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Q. How can I differentiate between anxiety attack and heart attack?

Answered by
Dr. Prashant Valecha
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 07, 2021

Hi doctor,

I need an ECG analysis. Recently I went into urgent care with heart pain and shortness of breath, and got the attched ECG taken but was told to follow up with a cardiologist. This happened last week and after that the shortness of breath slightly got worsened and has not gone away. Kindly help.

Thanks.

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Hi,

Welcome to icliniq.com.

As per the reports attached (attachments removed to protect the patient's identity) it is a normal ECG (electrocardigram) as it shows a normal axis and sinus rhythm.

Regards.

Hi doctor,

Thanks for the reply.

Could you please explain me the reply in detail and what would you suggest for the symptoms?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Sinus rhythm means your heart rhythm origin is normal and its impulse direction is in normal axis, which is seen in normal people. For your symptoms, in order to rule out cardiac cause, I suggest you need to do an 2D (two dimensional) echocardiogram. If it appears normal, it can be due to non-cardiac cause, for example panic anxiety attacks, thyroid dysfunction or anemia.

Regards.

Hi doctor,

I do struggle with anxiety but the symtoms are present even when I am not dealing with an anxiety attack. I had a bike crash with another biker about two months ago and I was diagnosed with a concussion, some chest wall irritation and pnuemonia. Do you think does this have some relation with my present state?

Thanks.

#

Hi,

Welcome back to icliniq.com.

If there is not complete recovery after pneumonia, residual inflammation or lung damage may cause shortness of breath and chest pain. Your ECG is not suggesting any cardiac problem. In order to rule out any underlying causes related to lungs and heart I suggest doing few tests; TMT (treadmill test) and 2D echocardiogram tests for heart and chest X-ray and PFT (pulmonary function test) for lungs.

Regards.

Hello doctor,

I had a chest X-ray done a month after the accident and it was perfectly normal so it cannot be from my accident. I am working on my anxiety management. Is there anything else you could recommend?

Thanks.

#

Hi,

Welcome back to icliniq.com.

It is good that the X-ray is normal. For anxiety and panic, I suggest consulting a psychiatrist as they can prescribe some Benzodiazapines which will resolve anxiety. Other than drug, CBT (cognitive and behaviour therapy) will help.

Regards.

Hi doctor,

Thank you for the reply.

#

Hi,

Welcome back to icliniq.com.

You are welcome.

Regards.

Hi doctor,

Since anxiety is something I deal with, in case if I am having a heart attack how can I differentiate between an anxiety attack and a heart attack. Is there anything you would recommend doing about the symptoms?

Thanks.

#

Hi,

Welcome back to icliniq.com.

Symptoms of anxiety can come from anywhere, even without any exertion just while you are sitting or lying down. Pain of heart attack increases with exertion or walking and relieves on rest. In severe cardiac diseases, postprandial (after having food) chest pain is seen. I suggest, starting exercises or do brisk walking every day for 30 minutes. Exercise helps in overcoming anxiety and depression as it releases natural endorphins in body. If you feel chest pain on walking and if its intensity increases on further walking then cardiac cause to be ruled out.

Regards.


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