Causes of Increased Heart Rate During a Panic Attack

Updated June 1, 2022
Young woman with hand on chest

Panic attacks can be incredibly scary. During an attack, you might experience hyperventilation, sweating, dizziness, or intense heart palpitations. For many, the increased heart rate can feel as if they are having a heart attack, or even dying. While the typical heart rate ranges between 60 and 100 beats per minute, the average heart rate during a panic attack can reach above 110 beats per minute.

It is estimated that about 33% of people are affected by an anxiety disorder at some point in their lifetime. which means that this disorder is fairly common and that it is likely that you may even know someone that is experiencing it. Understanding more about panic attacks may be able to better help you and your loved ones that may be experiencing them.

What Is a Panic Attack?

Panic attacks are often referred to as "anxiety attacks" because they are often experienced by people that have been diagnosed with an anxiety disorder. Anxiety disorders are one of the most prevalent mental conditions faced by people today.

If you experience a panic attack, you're likely to feel an immediate and intense sense of apprehension or fearfulness, according to the American Psychological Association (APA). However, the emotions occur in the absence of actual danger. You might also experience physical symptoms such as "heart palpitations, difficulty breathing, chest pain or discomfort, choking or smothering sensations, sweating, and dizziness." While the symptoms of a panic attack are similar to those of a heart attack, the different conditions are very different.

Panic Attack vs. Heart Attack

A heart attack occurs when blood flow to the heart stops. Unlike a panic attack, a heart attack is often caused by plaque build-up and ruptures. The heart needs oxygenated-blood to continue pumping and delivering oxygen to other muscles throughout the body, but when it isn't able to receive any blood or oxygen, the heart muscle begins to die.

Senior man suffering from chest pain in bed

Due to their similarities, people often mistake panic attacks for heart attacks, but there are some key differences:

  • During a panic attack, you are likely toexperience tightness or stabbing feeling in the chest whereas during a heart attack you are likely to experience crushing, squeezing, or high-pressure pain in the chest.
  • During a panic attack, the pain usually stays in the chest area. During a heart attack, pain may spread to a different part of the upper body, such as the neck or arm.
  • Symptoms of a panic attack gradually grow, peak, and then typically reduce on their own. Pain during a heart attack generallyremains persistent and needs to be treated by medical attention.
  • A panic attack is often triggered by an emotional reaction to a person's environment whereas a heart attack is usually triggered by physical strain or overexertion.

What Happens to Your Heart During a Panic Attack?

During a panic attack, people experience tachycardia, which is the medical term for increased heart rate. Tachycardia can be caused by many different factors and affect the heart in different ways. The most common type of tachycardia causes irregular and chaotic electrical signals in the heart, which causes the heart to beat faster and out of rhythm.

Panic attacks occur when you feel triggered by something in your environment. Many experience this trigger on an unconscious level, and it is difficult to identify. Think about the last time you felt startled. Panic attacks are similar in that the mind and body experience a fear response. Research suggests that your heart also races because:

  • Your body initiates the fight or flight response too strongly, too frequently, or a combination of the two.
  • Your body releases adrenaline, also known as epinephrine. It gives a surge of energy to act quickly and make fast decisions.
  • Your body is reacting to stress and the environment around you.

Panic attacks can last anywhere between a few minutes to an hour, with symptoms gradually building, peaking around 10-20 minutes, and then slowly reducing. The feeling of a racing heart is similar to what it feels like after something has really scared you, if you've had an excessive amount of caffeine, or during an intense workout. Your heart may be pounding in your ears, and it may feel like it's going to beat out of your chest. Many people find this feeling incredibly uncomfortable and unsettling. The increased heart rate may occur in conjunction with other symptoms, including:

Upset stressed older woman feeling heartache
  • Bodily discomfort
  • Chest pain
  • Dissociation or feeling like you aren't in your body, or aren't connected to the world
  • Feeling like you are dying
  • Feelings of choking
  • Lightheadedness or faintness
  • Shaking
  • Sweating

How to Manage a Panic Attack

Many people can eventually learn how to ground themselves during an attack, or right before they experience another. If you've had more than one panic attack, think about what happens right before your symptoms show up. If you are able to identify when you are about to have a panic attack, it may be easier for you to calm yourself before experiencing one. Here are a few exercises to try before, during or after a panic attack has occurred:

Relaxed young woman with eyes closed sitting on her bed enjoying music over headphones
  • Cognitive behavioral therapy (CBT)- Is a research-based form of psychotherapy centered around the belief that thoughts, emotions, and behaviors are all interconnected. Recent studies have found that CBT has moderate effects on improving symptoms of panic disorder and often involves a combination of physical exercise, thought challenging, meditation, and exposure therapy.
  • Progressive muscle relaxation: Progressive muscle relaxation has been found to reduce feelings of stress and increase relaxation on both the psychological and physiological levels. The practice involves bringing attention to the body, discovering what your body is feeling, and gradually releasing tension.
  • Guided imagery relaxation exercise: This is an audio-based exercise that people experiencing any kind of stress can listen to in order to experience relaxation and reduce symptoms of anxiety. It can be thought of as being reminiscent of being read a story and paints a vivid picture for those listening and that takes their mind to a more relaxing place.
  • Breathing training: Practicing deep breathing exercises has been used to reduce feelings of panic in the body, as well as reduce hyperventilation and stress. These offer a quick way to relax and slow down your heart rate.
  • Selective serotonin reuptake inhibitors (SSRIs): Are referred to as the "first-line treatment option" for people experiencing panic disorders according to the NIH. They work by blocking the reuptake of serotonin in the brain.
  • Selective norepinephrine reuptake inhibitors (SNRIs): Are a type of medication used to treat both anxiety and depressive disorders that have been found to reduce symptoms during a panic attack. They work by interfering with the amount of norepinephrine that is reabsorbed by neurons in the brain.
  • Benzodiazepines: Some studies have found that benzodiazepines can improve symptoms during panic attacks. These depress the central nervous system (CNS) and help skeletal muscles relax and have sedative effects.

It is important to remember that most of the time, panic attacks subside within 10 to 15 minutes. If you are experiencing multiple panic attacks each day, or are not able to ground yourself, it is best if you find a therapist who can assist you with decreasing your symptoms and identifying your triggers as chronic anxiety can negatively impact your health. If you feel you need urgent assistance, you can head to the hospital, although your symptoms may subside by the time you arrive. Take care of yourself and find appropriate help if you are struggling with these symptoms as they tend to worsen over time.

Two women talking in psychotherapy

Your Heart Rate and Panic Attacks

Panic attacks are mentally, emotionally, and physically draining. They can make people experience high levels of hyperventilation, and stabbing chest pain, and even make them feel as though they are going to die from the experience. They are so intense that many people often confuse them for having a heart attack. While everyone's heart rate will vary during a panic attack, know that a racing, palpitating heartbeat is typical and that the symptoms will eventually decrease. If you or someone you know experiences panic attacks, creating a plan of action, exploring therapy options, and talking with your doctor about potential medicines that are a good fit for you are great ways of increasing your quality of life and reducing panic attack symptoms.

Causes of Increased Heart Rate During a Panic Attack