Can you have a panic attack without a racing heart?

Panic is a sudden surge of the body's alarm response. Some people notice fear, a sense of losing control, tight breathing, shaking, sweating, nausea, light-headedness, or tingling more than a fast pulse. A normal-feeling heartbeat does not rule out panic, and a panic episode does not by itself diagnose panic disorder. Caffeine, medicines, thyroid problems, anaemia, low blood sugar, and heart or breathing conditions can cause similar sensations, so repeated or unfamiliar episodes deserve a clinical review.

Sit somewhere safe and loosen restrictive clothing. Breathe gently, allowing the out-breath to be a little longer than the in-breath; avoid taking repeated large breaths. Name a few things you can see and feel, and remind yourself that the sensations are real but may settle as the alarm response eases. Do not drive while dizzy. Write down the setting, symptoms, medicines, caffeine, and how long recovery takes so a clinician can look for patterns.

Get emergency help for new or severe chest pressure, pain spreading to the arm, jaw, or back, fainting, severe breathlessness, blue lips, confusion, or weakness on one side. These warning signs need urgent assessment even when anxiety is present. Arrange a GP Consultation if episodes recur, interfere with sleep or daily life, or feel different from previous episodes. An Electrocardiogram may be considered when symptoms could involve the heart.

Ask whether your symptoms fit panic, which physical causes should be checked, and whether your medicines or stimulants could contribute. You can also ask what signs should prompt emergency care and which treatment or talking support may help.