Can I Get Chest Pain From Anxiety?

Updated May 11, 2021

Medically Reviewed By: Nicole Gaines, LPC

Anxiety can spring up from many different sources in our lives, and it doesn’t affect everyone in the same way. While some people’s symptoms may be limited to emotional or psychological effects of anxiety, many people also experience physical symptoms. Some of the common physical symptoms of stress are tightness in the chest, shallow breath or difficulty breathing, and chest pain. While these symptoms can also point to more significant health problems like a coronary disease or a heart attack, if you’re a young and generally healthy person, it’s more likely a result of an anxiety attack.

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Anxiety And Panic Attacks

Anxiety and panic attacks aren’t uncommon, with about 18% of the adult population in the US experiencing an anxiety disorder in a given year. Many of these cases are further classified as a social anxiety disorder. The most significant indicator of a social anxiety disorder is an anxiety or panic attack. The good news is that anxiety disorders are highly treatable with help from a therapist.

Experiencing acute physical symptoms due to anxiety is referred to as either a panic attack or an anxiety attack. While many people use the terms “panic attack” and “anxiety attack” interchangeably, there are some important differences. It’s true that both similar feature symptoms, such as shortness of breath and chest pains. But the most significant difference between anxiety and panic attacks is that the symptoms of panic attacks usually come on unexpectedly and last for a shorter time. On the other hand, an anxiety attack typically comes on due to a triggering situation, and the symptoms last for a longer time. In this case, your chest pain and anxiety are the same.

Chest Pain From Anxiety

There are a lot of different factors that contribute to anxiety, chest pain, or angina. Anxiety chest pain can spring from either cardiac or non-cardiac reasons. Let’s take a look at those reasons for anxiety chest pain:

Cardiac Reasons for anxiety chest pain are caused directly by the working of the heart organ. This means that the heart muscle is contracting and straining, and you feel the pain in your chest due to the heart’s strain. This tight contraction is often caused by hyperventilation, which is fast and shallow breathing that doesn’t bring enough oxygen into the lungs. This is another typical physical response to an anxiety attack.

Non-cardiac Reasons for anxiety chest pain usually originate in the musculoskeletal system or esophagus. This means that even though you feel the chest pains near your heart, the pain itself is actually caused by muscles near the throat or along the intercostal chest contracting. These contractions are also often caused by hyperventilation. This is a precise instance of chest pain caused by anxiety.

So, while a social anxiety disorder can cause cardiac and non-cardiac chest pain, it’s important to note that hyperventilation also often plays a role. Watching out and being mindful of hyperventilation is an excellent way to predict upcoming anxiety chest pain.

Anxiety Chest Pain Vs. Heart Attack

If you’re prone to anxiety chest pains, it’s very important to know the difference between anxiety attack symptoms and heart attack symptoms. Understanding these differences can prompt you to act and save your life since cardiac issues need to be handled quickly.

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Almost 25% of patients admitted to emergency rooms with chest pains are found to have been experiencing anxiety chest pains and not a heart attack. Of that 25 %, most of them are young women. However, while the symptoms and signs of anxiety chest pain may be similar to those of a heart attack, there are some key differences.

For one, the risk factors are totally different. While symptoms of panic or anxiety attacks may look similar, a heart attack (and related heart attack pain) usually doesn’t happen without risk factors. For example, coronary artery disease is the leading cause of heart attacks. The risk factors for coronary artery disease include older age, high blood pressure, tobacco use, family history of heart disease, high cholesterol, and diabetes. So, if you’re free of these risk factors, you’re more likely to experience anxiety chest pain than an actual heart attack.

What To Do If You Feel Chest Pain

Since you may not know if you’re experiencing anxiety, chest pain, or a deeper, more immediately threatening cardiac problem, it’s important to take stock of your situation as soon as you start to feel chest pain angina. If you’re experiencing chest pain, don’t panic. The absolute first step is to stay calm.

Then, try to take deep breaths. If the chest pain has been brought on by anxiety, then deep breathing will help to relax the muscles that usually contract to cause the pain in the first place. If this does nothing to help ease the chest pains, you need to consider contacting a doctor because it could be pain from a heart attack. If you think it’s heart attack pain, immediately call an ambulance.

When Anxiety Attacks

While chest pain and anxiety don’t always go hand in hand, chest pain, combined with anxious thoughts and feelings of dread and a triggering situation, can be a key indicator of an anxiety attack. One of the most common physical symptoms of an anxiety attack is tightness in the chest or chest pain. Shallow breathing or shortness of breath, trembling, or tightness in the muscles are other popular anxiety symptoms. There are several small exercises that you can do if you feel chest ache and suspect that anxiety chest pains are coming on.

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Avoid Triggering Situations

First of all, you can prevent anxiety attacks before they even start by avoiding stressful or triggering situations whenever possible. It can be difficult when and where triggers of an anxiety attack may pop up, but you should be aware of places, times, and events when they’re more likely to be present. For example, if crowded spaces or loud noises are triggering for you, then you should probably politely decline your friend’s invitation to their rock concert. Or, if being in unfamiliar social situations is unnerving and triggering for you, you can bring an understanding friend as your plus-one instead of totally refusing to attend an old friend’s wedding. These will help reduce and avoid the common symptom of anxiety.

Whatever your triggers may be, it is important to identify them and avoid them when you can. Of course, this doesn’t mean that you have to stay in all the time for fear of a panic or anxiety attack! Instead, make a habit of recording your anxiety attacks in a journal, along with the detailed description of the trigger that caused it. Over time, you’ll notice patterns that will help you identify specific situations to avoid while continuing to live and enjoy your life.

Deep Breathing And Mindfulness

You can also practice measured and deep breathing. This will help focus your mind on your body. It will also promote oxygen flow to your core and your muscles, preventing them from tightening and causing chest pain. When you experience anxiety, it’s important to focus on your body's very real and tangible parts experiencing chest pain. Focus on taking deep breaths, and imagine that you are directing the clean, fresh, oxygen-filled air to specific parts of your body. Start with your chest: inhale and send that lovely fresh breath straight to your heart. This method can help stop anxiety or a panic attack, and it can reduce anxiety stress.

Once your breathing is under control and you’re not hyperventilating, turn your attention to the things around you. Identify one thing that you can smell at that moment, touch something near you, and spend a full minute describing it to yourself. These small mindfulness exercises, and others like them, can help move your attention away from the anxiety attack and the triggering situation that caused it.

Long-Term Work with a Therapist

One of the best and most long-lasting ways to treat a social anxiety disorder is to work with a therapist. While this may not be the fastest or easiest route, it is a treatment option that has shown remarkable results for many patients. This can really help if you’re stressed or anxious frequently and to reduce anxiety in your life in general.

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While there are different methods for diving into an anxiety disorder, most therapists will take the time to talk through your experiences with anxiety attacks. They’ll then encourage and help you explore the triggers and situations that often lead to anxiety attacks. In this way, over time, you’ll likely make progress on the anxiety disorder so that anxiety attacks and the fear or dread of anxiety attacks become less and less of a problem over time.

While these options are great for treating anxiety disorders and panic disorders as a whole, they shouldn’t be a substitute for also talking to your doctor about chest pain. You can seek chest pain and an anxiety disorder; this will involve talking to different professionals.

What if the Chest Pain Continues?

If you experience chest pain for longer than several minutes, you need to consult a doctor. If the acute pain subsides, but there is lingering, dull chest pain, see your doctor. This dull and long-lasting pain could be the symptom of many disorders, but it is not often associated with an anxiety disorder or panic attack. It could be symptoms of coronary problems or symptoms of heart disease. So, you should have your doctor look into it.

When it comes to chest pain, always err on the side of caution. This means that if you have even a suspicion that your chest pain is more than an anxiety attack, take it up with a medical professional. Remember, in matters of the heart. It’s better to be safe.


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