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Panic attack or heart attack?

Anticipating events which can lead to extreme panic, such as a roller-coaster ride, can help patients avoid such situations.
Anticipating events which can lead to extreme panic, such as a roller-coaster ride, can help patients avoid such situations.PHOTO: ISTOCKPHOTO

Symptoms are quite alike, but a panic attack makes you feel like you are going out of control

A polytechnic graduate taking a roller-coaster ride experienced such extreme panic that she would later feel the same awful sense of fear on buses and trains.

The panic attacks got so bad that she could not leave her house alone for nearly two years.

Thankfully, oral medication helped to calm her and, within a month of receiving the treatment, she was able to attend job interviews.

A Singapore study conducted in 1998 estimated that 2.7 per cent of the population here may have similar panic disorders, said Dr Victor Kwok, head of the department of psychiatry at Sengkang Health, which manages Alexandra Hospital.

HARD TO DIFFERENTIATE

It is not easy for anyone to differentiate a panic attack from a serious medical condition and it is not safe to assume that it is a panic attack at the start.

DR VICTOR KWOK, head of the department of psychiatry at Sengkang Health, which manages Alexandra Hospital.

A panic disorder refers to the occurrence of repeated panic attacks, episodes of intense fear that can last for a few minutes.

A panic attack can involve physical symptoms such as:

• Increased heart rate

• Sweating

• Giddiness

• Numbness in the hands

• Chest pain

• Shortness of breath

Dr Kwok said that some patients have rushed to the accident and emergency department when they experienced these symptoms, thinking that they were having a heart attack.

A psychological evaluation, through the use of questionnaires or consultations with a psychiatrist, can be used to diagnose patients.

However, doctors have to rule out a heart attack, stroke or asthma attack before a panic disorder can be considered.

Dr Kwok said: "It is not easy for anyone to differentiate a panic attack from a serious medical condition and it is not safe to assume that it is a panic attack at the start."

What differentiates a panic attack from a feeling of panic - which is normal in some circumstances - is the intensity and duration of an episode.

Emotionally, a panic attack may make a person feel like he is going out of control. It can be frightening and confusing.

These disorders can affect a patient's day-to-day activities, Dr Kwok added.

Patients should learn to anticipate events which can lead to panic and change their habits to avoid such situations.

Panic disorders can be treated through a combination of drugs and therapy.

Dr Kwok said: "Patients on medication often show marked improvement. Therapy that involves challenging unhelpful thoughts or relaxation techniques like breathing exercises can also be helpful."

Abigail Ng

A version of this article appeared in the print edition of The Straits Times on February 21, 2017, with the headline 'Panic attack or heart attack?'. Print Edition | Subscribe