Panic or Heart Attack? How to Know the Difference.

The human body is really good at signaling when something is wrong. Unfortunately, it’s not very good at diagnosing itself. In fact, many of the signals it sends are virtually the same for a wide variety of conditions. And we tend to minimize our symptoms. So, if your body is telegraphing chest pain, shortness of breath, nausea and lightheadedness, you may be inclined to chalk it up to stress or anxiety. Chances are, you’ll rule out anything more serious despite the fact that these can also be symptoms of a heart attack. So how can you tell if you’re having a panic or heart attack? Knowing the difference and acting fast could save your life.


Panic or heart attack? Maximizing your symptoms.

If you’ve never had a panic attack or heart attack and aren’t being treated for heart disease, it can be nearly impossible to differentiate between the two. Overlapping symptoms can include:

  • Chest pain or discomfort
  • Anxiety or fear of impending doom
  • Racing, pounding or fluttering heart
  • Breathing difficulties; shortness of breath
  • Sweating or chills
  • Lightheadedness or dizziness
  • Nausea or vomiting

If you experience any of these symptoms, call 911 immediately.

With a heart attack, minutes equal muscle. In other words, the chances of saving precious heart muscle decrease with every minute that it takes to be diagnosed and treated. Don’t wait more than 5 minutes to call.

Recognizing and acknowledging your symptoms can help you minimize the damage caused by a heart attack.


Additional heart attack clues.

If you have been diagnosed with cardiovascular disease, you already know that you should take the symptoms listed above seriously and call for help. But if you don’t have a diagnosis or haven’t had a heart attack, there are additional symptoms that often accompany a heart attack but typically not a panic attack. They include:

  • Pain in one or both arms
  • Pain in the jaw, back, shoulders, neck or upper abdomen (often more common in women)
  • Heartburn

Additional panic attack clues.

These additional symptoms of an anxiety attack may help you tell whether you are having a panic or heart attack.

  • Sudden feelings of terror for no reason
  • Shaking or trembling
  • Abdominal cramping
  • An urge to flee
  • Feelings of unreality or being detached from your body

If you’ve suffered from anxiety before and this feels similar to a past panic attack that turned out to be stress-related, try some deep breathing exercises or meditation to see if your symptoms ease. If they don’t, get medical help right away.

When you’re not sure if it’s a panic or heart attack, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free, 24/7 Ask-A-Nurse hotline.

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Your Fluttering Heart: Is it Love or an Arrhythmia?

Most people are not really aware of their heart beating and that’s a good thing. It generally means they do not have an arrhythmia — an irregular contraction of the heart muscle caused by a problem with the heart’s electrical system. People often describe these skips, flips and blips as heart palpitations or heart flutters. When they happen only once in a while, last only a second or two and can be traced to something you ate, drank or did (including, possibly, falling madly, deeply in love) a fluttering heart is probably harmless.


But if a fluttering heart is causing a change in your lifestyle, you should probably make an appointment with your primary care physician or heart specialist to have it checked out, according to Dale Yoo, MD, a cardio electrophysiologist at Medical City McKinney.

And if it’s causing immediate problems, Dr. Yoo recommends heading straight to an ER or urgent care center such as CareNow.

If your fluttering heart is accompanied by these symptoms, head to the ER.

  • Sudden weight gain
  • Swollen legs
  • Shortness of breath
  • Exhaustion

“These symptoms can be a sign of an arrhythmia, such as atrial fibrillation (AFib),” said Dr. Yoo, “but they can also be symptoms of other heart conditions, including congestive heart failure or a pulmonary embolism. Each of these can be deadly and requires immediate medical attention.”

Other signs of irregular heart rhythms.

“Heart palpitations are the most common symptom of arrhythmias,” said Dr. Yoo, “but there may be other signs as well.”

Additional symptoms that your fluttering heart may be something more than amore include:

  • Feeling dizzy or lightheaded
  • Passing out (fainting) or nearly fainting
  • Feeling tired, like you can’t walk as far as you used to
  • Feeling ill, like you’re getting a cold or the flu
  • Changes in your blood pressure
  • Changes in heart rate; speeding up (racing heart) or slowing down

Causes of arrhythmias and how stimulants can trigger heart palpitations.

There are many potential causes of arrhythmias, according to Dr. Yoo, including physiological changes that you have no control over (such as aging) and some that you may not even be aware of. But arrhythmias can also be caused by behaviors that you do have some control over.

Potential causes of irregular heart rhythms include:

  • Medications
    • Taking the wrong dosage
    • Forgetting to take them
    • Taking too little or too much
    • Taking some diet pills, cough medicines, decongestants and prescription medicines
  • Stress and anxiety
  • Dehydration
  • Illness
  • Chemicals/stimulants
    • Caffeine
    • Theophylline (found in tea)
    • Red Bull® and other energy drinks
    • Tobacco and alcohol

If you think your heart palpitations are caused by any of the potential triggers above, talk to your doctor so you can identify them and take steps to decrease them.

“Anything that increases adrenaline or an adrenaline state (increased awareness) is a stimulant and can cause heart palpitations,” said Dr. Yoo. “There are lots of triggers for arrhythmias and a wide variety of symptoms, including heart fluttering, but usually there’s a dramatic change in what you can do or what you call normal.”

If your heart skips a beat and it’s not because of your valentine, you’ll find expert emergency care at one of our many Medical City ER locations across North Texas. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free, 24/7 Ask a Nurse hotline.

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Flu and Your Heart: Can Flu Make Your Heart Sick?

When it comes to flu and your heart, the bad news is, flu can make your heart sick. Just not in that angsty, teenage, love-struck way. It’s more life-threatening than that (although your teen may not agree) and involves mounting research showing a link between influenza and both heart attack and stroke.

A January 2018 study published in the New England Journal of Medicine confirmed the heart/flu link. The study found that heart attacks are six times more likely in the seven days following a flu diagnosis. They also noted that heart attack risk increased slightly for those over 65 and that sixty-nine percent of study participants had not received a flu shot.

The good news is, researchers from UT-Houston found that the flu shot probably reduces the risk of heart attack, stroke or sudden death by as much as 25 percent. They estimate that 90,000 coronary deaths a year could be prevented in the U.S. if more heart patients received flu shots. Four additional studies suggest that the flu vaccination does in fact protect against atherosclerosis — a condition which hardens and clogs arteries from a buildup of fatty deposits, or plaque. These plaque deposits can become dislodged during episodes of inflammation, such as having the flu, and can cause blood clots and heart attacks.


We asked Keith Vasenius, DO, an interventional cardiologist at Medical City Fort Worth, to discuss flu and your heart, including whether cardiac patients are more susceptible to the flu, if regular heart medications should be continued during the flu, and some of the health and lifestyle factors that can increase someone’s risk for heart disease.

Dr. Vasenius noted that flu can be hard on anybody — it’s a tough disease and it can set you up for secondary infections and other diseases, such as pneumonia. Most people in good health will suffer five to seven days with the flu and get better — they generally don’t need to go to the ER. But, it’s the very young, the very old and people with other medical problems, such as heart disease, who might need to consider going to the ER if they are having complications with the flu.

Unfortunately, there is no minimum age requirement for heart disease or stroke — they can affect anyone at any age, including a high school soccer star and a 21-year-old college student.

Flu and your heart: Are cardiac patients more at risk?

Cardiac patients are at no higher risk of getting the flu than everyone else but, because they have heart problems, they are more likely to get sicker with the flu. Flu is a respiratory illness and because of that, patients can develop problems with appropriate oxygen levels, which can affect every organ in the body, including the heart. It can especially take a toll on the heart if you already have heart problems.

“As a chest pain center, Medical City Fort Worth is seeing a number of cardiac patients being treated with flu complications,” said Dr. Vasenius. “For example, a patient might have low ejection fraction (EF), meaning their heart doesn’t pump very well. Untreated flu complications can lead to tachycardia, where the heart beats faster than normal while at rest. This makes the heart work harder and, in turn, can put it at risk for demand ischemia, a type of heart attack that can happen when a patient’s heart needs more oxygen than is available in the body’s supply. It may occur in patients with infection, anemia or abnormally fast heart rates.”

Flu and your heart: Should heart patients with flu continue regular medications?

With the flu and other illnesses, it’s important for heart patients to continue taking the medications their doctor has prescribed to treat their heart condition. That includes blood pressure and cholesterol medications.

“Sometimes when people are feeling ill — maybe they’re having nausea and vomiting — they don’t take their heart medications as prescribed,” Dr. Vasenius said. “This can lead to bad outcomes so, if this is happening to you, be sure and tell your doctor. If you let us know early enough, we can make adjustments for that.”


Pay attention to the warning signs of a potential heart attack.

Flu complications can develop very quickly, so it’s important to pay attention to signs and symptoms. Dr. Vasenius said he always watches for these classic warning signs of a potential heart problem, with or without the flu:

  • Shortness of breath and chest pain — discomfort, extreme squeezing or pressure
  • Dizziness or feeling like you might faint

If you have these symptoms in activities or situations where you’ve never had problems before, you should be seen by a medical professional immediately. That’s especially important if you have any risk factors for heart disease, including:

  • Diabetes
  • High blood pressure
  • High cholesterol
  • Family history of heart disease
  • Smoking

If you have two or more of these risk factors, you should see a doctor to be screened for heart disease — with or without the flu.

Finally, protect yourself by getting your flu shot every year. The flu can be a life-threatening infection, especially in people at risk.

Flu shots are available at CareNow Urgent Care locations across DFW.

If you have the flu and any of the symptoms or risk factors listed above, one of our many Medical City ER locations across North Texas can help you avoid getting heart sick. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free, 24/7 Ask a Nurse hotline.

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9 Most Popular Health and Safety Blogs of the Year

We know it’s a full-time job taking care of your family’s health and safety, so we’re committed to doing all we can to help. That’s why we’ve presented this roundup of our top 9 health and safety blogs of 2017. Whether you’re concerned about snakebites, the opioid crisis, burns, texting on the toilet or other hot topics, we’ve got the expert advice you’re looking for — including ways to keep your family out of the ER.

Health and Safety Blog No. 1: Do You Know What to Do in a Snakebite Emergency?

Snakes have been in the news for the last few years, flushed out of their natural habitats by several consecutive wet seasons in North Texas. 2018 could very well follow that trend, so brush up on your snakebite emergency skills. You might also want to add these blogs to your list of serpent-themed surfing:

Snakes in the Grass: Know How to Avoid and Treat Snakebites

Pokémon Go: Know How to Avoid Injuries and Ekans Bites

Multigen-family-running-FB.jpgHealth and Safety Blog No. 2: First Aid for Burns: 5 Things You Should Never Do

We all learned “stop, drop and roll” in school but not how to treat burn injuries. Some of the most common burn treatment myths, such as using butter, are just that — incorrect information that can cause more harm than good. This blog will teach you how to recognize the severity of a burn and how to avoid the most common mistakes people make when treating burns. If you’re looking for an advanced degree in burns, add these to your reading list:

Learn About Burns: Get Schooled in Burn Awareness

How to be Fire-Safe and What to Do if You Get Burned

Don’t Get Burned: Know the Top Rules of Fire Safety

Jason West, MD, an emergency medicine physician at Medical City Denton, discusses when to go the ER for a burn and how to tell what percentage of a person’s body is burned.

Health and Safety Blog No. 3: Bathroom Blues: Are You Taking Your Tech to the Toilet?

The No. 3 spot goes to constipation and hemorrhoids. As well it should, since our expert says it takes just 20 minutes a day lounging in the loo to bum out your bum.

Health and Safety Blog No. 4: 10 Signs You Need to Go to the ER

From chest and abdominal pain to persistent vomiting, diarrhea and depression, this blog is packed with tips for how to recognize when your symptoms need emergency medical attention.

Manisha Gupta, MD, an emergency medicine physician at Medical City Denton, explains when your stomach pain warrants a trip to the ER.

Health and Safety Blog No 5: Five Opportunities and Insights from “13 Reasons Why”  

“13 Reasons Why” became the most-watched Netflix show when season one debuted last March. Based on a novel, the story centers on teen suicide and got parents, teachers and kids talking about this previously taboo subject. In this blog, our Medical City Green Oaks Hospital expert offers insight into how to use the show as an opportunity to talk to your own kids about depression, bullying, sexual assault and more.

In the follow-up blog, How “13 Reasons Why” Can Be a Lessons for All Ages, our expert discusses the growing rates of suicide in middle-aged adults and seniors.

Health and Safety Blog No 6: What You Need to Know About RSV

RSV (respiratory syncytial virus) is the virus responsible for a whole host of respiratory conditions, including colds, bronchitis, pneumonia and croup. Most children will have had an RSV infection by the age of two. In kids younger than 3, RSV can cause a dangerous illness called bronchiolitis — the most common cause of hospitalization in infants 12 months old and younger.

Health and Safety Blog No 7: The Growing Opioid Crisis: What You Need to Know

Labeled an epidemic by the CDC, the opioid crisis continues to take the lives of Americans of every age, race and socioeconomic level. In fact, drug overdoses are now the leading cause of death among those under 50. Read what our expert has to say about this growing concern, learn how to spot opioid abuse, discover common drugs you may not have known were opioids and find out what type of drugs you should never mix with opioids.

Health and Safety Blog No 8: How Much Water Do You Need to Drink Every Day?

The human body is made up of mostly water and yet almost 70% of us don’t drink enough to keep our bodies functioning properly. Symptoms of dehydration begin when we’ve lost just 1% of our water. At 2-3%, things start to crash. Could your fatigue, irritability, headache, dry skin or fuzzy brain be “cured” just by drinking more water? Read this and find out.


Health and Safety Blog No 9: Heartburn or Heart Attack? How to Save Your Own Life.

The symptoms of heartburn and heart attack can be surprisingly similar. In fact, heartburn is often a sign of heart attack, especially in women. Our experts discuss how to tell the difference between the two and when to call 911 or head to the nearest ER.

Steven Kaster, MD, a gastroenterologist at Medical City McKinney, shares the signs and symptoms of heart attack and heartburn and how to tell the difference.

Matt Bush, MD, an emergency medicine physician at Medical City Dallas, shares how to save a life with hands-only CPR.

For expert emergency care whenever you’re concerned about your family’s health and safety, one of our many Medical City ER locations across North Texas has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free, 24/7 Ask a Nurse hotline.

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When to Be Concerned About These 5 Common Health Symptoms

We all know someone who, at the first sign of a sniffle or tummy ache, runs to the doctor for a prescription. Then there are those on the other end of the spectrum who have to be dragged kicking and screaming to an emergency room for advanced treatment. Most of us fall somewhere in between but tend to wait a bit too long before admitting that we need help to diagnose or treat an illness. For those of us guilty of a “wait and see” mentality, here are 5 common health symptoms that may be more serious than you think and shouldn’t be ignored.

You’ve had a cough for more than three weeks.

The common cold typically lasts 1- to 14 days, but some can last as long as 21 days. One of the viruses that causes colds is RSV, a highly contagious upper respiratory illness that also causes bronchitis, pneumonia, croup, bronchiolitis and asthma. When you’ve had what you think is a cold and have been coughing for three weeks or longer, you should probably have it checked to rule out one of these more serious secondary infections.

20171212 HCA Influenza Infographic

Learn how to cough and sneeze without infecting others.

Your nose is kinda runny and some people think it’s funny but it’s snot.

Most people produce 1 to 1.5 liters of mucus a day even when they’re not sick. It’s useful for moisturizing passageways, blocking foreign invaders and transporting protective antibodies, enzymes and white blood cells. When you have a cold, flu or other upper respiratory illness, your mucus tends to thicken. But what you really need to be concerned about is the color and/or any odor. Yellow or green mucus could mean you have a sinus infection, especially if accompanied by headache, congestion, fever or pain and pressure in your face.

Learn how to tell what the color of mucus means.

Your blood pressure is 120/80.  

A blood pressure reading of 120/80 used to be the gold standard of good health. But recently the American Heart Association revised its guidelines, putting nearly half of U.S. adults in the high blood pressure category, up from 33 percent. The goal of the change is to encourage earlier treatment with lifestyle changes and medication where appropriate. High blood pressure typically has no symptoms put puts you at increased risk for heart attack and stroke.

Here’s what to look for:

  • Normal
    • Less than 120 systolic and 80 diastolic
  • Elevated
    • Between 120-129 systolic and less than 80 diastolic
  • High Blood Pressure (Hypertension Stage 1)
    • Between 130-139 systolic or between 80-89 diastolic
  • High Blood Pressure (Hypertension Stage 2) =
    • Between 140-180 systolic or between 90-120 diastolic
  • Hypertensive Crisis (seek emergency medical help immediately)
    • Higher than 180 systolic and/or higher than 120 diastolic

Learn how to recognize the signs of stroke.



You’re having stomach pain.

Abdominal pain is the No. 1 reason for emergency room visits — probably because it’s hard to tell exactly what’s going on in there. A ruptured appendix, diverticulitis, stomach flu, food poisoning, gallstones, kidney stones and cholecystitis are just a few of the possible diagnoses. See a doctor if the pain is severe, lasts for more than 24 hours or is accompanied by other symptoms, such as high fever, dehydration, bleeding, nausea and vomiting or other unusual signs.

Learn when to visit the ER with stomach pain.


You’re feeling sluggish, guilty, irritable, achy, impulsive or unfocused.

Having even just one of these common and seemingly mild symptoms could indicate depression. While most of us are quick to find other explanations for these signs, it’s important to talk to someone if you feel there might be something more. Consider also what time of year it is; people suffering from seasonal affective disorder (SAD) or social anxiety often have a harder time throughout the bleak winter months and during the busy, social holiday season.

Be aware that while the Netflix show “13 Reasons Why” highlighted teen suicide, suicide rates among older adults is increasing more rapidly. According to the CDC, depression is a true and treatable medical condition and not a normal part of aging. It’s important to get help for depression regardless of age.

For help with mental health issues or depression, call Medical City Green Oaks Hospital’s crisis line 24/7/365 at (972) 770-0818.

For fast, emergency help with these common health symptoms and more, look to one of our many Medical City ER locations across North Texas. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City ER near you or call our free 24/7 Ask-A-Nurse hotline.

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Why You Need to Be Holiday Heart Smart

“I only eat like this around the holidays.”

“I don’t drink very often, but there are so many social functions this time of year.”

“I thought it was just heartburn. I didn’t want to make a fuss and ruin everyone’s good time.”

Any of these sound familiar? They do to virtually every ER doc in the United States, some of whom coined the term “Christmas coronary” to describe the more than 30% increase in heart attacks and heart-related problems that occur in the winter — specifically on Christmas, the day after Christmas and on New Year’s Day. Another name doctors use for this trend is holiday heart.

That’s because many Americans celebrate the holidays with sudden binges of alcohol and food that puts added stress on weakened hearts. To make matters worse, they’re more inclined at this time of year to ignore or mistake the warning signs of heart attack.


Heart disease is the leading cause of death for both men and women in the United States. Someone has a heart attack every 43 seconds. And holiday heart doesn’t discriminate — the increase in heart incidents holds true across all ages and genders and can manifest in young people as dangerous heart rhythms. Left untreated, it can lead to more serious conditions, including atrial fibrillation (AFIB), stroke and diabetes.

6 stressors associated with holiday heart attacks:

  • Overindulging in alcoholic beverages, rich foods and higher salt consumption increases blood pressure and water retention, putting additional strain on the heart. So does the 1- 2 pounds (on average) Americans gain during the holidays.
  • Cold weather strains the heart by constricting blood vessels and increasing blood pressure and making blood clot more easily.
  • Sudden strenuous outdoor activity in extremely cold weather, such as shoveling ice and snow, trudging through snow drifts or sledding with the kids, causes a spike in demand on the heart.
  • Skipping or not taking medications on time can have dire consequences for people taking insulin or other medications for chronic conditions. Entertaining, social functions and travel can disrupt regular exercise and medication routines.
  • Greater emotional stress and disrupted sleep during the holidays can weaken the immune system, making you more susceptible to colds and flu. Serious infections and fever can damage the heart muscle.
  • Delaying treatment for symptoms of a heart attack so as not to disrupt holiday activities is never a good idea. Every second counts to save a life and prevent damage to heart tissue.


To reduce the risk of holiday heart attacks:

  • Keep calm. Manage emotional stress and avoid anger.
  • Stay well. Get a flu shot and wash hands frequently to prevent cold and flu.
  • Eat right. Avoid food and alcohol binges, and select healthier food choices to reduce sodium. Drink plenty of water.
  • Keep moving. Continue normal exercise routines to maintain cardiovascular health and ward off weight gain. When engaging in outdoor activities, dress warmly, go slowly, rest often and listen to any warning signs your body is providing.
  • Mind the time. Stay on schedule with prescription medications, and if traveling, be sure to carry enough for the trip (in original prescription bottles) plus a few extra in case of delays.
  • Stay warm. Dress in layers for the weather and avoid heavy physical exertion in the cold.

Know the symptoms of a heart attack and call 911 immediately if you experience:

  • Pain or discomfort in the chest, arms or shoulders.
  • Shortness of breath.
  • Feeling lightheaded, weak or faint.
  • Heartburn, nausea or vomiting.
  • Unusual fatigue.

The best thing about the holidays is being healthy to enjoy them. So have fun, enjoy time with friends and family and stay heart smart.

If you or someone in your family experiences chest pain, one of our many Medical City Healthcare emergency locations or Accredited Chest Pain Centers has you covered. With average wait times posted online, if you do have an emergency, you can spend less time waiting and more time on the moments that matter most.

Find a fast Medical City Healthcare ER near you or call our free 24/7 Ask-A-Nurse hotline.

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