The number of men and women who suffer from heart disease is very similar. However, women are less likely to receive life-saving treatment for a heart attack because patients and doctors often don’t recognize the characteristic symptoms and dismiss them as stress or anxiety.
In the event of a heart attack, women are 50% more likely to be misdiagnosed than men due to unconscious biases held by members of the medical community and a continuing gap in research on women’s bodies. In this article, we discuss the differences between heart attacks and panic attacks. We also consider why women sometimes delay seeking medical attention, why their issues might be dismissed when they do, and how you can advocate for your own health.
A panic attack is a sudden rush of fear that triggers a surge of adrenaline, preparing the body for a fight-or-flight response to danger. The body responds with increased heart rate, rapid breathing that can feel like shortness of breath, and sweating. Constricting blood vessels can also cause you to feel dizzy or light-headed.
A panic attack can come on suddenly with no warning or develop more gradually. A particular experience triggers intense anxiety, but an extended period of high stress can cause even the slightest obstacle to push you over the edge. Some people experience only one or two episodes throughout their lives, while others struggle with repeated panic attacks. In some cases, the fear of having a panic attack can be paralyzing and may lead to avoiding certain activities and situations.
If you've ever had a panic attack, you know how terrifying and unexpected they are. When the panic sets, the fear is intense, and everything seems much worse than it is. Fortunately, most panic attacks subside within a few minutes or hours.
Symptoms of a panic attack
A panic attack often starts as an overwhelming feeling of stress, doom, and fear. Then you might experience:
Although terrifying, panic attacks are rarely life-threatening in themselves. However, medical data shows that in women, the symptoms of a heart attack can be similar to those of a panic attack.
A heart attack, or myocardial infarction, happens when blood flow to the heart is blocked, causing damage to the heart muscle. Most blockages occur when cholesterol and other substances build up layers of plaque in the arteries. When the plaque ruptures, a blot clot quickly forms and blocks or constricts one of the coronary arteries that bring blood to the heart. When the heart is deprived of blood and the oxygen it carries, the muscle cells become damaged and begin to die within 30 minutes of the initial blockage. This means the heart can no longer function as it should.
A heart attack is a life-threatening condition that requires immediate medical attention, even if your symptoms seem to subside. If you have a family history of heart disease or have been experiencing an ache in your chest, it’s crucial to act fast! Call the emergency services and get help immediately.
Early warning signs can appear days or even weeks before a serious heart attack. Symptoms you should not ignore include fatigue, unease, cold sweats, back pain, and heart palpitations. When a heart attack comes on suddenly it is more likely to be fatal.
Symptoms of a heart attack
The most recognized symptoms of heart attack are pain and tightness of the chest. The pain may radiate from the chest up to the jaw and down the left arm or both arms, and you may feel like an elephant is sitting on your chest.
Many women who suffer heart attacks may not feel chest pain at all, but predominantly experience other symptoms such as debilitating fatigue and pain or tightness in the neck, jaw, and shoulders, between shoulder blades, and in the upper back.
For many decades, doctors believed that heart disease affects mostly men. We now have statistical evidence that shows both men and women suffer from heart attacks equally, but women are more likely to die from myocardial infarction because we tend to concentrate on the chest pain, which is the most common symptom in men, and focus less on the symptoms women are more likely to experience.
As you can see, many of the symptoms of a panic attack and a heart attack overlap. The main difference is that the pain of a heart attack feels like a sharp, squeezing, radiating pain that can come and go in waves. During a panic attack, the heart races, and you might feel a tightness in the chest due to shortness of breath, but you shouldn't feel radiating pain.
Additionally, a panic attack usually lasts anywhere from a few minutes to an hour. A heart attack continues much longer as the waves of pain ebb from extreme and radiating to a milder tightness in the chest.
Because women often don't feel intense pain in their chest but instead experience fatigue, anxiety and pain in their back, arms, and jaw, it's easier for patients and doctors to mistake a heart attack for a panic attack.
To help distinguish between a heart attack and a panic attack, ask yourself:
Many women don’t seek medical attention because they are conditioned to put the needs of other people first and because they don’t associate the symptoms they experience with serious illness, attributing them to the flu or anxiety. But this problem is not just about individuals and self-care, it is systemic.
Heart disease is only one health concern in which women are commonly underserved. Studies show that up to 65% of women living with chronic pain have experienced lower quality care because of their sex. When a doctor dismisses a patient’s complaints, attributing the symptoms to the patient “imaging things” or “being dramatic”, we call it medical gaslighting. This can lead to missed or delayed diagnosis and improper treatment.
Although society has begun calling attention to this phenomenon, women and minorities remain at greater risk of medical gaslighting. When this happens, it lowers the patient’s morale, reduces their trust in medical professionals, and increases their risk of extended suffering and death from misdiagnosed conditions such as cancer, heart disease, autoimmune disease, and chronic pain. This leaves patients to doubt their own experience and makes it harder for them to get the help they need.
Medical gaslighting is not necessarily intentional, but it is the result of bias and lack of attention to women's concerns. To this day, most participants in medical trials are men leaving us with blind spots with regard to women's health: Do men and women react to medications in the same way? Do they present with the same symptoms? How do appropriate dosages differ?
For many decades women of reproductive age were excluded from medical trials because researchers believed that fluctuating hormone levels in women make them more difficult to study. There was also a fear that if a woman participating in a medical trial were to get pregnant, some unknown factor might harm the foetus. This fear grew after the drug thalidomide unexpectedly caused birth defects in the 1970s. Such potential dangers certainly should be taken into account but must not be used to justify a lack of medically relevant information about women.
Laws have been passed requiring the inclusion of women and minorities in medical trials, but these groups are still disproportionally underrepresented.
If you are currently experiencing any of the heart attack symptoms described above, seek medical help immediately. The only way to save your life and reduce the chances of permanent damage is to get professional help. However, if your doctor isn't taking you seriously, no matter the diagnosis, be prepared to advocate for your health.
Bring notes when you visit the doctor
Stress and worry can sometimes make us forget what we want to say. It is common for these feelings to come up at a doctor’s visit. Write down your symptoms and other concerns on a piece of paper and bring it with you so you have something to refer to when speaking with your doctor. Keeping a symptom journal can also be helpful: make a note of when each symptom appears and its duration and intensity. If you know what triggered the symptom, write that down too. This level of detail can help your doctor arrive at the proper diagnosis more quickly.
Get another opinion
If your doctor isn’t willing or able to give you the help you need, consult another doctor. You owe it to yourself to advocate for your own health. Doctors have special training and experience, but they are also just people who sometimes make mistakes and may be unaware of their own biases. Keep looking until you find a specialist who makes you feel safe and heard.
Listen to your body, believe in yourself
As children, we are taught to respect authority figures—our parents and teachers, doctors and leaders know better, and we should listen to them. This early conditioning can make us second guess ourselves when a respected doctor says something like "that's nothing to worry about, it's all in your head". You are the highest authority on your own experience.
Don’t be afraid to ask about the thought process behind your doctor’s diagnosis. You have the right to know because their decisions have a direct effect on you and your health. If your doctor is dismissive or reluctant to answer your questions, this is a serious red flag!
Remember, it’s ok to bring a friend, partner, or family member to a medical appointment. A supportive presence can help you feel more confident, ask difficult questions, and say what’s on your mind. A friend can also advocate for you if you feel overwhelmed and provide comfort if you must face a difficult diagnosis.
Your health is a precious asset and there may come a time when you will have to advocate for yourself in the face of deliberate or unintentional gaslighting. If you are concerned about something that turns out to be nothing, that will be experience gained and not time wasted. Learn about the characteristic symptoms of heart attack and panic attack so you can tell the difference if it happens to you.
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