People in the world today are unlike what they were a century back. They are well versed regarding many diseases, their respective symptoms, and even at times what needs to be done. This is mostly due to the rapid flux of information that is passing between individuals, but at times false information is also circulated, mostly due to well meaning ignorance. The topic for discussion in this comparison ‘ heart attack and anxiety attack’ is also of similar genre. Some have experienced one or the other, and some have experienced both. Without being aware of the pathophysiology, and just by going over the mere vague symptoms may carry lethal consequences in the medical profession. The treatment and follow up for each is so far apart, that they are tackle by two separate specialties.
Heart attack or myocardial infarction (MI) occurs due to the lack of blood supply to the heart, leading to the death of heart muscles. This is usually due to a clot, or a cholesterol plaque in the arteries supplying blood to the heart. They are induced by exercise, heavy meals, and severe infections. They present with central constricting type of chest pain, with radiated pain along the left arm and fore arm, neck, jaw, interscapular region. There is also associated shortness of breath, palpitations, dizziness and nausea. Electrocardiograph (ECG/EKG) shows unique changes, also there will be elevation of cardiac markers. Management will be based on initial antiplatelet treatment followed up with a liquefying the clot depending on the type of MI or bypass surgery. Follow up has to be very specific, with management of co morbidities, lifestyle modifications and regular investigative checkups.
Anxiety attack or panic attack is a psychological state of fear and apprehension with excessive awareness of the bodily functions. This is usually associated with agoraphobia or any other phobia or psychiatric disorder. The patient will complain of heaviness of the chest, palpitations, difficulty in breathing, dizziness, nausea and feeling of derealization. The ECG findings of these cases are normal, may be with an increased heart rate, and normal cardiac markers. Management is done through breathing into a paper bag, using benzodiazepines and /or antidepressants, and with the use of cognitive therapy. Follow up is required with psychotherapy, and long term use of medication is not recommended.
Difference between Heart Attack and Anxiety Attack
Both of these conditions present with almost similar presenting complaints, also they may be associated with psychological strain. But heart attacks are due to blockage of the coronary arteries, and the anxiety attacks are of psychological origin. Heat attacks elaborate specific investigative findings, and anxiety attacks do not show such findings. Heart attacks require specific management protocols with the use of medications to treat the underlying problem and may also have to go into surgery. Anxiety attacks only require medications to manage the symptoms of apprehension / fear and the further management can be done through physical techniques or using psychotherapy. Heart attacks require intense follow up to prevent recurrence or complications, but anxiety attacks do not require a stringent follow up scheme.
In summary, heart attacks can be deadly and need specific management of the condition and co morbidities. Anxiety attacks feel as they are lethal, but in actuality, they are just a barrier for some people that need to be crossed with understanding.