Chest pain is a frightening experience that sends many people to the emergency room. Nearly half of them learn they don’t have a heart problem. Of those, 30-40% discover that anxiety was the culprit.
In short, anxiety and chest pain share a close relationship, but that doesn’t mean you can assume anxiety is to blame. You can’t risk delaying medical attention when there’s a chance you have a heart condition or you’re having a heart attack.
If you suspect you’re having a heart attack, call 911. Otherwise, Laura Fernandes, MD, FACC, at Woodlands Heart and Vascular Institute can run diagnostics in the office to rapidly determine if you have cardiovascular disease.
Learn how anxiety causes chest pain and if it’s possible to tell the difference between anxiety and heart-related symptoms.
Anxiety defined
Anxiety is your body’s natural reaction to a threat, whether the threat is immediate or in the future. Any time you feel anxious, your brain automatically sends out hormones that activate the fight-or-flight response.
Whether you’re stuck in traffic, worried about a job interview, or face a threatening situation, your brain’s natural reaction energizes your body so you can deal with the threat or quickly react and escape the situation.
How anxiety causes chest pain
When you’re anxious, your brain sends a surge of adrenaline and cortisol through your body. These hormones immediately trigger a rapid rise in your heart rate and blood pressure. As a result, many people experience chest pain and sweating, or have a hard time breathing.
The sudden boost of adrenaline can narrow the arteries in your heart and attach to cells inside the heart. This condition, called stress cardiomyopathy, mimics a heart attack, from symptoms all the way down to changes in your heart’s electrical activity.
Though stress cardiomyopathy usually heals within a few days or weeks, it may lead to weak heart muscles, congestive heart failure, and abnormal heart rhythms.
Levels of adrenaline and cortisol don’t return to normal in people with anxiety disorders such as generalized anxiety disorder, panic disorder, and post-traumatic stress disorder. Chronically high hormone levels may trigger a panic attack (causing symptoms that feel like a heart attack) and increase your risk of cardiovascular disease.
Symptoms of anxiety vs. cardiac chest pain
It’s hard, if not impossible, to tell the difference between anxiety-induced chest pain and the pain caused by an underlying heart condition. In addition to your chest pain, both can cause:
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Dizziness
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Shortness of breath
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Sweating
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Heart palpitations
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Feeling of dread or being out of control
Everyone experiences slightly different symptoms, whether they have anxiety or a heart problem. For this reason, the following two qualities aren’t written in stone. However, they’re generally true and may help you determine the cause of your chest pain:
Pain location
Chest pain from a heart attack often spreads throughout your chest and radiates to your jaw, shoulders, and arms. By comparison, chest pain from anxiety stays in your chest.
Pain patterns
Chest pain from a heart attack starts slowly and gradually gets worse, while an anxiety attack causes sudden chest pain that slowly improves. Many people find that anxiety-related chest pain goes away in about 10 minutes. However, other anxiety-related symptoms can last up to an hour after the pain improves.
If you have any questions about chest pain or other heart-related symptoms, call our office in The Woodlands, Texas,or schedule an appointment online today.
Feeling worried, fearful, or nervous from time to time is quite normal for most people. These are typical reactions to atypical moments in everyday life.
Some people experience anxiety frequently. Symptoms can move beyond feelings of concern or worry to other physical reactions. Occasionally, these symptoms are mistakenly associated with other conditions.
As an example, chest pain is sometimes a symptom of anxiety. Often the result of a panic attack or heightened reaction, chest pain is a concern because of the possible connection to heart attacks and other heart conditions.
If you experience frequent anxiety, learning to understand your chest pain can help you find symptom relief and identify when you need additional medical help.
What anxiety chest pain feels like
Anxiety symptoms are rarely the same from person to person. Some days, symptoms aren’t even the same for the same person. Anxiety presents itself in a variety of ways, and that makes detecting or understanding symptoms difficult.
Chest pain associated with anxiety feels different for each person. Some people may experience chest pain on a gradual basis. For others, the pain may be sudden and unexpected. Anxiety chest pain can be described as:
- sharp, shooting pain
- persistent chest aching
- an unusual muscle twitch or spasm in your chest
- burning, numbness, or a dull ache
- stabbing pressure
- chest tension or tightness
If you don’t have a history of chest pain with anxiety, you may be alarmed. Many people assume they’re having a heart attack and go to the hospital’s emergency department for treatment.
An estimated 25 to 50 percent of patients who come to the emergency department with low risk chest pain (chest pain not related to a heart attack) experience moderate to severe anxiety, according to 2018 research.
If you visit a hospital emergency room and the doctors don’t find a specific cause for your chest pain, consider consulting with your doctor about other possible causes, including anxiety.
Anxiety chest pain vs. heart attack chest pain
Chest pain is a concerning symptom, and it’s usually best to seek emergency medical attention if you’re experiencing it. Even if the chest pain cause is anxiety, it’s better to know than to risk missing valuable time if you’re having a heart attack.
People describe chest pain in a number of ways when they’re having a heart attack. Some examples include:
- chest pain that radiates to other parts of your body, such as down your arms or up to your jaw
- chest pain that worsens with exertion
- nausea along with chest pain
- pressure in the chest, as if someone has put something heavy on your chest
- rapid heart rate
- shortness of breath
- squeezing sensation in the chest
An estimated 30 percent of patients who are having a heart attack don’t have chest pain, according to 2020 research. Some people report symptoms like back pain and fatigue as part of their heart attack symptoms.
While doctors know there is a connection between anxiety and chest pain, you still shouldn’t ignore your symptoms and seek medical attention.
Call your local emergency services if you’re having chest pain. Don’t attempt to drive yourself to the hospital. Emergency personnel can evaluate you and determine whether you’re having a cardiac event or if there’s another reason for your chest pain.
What causes anxiety chest pain
When you’re anxious, your body can and often does produce physical reactions like sweating or shortness of breath.
When you become anxious, your brain and body set off an immediate stress response. This includes a physiological change. Your body may tighten up or grow tense.
A stress response can also include a psychological or emotional response. You may become aggressive or upset more easily. These responses are referred to as the fight-or-flight response. When you become stressed or anxious, your body prepares to fight back or run away.
If you experience this fight-or-flight stress reaction infrequently, your body should fully recover within 30 minutes. But if you experience it frequently, your body can’t recover as quickly. This can lead to increased muscle tension, and this tension may become painful in your chest.
Likewise, in an even more stressful moment, your heart rate may increase, and the force of your heartbeats can grow stronger. That combined with tight chest muscles can make you feel unusual pain.
Home remedies
If you feel anxious, there are some simple techniques you can try. These techniques may not work every time, but they’re a great starting point when you need help managing your anxiety.
Practice deep breathing
Focused, deep breaths can calm both your mind and your body. Find a quiet room or area, and inhale for a count of 10. Hold for a second, and then exhale for a count of 10. Repeat this several times as you feel your heart rate fall.
Take stock of the situation
Accept your feelings of anxiety, recognize them, and then work through putting them in perspective.
Are you worried about something you can’t control? Are you fearful of an outcome that’s unlikely? Are you dreading a situation you can’t control the outcome of? Talk your way through your feelings to find the source, and then work to put them into perspective.
Picture a beautiful scene
If you’re feeling anxious, try visualizing a place that instantly calms you. This can be especially helpful if you’re feeling anxious while in a situation you can’t avoid, like a stressful meeting. Practice deep breathing while you envision this location.
Use a relaxation app
Smartphone apps for anxiety can walk you through stress reduction techniques and exercises. There are also meditation apps that may help you quiet your mind when you’re feeling anxious. Many of these apps are free, so you can try out several to find one that works for you.
Be proactive about your physical health
Are you taking good care of your body? Are you getting enough sleep? Are you eating well? Taking good care of your body is also taking good care of your mind. While this won’t help treat anxiety chest pain, it may help you reduce your risk for anxiety and subsequent chest pain in the future.
See a doctor
If your anxiety and chest pain are severe or chronic, you may need to consult with a therapist. They can talk you through situations that cause anxiety and share coping techniques.
These techniques may not come naturally to you if you’re often anxious. This is where a healthcare professional can help.
A therapist or doctor may be able to teach you coping techniques that help you feel in control and secure. When you begin to regain a sense of calm, your symptoms, including chest pain, will subside.
If coaching techniques or mental exercises aren’t successful, you may need to consider a prescription. Anti-anxiety medications have side effects and risks. But using them as a stopgap while you learn how to cope with symptoms can be helpful.
Chest pain shouldn’t be ignored. If you’re experiencing it, seek medical attention to rule out a heart condition. If your chest pain is found to be related to anxiety, then you can work with a therapist or doctor to learn coping techniques or determine the best treatment for you.
Outlook
Identifying anxiety as the cause of your chest pain is an important step in treating your condition. As you learn to manage the side effects of anxiety, you’ll also learn to manage unintended complications like chest pain.
While you can’t know for sure if or when you’ll experience anxiety chest pain again, preparing yourself with coping techniques and practices will help you feel more prepared and in control.
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