Five questions to ask when experiencing chest discomfort.
When it comes to chest pain, you should never take chances. Here, cardiologist Dr. Marc Eisenberg and emergency room doctor Sampson Davis tell Dr. Oz how to tell the difference between a heart attack and a panic attack, including what to watch out for and when you should seek medical attention.
If you are currently experiencing severe chest pain or think you are having a heart attack, take aspirin or Tylenol, and seek medical attention immediately.
1. Where Is the Pain?
Heart Attack: While a heart attack tends to present with chest pain, it may radiate to other areas of the body like the back, jaw, and neck. Pain from a heart attack is delivered to the brain by nerves of the heart, Eisenberg says, and because some of those same nerves also go to the arms, neck, and jaw, it can feel like the pain is radiating.
Women, in particular, tend to ignore the signs and dismiss the pain as part of every day living because their symptoms don't match what they are used to seeing on television as a typical heart attack.
Panic Attack: Dr. Davis says that pain from anxiety is usually located in the chest. Eisenberg adds that when someone is having a panic attack, pain is often caused by muscle or esophageal spasm and would not radiate throughout other parts of the body.
2. What Does the Pain Feel Like?
Heart Attack: Pain from a heart attack usually starts out as a heavy, crushing discomfort like a brick sitting on your chest, Davis says. You may have heard someone describing it as "an elephant sitting on your chest." The pain that comes with a heart attack is caused by a lack of oxygen in the muscle, Eisenberg says. So that is what causes the feeling of the "elephant" or "brick" on your chest, he adds.
Panic Attack: If the pain you are experiencing is sharp and "stabbing" muscle pain — and in just one spot — then that is more common with anxiety and panic attacks, Davis says.
3. How Did the Pain Start?
Heart Attack: Heart attack pain is usually brought on by exertion, Eisenberg says. For example, in winter, we hear a lot about heart attacks happening when people are shoveling.
Panic Attack: A panic attack, on the other hand, will usually happen during a stressful situation, Eisenberg notes.
4. How Long Does the Pain Last?
Heart Attack: With a heart attack, the pain will usually last longer than 15 minutes and can get more intense as time goes on. The pain gets worse because you are losing blood supply, Eisenberg says. You have a blocked artery to the heart, and it is not going to fix itself with some deep breaths, he adds. The vessel that is the culprit has completely closed.
Panic Attack: Davis says anxiety pain quickly diminishes. For example, he says, in many cases, when patients get to the ER, the pain they felt at home is already gone. A panic attack is a heightened anxiety state, Eisenberg says, and taking deep breaths can start to make the pain go away.
5. Do You Feel Tingling in Your Hands?
Panic Attack: There is one symptom that can happen with a panic attack that would not happen with a heart attack and that is tingling in the hands, Eisenberg says.
When people are panicking, it comes with shallow breathing, he says. The carbon dioxide levels in the blood decrease and the blood becomes less acidic, and that's one of the reasons you feel a tingling, Eisenberg says.
We've all seen the media portrayals of someone breathing into a paper bag when they are having a panic attack, he adds. Basically, it puts some of the lost carbon dioxide back into your body.
Dr. Eisenberg is answering all of your big, small, embarrassing and live-saving health questions in his column Rounds With Dr. E. Even the questions you didn't know you had! Click here to read more.
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