Panic Attack or Heart Problem? Anxiety Symptoms and When to Get Checked

A panic attack is a sudden wave of intense fear with physical symptoms: a pounding heart, chest tightness, shortness of breath, shaking, sweating, dizziness and a feeling of losing control. It usually peaks within about 10 minutes and passes. Because it can feel like a heart attack, new chest pain, or chest pain that doesn't fit your usual pattern, should be treated as a possible heart problem first. Ongoing anxiety is common and very treatable.

What a panic attack feels like

• A racing or pounding heart
• Chest tightness or pain
• Shortness of breath or a choking feeling
• Trembling, sweating, chills or hot flashes
• Dizziness, lightheadedness or nausea
• Numbness or tingling in the hands or face
• Feeling detached, or a sense of doom or losing control

Panic attack or heart attack?

They can overlap, and you can't always tell from the inside. A panic attack is more likely if it comes on during stress or out of the blue at rest, peaks within minutes, includes tingling and fear of losing control, and you've had the same thing before. A heart problem is more likely with pressure or squeezing in the chest, pain spreading to the arm, back, neck or jaw, symptoms brought on by exertion, or if you're older or have heart risk factors. Our post on heart attack symptoms covers the signs. If in doubt, call 911.

What helps in the moment

• Slow your breathing: in through your nose for 4 counts, hold for 4, out through your mouth for 6
• Ground yourself: name five things you can see, four you can hear, three you can touch
• Remind yourself that the feeling will pass, and it usually does within minutes
• Avoid caffeine, nicotine and alcohol, which can make symptoms worse

Managing stress and anxiety long term

• Regular exercise, even a daily walk
• Enough sleep, at regular times
• Limiting caffeine and alcohol
• Talking to someone you trust
• Therapy, especially cognitive behavioral therapy, which works well for panic and anxiety
• Medicine, when a provider thinks it would help

A primary care provider or mental health professional can help you build a longer-term plan.

What urgent care can do

Urgent care can check you after an episode that's passed, especially if it was your first: a clinician can examine you, do an EKG to look at your heart rhythm, and check for things that can mimic anxiety, such as thyroid problems, dehydration or low blood sugar. A telehealth visit can help you talk through symptoms and next steps.

At an AfterOurs clinic, a standard self-pay visit is $175, a visit with one moderate service such as an EKG is $250, and a self-pay in-clinic visit never costs more than $330. Telehealth is $75. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See the cost and insurance page.

Call 911 if you have chest pain or pressure that lasts more than a few minutes, pain spreading to the arm, back, neck or jaw, fainting, or symptoms that feel different from your usual panic attacks. If you're thinking about harming yourself or are in crisis, call or text 988 (the Suicide and Crisis Lifeline), any time of day.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.