[markwaldron]

I had a very similar experience. Started when I was 25 after a 3 month stint of being unemployed. It started with a panic attack (which I thought was a heart attack at the time), and I ended up going to the hospital, a cardiologist, sleep clinic, gastro, etc. until eventually came to the conclusion it was nothing wrong with my heart but rather panic disorder.

I take a low dose of xanax now and all the symptoms went away and I no longer have panic attacks. I'm working on finding a better daily medication, but it completely changed my life to have a temporary solution after 3+ years of struggle and suffering with panic attacks multiple times per week.

[xkcd-sucks]

So I just have to ask because I've experienced tons of panic attacks but also have very strong family history of death by cardiac arrest -- Is there a subjective, experiential way to differentiate between the two? I always assume it's a panic attack "and if it's not just die in bed" but...

[jdsfighter]

The problem is that both heart attacks and panic attacks share a variety of symptoms and even just learning about certain symptoms of heart attacks (after our CFO died of one about a year back) has made those symptoms manifest during my panic attacks. The other thing that makes this difficult is that anxiety attacks, panic attacks, and heart attacks don't have consistent symptoms among all individuals.

So it's really a crap shoot. I had a lot of cardiac work done, so I can pretty confidently say for the next decade or so, barring go through any drastic lifestyle changes, that my heart isn't going to go out on me. But I also found ways to mentally explain all the symptoms I was experiencing and deescalate myself.

Problem: "My chest is hurting." | Question: "Am I hyperventilating?" Problem: "My jaw is hurting." | Question: "Am I clenching my teeth?" Problem: "I feel short of breath" | Question: "Can I force myself to do breathing exercises?"

[markwaldron]

I agree with what jdsfighter said - you should go to the doctor to get some confidence that there isn't some sort of underlying heart issue. After that though, it's really a mental game that requires/required some therapy.

My panic attacks last from 3-10 minutes typically and can go up to 90 minutes. I wear an Apple Watch which would (hopefully) let me know if I had an arrhythmia. I also check my heart rate when I'm having a panic attack (which sometimes doesn't help) and I try to see if it's consistently going up, or if with deep breathing I'm able to get it to go down. Lastly, I have the xanax, which usually fully kicks in within 10-15 minutes. My attacks have the shortness of breath, feeling like I can't catch my breath, rapid heart rate, tunnel vision, etc. I try to find a calm/quiet space to relax, listen to my Calm app, and if I'm lucky, lay down for a bit.