Panic Attack or Medical Emergency? Steps to Take Right Now

Deciding between a panic attack or medical emergency comes down to safety first: chest pain, trouble breathing that does not ease, fainting, or symptoms that are new or different from your usual attacks should be treated as an emergency, so call 911. Once a medical cause has been ruled out, a panic attack can be ridden out with slow breathing and grounding, and followed up with care.

This guide is for adults in Texas who have panic attacks, or fear they might, and for the people around them. It explains which symptoms need emergency care, what to do step by step during an attack, and when panic itself becomes a mental health crisis. It is general information, not a diagnosis.

How can you tell a panic attack from a medical emergency?

You often cannot tell for certain in the moment, which is why new or severe symptoms should be checked. The National Institute of Mental Health (NIMH) lists panic attack symptoms such as a racing heart, sweating, trembling, trouble breathing, chest pain and a sense of doom, and advises seeing a health care provider to rule out other causes.

Several of those symptoms overlap with heart and lung problems. The Centers for Disease Control and Prevention (CDC) lists major heart attack symptoms, including chest pain or discomfort, feeling weak or light-headed, pain in the jaw, neck, back, arm or shoulder, and shortness of breath, and says to call 911 immediately.

When you are unsure whether it is a panic attack or medical emergency, a useful rule applies: if you have never had this before, if it feels different from your usual panic, or if you have heart or lung risk factors, treat it as a possible emergency. Getting checked and hearing "it was panic" is a safe outcome.

Which symptoms mean you should call 911?

Call 911 for symptoms that could signal a heart, lung or other serious medical problem. MedlinePlus, from the National Library of Medicine, advises going to the emergency room or calling 911 if breathing difficulty comes on suddenly or interferes with talking.

Call 911 if there is:

• Chest pain, pressure or squeezing, especially spreading to the arm, jaw, neck or back
• Shortness of breath that does not ease with slow breathing, or bluish lips
• Fainting or near-fainting
• Sudden weakness, numbness, facial drooping or trouble speaking
• Confusion or a severe headache unlike any before
• Symptoms after taking an unknown substance
• A first-ever episode with chest pain or a pounding heart

MedlinePlus also notes that a first episode of hyperventilation may be an emergency, because other conditions can cause similar symptoms.

What should you do during a panic attack? A step-by-step guide

If emergency signs are absent and you recognize the pattern as panic, slow your body down and wait for the wave to pass. MedlinePlus describes pursed-lip breathing and diaphragmatic (belly) breathing as ways to manage over-breathing.

1. Check for red flags. If any symptom from the 911 list is present, call 911.
2. Name it. Tell yourself, "This feels like panic. It is frightening, and it will pass."
3. Slow your breathing. Breathe in through your nose, then out slowly through pursed lips, longer out than in.
4. Breathe from your belly. Put a hand on your stomach and let it rise and fall.
5. Ground yourself. Notice five things you can see, four you can touch and three you can hear.
6. Stay where you are if you are safe. Staying put can help you learn that the feeling passes on its own.
7. Let it peak. Avoid fighting the sensations; notice them rising and falling.
8. Afterward, write it down. Time, place, symptoms and what helped.

If you are driving when panic starts, pull over safely before trying any of these steps. Our panic attack first aid guide has more quick strategies.

Why does panic make breathing feel so hard?

Panic often causes fast, shallow breathing, which can make you feel like you cannot get enough air. MedlinePlus lists emotional causes of hyperventilation, including panic attacks, with symptoms such as light-headedness, feeling unable to catch your breath and a pounding heart.

Over-breathing can also cause tingling in the hands or around the mouth, dizziness and chest tightness, which then feed more fear. Slowing the exhale breaks that loop for many people.

Breathing trouble with anxiety is common, but it is not always anxiety. Our guide on shortness of breath from anxiety explains what to look for and when to get checked.

Who should be more cautious about assuming it is panic?

Some people should lean toward emergency care even when they have had panic attacks before. The CDC advises that anyone with heart attack symptoms should call 911 immediately rather than waiting to see if they pass.

Be extra cautious if you:

• Have heart disease, high blood pressure, diabetes or high cholesterol
• Have asthma, COPD or a recent lung infection
• Are pregnant or recently gave birth
• Recently had surgery, a long flight or a period of not moving much
• Have symptoms that wake you from sleep or come on with exertion

In these situations, the question of panic attack or medical emergency should be answered by a clinician, not guessed at home. Tell your regular provider about any emergency visit so your records stay complete.

What can you say to someone having a panic attack?

Use a calm voice, short sentences and steady presence. The NIMH notes that people with panic disorder often feel a loss of control during attacks, so simple reassurance and structure help.

Things to say:

• "I'm here. You're not alone."
• "Is this like your usual panic, or does anything feel different?"
• "Let's breathe out slowly together."
• "Tell me five things you can see."
• "It's OK. We'll wait for it to pass."

Things to avoid: telling them to "calm down," crowding them, or dismissing new symptoms. If they have chest pain, fainting or any 911 sign, call 911 rather than waiting.

When does panic become a mental health crisis?

Panic becomes a mental health crisis when it comes with thoughts of suicide, self-harm, or a sense that you cannot keep yourself safe. The 988 Suicide & Crisis Lifeline is free, confidential and available 24/7 by call, text or chat.

Reach out to 988 if:

• You are having thoughts of ending your life during or after attacks
• You feel unable to cope and do not know what to do next
• Panic attacks are coming one after another with no relief
• You are using alcohol or drugs to stop the attacks

Call 911 if anyone is in immediate danger. A written plan made on a calmer day helps; see our mental health safety plan template.

What happens after an emergency visit for panic?

After emergency causes are ruled out, the next step is a follow-up with a primary care provider or mental health clinician. MedlinePlus notes that diagnosing panic disorder can include a history, physical exam and blood tests to rule out problems such as thyroid conditions.

Bring a checklist to your follow-up:

• The date and what happened, including what the emergency team found
• How often attacks happen and how long they last
• Any triggers you have noticed, such as caffeine, sleep loss or certain places
• Whether you are avoiding places or activities
• Any thoughts of self-harm

Panic disorder is treatable. Therapy, and sometimes a psychiatric evaluation, can reduce how often attacks happen and how much they control your life.

How can you prevent the next panic attack?

Prevention focuses on lowering overall arousal and reducing the fear of the attacks themselves. MedlinePlus notes that people with panic disorder often worry about future attacks and avoid places where attacks have happened, which keeps the cycle going.

• Track attacks to find patterns.
• Cut back on caffeine and protect sleep.
• Practice slow breathing daily, not only during attacks.
• Gradually return to places you have been avoiding, ideally with a therapist's guidance.

Severe or frequent attacks deserve professional help; our guide to severe panic attacks covers this in more depth.

What should Texans know about crisis help?

Texans have 24/7 crisis options beyond 911, including 988 and county crisis lines. Texas Health and Human Services lists crisis lines by county; as of October 2026, it lists MHMR of Tarrant County at 800-866-2465 and the North Texas Behavioral Health Authority at 866-260-8000.

Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs. For emergencies, use 911 or the nearest emergency room.

Getting support in Texas

Ongoing support for panic usually includes therapy and, when needed, a psychiatric evaluation. Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. All Lyte Psychiatry services are available in Spanish.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. Availability, insurance and clinician fit require confirmation.

Learn about anxiety and panic care or therapy at Lyte Psychiatry.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.