Panic or Heart Attack? When Fear Feels Fatal

It happened to Marcus*, a 37-year-old working professional in Singapore, on an ordinary Wednesday morning. Chest tightness. Sweaty palms. Heart pounding out of his chest. He thought, "This is it. I’m having a heart attack."

At the A&E, doctors ran tests. The ECG? Normal. Blood pressure? Slightly elevated. Heart? Fine. The real diagnosis? A panic attack.

The Overlap: When Panic Imitates the Heart

Panic attacks and heart attacks can feel frighteningly similar, shortness of breath, chest pain, dizziness, and a feeling of impending doom. The difference? While heart attacks stem from blocked arteries, panic attacks arise from intense anxiety surges, often without a clear trigger.

Many in Singapore, like Marcus, mistake panic for cardiac distress, leading to repeated ER visits and ongoing fear. Unfortunately, this confusion can delay both timely cardiac intervention in true emergencies and appropriate mental health care for recurring panic.

What Causes a Panic Attack?

A panic attack is a sudden rush of intense fear or discomfort, peaking within minutes. Causes vary but often include:

• Stress or trauma history

• Genetic vulnerability

• Medical or substance use triggers

• Underlying anxiety disorders

In Singapore’s fast-paced, high-expectation culture, it's no surprise that more are reporting these episodes, though stigma still keeps many silent.

Signs to Look Out For

Common symptoms of panic attacks include:

• Chest pain or tightness

• Racing or irregular heartbeat

• Shortness of breath

• Nausea or light-headedness

• Trembling, chills, or hot flashes

• A fear of losing control or dying

Heart attacks may present similarly, but often involve:

• Pain radiating to the jaw, arm, or back

• Nausea with cold sweat

• Worsening symptoms with exertion

Still unsure? Seek medical help first. Always rule out a cardiac cause.

The Emotional Toll of Panic

Even a single panic attack can leave lasting scars - constant worry, sleep disruption, avoidance of triggers (like MRTs or lifts), and in some cases, agoraphobia. Loved ones may not understand or believe what’s happening, leaving individuals feeling isolated and ashamed.

And here's a myth worth busting: “It’s all in your head.”
No, panic attacks are real, with physiological responses that feel very much like a crisis.

Hope, Help, and Healing

With Awareness, we can learn to differentiate and act wisely. With Courage, we can seek professional support. And with Love, we create a safe space to heal.

Psychological treatments like Cognitive Behavioural Therapy (CBT) are highly effective. Therapy helps individuals:

• Identify triggers and patterns

• Challenge catastrophic thinking

• Learn breathing and grounding techniques

• Rebuild confidence and resilience

In more persistent cases, a psychiatrist may recommend medication alongside therapy.

What You Can Do—For Yourself or Someone Else

• Don’t ignore symptoms. Seek medical advice.

• If it’s panic, consider therapy. Early intervention helps.

• Practise deep breathing, mindfulness, or progressive muscle relaxation.

• Speak to someone you trust — friend, family, or therapist.

• Encourage loved ones without judgment. Listen, don’t fix.

Final Thoughts

The body remembers fear. But it can also relearn safety.

If you or someone you love is experiencing overwhelming anxiety or unexplained physical symptoms, you’re not alone. Let’s talk about it. Because what feels like a heart attack could be a heart in distress, not from blocked arteries, but from bottled fear.

Start your journey with us today. We’re here — with awareness, courage, and love.

[Marcus is a pseudonym to protect identity.]