You wake up in the middle of the night with a tight pain in your chest.

Your heart is racing. You feel short of breath.  

You're thinking: "Is something wrong with my heart, or am I having a panic attack?"

Experiencing any of the above symptoms can be scary, especially when they suddenly develop without warning. That fear can also make it difficult to determine whether to call 911 or stay home and do breathing exercises to calm down.

The truth is what you're experiencing could be a panic attack or it could be a condition an estimated 12.1 million people in the United States will have in 2030.

According to the Centers for Disease Control and Prevention, atrial fibrillation or AFib is the most common type of treated heart arrhythmia, which occurs when the heart beats too slowly, too fast or irregularly.

If there is ever any doubt about what is causing your symptoms, call 911.

So, how do you tell the difference? It's helpful to understand what causes these two conditions to develop.

What's the difference?

A panic attack is a symptom of panic disorder, a common mental health condition causing bouts of overwhelming fear when there is no specific cause for the fear. People with panic disorder may be more sensitive to hormones, which trigger excited feelings in the body.

AFib causes the two upper heart chambers (the atria) to beat irregularly, and blood doesn't flow as well to the two lower chambers (the ventricles). It can occur in brief episodes, but it can also be a permanent condition.

Here is a list of common symptoms for each condition.

Panic Attack

• Chest pain and other symptoms that seem like a heart attack
• Chills or hot flashes
• Dizziness or lightheadedness
• Fear of dying
• Fear of losing control
• Feeling disconnected from oneself or unreal
• Increased or racing heart rate
• Numbness
• Pain that gets better over time
• Pounding heart
• Sense of choking
• Shortness of breath
• Sudden onset or onset during extreme stress or anxiety
• Sweating
• Tingling in the hands
• Trembling or shaking
• Belly pain or upset stomach (nausea)

AFib

• Chest pain or pressure
• Dizziness or lightheadedness
• Extreme fatigue
• Faintness or confusion
• Heart palpitations
• Irregular heartbeat
• Shortness of breath and anxiety
• Sweating
• Weakness

Because both conditions have similar symptoms, it's important to be evaluated by your healthcare provider, who can run tests to determine the cause of your symptoms.

Electrocardiogram (ECG) – An ECG is one of the fastest and simplest tests used to evaluate the heart. During the test, small, plastic patches that stick to the skin (electrodes) are placed at certain spots on your arms, chest, arms, and legs. Lead wires are then used to connect the electrodes to an ECG machine. No electricity is sent into your body as the heart's electrical activity is then measured.

Holter monitor – A Holter monitor is a portable ECG machine that records your heartbeat over a period of 24 hours or longer as you go about your day-to-day activities. Your provider will read and evaluate you're the recordings when you return the monitor.

Stress test – A stress test can help determine if exercise triggers your symptoms. During the test, your provider may have you run on or pedal a stationary bike while a technician monitors your heart.

Blood test – A blood test can help rule other conditions like kidney and thyroid problems.

Chest X-ray – An X-ray helps doctors see the condition of your heart and lungs, which can help rule out certain conditions.  

One of the best things you can do to prevent having to experience any of these conditions is to talk to your provider. They can evaluate you and advise you on what you need to do to take care of your heart and mental health.

If you don't have a primary care physician or a cardiologist, call Tanner's 24-hour physician referral line at 770-214-CARE or use Tanner's web-based Find a Provider tool.