasoconstriction can damage blood vessel linings and lead to clot formation, a major risk for heart attacks.

One of the most challenging aspects of managing anxiety is finding a difference between a panic attack and a heart attack, as both share common symptoms like chest pain, shortness of breath, and palpitations. Dr Bahrani stresses the importance of understanding symptom patterns. “Panic attacks typically peak within 10 minutes and are often accompanied by intense fear, while heart attack symptoms develop more slowly, with increasing pain or discomfort.” He advises that if there is any doubt, it is crucial to seek medical help to rule out a heart attack.

Dr Govil points out additional differences, such as the sensation of chest heaviness or pain radiating to the jaw and arms, which are more common in heart attacks. “If you are experiencing chest heaviness, a choking sensation, or jaw pain, it is essential to get to a hospital immediately for an ECG,” he says.

If you are unsure whether you are having a panic attack or a heart attack, Dr Bahrani recommends immediate actions to manage panic symptoms. “Practice deep breathing, ground yourself using techniques like the 5-4-3-2-1 method, and find a quiet space to calm your mind.” However, if these steps don’t reduce the symptoms, or if they persist, it is critical to seek emergency care.

Dr Govil advises that in cases of chest pain or discomfort, getting to a hospital quickly is vital. “If the patient collapses, start CPR immediately. Cuffing—forcefully coughing—can also help by causing vasodilation, which improves blood flow to the heart,” he adds.

Both experts agree that managing stress and anxiety is essential for maintaining heart health. Dr Bahrani suggests incorporating regular exercise, mindfulness, and a healthy diet as effective ways to reduce anxiety. “Sleep is crucial, as is avoiding excessive caffeine and sugar,” he says.

Dr Govil recommends daily practices like yoga, meditation, and even activities such as gardening or listening to music. “These can help lower stress hormones, improve heart rate variability, and promote overall cardiovascular health.”

Ultimately, differentiating between a panic attack and a heart attack can be difficult without medical evaluation. As Dr Bahrani advises, “If you’re ever unsure, it’s better to treat the situation as a potential heart attack and seek emergency care immediately.” Quick action is the secret, as timely intervention can make a significant difference in the outcome.

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