Can Anxiety Cause Chest Pain: What Do I Need To Know?


Woman looking panicked, with her hand on her chest
Summary
  • Chest pain can be a symptom of several conditions, including digestive issues, heart attacks, and anxiety.
  • Although a heart attack and chest pain related to anxiety can feel similar, there are distinctions between them; being able to tell the difference is crucial.
  • People with anxiety disorders may be more prone to experiencing anxiety-induced chest pain.
  • Always contact emergency services if you’re unsure what's causing your chest pain so that any life-threatening conditions can be ruled out and/or addressed.

According to the American Psychiatric Association (APA), anxiety disorders are the most common mental health disorders, with around 30% of all adults struggling with it at some point in their lives.

Statistics obtained from the Anxiety & Depression Association of America (ADAA), show that 15 million people in the U.S. struggle with social anxiety disorder (SAD), 6.8 million have generalized anxiety disorder (GAD), and 6 million have panic disorder (PD).

According to their research, GAD and PD are the two most common anxiety disorders that patients who visit the doctor with noncardiac chest pains have. This suggests a link between anxiety and chest pain.

In this article, we'll explore the connection between anxiety and chest pain in more detail, including how to tell if your anxiety is causing chest pain, treatment and management tips, and when you should see a doctor.

During a panic attack or bout of anxiety, the body releases the hormones cortisol and adrenaline — also known as the fight or flight hormone. These hormones cause an increase in heart rate and blood pressure, which can result in, among other things, chest pain.

Anxiety can also cause intense muscle contractions that cause chest pain and discomfort long after a panic attack has passed.

It also works the other way around, as chest pain can cause anxiety. After all, experiencing chest pain of any kind is never a good feeling — it’s enough to make anyone anxious.

Although chest pain anxiety looks different for everyone, most people will experience feelings of anxiousness before they experience pain in the chest.

A man sitting on a bed with his right hand over the left side of his chest
Key Point: What is Noncardiac Chest Pain?

Noncardiac chest pain (NCCP) is recurring chest pain experienced by people who do not have heart disease.

This pain can be felt behind the breastbone, close to the heart. It’s frequently caused by gastroesophageal reflux disease (GERD), but it may also be caused by anxiety.

What Does Chest Pain from Anxiety Feel Like?

The physical symptoms of anxiety can differ from person to person. Chest pain from anxiety may also feel different depending on the individual.

Anxiety symptoms related to the chest may be experienced as:

  • A sudden, sharp, or shooting pain in the chest

  • A dull, burning sensation in the chest

  • Unusual chest spasms and twitches

  • Stabbing chest pain

  • A dull, unrelenting pain in the chest

  • Heart palpitations or a rapid heart rate

  • Chest numbness or tightness

The symptoms that accompany chest pain caused by anxiety are very similar to common anxiety symptoms. These symptoms can appear before, during, or after the chest pain has passed.

Symptoms to watch out for include:

  • Irritability and restlessness

  • Fatigue

  • Dizziness or feeling faint

  • Concentration difficulties

  • Unexplained or unusual pains, such as headaches, stomach pains, or muscle aches

  • Shortness of breath or rapid breathing

  • Intense feelings of worry

  • Muscle tension

  • Nausea

  • Sleep disturbances

How Long Does Anxiety Chest Pain Last?

Anxiety chest pain typically starts off as a sharp pain that subsides within a few minutes, unlike other symptoms that may last longer than this.

Anxiety-induced chest pain shouldn’t persist or worsen, though it’s normal for those who experience frequent anxiety to have lingering soreness in the chest area after an anxiety attack.

If you experience anxiety chest pain that lasts for hours after a panic attack, or you have any concerns regarding persistent chest pain, contact your doctor.

Anxiety Chest Pain vs. Heart Attack: What’s the Difference?

The moment we feel chest pain, we tend to assume the worst. But pain in the chest is not always a sign of a heart attack. Other conditions can also cause chest pain.

It’s important to be able to tell the difference between heart attack chest pain and chest pain caused by anxiety.

The table below highlights the differences and similarities between anxiety-induced chest pain and chest pain related to a heart attack.

Anxiety Chest Pain

Heart Attack Chest Pain

Anxiety chest pain typically starts when you are resting or inactive.

Heart attacks may be triggered by physical exertion.

Chest pain begins suddenly and gradually decreases.

Chest pain persists and gets worse during activity.

The pain is localized (occurs in one area).

The pain can move to the arm or jaw.

Pain is typically preceded by other symptoms of anxiety, such as shortness of breath.

Pain or discomfort may be felt in the back, neck, arms, or jaw prior to the heart attack. You may also experience cold sweats or nausea before showing any heart attack symptoms.

Anxiety chest pain is sharp and sudden.

Heart attack pain feels like something is pressing or squeezing the chest (a sort of crushing sensation).

What Are Some Anxiety Disorders That Can Cause Chest Pain?

Everyone experiences anxiety at some point in their lives, but anxiety disorders occur when your level of anxiety affects your ability to function on a daily basis.

Those with anxiety disorders are more prone to experiencing anxiety-related chest pain.

Around 30-40% of people admitted to the emergency room with low-risk chest pain also have anxiety.

Key Point: What is Low-Risk Chest Pain?

Low-risk chest pain carries a risk of between 0.6 and 1.7% of adverse cardiac events, such as heart attacks.

The HEART score used to predict major cardiac events in those who experience chest pain takes into account factors such as:

  • Family history (for example, a history of coronary artery disease)
  • Age
  • Electrocardiography (the level of electrical activity in the heart)
Drawing of woman with her hand on her hand and swirly designs all around her representing anxiety.

Listed below are a few disorders that can cause anxiety-related chest pain.

Generalized anxiety disorder (GAD)

People at any age can develop GAD. It is characterized by severe anxiety that affects day-to-day activities.

Panic disorder (PD)

People with panic disorder regularly experience anxiety attacks, which are characterized by feelings of panic and may also cause sudden chest pain.

Obsessive-compulsive disorder (OCD)

People with OCD experience obsessive — often unreasonable thoughts — that lead to repetitive behaviors.

A fear of contamination or a desire for things to be orderly is often a hallmark of this disorder.

Post-traumatic stress disorder (PTSD)

This disorder occurs in response to experiencing or witnessing a dangerous or terrifying event.

PTSD can last months or years after a traumatic occurrence, and memories or feelings may be triggered by various stimuli.

Social phobia

Also called social anxiety disorder, social phobia is characterized by an intense fear of everyday social interactions.

What Else Can Cause Chest Pain?

There are many other reasons you can experience chest pain — it’s not always a heart attack or an anxiety attack.

Once chest pain starts, it’s easy to assume the worst. If your symptoms are severe or worsen, seek professional medical advice. Only a doctor will be able to accurately diagnose the cause of your chest pain.

Some causes of chest pain include:

  • Heart conditions, such as pericarditis, aortic dissection, and angina

  • Lung problems, such as pulmonary embolism, pleurisy, and pneumonia

  • Covid-19

  • Tuberculosis (TB)

  • Asthma

  • Digestive problems, such as GERD, peptic ulcers, and pancreatitis

How Do I Manage Anxiety Chest Pain?

By leading a healthy lifestyle and getting treatment for anxiety, you can relieve the symptoms — such as chest pain — that are associated with it.

Treatment for Anxiety Chest Pain

You can treat anxiety chest pain by keeping your anxiety in check. There are several ways to do this, including:

  • Seeing a therapist for counseling

  • Using medication prescribed by your doctor, such as anti-anxiety drugs or antidepressants

  • Performing deep breathing exercises to relax

  • Meditating and practicing mindfulness

  • Regularly doing activities that reduce anxiety symptoms, such as going for walks in nature or practicing yoga

  • Getting enough sleep

  • Eating a balanced diet

  • Reducing caffeine and alcohol intake

  • Quitting smoking

What Can I Do to Improve My Mental Health?

Poor mental health can negatively impact both your personal and professional life, so it’s important to prioritize your mental health and get the help you need to feel better as soon as you can.

There are many things you can do today to decrease anxiety symptoms. Some of these are mentioned in the above list.

Simply being attuned to your feelings can help you identify problematic thoughts that arise.

Keeping a journal is a good way to express your feelings and thoughts safely, and it can also help you to determine when you need help.

You can get professional help by reaching out to a mental health services provider. These days, it can be done from the comfort of your own home.

A woman sits holding her head while looking at her laptop screen.

When Should I See a Doctor for Chest Pain?

If the pain in your chest doesn’t pass in a few minutes, and it gets progressively worse, seek medical help immediately.

It may be nothing more than indigestion, but a crushing pain or pressure in the chest may be the first sign of a heart attack.

It’s crucial to address chest pain to rule out any life-threatening conditions — especially if you have a family history of, for example, heart disease.

Where Can I Learn More About Chest Pain and Anxiety?

Do you get regular chest pain? Does it occur alongside symptoms such as shortness of breath, muscle tension, and concentration difficulties? It could be anxiety. And LifeMD can help. Meet with a board-certified doctor from your smartphone, computer, or tablet.

Visit LifeMD.com to book a video appointment today.

Dr. Anthony Puopolo

Dr. Puopolo holds a B.A. in Biology from Tufts University, M.A. in Biology from Boston University, and Doctor of Medicine from the Boston University School of Medicine. He also completed a Family Medicine and Psychiatry residency program in the U.S. Army.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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