By Kayt Sukel
Rosalie was about to head back to work to try finish up an important project after hours when she started feeling lightheaded. All of a sudden, she felt sweaty and
flushed, and she felt her heart racing. She felt a distinct heaviness in her chest —heavy to the point that she worried she might be dying.
“I called my sister immediately and told her how I was feeling. I was really scared. She told me to call 911 right away because it sounded like a heart attack,” she says.
“But when I finally got to the ER and saw the doctor, and he did a few tests, I was told it was actually a panic attack.”
Manisha Gupta, an emergency medicine physician from Plano, Texas, says Rosalie’s story is more common that you might think. Panic attacks, a hallmark symptom of a particular type of anxiety disorder called panic disorder, affect millions of Americans each year. And many people experiencing a panic attack enter the emergency room thinking that something more sinister is going on with their health.
“Symptoms can definitely vary from person to person, but it is common to see hyperventilation, shortness of breath, sweating, feelings of doom, tingling in the
arms and legs, and some people also have chest pains as well,” she says. “It’s something that can be really frightening for patients.”
What is happening to cause these symptoms? While everyone feels anxious sometimes, and will have bodily responses to life’s ups and downs like an elevated
heart rate or a case of the sweats, individuals with panic disorder have exaggerated responses to common stressors that ultimately build up into panic attacks. Gupta says that’s why the symptoms often mimic cardiac or other more dire health conditions.
“People having panic attacks often tend to hyperventilate. That can cause contractions of the chest muscles, which can be painful. It can constrict blood vessels, which could also be a source of pain,” she says. “And frankly, in my experience, when people are very anxious, their mind seems to quickly go to worst case scenarios like a heart attack or stroke.”
When Rosalie arrived at the emergency department, the physicians there gave her a thorough work-up. They checked her vitals, did an electrocardiogram (EKG) to check her heart, and also looked at her lung function. Her doctor ruled out all other potential conditions before discussing her anxiety and stress levels with her—where he learned about her big, and seemingly impossible, deadline at work.
Gupta says that’s par for the course.”The first thing you want to do is look at the patient’s risk factors. Do they have a history of diabetes? High cholesterol? High blood pressure? If so, the chest pain is more likely to have a more dangerous source,” she says. “If it’s a 24-year-old with no history but a lot of stress, we usually know it’s more likely to be anxiety. But we don’t just leave it at that. We do a variety of tests to understand what may be going on.”
Rosalie’s trip to the emergency room resulted in a prescription for anti-anxiety medication and a referral to a mental health professional. And since then, she’s feeling much better. While she says she’s a bit “embarrassed” for causing such a fuss, she’s glad she is getting the help she needs to manage her anxiety.
Gupta says she has no reason to be embarrassed—and applauds her for seeking help early.
“My rule of thumb is that, if you are having chest pains, it’s better to see a medical professional to find out what’s really going on. Don’t try to figure out if it is anxiety
or something else on your own,” she says. “There’s no need to wait it out. Let a professional help you.”