“It felt like a panic attack”: The overlooked pulmonary embolism symptom doctors want people to recognise sooner

Your heart is racing. You can't catch your breath. There's a weight on your chest and your mind is screaming that something is terribly wrong. You feel it in your gut—pure dread. Most people in this situation would assume they're having a panic attack. Their friends would tell them to breathe, to calm down, to get help for their anxiety. But what if none of that was true? What if you weren't panicking at all? This nightmare happens more often than you'd think. Pulmonary embolism is being mistaken for panic attacks with alarming regularity.

Dr. Nitish Anchal, HOD and Consultant—Vascular and Endovascular Surgery at Manipal Hospitals Dwarka in New Delhi, has spent his career watching this misdiagnosis play out. He puts it bluntly: "Shortness of breath, a pounding heart, and an overwhelming sense that something is terribly wrong, most people would associate these feelings with anxiety or a panic attack. But what many do not realise, however, is that these exact symptoms can be the body's signal of something far more dangerous, pulmonary embolism. This life-threatening condition is commonly missed due to the close resemblance of its symptoms to a panic attack."

Pulmonary embolism is the third most common cardiovascular disease after cardiac ischemic syndromes and stroke. And yet it kills more people than heart attacks do. The death rate from pulmonary embolism exceeds the death rate from myocardial infarction, because myocardial infarction is much easier to detect and to treat. Think about that. A PE is less recognized but deadlier than a heart attack.

The incidence is staggering. Venous thromboembolism affects an estimated 300,000-600,000 individuals in the U.S. each year with estimates ranging from 1 to 2 per 1,000 to as high as 1 in 100 for people over 80. But because the symptoms mimic panic, misdiagnosis is shockingly common.

It's a blood clot that forms somewhere in your body—usually in your leg or arm—and then breaks loose and travels through your veins to lodge in your lungs. Dr. Anchal explains: "A pulmonary embolism is a blood clot in one of the blood vessels in the lung. This happens when a clot in another part of the body (often in the leg or arm) moves through the veins to the lung. A PE restricts blood flow to the lungs, lowers oxygen levels in lungs and increases blood pressure in pulmonary arteries."

When that clot gets stuck in your lungs, things fall apart fast. Your heart has to work harder. Your oxygen levels plummet. Your body panics—literally, your nervous system goes into survival mode, which is why you feel like you're dying. Because on some level, your body knows you might be.

The symptoms are sneaky. They show up suddenly or they build slowly. Sometimes they hit you like a truck. Sometimes they're subtle enough that you convince yourself it's just stress. Dr. Anchal outlines what to actually watch for: "Sudden shortness of breath: Breathing suddenly feels difficult, whether somebody is resting or moving, and doesn't settle easily. Chest pain that spreads: Sharp, unexplained pain in the chest that can travel to the arm, back, shoulder, neck or jaw and may worsen on deep breathing. Fast breathing with wheezing: Breaths become quicker than usual, sometimes with a whistling sound. Cough, sometimes with blood: A persistent cough that may bring up bloody mucus in some cases. Rapid heartbeat with sweating and skin changes: Pulse races along with excessive sweating, and the skin may turn pale, clammy or even bluish. Dizziness, anxiety or fainting: Feeling unusually anxious, lightheaded, or in severe cases, fainting or passing out."

But here's what matters for getting diagnosed: if you've had recent surgery, a recent injury, been immobilized for a long time, or have a family history of clots, you're at higher risk. Dr. Anchal emphasizes this: "For those with underlying risks like diabetes, cancer, recent injury, or a family history, the chances of missing something serious like this only get higher. What feels like anxiety in the moment may actually be your body asking for urgent attention."

Dr. Anchal's final warning is worth listening to: "Ignoring it or waiting it out can cost valuable time. Getting it checked early isn't overreacting, it's the difference between catching it in time and dealing with something far worse."