What Is Panic Heart Attack

By Simeon Margolis, M.D., Ph.D.


About 20 years ago, during a visit to our daughter, my wife had the sudden onset of shortness of breath and chest pain while she was taking a casual walk in the Boston Commons.

Although the episode lasted for only about 15 minutes and, except for being frightened, she felt otherwise well afterwards, she was concerned that something might be wrong with her heart. Back in Baltimore, she had one other similar episode a few days later. An examination by an experienced cardiologist, an electrocardiogram, and blood tests were all normal. The cardiologist and I were both convinced that her symptoms were due to a panic attack. With strong reassurance, she has never suffered another such episode.

Panic disorder is a common problem. The National Institute of Mental Health estimates that 6 million American adults (about 2.7 percent of adults in the population) suffer from panic disorder each year. These attacks are more common among women and are frequently neither diagnosed nor treated.
According to the Johns Hopkins White Paper on Depression and Anxiety, panic attacks are characterized by some combination of the following symptoms:
-shortness of breath or rapid breathing
-rapid heart beat
-chest discomfort
-dizziness or feeling faint
-sweating
-trembling or shaking
-fear of dying
-choking, nausea, or stomach pain
-hot or cold flashes
-tingling or numbness
The symptoms of a panic attack seem to come with no warning or precipitating cause and generally last for no more than 20 minutes. But many of the above symptoms do resemble those of a heart attack, and individuals often go immediately to an emergency room or make an appointment with a cardiologist.

A common complication of frequent panic attacks is the fear of being in public places (agoraphobia), especially when alone. This probably stems from an effort by the person to avoid situations that have triggered previous panic attacks. Clearly, untreated panic disorder and agoraphobia can severely limit an individual's life.
Recognition and treatment of panic disorder are thus important if this immediate, scary discomfort and any long-term complications are to be avoided. The most effective treatment is a combination of psychotherapy and medications that may have to be continued for many months, along with the knowledge that relapses are common when drugs are stopped.

My wife's experience is unusual since such attacks frequently recur if adequate treatment is not given. Perhaps she was "cured" because of her faith in the cardiologist, a friend of ours, along with my long reassuring talks with her—a cheap but often ineffective form of psychotherapy.

Be sure to talk with your doctor if you are frightened by repeated short episodes of symptoms like those described above.