Heart rate during a panic attack: what’s normal, and when to worry

Of all the feelings in a panic attack, a racing heart is often the one that frightens people most. It can pound so hard you see it in your chest, flutter, skip or race so fast it feels like it can’t possibly be safe.

Here’s what happens to your heart during a panic attack, and how to tell when it needs a doctor.

Call 911 if your heart is racing and it doesn’t settle, or it comes with chest pain, shortness of breath, or you feel faint or pass out. Don’t drive yourself.

Why panic makes your heart race

During a panic attack, your body’s fight-or-flight response releases adrenaline. Adrenaline makes your heart beat faster and harder, to pump more blood to your muscles so you can run or fight. That can feel like:

• pounding or thumping
• racing
• fluttering
• skipping or extra beats (palpitations)
• your heartbeat in your throat, neck or ears

For most adults, a normal resting heart rate is between 60 and 100 beats a minute. During panic, it often rises well above your usual level, much like during exercise.

Is a fast heart rate during panic dangerous?

In a healthy heart, no. Your heart is a strong muscle built to beat fast for long periods, like during a run, a workout or climbing stairs. Panic can’t make a healthy heart “give out” or stop.

The rate comes back down as the adrenaline is used up and your body’s calming system takes over, usually within minutes. Every out-breath helps a little, because your heart naturally slows slightly each time you breathe out.

Why it feels so scary

A racing heart is easy to read as a sign of a heart attack, and that fear releases more adrenaline, which makes your heart race even more. This loop is a big part of why panic attacks build so fast. We explain it in What causes panic attacks?

The smartwatch trap

Smartwatches and heart rate apps can be helpful, but during panic, checking them again and again often makes things worse. Each glance keeps your attention locked on your heart, and seeing a high number can spike the fear. If you notice yourself checking constantly, try taking the watch off for a while, or turning off live heart rate alerts, after talking to your doctor if you have a heart condition.

How to help your heart settle

• Breathe out slowly: in for 4, out for 6. The long out-breath is the key.
• Name it: “This is adrenaline. My heart is built for this. It will slow down.”
• Sit down and let your body be still.
• Splash cold water on your face, or hold something cold. Many people find this calms them quickly.
• Don’t fight the feeling. Let your heart pound, and watch it settle.

How Breatheasy can help

When your heart is pounding, Breatheasy can help you slow down. Tap “I’m feeling anxious” and Luma walks you through it: rate how strong it feels, breathe slowly as your phone pulses gently, ground yourself with 5-4-3-2-1, then see how far the anxiety came down. Breathing in time with the pulses gives your heart a calm rhythm to follow. It works without internet, and it’s always free. Breatheasy is coming soon to iPhone and Android.

When to see a doctor

According to the NHS, see a doctor if palpitations:

• keep coming back, or are happening more often
• last for more than a few minutes
• happen and you have a heart condition, or a family history of heart problems

Call 911 if your palpitations don’t go away, or come with chest pain, shortness of breath, or fainting. If you had those warning symptoms but they’ve now stopped, still get medical advice the same day.

It’s always worth getting checked after your first panic attack. A normal heart check can make it much easier to trust that next time, it’s panic.

Sources

• Heart palpitations, NHS
• Panic disorder, NHS
• Panic attacks and panic disorder, Cleveland Clinic