Panic Attacks & A Heart Attack 

“Will panic attacks and anxiety cause a heart attack? I am scared because I have a lot of muscle tension and pain.”

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To directly answer the question: No, having a panic attack does not cause a heart attack. 

Once ruled other causes have been ruled out as discussed above, you should now know that tension and pain has been associated with panic attacks and many people who have a panic attack think that they are having a heart attack.

The tricky part is that even people who have been through the process several times (having a panic attack and thinking they’re having a heart attack) – even after being checked out and found to be in good physical health – seem to still worry that they’re having a heart attack (or at least it runs through their mind).

However, while it does not make the process more comfortable, it is reassuring to know that a panic attack does not become a heart attack.

My experience (including my own first hand experience as a sufferer and also one working with other sufferers) is that panic attack sufferers can benefit from adequate explanations.  So I would specifically like to explain the difference between a heart attack and panic attack.

A heart attack usually occurs when a blood clot blocks the flow of blood through a coronary artery.  A coronary artery is a blood vessel that feeds blood to a part of the heart muscle. This interruption of blood flow to the heart can damage or destroy a part of the heart muscle.

A panic attack typically occurs when the body releases a series of chemicals such as adrenaline, noradrenaline and cortisol into the bloodstream which causes a series of physiological effects known as the "Fight or Flight" response – when no actual threat is present. 

Such physiological changes can include a racing heart, dilated pupils, increased respiration, and can include an additional symptoms. This of course causes psychological distress and you may begin to panic.

However, the whole process is a cyclical because while your physiological symptoms can cause and/or increase your racing thoughts and worries, your racing thoughts and worries can also cause and/or increase our physiological symptoms.

During a panic attack your thoughts begin to race and you are on a heightened alert.  We are hypersensitive to things that normally wouldn’t bother us.

For example, if you had muscle pain or chest pain – that, for example, might be related to an anatomical issue, – you hone in on these things - and in the moment become very stressed over them because of being in a heightened alert state.

As you can see from above explanations, a panic attack and heart attack are not the same process, and have nothing to do with each other, even though many panic attack sufferers incorrectly link the two things together in their mind.

For many the above logical explanation is helpful but it would be good to provide a reminder about a technique I suggested previously. 

Do you remember?

It involved using the physiological processes that are involved in a panic attack to your advantage, and in particular, using them to reverse your panic attack.

To outline, the process it involved the following two steps:

1. Keep track of your behaviors when you become anxious or panic. Of course this might not be feasible for you if you’re having a panic attack but you can do it after it’s over.

2. Do the opposite of your anxious behaviors, e.g. instead of pacing, sit still, etc.  Once you have a list of your tendencies, you now need to think in terms of opposites. 

In other words, if you talk fast, talk slower, etc.

If you typically would pace back and forth and hold your head in your hands, then remain still and hold your head up straight instead of holding your head in your hands. 

If your reflex is to speak quickly then speak slowly and softly.

So the next time you’re feeling really anxious or in the middle of a panic attack, start doing some of the things that would be the opposite of your normal tendencies.

Initially you’ll probably resist this approach.  However over time you’ll notice that you are able to reduce your physiological symptoms and regain control.

What is going on here?

Rather than feeding your physiological symptoms with actions that would increase them more and more, you actually are taking actions that have the opposite effect.  It seems that the brain receives a message that there is no need to continue the “fight or flight response.”

So once again please remember that a panic attack and heart attack are completely distinct.