How Does Anxiety Cause Chest Pain?

In Diagnosis & Treatment, Online Doctor by Dr. Clinton Osborn

According to the CDC, there are approximately 790,000 people in the United States that have coronary artery disease. If we look closer, 12 to 16% of the population will experience some form of chest pain during their lifetime. Keep in mind that not all chest pain signifies an oncoming heart attack. Sometimes, these chest pains are due to anxiety and panic attacks.

Medical scientists have theorized that 25% of individuals looking for a treatment to alleviate their chest pain are actually suffering from anxiety or panic disorder. Because of the similar symptoms between anxiety chest pains and heart attack chest pains, it’s essential to know ways to differentiate between them. This will help you communicate more effectively with your healthcare provider.

What are Anxiety Attacks?

Anxiety attacks, also called panic attacks, occur when you experience intense emotions and fear that often occurs at random times and without any warning. The symptoms can last up to an hour, but it varies depending on the individual.

Usually, these attacks have specific triggers such as spiders, heights, elevators, or anything that the person may be afraid of. Some anxiety attacks are minor while others can affect a person’s quality of life.

When a person suffers from a panic attack, they usually spend a significant amount of time worrying about recurrent attacks. This could lead to unreasonable lifestyle changes to avoid potential triggers. For example, if a person experiences a panic attack every time they ride in an elevator, they may start avoiding elevators and take the stairs instead.

Some panic attacks can cause a person to be housebound and withdrawn from everyday life. This is why if any anxiety attack becomes too severe, it’s essential to seek help right away.

Symptoms of Anxiety Chest Pain

Chest pain related to anxiety attacks varies from person to person. Some people may experience gradual symptoms, while others experience severe and unbearable symptoms. Usually, the symptoms of anxiety chest pain entail a persistent chest aching, sharp/shooting pain, muscle twitch or spasm on the chest. People may feel tension, numbness, stabbing, or a burning sensation in their chest area, lasting for 5 to 10 seconds.

Related: Anxiety Relief With the Power of Telemedicine

Anxiety Chest Pain Versus Heart Attack

If you’re curious if your chest pain has to do with anxiety or your heart, we have some useful information for you.

If your chest pain is stimulated by exertion, then it’s most likely a heart attack, but if the chest pain occurs at rest, you may be experiencing some sort of anxiety. However, heart attacks and anxiety both exhibit increased heart rate, so chest pain isn’t the only symptom you should be looking at to differentiate between the two.

Chest pain that’s accompanied by stress and anxiety may be caused by a panic attack. If your chest pain is constant or radiates from your chest to other areas like your jaw or arms, then it’s most likely a heart attack. Chest pain that’s accompanied with shortness of breath is more linked with heart attacks.

Evaluating Chest Pain

There are numerous reasons why you may be experiencing chest pain. If you suspect a heart attack, then it’s essential to see your doctor immediately. Your doctor will perform a physical examination and thoroughly examine your medical history to determine the etiology of the pain.

Often times, your doctor will check your cardiac enzymes and troponin levels, and perform examinations like an EKG and stress test. If the results come out positive, your healthcare provider will provide medications like Morphine, Oxygen, Nitrate, Aspirin, Beta Blockers, Lisinopril, Simvastatin, Heparin, and Clopidogrel. If coronary artery vessels are severely closed up, your physician will perform coronary artery bypass surgery (CABG) or provide a stent.

What Causes Anxiety Chest Pain

When you are stressed or anxious, your body releases adrenergic hormones like epinephrine, norepinephrine, or adrenaline. These hormones make up the sympathetic nervous system, which is in charge of the fight or flight response. When that happens, your body is prepared to run or fight back. This would cause extreme excitement, surges of energy, muscle tightening, and make your heartbeat speedily.

If your anxiety is very severe, your body might release a high level of stimulant hormones, which can cause your heart to beat uncontrollably to the point where it can exhaust the heart muscles. Plus, your chest can begin to contract and increase in tension and pressure. The combination of the tightness in your chest and the fast heartbeat can result in severe chest pain.

Related: Where and When Can I Use Telemedicine and What is the Cost?

How to Treat Anxiety Chest Pain

If your anxiety chest pain has gotten out of control, it’s critical to seek help from your healthcare provider. They may initiate cognitive behavior therapy to help you cope with the panic attack. Cognitive behavior therapy teaches the person to change their thoughts in order to identify the triggers to their anxiety. This can help decrease and manage the symptoms of the anxiety attack without using medication. If the doctor feels that therapy and medication would be more adequate, he or she may prescribe you benzodiazepine or selective serotonin reuptake inhibitor.

If a panic attack were to happen, it’s best to find a safe place to slowly calm down. After that, try a deep and steady breathing technique to decrease anxiety. Keep in mind that the chest pains are temporary and will disappear once you have calmed down. The best thing you can do is stay positive and focus on peaceful imagery to reduce the symptoms. You can try counting to 10 or 20 to keep yourself focused. After the panic attack, it’s best to give it a rating between 1 to 10, 10 being the most severe, so you know if the treatment is working or not.

How to Prevent Anxiety Chest Pain

If you fear to have another panic attack, there are strategies that you can take to help reduce the chances of it recurring.

Lifestyle Modification

There are some lifestyle modifications that you can take to decrease the risk of a panic attack.  This includes getting enough sleep, exercising on a daily basis, and avoiding sugary foods, caffeine, alcohol, and smoking.

Deep Breathing

Deep breathing exercises can relax your mind and body. The first step is to find a quiet place, inhale for 10 seconds, hold it for one second, then exhale for 10 seconds. Repeat this several times until your heartbeat slows down.

Use Your Imagination

If you feel anxious, you can calm yourself by imagining a beautiful scenery. For example, you can picture yourself in a tropical rainforest, relaxing, and taking in the ambiance.

Relaxation App

There are relaxation apps that have peaceful sounds from nature or guided meditation to help reduce your stress.

Avoid Triggers

The main cause for an anxiety attack is a specific trigger such as fear of elevators, snakes, spiders, or bridges. The important thing is to identify the triggers and to avoid it.

The Prognosis of Anxiety Chest Pain

The likelihood of having chest pains from anxiety is often high. It’s important for your doctor to rule out cardiac problems, so they know that it’s truly anxiety or a panic attack. Fortunately, with the right cognitive behavioral therapy techniques and medication, patients often experience significant improvement in their symptoms. Unfortunately, misdiagnosed coronary artery disease it can lead to fatal issues down the line.

When to See a Doctor

Whenever you experience excruciating chest pain, it’s best to see a doctor immediately. You want to rule out heart problems like coronary artery disease, which can potentially be fatal and dangerous. Coronary artery disease occurs when blood clots form on one or multiple heart vessels, therefore reducing blood flow and oxygen to the body. The heart will beat faster to compensate, therefore resulting in severe pain.

Doctors can use a variety of diagnostic exams to find the underlying causes so they can treat it immediately. However, if cardiac problems are eliminated, then it’s most likely an anxiety attack. When this is the case, your doctor can prescribe you the proper medication and refer you to a psychologist to initiate cognitive behavior therapy.

Since chest pain from coronary artery disease and anxiety attacks are very similar, it can be very tough to differentiate. Luckily, there are online clinics, such as GuruMD, that can give you access to an online healthcare provider. The doctor can initiate an examination through a video to provide you with a basic idea of what’s going on. That way, you won’t have to spend hours at urgent care.

Related: Why Should I Use an Online Doctor?


Anxiety attacks can make life miserable. It can increase your heartbeat, resulting in severe chest pain. Because chest pains are very similar to heart attacks, it’s essential to talk to a doctor or physically see one for the proper physical examination and diagnostic to rule out coronary artery disease. Once that is ruled out, you can begin treatment for the panic attack.

You may need to make some lifestyle modifications, such as reducing your intake of alcohol, smoking, or any stimulant substance to decrease the symptoms. You can start doing meditation, relaxation exercises, deep breathing, or anything that can help relax you. Contact GuruMD today and talk to an online physician if you’re experiencing any of these symptoms.