Some conditions can make the heart beat faster than expected, causing pain and making someone feel like their heart might explode.

In reality, heart explosions cannot occur, but some conditions may rupture the wall of this organ, though this is rare. According to a 2020 study, cardiac or heart rupture can be serious and survival rates are low.

In this article, we discuss why someone might feel like their heart could explode. We also look at heart rupture, panic attacks, and when someone should seek emergency treatment.

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The American Heart Association (AHA) recommends that individuals contact the emergency department if someone has a cardiac arrest, is not responding, or gasping for air.

Symptoms that indicate someone should seek help include:

People should also consult a doctor if they experience tachycardia, a fast resting heart rate, lasting more than 30 minutes. Healthcare professionals can perform an EKG and determine the best treatment.

Some conditions that cause the heart wall to rupture may include:

Myocardial rupture

Myocardial rupture may occur in people with acute myocardial infarction, the medical term that refers to a heart attack. It can occur mostly in older adults and those with leukocytosis, which refers to an increased number of white cells in the blood.

Heart rupture is life threatening but uncommon. It may happen between 1 day and 3 weeks following a heart attack and cause a rupture of the heart’s muscles, walls, or valves.

Symptoms of myocardial rupture may include:

  • chest pain
  • cold hands and feet
  • fast heartbeat
  • fast breathing
  • pale skin

Ehlers-Danlos syndrome

Ehlers-Danlos syndrome is an inherited disorder that affects the connective tissues, such as the blood vessel walls, skin, and joints.

People with this syndrome have flexible joints and stretchy skin that stitches may not hold if they have a wound.

Those with Ehlers-Danlos syndrome may have various symptoms, including:

Heart trauma injury

A heart rupture could occur in someone who has been hit in the chest, causing them to feel that their heart is going to burst. That said, the amount of force necessary to cause a cardiac rupture is very high. It would likely result in a loss of consciousness or a fatality in the person experiencing it.

A traumatic myocardial rupture could occur in people with an injury, affecting the diaphragm, pericardium, and papillary muscles.

A 2020 study indicates that a heart rupture could occur with a displaced rib fracture.

One study looked into case reports of atrial and pericardial rupture that occurred from blunt cardiac trauma, which is trauma that affects the anterior chest wall. The authors explained that most injuries were from motor vehicle collisions, vehicles hitting pedestrians, or people falling from high buildings.

Early diagnosis is crucial in people with left ventricular rupture, as the mortality rate is high.

The following tests may help doctors determine if an individual has a heart rupture:

Transthoracic echocardiogram (TTE)

A TTE is the most common type of EKG exam.

A doctor places a device that uses sound waves on the individual’s chest to create heart images.

It can help determine the causes of cardiac-related symptoms, such as edema, heart murmur, and shortness of breath.

The TTE test can take place in a doctor’s clinic or hospital.

Transesophageal echocardiogram (TEE)

The TEE is another type of echocardiography exam that offers a detailed view of the heart.

A healthcare professional attaches the transducer to a flexible tube and inserts it into the individual’s throat and esophagus. The exam takes place while a person is under sedation.

The AHA explains that this type of echocardiogram helps doctors check the following:

  • the size of the heart
  • if there are blood clots in the chamber, especially if a person has had a stroke
  • whether there is suspicious tissue indicating possible cancer or a bacterial or viral infection
  • if there is a blockage in the heart valves

After the test, an individual may have a sore throat for a few days.

MRI

An MRI uses a magnetic field and radiofrequency waves to produce images of the organs inside the body.

It can help doctors examine the heart and blood vessels and check the brain after a stroke.

An MRI can also check if the heart has damage from a heart attack or a blockage in the arteries.

There are different medications that cardiologists may prescribe to treat heart rupture:

  • Diuretics: These are often the first type of treatment that people with congestive heart failure receive. They could be a suitable option for those who have had a heart attack.
  • Vasodilators: These are medications, including minoxidil, losartan, and benazepril, that widen or open the blood vessels making it easier for blood to pass through. Vasodilators can treat hypertension, angina, myocardial infarction, and heart failure. A doctor monitors an individual’s blood pressure and heart rate during treatment.
  • Inotropes: These drugs act on cardiomyocytes, the heart muscle cells. They may benefit people with congestive heart failure or cardiomyopathy, as they can help strengthen their heart’s contractions. Cardiomyopathy is a disease that involves a weakened heart muscle. Inotropes can also slow the heart rate to treat hypertension, arrhythmias, and chest pain.

Panic attacks are intense episodes of fear and can cause various symptoms that resemble those of a heart attack, including:

  • heart palpitations
  • dizziness
  • shortness of breath
  • trembling

The National Institute of Mental Health (NIMH) states that individuals may also have a panic disorder if they experience frequent panic attacks, which can also cause anxiety.

Treatment for panic attacks may include anxiety medications, antidepressants, and beta-blockers.

The NIMH recommends that individuals speak with a therapist if they experience panic attacks or a panic disorder. They should also discuss any symptoms they might be experiencing.

People having a panic attack may think they are experiencing a heart attack. However, the AHA explains that heart attacks occur when there is less blood supply traveling to the heart, which causes mild pain or discomfort that worsens in a few minutes.

Panic attacks appear quickly, and their intensity peaks in around 10 minutes. They usually occur when someone is stressed or has experienced trauma.

A person with a ruptured heart wall may feel that their heart will explode as their heart rate increases.

Different tests and machines can help provide a diagnosis, including a cardiac MRI, TTE, and TEE.

Heart rupture cases are rare and have low survival rates. Therefore, it is important to consult a doctor for regular checkups and inform them of any heart-related symptoms for early diagnosis and treatment.