An EKG can tell a lot about your heart — but can it actually detect when you’re having a panic attack or even if you recently had one?
An EKG — short for electrocardiogram — measures the electrical activity of your heart.
It can pick up changes like a faster heartbeat or abnormal rhythms.
But a panic attack isn’t a heart disease. It’s a surge of anxiety triggered by your nervous system.
I know from personal experience. I had my first panic attack at about 4:00 in the morning — during a dream.
My thumping heart became part of the dream, even though the dream wasn’t scary. It’s just that while in the dream, I began feeling my heart thumping away.
But because it persisted, it eventually woke me. After several minutes and experiencing a fear that I was going to die, I called 9-1-1.
My heart rate was still abnormally elevated by the time I was hooked up to an EKG.
Research on heart activity during panic shows mixed but interesting results.
One early study (Taylor, Telch & Havvik; Journal of Psychiatric Research, 1983) monitored 10 people over 24 hours.
Seven reported panic attacks. In three of those episodes, heart rate increased significantly compared with what their activity level justified.
That means the heart was beating fast even without exercise or physical exertion.
A later study (Taylor, Sheikh et al.; The American Journal of Psychiatry, 1986) tracked 33 self‑reported panic attacks over six days of continuous monitoring.
Nineteen of those attacks showed heart rates much higher than expected for normal activity — typically sinus tachycardias rather than dangerous arrhythmias.
In longer‑term studies of people diagnosed with panic disorder, investigators found differences in how the autonomic nervous system regulates the heart compared with healthy people.
For instance, a 2020 meta‑analysis (Zhang, Zhou, Qiu et al.; Journal of Affective Disorders) showed that patients with panic disorder tend to have lower heart rate variability.
Lower heart rate variability often indicates more stress on the cardiovascular system.
So what does this mean in practice?
If someone has a panic attack and gets an EKG or wears a heart monitor, the test might record a fast heart rate or other changes.
In the ER, while I was seemingly relaxed on an inclined bed, I saw my heart rate on a monitor: in the low 140s. Just crazy ridiculous!
An EKG can help rule out serious heart problems like dangerous arrhythmias such as long QT syndrome (which one is usually born with but may not know they have).
It gives doctors useful information: If the heart looks structurally fine and rhythms are normal aside from speed, serious cardiac emergencies can be less likely.
But there is no reliable “panic attack marker” on an EKG.
An EKG can’t prove someone is having a panic episode or had one earlier.
Elevated heart rate or lower heart rate variability can result from many causes — mental stress, caffeine, exercise, dehydration or ailments.
Since those signs aren’t exclusive to panic, an EKG can’t confirm a panic attack.
In short, an EKG can show that your heart is reacting (fast rate, rhythm changes or signs of stress), which happens during a panic attack.
But the test does not diagnose a panic attack itself.
Doctors rely on symptoms, timing, your history and context. The EKG’s role is to rule out dangerous heart issues, not to detect anxiety.
After being in the ER for several hours, I was discharged with a diagnosis of anxiety.
The reason I was there for several hours was because I had two blood draws about five hours apart for troponin — a protein that leaks from the heart when one has a heart attack.
If the first test shows no leak, you still get a second test several hours later because it can take a while before damaged heart muscle leaks enough of this important enzyme into the bloodstream to be detected.
Both my tests, thank God, were negative, but I went on to have several more panic attacks over time — and only several more, because I figured out a clever way to stop them dead in their tracks.
