Anxiety may also resemble heart disease with symptoms including rapid heartbeat, dizziness, nausea, sweating, and shortness of breath. Because the early warning signs of an anxiety attack can also resemble those of a cardiac event, confusion is rampant — and a postponement of correct diagnosis can be a dangerous practice. So understanding the difference is very important.

To share this, HT Lifestyle sat down with Dr Bipeenchandra Bhamre, Consultant Cardiac Surgeon at Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai. Chest pain, breathlessness, sweating and palpitations can arise in both anxiety attacks and heart problems, so it is crucial to recognize subtle differences, he added. “Many people come to your emergency room because they’re afraid of a heart attack, only to learn later that it’s a panic attack or an anxiety attack,” Dr Bhamre said. The overlapping symptoms often amplify fear; this in turn makes it even more difficult for people to decide how they feel about their condition accurately and well.

Why When Anxiety and Heart Problems Feel alike?

Dr Bhamre's lecture explained that when anxiety hits, the body triggers the "fight or flight" response and this has to be the same release of stress hormones such as adrenaline. This can elevate heart rate, blood pressure and breathing rate; muscles can tighten — and you end up having chest discomfort sometimes. Heart issues, in fact, are caused by decreased blood flow to the heart muscle. “Cardiac problems usually result in chest pressure, heaviness or pain that can radiate to the left arm, jaw, neck or back,” he said. These episodes can also come along with sweating, nausea and extreme fatigue.

How to Tell the Difference

Even though the symptoms of tension may overlap, there are specific features of them that may distinguish anxiety and heart-related pain that can indicate an entity of concern from heart-related pain. Symptoms of anxiety are usually experienced when emotional stress is intense and usually resolve in the process and become less likely to occur if we have been relaxed. Heart-related chest pain likely feels like pressure or squeezing and can be aggravated by exertion. Anxiety chest pain is usually sharp and localized and cardiac pain is heavier, tighter or spreading. Heart symptoms are usually longer lasting and don’t subside with calming methods like deep breathing. 

Those with risk factors such as diabetes, high blood pressure, smoking habits or a family history of heart disease should seek immediate medical attention as soon as symptoms appear. Dr Bhamre reminded us not to dismiss persistent chest pain. He also advised a heart-healthy lifestyle including proper diet, quitting smoking and excessive alcohol consumption, and practicing physical activity at least five separate days a week which can contribute to coping with stress, as well as lowering the risk of anxiety and heart disease.