He woke up with palpitations, cold sweats and a sense of doom. Was it heart attack or a panic attack?

A 40-year-old man awoke one morning feeling as if his heart was racing uncontrollably and his body was drenched in cold sweat. He also experienced an overwhelming sense of dread. Fearing a life-threatening heart condition, he immediately sought medical attention at our hospital. Initial tests, including cardiac marker analysis, confirmed no signs of a recent heart attack.

However, the symptoms persistently returned, leading the patient to return three days later for further evaluation. Despite undergoing a series of heart-related tests, including a CT coronary angiography, no evidence of a heart attack was found. The patient's persistent fear and anxiety surrounding these episodes, coupled with his underlying depression, indicated a possible diagnosis of panic attacks.

It is crucial for emergency room physicians to differentiate between panic attacks and heart attacks, as misdiagnosis can lead to unnecessary worry and repeated hospital visits. Panic attacks involve intense episodes of fear and physical symptoms that can mimic heart attack signs, but they stem from psychological triggers rather than cardiac issues.

A panic attack typically begins with a surge of anxiety, followed by rapid heartbeat, rapid breathing, sweating, trembling, dizziness, and chest discomfort. The fear of having another attack can lead individuals to alter their lifestyle, avoid physical activity, and seek constant reassurance, which can worsen both anxiety and depression.

Proper diagnosis and treatment, including appropriate psychological therapy and management of any underlying depression, are essential to alleviate the symptoms and prevent the cycle of false alarm and repeated medical visits.