When a heart attack is mistaken for a panic attack: why the difference matters
Recent media coverage surrounding television presenter Alison Hammond has highlighted an important medical issue. After experiencing alarming symptoms during a live television broadcast, Ms Hammond feared she may have been having a heart attack.
Following medical assessment, she later confirmed that her symptoms were caused by a severe panic attack rather than a cardiac event. She described the episode as feeling ‘very real’, a reminder that panic attacks and heart attacks can produce strikingly similar symptoms.
A panic attack is a sudden episode of intense fear or anxiety that causes very real physical symptoms, often with no obvious danger present. Although not usually physically harmful, it can feel overwhelming and may closely resemble a serious medical emergency. Panic attacks typically reach their peak within a few minutes and often resolve within 10 to 30 minutes, although feelings of exhaustion or distress can last much longer. Many people experiencing a panic attack for the first time genuinely believe they are having a heart attack or another life-threatening condition.
While panic attacks are common and can be extremely distressing, one of the difficulties facing healthcare professionals is that many of their symptoms overlap with those of a heart attack. Chest pain, shortness of breath, dizziness, palpitations, sweating, nausea, and an overwhelming sense of fear can occur in both conditions. For this reason, clinicians must take care not to assume that symptoms are psychological in origin without first considering whether there may be an underlying cardiac cause. A diagnosis of panic attack should often be reached only after an appropriate clinical assessment has been undertaken and serious physical causes have been excluded.
In medical negligence cases, concerns can arise where a patient presenting with possible cardiac symptoms is reassured that they are suffering from anxiety or a panic attack, only for it to emerge later that they were experiencing a heart attack or another significant cardiovascular event. Some patients, particularly women, younger adults, and those without a recognised history of heart disease, may present with symptoms that are considered atypical. If appropriate investigations, such as an ECG, blood tests, monitoring or specialist review, are not undertaken, there is a risk that an important diagnosis may be delayed or missed altogether.
Even where a heart attack is eventually identified, questions can arise about the adequacy of follow-up treatment. Timely referral to cardiology services, appropriate medication, rehabilitation, and investigation of underlying risk factors can all play a vital role in reducing the risk of further cardiac events. Where follow-up is overlooked or delayed, patients may miss opportunities to receive treatment designed to protect their long-term health and reduce the likelihood of recurrence. In some cases, this can have serious consequences for both recovery and prognosis.
Fortunately, cases such as that of Alison Hammond demonstrate that symptoms suggestive of a heart attack do not always indicate serious heart disease. However, they also serve as an important reminder that because panic attacks and cardiac events can appear so similar, careful assessment is essential. From a patient safety perspective, the key lesson is that symptoms should be fully investigated before being attributed to anxiety alone and that, where cardiac disease is identified, appropriate follow-up and ongoing management are just as important as the initial diagnosis itself.
The Penningtons Manches Cooper medical negligence team has seen examples of situations where medical care, unfortunately, was not thorough enough in these circumstances, and cardiac issues were initially attributed to anxiety.
A recent claim arose from a GP’s failure to investigate exertional chest pain in a 41-year-old woman who had sought an emergency GP appointment, fearing that she had had a heart attack that day and in the knowledge that she had a family history of heart disease. The GP failed to ensure that she underwent an ECG examination of her heart and recorded that her symptoms were likely to be due to anxiety. Our client went on to suffer a heart attack whilst working abroad, which she was very fortunate to survive. As a result of her cardiac arrest, she required emergency hospital treatment abroad and suffered significant physical and psychological symptoms, impacting on her day-to-day abilities and her career progression. Had an ECG been performed, it would likely have led to preventative treatment, including surgery for cardiac stenting, significantly reducing the risk of a major heart attack.
The claim was disputed and litigated, and a significant amount of expert evidence was analysed. Ultimately a compromised settlement was agreed, avoiding the need to proceed to trial.
Alison Johnson, partner in the medical negligence team, comments: “As a medical negligence solicitor, I regularly see the importance of keeping an open mind when assessing symptoms that may have more than one explanation. Ensuring that serious cardiac conditions are properly investigated can be critical to patient safety and long-term outcomes.”