A pounding heart, a tight chest, trouble breathing and a sudden fear that something is badly wrong. These panic attack symptoms are frightening, and many of them overlap with the warning signs of a heart attack. Some people only hear the word panic after an emergency visit finds no heart problem, and they go home relieved but unsure what happened or how to prevent the next one.
This guide from Palm Urgent Care in El Cajon covers how to stay safe, how a panic attack differs from panic disorder, which treatments work, and where to find free crisis support in San Diego County.
New Chest Pain Is Always a 911 Call First
No article or past experience can tell you whether a specific episode is panic or a heart problem. Only a medical evaluation can. The CDC lists the major heart attack warning signs as chest pain or discomfort, pain in the jaw, neck, back, arms or shoulders, shortness of breath, and feeling weak, light-headed or faint. Women are more likely to also have unusual tiredness and nausea or vomiting. The CDC advises calling 911 right away, because faster treatment means less damage to the heart muscle.
Call 911 right away for:
- New chest pain, or sudden crushing, squeezing, tightening or pressure in the chest
- Pain that spreads to the jaw, left arm or between the shoulder blades
- Chest discomfort with nausea, dizziness, sweating, a racing heart or shortness of breath
- Sudden, sharp chest pain with shortness of breath, especially after a long trip
- Anyone at immediate risk of harming themselves or someone else
The chest pain warning signs above come from MedlinePlus. If it turns out to be panic, getting checked cost you nothing. New chest pain does not belong at urgent care, and our guide to urgent care vs the emergency room explains why.
Panic Attack Symptoms: What They Feel Like and Why They Feel Physical
The National Institute of Mental Health (NIMH) describes a panic attack as a sudden episode of intense fear with physical and emotional symptoms. Common panic attack symptoms include:
- A pounding or racing heart
- Sweating, chills, trembling or tingling
- Difficulty breathing or chest pain
- Weakness, dizziness or stomach pain
- A fear of death, a sense of doom or a feeling of losing control
According to NIMH, an attack can last from a few minutes to an hour or sometimes longer, and it can strike without a clear trigger, even during sleep.
Why does fear feel so physical? MedlinePlus explains that anxiety can make you sweat, feel tense and have a rapid heartbeat, and its chest pain guide lists panic attack, which often occurs with fast breathing, among the causes of chest pain. NIMH notes that panic attacks often include physical symptoms that might feel like a heart attack. Once a heart cause has been ruled out, the sensations are still real. They come from anxiety, and that is what treatment targets.
Panic Attack vs Panic Disorder
One panic attack does not mean you have a mental health condition. NIMH describes a panic attack as a one-time or occasional episode. In panic disorder, attacks are repeated and unexpected, and the person has ongoing worry about future attacks or changes their behavior because of that fear, such as avoiding places where attacks have happened.
Panic disorder is common. NIMH estimates that 2.7% of U.S. adults had panic disorder in the past year, with higher rates in women (3.8%) than men (1.6%), and that 44.8% of those adults had serious impairment. MedlinePlus adds that it often starts in the late teens or early adulthood.
Treatments That Work: Therapy and Medication
NIMH states that with the right treatment and support, people with panic disorder can manage their symptoms and improve their quality of life.
Cognitive Behavioral Therapy
NIMH calls cognitive behavioral therapy (CBT) the gold standard choice for psychotherapy. CBT teaches new ways of thinking, behaving and reacting to the feelings that come before or during an attack. Exposure therapy, one part of CBT, involves confronting the fears tied to panic, including the body sensations themselves, and may be paired with relaxation and breathing training.
Medication
NIMH lists selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), both antidepressants, as common options. They may take several weeks to work, and side effects such as headaches, nausea or trouble sleeping are usually not severe, especially when the dose starts low. Beta-blockers can ease physical symptoms such as a rapid heart rate, sweating and tremors. Benzodiazepines work quickly, but because some people build tolerance or become dependent, providers may prescribe them only for brief periods.
MedlinePlus also suggests cutting back on caffeine, exercising regularly, sleeping well and joining a support group. Talk with your prescriber before starting, stopping or changing any medication.
How a Behavioral Health Visit Helps After Heart Causes Are Ruled Out
MedlinePlus explains that diagnosing panic disorder includes checking whether an unrelated physical problem is behind the symptoms, which can involve a heart health check and blood tests for thyroid problems. That is why the emergency or medical workup comes first. Once it finds no heart cause, the next step is treating what is driving the episodes.
At our clinic at 505 N Mollison Ave, Suite 201, in El Cajon, our behavioral health team can:
- Review your history: when attacks happen, how long they last and what you now avoid
- Screen for panic disorder and related concerns such as depression
- Talk through therapy options and coping skills
- Provide medication management, with follow-up to track results and side effects
- Review discharge papers or test results from your emergency visit
Please do not come to our clinic for new or unexplained chest pain. Call 911 or go to an emergency department.
East County is home to many families, including large Arabic-speaking and Chaldean communities, and describing anxiety in a second language can feel harder. The county crisis line below offers interpreters, and panic disorder is a recognized, treatable condition.
Crisis Support in San Diego County: 988 and the Access and Crisis Line
Help is available now, without an appointment.
- 988 Suicide & Crisis Lifeline: call or text 988, or chat through 988lifeline.org. It is free, confidential and open 24/7 for mental health struggles, emotional distress, alcohol or drug concerns, or anyone who needs someone to talk to.
- San Diego Access and Crisis Line (ACL): 1-888-724-7240. Offered by the County of San Diego, this free, confidential line is open 24 hours a day, 7 days a week, with interpreter services in more than 200 languages. As the county's local 988 crisis center, it offers crisis intervention, mobile crisis response, and mental health and substance use referrals.
- 911: for chest pain, any medical emergency, or immediate danger.
Frequently Asked Questions
Can a panic attack feel like a heart attack?
Yes. Both can cause chest pain, a racing heart, shortness of breath and sweating, and the National Institute of Mental Health notes that panic attacks often include physical symptoms that might feel like a heart attack. Treat new chest pain as an emergency and call 911.
How long do panic attack symptoms last?
According to the National Institute of Mental Health, a panic attack can last from a few minutes to an hour or sometimes longer. Call 911 if symptoms include chest pain or keep getting worse.
What is the difference between a panic attack and panic disorder?
A panic attack is a single or occasional episode of intense fear. Panic disorder means repeated, unexpected attacks plus ongoing worry about future attacks or changes in behavior to avoid them.
Who can I call in San Diego County during a mental health crisis?
Call or text 988, or call the San Diego Access and Crisis Line at 1-888-724-7240. Both are free, confidential and available 24/7. Call 911 for chest pain or immediate danger.
If panic attacks are shaping how you live, you do not have to handle them alone. Not sure it is time to reach out? Read our guide to signs you may need mental health support. For directions, hours and how to reach our behavioral health team, visit the Palm Urgent Care El Cajon (Mollison) page.
This article is for general information and is not a substitute for medical advice from a licensed clinician.