Anxiety Chest Pain

By Danielle Boland

Anxiety is a common mental health disorder affecting approximately 3.1% of the United States population, particularly in women. It can happen at any time during someone’s life and is often made worse by specific stressful events or changes. Chest pain is one of the symptoms of anxiety that causes many people to seek out medical care. Knowing the difference between chest pain from anxiety and chest pain from a cardiac issue is important.  

Physical Anxiety Symptoms

Anxiety is a mental health diagnosis that does not only affect emotional health. Depending on the level of someone’s anxiety, anxiety can manifest itself into very real physical symptoms. The physical symptoms of anxiety can include:

• Dizziness
• Fatigue
• Heart palpitations
• Chest pain
• Muscle aches
• Tremors
• Dry mouth
• Excessive sweating
• Shortness of breath
• Stomach ache
• Headache
• Numbness
• Insomnia

Can Anxiety Cause Chest Pain?

In short, yes. In a recent study, half of the 151 people surveyed with anxiety felt chest pain when anxious, which caused them to seek out medical attention. 

Chest pain caused by anxiety can also mimic the physical symptoms of a heart attack, leading to an emergency room visit. This is both an expensive and time-consuming process that often leaves the person without an answer for their symptoms.

What Does Chest Pain From Anxiety Feel Like? 

Anxiety-induced chest pain can feel different for everyone. Some people have consistent symptoms and others have them sporadically. The symptom can gradually occur or begin suddenly, depending on the person. Chest pain brought on by anxiety has been described as a tightness in the chest that accompanies a rush of bad feelings or dread. Most people have a hard time distinguishing anxiety chest pain from a heart attack. 

Anxiety Chest Pain Symptoms

Chest pain related specifically to anxiety can feel like:

• Sharp or shooting pain
• Continuous aching in your chest
• Muscle spasm or twitch in your chest
• Burning
• Numbness
• Dull ache
• Stabbing feeling
• Pressure
• Chest tension or tightness

How Long Does Anxiety Chest Pain Last?

Chest pain caused by anxiety is unique to those who experience it. Some people have long-lasting symptoms, and others are able to recover quickly. In general, this type of chest pain lasts around ten minutes. Those who have coping mechanisms to help manage their anxiety are often able to reduce the amount of time they experience their symptoms. 

Anxiety Chest Pain vs. Heart Attack

Heart attacks and anxiety chest pain can share similar and sometimes identical symptoms. It is important to know the difference in order to best seek out treatment. Heart attack symptoms include:

• Mild to severe discomfort in the middle or left side of the chest. It can feel like fullness, pressure or squeezing
• Discomfort lasts several minutes, stops, then returns
• Difficulty breathing, regardless of physical activity
• Mild to severe chest pain that can radiate into arms, neck, shoulders or jaw
• Nausea and dizziness
• Heavy sweating
• Weakness in limbs, loss of coordination
• All symptoms end and then return, continuing that cycle for several hours

Symptoms of chest pain caused by anxiety are generally a sudden onset, with sharp or stabbing pains that go away and do not come back after about ten minutes. Regardless of the source, if you are experiencing chest pain, you should seek out medical attention to be evaluated. 

Why Does Anxiety Cause Chest Pain?

It can be concerning when you experience chest pain while feeling anxiety. When we become anxious, our body has a natural physical reaction. Chest pain that results from anxiety can occur for a few reasons. These include:

• Esophageal dysmotility: irregular contractions in your esophagus
• Cardiovascular response: Anxiety can elevate blood pressure and increase heart rate.
• Hyperventilating: rapid breathing that causes lower carbon dioxide levels in your blood, so you feel lightheaded and numb

How To Stop Anxiety Chest Pain

Certain techniques can be used to help de-escalate the symptoms of anxiety, including chest pain. Interventions such as meditation and mindfulness can help in the moment, while long-term tools like self-care and a healthy sleep schedule can help manage anxiety over time. 

Deep Breathing Techniques

Deep breathing is a great way to manage anxiety that manifests in the body. Deep breathing sends a message to the brain and body to calm down. When you breathe deeply, physical reactions to anxiety such as increased heart rate, fast breathing and high blood pressure decrease.

Meditation

Meditation can help the body relax and reduce chest pain experienced due to anxiety. This is referred to as “rest and digest,” which can help minimize the feelings of chest pain.

Practicing Mindfulness

Mindfulness helps us be in the moment and work to stay in the current thoughts, feelings or behaviors that are occurring. Mindfulness can be a useful tool when experiencing chest pain due to anxiety by rationalizing what is currently happening and the physical symptoms you may be feeling. 

Getting Plenty of Sleep

A lack of sleep can affect your mood, leading to an increase in anxiety. Important biological functions happen while we sleep that help us feel rested and energized. Having a healthy sleep routine can help reduce anxiety and symptoms related overall. 

Limiting Caffeine and Alcohol Intake

Excessive caffeine has been shown to increase risk of anxiety and its symptoms. These substances can contribute to the physiological arousal associated with anxiety. Reducing your caffeine and alcohol intacke can reduce the likelihood of anxiety-induced chest pain. 

Physical Activity 

Physical activity can be a very useful tool in reducing anxiety-related chest pain. Engaging in exercise can help reduce anxious thoughts, decrease muscle tension and increase serotonin levels. 

Treating Anxiety Chest Pain

Although chest pain can be a scary symptom of anxiety, there are treatments available to help reduce this symptom and anxiety overall. 

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy, or CBT, is a type of psychotherapy that focuses on reframing negative or untrue thoughts, feelings and behaviors. Identifying which thoughts and feelings are based on reality and which come from your anxiety can help reduce anxiety symptoms. 

Talk Therapy

Someone suffering anxiety-induced chest pain could benefit from talk therapy. In talk therapy, therapists help patients develop coping mechanisms to reduce their anxiety symptoms.

The Nobu mental wellness app is one resource for talk therapy. For a fee, you can use the app to connect with a licensed therapist for online therapy sessions and messaging. The app also features many free-to-use resources, including mindfulness tools, mental health lessons, journaling and goal-tracking. 

Anxiety Medication

In a recent study, the majority of patients with anxiety stated that their symptoms, including chest pain, were better managed after beginning a medication. Specifically, selective serotonin reuptake inhibitors (SSRIs) showed a positive result in helping to reduce and better manage anxiety symptoms. Common medications used to treat anxiety symptoms are:

• Zoloft
• Prozac 
• Celexa 
• Lexapro

When To See a Doctor for Chest Pain

Regardless of your anxiety levels, chest pain should never be ignored. If you are experiencing chest pain, it is best to seek medical attention to rule out any problems. Symptoms that should not be ignored include:

• Chest pain or pressure
• Pounding or racing heart
• Feeling lightheaded or faint
• Sweating, including cold sweats
• Pain or discomfort in the upper body, such as the jaw, neck, arms, shoulders or back
• Shortness of breath
• Nausea or vomiting
• Feeling of impending doom

It may just be anxiety-related chest pain, but it’s always better to be sure.