Tuesday, March 07, 2006

Panic vs heart attack

This post is in response to one of the questions posted on Dr Helen.

Sarah asks

How do I know the difference between a panic attack and a heart attack? Cold sweat, shaking, short of breath, sense of doom. With a family history of heart problems, though my numbers are good.

This is a common problem, particularly in the elderly from western societies where senior citizens live alone. The fear of death alone can cause severe panic. The symptoms described: the cold sweat, shaking, short of breath and sense of doom, can occur in both a heart attack and a panic attack, except that in a real heart attack, there may be chest discomfort usually although not necessarily always. Heart attacks in the elderly can often occur atypically.

Coming back to Sarah, usually the shaking and sense of doom is much less with heart attacks, than with panic where these features override the chest discomfort. A call for help, and a simple ECG would help to clarify the situation.

As always with coronary artery disease presentation, the coronary risk profile of the subject is very important. If there are obvious coronary risk factors of diabetes, hypertension, high cholesterol, cigarette smoking, previous heart attacks, then the "panic" symptoms should not be taken lightly and a call for help is reasonable. As always, when in doubt and if you are in the coronary risk category (2 or more of the coronary risk factors), a call for help, with the assumption that it is an impending heart attack, is better then ignoring it as in " panic" attack.

1 comment:

Brate said...

In the cases of heart attack and cardiac arrest, or any other heart shocks, time sets to be the most crucial factor for the survival of the patient. Sometimes, a little knowledge regarding the immediate actions to be taken may help your near and dear ones to survive in such incidents. The response a person takes to treat a victim decides the probability of his/her survival. Its been my personal experience fighting to survive against a heart attack. A quick reorganization of your bodily responses may increase your chances of survival. Because of having many heart problems, I was enrolled in a concierge Healthcare program from elite health. I was attacked by a severe heart attack in a party, luckily surrounded by many people. Some of the sudden changes in my body was recognized by me and anticipated immediately. I got a very severe chest pain which was almost unbearable for more than a minute. I got the suspicion that I might be having heart attack, and immediately called my physician on the phone, and explained my condition and its severity. Because of the immediate guidance, I was directed immediately to have an aspirin which I used to carry with me as prescribed by my physician. It was quite a frightening experience for me to face such a heart attack, but somehow I managed to be calm until 911 arrived. I was immediately taken to the nearest hospital, where already my physician were present and have got everything setup according to my medical history. And it was in some matter of seconds that everything was in control. A doctor, who already have the complete knowledge of the medical history and fitness of the person, extra ordinarily ameliorate your recovery process. Hence such a concierge level program from Elite health, helped me a save my life, like many others.