How can you distinguish a panic attack from an overdose or heart attack?

Go to the ER: If the person has never previously been diagnosed with panic attacks or panic disorder, some type of evaluation is needed to rule out potentially life threatening causes such as overdose or heart attack.

Panic attacks: Attacks can simulate heart attack, but exam & workup in the er shows no physiological abnormalities to indicate cardiac condition. Also, depending on the substance used & the amount, an overdose can have other signs of toxicity & the sensorium (alertness) is affected such as delirium.