Anxiety Chest Pain: Why Does it Happen?

Published on: 19 Oct 2021
man sitting with face in his hands

Those who’ve ever experienced it know: anxiety can be terrible. Despite it being a natural response to stress, anxiety and anxiety disorders can take control over your whole life. Anxiety can result in physical symptoms like shaking, sweating, and yes…chest pain. 

What is anxiety chest pain and why does it happen? More importantly, how can you be sure it’s anxiety and not something else?

Read on as we discuss all this and how to deal with anxiety so that anxiety chest pain doesn’t happen as often.

What is Anxiety Chest Pain and Why Is It So Common? 

Is your chest tightness anxiety, or is it something more? Research shows that anxiety is a contributing factor for about 30% to 40% of people who experience low-risk chest pain and go to the ER.

Even just the thought of chest pain can make us, well, anxious. Feeling anxiety in chest regions, however, is a fairly common symptom of anxiety. It’s the association of chest pain with heart related conditions or, in the worst cases, a heart attack, that makes any type of chest pain seem frightening.      

Knowing the difference between anxiety-driven chest pain, and when it could be something more, is important. To do that, you need to understand how anxiety chest pain usually feels.

What Does Anxiety Chest Pain Feel Like?

One of the hardest parts about anxiety is that it often doesn’t present the same way in any two people. What type and how severe your anxiety symptoms are can range from day to day. 

Even the same physical symptom of chest pain from anxiety can differ from person to person. For most, the pain is sudden, harsh, and sharp but others may experience anxiety chest pain gradually. 

Chest tightness anxiety symptoms can be described as any of the following:

  • A persistent ache in the chest
  • A shooting or sharp pain
  • A burning, dull ache, or numbness in the chest area
  • An abnormal muscle twitch or spasm
  • Chest tightness or tension
  • Stabbing pressure in the chest

“For those with anxiety chest pain, people describe it as though there is a heavy weight on their chest, making them feel as though they are suffocating — which can be absolutely terrifying.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

Causes of Anxiety Chest Pain

Understanding what can cause chest pain that’s related to anxiety can help you manage it. 

Stress Response

When we become anxious, our body has a natural physical reaction. Sweating, shortness of breath or difficulty breathing, your body tensing up, a racing heartbeat, and more can all be the result of a physiological change due to your brain setting off a stress response.

Sometimes there are emotional or psychological responses, too. You may find that you’re suddenly very aggressive or hostile, or you’re easily upset when you’re anxious. These responses are commonly known as fight-or-flight responses. They’re a way for your head and body to take over in dangerous situations. However, when you experience fight-or-flight reactions often, it can take your body a lot longer to recover. The result can be extreme muscle tension you may feel in your chest. 

Combine this tightness with the potential for an increased heart rate (another symptom of anxiety), and you may suddenly begin wondering if what you’re feeling is really just anxiety in your chest or if it’s something much more. 

“There are so many causes of anxiety chest pain, but the more major ones include either traumatic experiences for the first time or regularly triggering past traumatic experiences. Typically, our perception has led us to believe that we need to fight or flight for longer periods of time. It wears on our emotional capacity and eventually leads to physical symptoms.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

Cardiovascular System Mechanism

Chest pain that results from anxiety can be from cardiac system mechanisms, or they may not be related at all. In some cases, it may even be a combination of the two. If you’re experiencing anxiety chest pain that’s not cardiac related, your pain may be due to:

  • Esophageal dysmotility — Due to irregular contractions in your esophagus.
  • Hyperventilating — Due to rapid breathing that causes lower carbon dioxide levels in your blood, which can cause tingling in your extremities and lightheadedness.

How Does Anxiety Chest Pain Differ From a Heart Attack?

Though they may seem very similar in how they feel, they are different. You might be able to calm yourself down a bit by knowing how anxiety chest pain and heart attack chest pain differ.

Anxiety chest pain symptoms 

Anxiety chest pain often starts suddenly with a stabbing pain in the chest area that might begin even if you’re sitting quietly. It may also come on after you’re already feeling other symptoms of anxiety. It usually starts and fades fast — often within just about 10 minutes or so.

Other symptoms can include: 

  • Feeling faint
  • Trembling
  • Feeling out of control
  • Heart palpitations 
  • Feeling dizzy
  • Having shortness of breath
  • Body temperature changes
  • Feeling numb
  • Sweating

Heart attack symptoms 

Heart attack symptoms, by contrast, typically come on during periods of activity. Many describe feelings of pain that:

  • Start in the chest and travel to other body parts (like the shoulder, jaw, or arms)
  • Begin slowly and increase gradually
  • Feel like heavy pressure or a squeezing sensation

“While anxiety chest pain and a heart attack have more in common than they don’t, a heart attack differs from anxiety chest pain in that many people report a squeezing in their chest (around their heart) and/or a fullness that seems to be different from the suffocating feeling that anxiety chest pain offers. Heartburn and/or belching also seem to be unique to heart attacks.”

Talkspace therapist Meaghan Rice, PsyD, LPC.

How to Treat Anxiety Chest Pain

Fortunately, if you have pain in your chest from anxiety, there are a number of treatment options you can try. First and foremost, in-person or online therapy can be extremely helpful in learning how to manage your anxiety and alleviate your symptoms. 

A therapist can use cognitive behavioral therapy techniques to help you restructure the thought processes that may be leading to your anxiety and contributing to your chest pain. Many people find this route of treatment preferable if they’re hoping to avoid medication. 

However, you should know that anxiety medication is another effective form of treatment for many people. However, therapy and medication aren’t the only two ways you can handle chest tightness anxiety. 

You can also try: 

  • Using deep breathing techniques to slow your heart rate and keep your anxiety from worsening
  • Finding a safe place that you feel comfortable in to help you reduce your anxiety
  • Focusing on positive or peaceful things or images to reduce how severe your anxiety attack might become.
  • Journaling regularly to help manage your stress and allow yourself to let go of some of the anxiety you may be feeling.
  • Working out — yoga, biking, swimming, walking, and dancing are all ways to manage and eliminate some anxiety
  • Meditating to calm your mind and practice staying in the moment  
  • Getting on (and sticking to) a good sleep pattern. 
  • Eating healthy and avoiding high-processed foods or foods high in refined sugar 
  • Reducing or completely avoiding caffeine and alcohol
  • Quitting smoking and/or using drugs

Anxiety disorder symptoms can be challenging enough, even without chest pain. Additionally, t can become so much worse when you have the fear that chest pain often brings on. To eliminate the possibility that something more is going on, you should see a doctor or healthcare provider to be evaluated any time you have chest tightness anxiety, heart palpitations, or any other type of chest pain. This can rule out any other conditions if you’re still unsure. 

While it’s a common symptom for anxiety to sometimes cause chest pain, you can’t just assume that what you’re experiencing is non-cardiac chest pain. Having a proper diagnosis by a doctor or licensed therapist may even help you manage your anxiety and understand where your chest pain symptom is coming from.

If you need help managing your anxiety, reach out to Talkspace today. Our licensed therapists are specialized in anxiety in teens and adults so you can get the treatment you need.

Sources:

1. Musey Jr, MD, MS P, Patel, MD, MPH R, Fry, MS C, Jimenez, MS G, Koene, BA R, Kline, MD J. Anxiety Associated With Increased Risk for Emergency Department Recidivism in Patients With Low-Risk Chest Pain. Am J Cardiol. 2018;122(7):1133-1141. doi:10.1016/j.amjcard.2018.06.044. Accessed September 14th, 2021. https://scholarworks.iupui.edu/bitstream/handle/1805/17233/Musey_2018_anxiety.pdf;jsessionid=7B2CAA206B608AA638AD651F1618FF3F?sequence=1

2. DeVon H, Mirzaei S, Zègre‐Hemsey J. Typical and Atypical Symptoms of Acute Coronary Syndrome: Time to Retire the Terms?. J Am Heart Assoc. 2020;9(7). doi:10.1161/jaha.119.015539. Accessed September 14th, 2021. https://www.ahajournals.org/doi/10.1161/JAHA.119.015539

Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.

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