Can you get sharp chest pains from anxiety

Are They Linked?: Woodlands Heart and Vascular Institute: Cardiologists

Anxiety and Chest Pain: Are They Linked?: Woodlands Heart and Vascular Institute: Cardiologists

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:

  • Dizziness
  • Shortness of breath
  • Sweating
  • Heart palpitations
  • 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.

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What It Feels Like, Causes, and Remedies

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.

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.

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.

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.

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.

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.

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.

Read this article in Spanish.

Chest pain - causes, symptoms and diagnosis, indications for seeking medical attention

Almost everyone perceives chest pain as a potential heart problem. However, there can be many reasons for discomfort. In any case, it is impossible to determine on your own what caused the discomfort. Only a qualified doctor can determine the cause.

Wrong diagnosis, lack of treatment, uncontrolled attempts to anesthetize the place of discomfort often lead to the development of severe pathologies.

To make sure that the pain is not a sign of a serious illness or to choose a treatment for an identified pathology, it is better to visit a doctor. Causes of pain can be caused by diseases of the heart, lungs, gastrointestinal tract and neurological problems. If you do not know which doctor to make an appointment with first of all, come to the Kutuzov Medical and Diagnostic Center. We have all the experts who will help you make an accurate diagnosis. Start by making an appointment with a therapist and follow his instructions.

Such different chest pains

Thoracalgia is a term for chest pain (from the words "torax" - chest and "algia" - pain).

It can hurt, both on one side of the chest, and in the middle, in the upper or lower part. The nature of the pain is:

  • Pungent and burning.
  • Dull and aching.
  • Stab.
  • Compressive.

Among the main causes of a disturbing symptom in the chest are diseases, injuries and pathologies:

  • Heart and vessels.
  • Lungs.
  • Musculoskeletal system - muscles, ribs and spine.
  • Nervous system
  • Gastrointestinal tract.

Let's dwell on them in more detail.

Heart problems

Pain in the chest in the middle or in its left side occurs in various diseases of the heart:

  • coronary artery disease, angina pectoris - impaired blood flow in the heart arteries. Often an attack of sharp pain lasts up to 15 minutes. Occurs during physical exertion, stress, excitement, disappears after rest.
  • Myocardial infarction - cell death and scarring of the heart muscle. It is characterized by severe pain in the chest on the left and in the middle, which does not go away after 15-20 minutes. Additional symptoms include weakness, fear of death.
  • Pericarditis or myocarditis is an inflammatory process in the muscle or lining of the heart. They are characterized by acute or aching pain in the chest when inhaling in the middle of the chest, which are aggravated by eating or lying down.
  • Mitral valve prolapse - in addition to chest pain, it causes shortness of breath, dizziness, up to fainting.
  • Pulmonary hypertension - increased pressure in the pulmonary arteries, the attack is similar to a heart attack.

A characteristic feature of heart pain is that it often occurs against the background of emotional or physical stress, accompanied by a feeling of panic, fear of death.

Lung diseases

This is a common cause of chest discomfort. Main causes and characteristic symptoms:

  • Inflammation or abscess of the lung - the process proceeds with severe pain in the chest (right or both parts of the chest), fever, cough.
  • Pleurisy (inflammation of the pleura) - there is pain with a deep breath, usually accompanied by fever, cough.
  • Thromboembolism of the pulmonary artery with a blood clot - there is a sharp pain in the chest, tachycardia, difficulty breathing.
  • Pneumothorax - accumulation of air in the pleural cavity when the lungs are damaged due to injuries of the ribs, spine. There is pain when inhaling, shortness of breath, dry cough, blood pressure may decrease.
  • Bronchial asthma - acute spasms resolve with chest pain and wheezing, wet cough, bouts of shortness of breath

Diseases of the gastrointestinal tract

Major diseases that cause pain in the esophagus or may spread from the abdomen to the chest area:

  • Gastroesophageal reflux disease (GERD) - irritation of the esophageal mucosa due to reflux of gastric contents.
  • Dyskinesia or perforation of the esophagus - increased pressure in the esophagus due to the slow movement of food or rupture due to injury.
  • Gastric ulcers.

Gastrointestinal diseases are characterized by pain that occurs before, after or during meals, and may be accompanied by heartburn and other symptoms.

Injuries and diseases of the musculoskeletal system

Thoracalgia appears due to injuries, diseases of the spine, aggravated after physical exertion. Main causes and symptoms:

  • Osteochondrosis, herniation and protrusion of the intervertebral discs in the thoracic spine, scoliosis cause chest pain, which is aggravated by movement or prolonged immobility.
  • Rib fractures.
  • Muscle spasms, sprains, intercostal neuralgia - cause pain in the chest on the right or left, depending on the place where the pathology has arisen.
  • Tietze's syndrome or inflammation of the costocartilaginous joints.
  • Pain of a neurological nature - from "goosebumps" in the chest to severe pain occurs due to mental disorders, with panic attacks.

Pain in the right or left side of the chest may have other causes: neoplasms in the lungs or breast, shingles and other diseases.

The doctor's task is to make a diagnosis in time and correctly. This will help: heart examinations, ultrasound, radiography and other diagnostic procedures.

Medical emergency needed if:

  • Acute chest pain does not improve after 15 minutes and after rest.
  • There is dizziness, shortness of breath, increased sweating, palpitations.

In other cases, it is also advisable not to postpone the consultation with the doctor for a long time. Who to contact - a cardiologist, a neurologist, a gastroenterologist - depends on the symptoms. But this is not always possible to determine independently. In this case, start with a consultation with a therapist who will help you understand the issue and, if necessary, refer you to a specialist.

In other cases, it is also advisable not to postpone the consultation with a doctor for a long time. Who to contact - a cardiologist, a neurologist, a gastroenterologist - depends on the symptoms. But this is not always possible to determine independently. In this case, start with a consultation with a therapist who will help you understand the issue and, if necessary, refer you to a specialist. Be healthy!

Diagnosis of any disease requires modern equipment and vast medical experience. Especially when it comes to chest pain.

Our clinic offers its patients a full range of medical examinations on high-precision equipment. Our doctors select the most informative and safe diagnostic methods.

Turning to us, you can be sure that the cause of the pain will be established as quickly and accurately as possible. High-tech diagnostic devices allow you to monitor the work of all organs and systems without causing you unnecessary discomfort.

We value the time of our patients, so all consultations and procedures are by appointment. By booking an appointment, you can be sure that the doctor will be waiting for you. Come to the clinic to find out the cause of pain and discuss treatment options.

Chest pain treatment prices



Reception (examination, consultation) of a general practitioner primary 2200 ₽


Repeated appointment (examination, consultation) with a general practitioner 1900 ₽


Publication checked:

Pilenitsyn Andrey Yurievich

Experience: 24 years old

Cardiologist of the highest qualification category, general practitioner

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Tactics of behavior in case of chest pain and risk factors for myocardial infarction - Prevention of diseases and healthy lifestyle - Budgetary institution of the Khanty-Mansiysk Autonomous Okrug - Yugra

The most common cause of chest pain is angina pectoris or "angina pectoris".

Angina pectoris is a form of coronary artery disease (CHD), the obvious signs of which are considered to be pain in the heart and shortness of breath. This pathology occurs against the background of a violation of the supply of the heart with a sufficient amount of blood, which is a consequence of the defeat of the coronary arteries by atherosclerosis.

Since this pathology is one of the forms of coronary artery disease, if it is present, there is an obstruction in one or both coronary arteries, which prevents the blood from circulating normally. This condition is accompanied by attacks of myocardial ischemia, that is, a lack of oxygen in the heart muscle.

The most obvious sign indicating the development of angina pectoris is considered to be the so-called imbalance between the need of the heart muscle for oxygen and the supply of oxygen to the region of the heart. To put it simply, the patient's heart receives much less amount of blood than he needs.

Lack of oxygen makes itself felt at the moment of physical activity - that is why in patients with this pathology attacks develop during physical work or under the influence of a stressful situation.

Painful sensations resemble seizures. Pain during such attacks is simply unbearable - it seems to burn, press and compress, it arises in the area behind the sternum and radiates to the left shoulder or to the whole arm. Very often, the pain of is also accompanied by strong anxiety, and fear : a person is trying to find a place for himself, he is holding on to his left chest and cannot fully understand what is happening.

In the case of the initial forms of the development of the disease, pain recedes within one to five minutes after taking the drug. If the pain does not disappear after this period of time, then this is a signal that the disease has acquired a more severe course, and, therefore, the chances of developing a myocardial infarction are high.

In most cases, just one tablet of Nitroglycerin helps to forget about the pain. If one tablet is not enough to get rid of pain, it means that the risk of developing myocardial infarction is increased.

At the first manifestations of retrosternal pain, you should immediately consult a doctor. It should not be thought that young age excludes the possibility of angina pectoris, or that burning behind the sternum when running or walking quickly uphill cannot be a sign of "angina pectoris" in a person involved in sports.

During an attack, the following measures are recommended for immediate relief of pain:

  • create physical and psycho-emotional rest for the patient: lie down, sit down, or stop if chest pains appear during exercise;
  • urgently needs to take 1 tablet of nitroglycerin under the tongue. The analgesic effect of nitroglycerin usually occurs within 1-5 minutes. To stop an attack, 1-2 tablets of nitroglycerin are enough.
  • if the attack is delayed (lasts 15-20 minutes) and repeated doses of nitroglycerin were ineffective, you should immediately call an ambulance.

Do not self-medicate. If you do not promptly consult a doctor and do not start the prescribed treatment, the disease progresses.

Under conditions of "oxygen starvation" in case of pain, myocardial cells can live for 20-30 minutes . Then they die. This is a heart attack, a site of necrosis in the tissue of the heart. A scar remains on the affected area.

There are risk factors for the development of myocardial infarction , the elimination of which significantly reduces the risk of its development: smoking, high levels of low-density lipoprotein cholesterol and hypercholesterolemia, arterial hypertension.

For the first time chest pain or shortness of breath on previously well tolerated exertion, an urgent need to consult a cardiologist. The District Cardiological Dispensary has the whole range of diagnostic procedures necessary in this case: all currently known methods for diagnosing coronary heart disease, both performed on an outpatient basis and in a hospital.

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