Can Anxiety Cause Chest Pain?

For some people with anxiety, chest pain might be a mental health symptom — not a sign of a heart attack.

Chest pain can be a frightening experience, often evoking fears of a heart attack or other serious conditions. However, in many cases, this discomfort may be linked to anxiety rather than a physical heart problem. Anxiety disorders, which affect millions of people worldwide, can manifest in various physical symptoms, including chest pain. Understanding the connection between anxiety and chest pain is crucial for distinguishing between anxiety-induced symptoms and more serious medical conditions like severe chest pain or heart attack symptoms. Below, we explore how anxiety can contribute to chest pain, the mechanisms behind this phenomenon, and the importance of seeking appropriate medical evaluation and treatment.

The link between anxiety and chest pain

An anxiety disorder affects the body in a multitude of ways, primarily through the activation of the body’s stress response system. When faced with anxiety, the body perceives a threat and triggers the “fight-or-flight” response, which involves a range of physiological changes. These changes are designed to prepare the body to confront or escape the perceived threat, but they can also lead to a variety of distressing symptoms — including anxiety-induced chest pain and panic attack symptoms. Here are some common ways anxiety affects the body and can cause symptoms of chest pain:

• Anxiety stimulates the release of adrenaline and other stress hormones, leading to a heightened heart rate that can contribute to feelings of heart palpitations and chest discomfort.
• Anxiety often causes muscle tension, particularly in the chest muscles and shoulders, which can create a sensation of tightness or pain in the chest area.
• Anxiety can lead to rapid, shallow breathing (hyperventilation), which decreases carbon dioxide levels in the blood and may cause chest tightness, dizziness, and tingling sensations.
• Elevated blood pressure is a stress response can result in temporarily increased blood pressure, which can also contribute to the sensation of chest pressure or pain.
• Anxiety can heighten the body’s sensitivity to pain, making normal sensations feel more intense and potentially exacerbating chest discomfort.
• Psychological symptoms of anxiety (like a sense of impending doom, racing thoughts, or the inability to self-soothe) can amplify the sensation of chest pain.

Types of chest pain commonly associated with anxiety

As mentioned, chest pain is a common symptom of anxiety, but the kind of muscle tension can vary in sensation and intensity. Anxiety-induced chest pain is typically linked to muscle tension, hyperventilation, and stress responses. Also, the nature of this physical symptom often differs from the pain caused by cardiac issues, a heart condition, or heart disease. Here are some common types of chest pain that can be associated with anxiety. 

• Sharp or stabbing pain
• Dull or aching pain
• Tightness or pressure
• Radiating pain
• Pounding or palpitations
• Pain triggered by breathing

Warning signs of serious conditions

Recognizing the warning signs of serious conditions associated with chest pain is crucial for timely medical intervention. While anxiety can cause chest pain, certain symptoms may indicate more severe health issues that require immediate attention. Differentiating between anxiety-induced pain and potentially life-threatening conditions is essential for ensuring proper care and avoiding unnecessary panic.

Severe or crushing pain

Intense, crushing pain in the chest that lasts for more than a few minutes or gets worse over time can be a sign of a heart attack or other serious cardiac condition. This pain often feels like pressure or heaviness and may not be alleviated by rest.

Pain radiating to other areas

Pain that spreads to the arms, shoulders, neck, jaw, or back, especially when accompanied by chest pain, could indicate a heart attack or other serious issue. The radiating nature of the pain is a red flag that should not be ignored.

Shortness of breath

Difficulty breathing or shortness of breath that occurs alongside chest pain can be a sign of a heart attack, pulmonary embolism, or other critical respiratory or cardiovascular issues. This symptom requires prompt medical evaluation.

Sweating and nausea

Excessive sweating, nausea, vomiting, or dizziness that accompanies chest pain may suggest a serious condition such as a heart attack. These symptoms can signal the body’s severe stress response or underlying cardiac problems.

Rapid or irregular heartbeat

A noticeable increase in heart rate or irregular heartbeats (palpitations) that occur with chest pain could indicate arrhythmias or other serious cardiac conditions. Monitoring and reporting these symptoms to a healthcare provider is important.

Unresponsiveness or loss of consciousness

If chest pain is accompanied by sudden loss of consciousness or unresponsiveness, immediate medical attention is required, as this could be a sign of a heart attack or other critical health emergency.

Managing anxiety-related chest pain

Treating anxiety symptoms — including chest pain — effectively often requires a multifaceted approach that addresses both the psychological and physical aspects of the condition. A common strategy involves therapy, particularly cognitive-behavioral therapy, which helps individuals identify and modify negative thought patterns. Medications also play a crucial role, with selective serotonin reuptake inhibitors (SSRIs) frequently prescribed for long-term management and benzodiazepines used for short-term relief. 

Complementing these treatments, mindfulness and relaxation techniques can help manage symptoms, while lifestyle changes such as regular physical exercise, a balanced diet, and adequate sleep support overall well-being. Additionally, support groups provide valuable social support, and stress management techniques like time management and problem-solving strategies can further enhance coping abilities.

How Charlie Health can help

If anxiety symptoms are affecting your mental health, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides mental health treatment for people dealing with serious mental health conditions, including generalized anxiety disorder, panic disorder, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic online therapy, managing your mental health is possible. Fill out the form below or give us a call to start healing today.