Do panic attacks cause chest pains

Panic Attacks and Chest Pain | Chest Pain From Stress

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When someone has a panic attack, chest pain is a common and frightening symptom. It can be so severe, and accompanied by palpitations, difficulty breathing and other physical symptoms of panic attacks, that it makes a person feel as though they are having a heart attack where they worry that they are going to die. Often, it is stress that causes the chest pain.

Can stress cause chest pain during panic attacks?

Your body’s stress responses are activated during a panic attack. These are also known as your ‘fight or flight’ responses.  

Contraction of your muscles is one of these stress responses. Your body does this to protect you from danger, as the tension makes you more resilient. This stiffness in your chest wall muscles and nearby areas can cause chest pain both during and after panic attacks.

Another stress response that can be activated during a panic attack is hyperventilation, where you ‘over-breathe’ as your body believes it is going to have to move fast. This can cause you to use your chest muscles to expand your rib cage, causing chest pain when your muscles become tired. This hyperventilation can then cause carbon dioxide levels in your blood to decrease, another factor that can lead to chest pain as well as tingling, dizziness, numbness and a dry mouth.

Stomach and digestive functions also alter during a “fight or flight” response and it is possible for problems with these functions to be experienced as chest pain or tightness.

How long does panic attack chest pain last?

A panic attack will usually last a few minutes but can come in waves and feel more continuous. As people can experience severe chest pain during a panic attack, it is possible to feel soreness afterwards. 

Relief for chest pain caused by a panic attack

During a panic attack, the following strategies can help you to manage the symptoms:

  • Focus on controlling your breathing – breathe in slowly and deeply through your nose for three seconds, hold for two seconds and breathe out for three seconds. You may want to close your eyes to help you focus. By concentrating on your body and your breathing, you can break the panic cycle, calm your hyperventilation and reduce your chest pain
  • Remind yourself that this moment will pass – panic attacks can be incredibly frightening to experience. There are occasions where some may experience anxiety chest pain all day, but when you are having a panic attack, try to repeat a positive phrase such as: “I know this is a panic attack and I know it will pass”. This can serve as a reminder that the moment will disappear just as it appeared. Recognising the transience of a panic attack can help to lessen the worry caused by the symptoms, helping the panic attack to subside
  • Refocus – when you feel a panic attack start to pass, begin to focus on your surroundings rather than on the experience. Think carefully about what you can see, hear, taste, smell and touch. You may also want to hone in on a particular object, and think carefully about its shape, colour and size

There are also preventative measures you can take to avoid panic attacks, which include the following:

  • Limit your caffeine, alcohol and nicotine intake
  • Exercise regularly to relieve tension and boost your mood
  • Eating healthy regular meals to keep your blood sugar levels stable
  • Get good quality sleep – try to achieve eight hours a night and stick to the same bedtime routine all week

Getting support and treatment for panic attacks

Panic attacks can be incredibly frightening and cause you to worry about if and when another will happen again, causing a ‘vicious cycle’.

At Priory, we can help you to learn strategies so that you are able to better manage your panic attacks and reduce the likelihood of them happening in the future.

Cognitive behavioural therapy (CBT) is an evidence based treatment available at Priory, where you learn how to identify and reframe your panic attack triggers and anxiety-inducing thought patterns.

Mindfulness sessions are also useful for learning how to identify and move past unpleasant thoughts and sensations without allowing panic to take over. During sessions at Priory, you can also receive relaxation training to understand deep breathing techniques and progressive muscle relaxation.

Exposure treatment may also be used after sessions in relaxation, cognitive reframing and mindfulness. During this time, you have the opportunity to practise the strategies you have learnt, and recognise that you can cope in challenging scenarios.

Certain medications, including selective serotonin reuptake inhibitors (SSRIs), or other medications, may be recommended or prescribed if necessary to further support in the management of your panic attacks.

If you think you are having a medical emergency, please seek immediate support.

Blog reviewed by Dr Ed Burns (MBChB, MRCPsych, MSc), Consultant Psychiatrist at Priory Hospital Roehampton

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Panic Attacks Information

How to tell if it is a panic attack or a heart attack

The symptoms of a panic attack and a heart attack can be very similar, making it difficult to tell the difference.

Having a heart attack also can cause someone to panic, which may make the situation more confusing. If someone thinks they may be having a heart attack, they should seek emergency medical attention.

Symptoms of a panic attack can include:

  • sharp pain in the chest
  • tingling in the hands
  • shortness of breath
  • racing heart
  • sweating
  • shaking

A panic attack can happen alone or as a symptom of panic disorder. Every year, about 2–3% of people in the United States experience panic disorder, and more will experience a panic attack without having panic disorder. To learn more about the links between a panic attack and panic disorder, see our decidated article here.

Every year, about 805,000 people in the U.S. have a heart attack. Symptoms of a heart attack can include:

  • chest pain
  • shortness of breath
  • nausea
  • vomiting
  • sweating

While the symptoms of these two conditions overlap, knowing how to tell the difference can be lifesaving.

Knowing the difference between a panic attack and a heart attack can be difficult, especially if a person has never experienced the symptoms of either before.

A person can distinguish between the two conditions by weighing several factors, including:

Characteristics of the pain

Although chest pain is common to both a panic attack and a heart attack, the characteristics of the pain often differ.

During a panic attack, chest pain is usually sharp or stabbing and localized in the middle of the chest.

Chest pain from a heart attack may resemble pressure or a squeezing sensation.

Chest pain that occurs due to a heart attack may also start in the center of the chest, but can then radiate from the chest to the arm, jaw, or shoulder blades.


The onset of symptoms may also help a person determine if they are having a panic attack or heart attack.

Although both conditions can develop suddenly and without warning, some heart attacks come on due to physical exertion, such as climbing the stairs.


The duration of symptoms might also help distinguish between a heart attack and a panic attack.

Most panic attacks are over in several minutes, though they can last longer.

During a heart attack, symptoms tend to last longer and get worse over time. For example, chest pain may be mild at the onset of a heart attack but become severe after several minutes.

A panic attack will not cause a heart attack. A blockage in one or more of the blood vessels to the heart, which leads to an interruption of vital blood flow, causes a heart attack.

Although a panic attack will not cause a heart attack, stress and anxiety might play a role in the development of coronary artery disease.

Panic attacks can occur as isolated events or as part of an anxiety disorder.

Some research indicates that people with anxiety disorders may have an increased risk of developing heart disease due to low heart rate variability (HRV).

HRV is the time between each heartbeat. The autonomic nervous system controls the heart rate. The heart rate is meant to vary throughout the day, depending on a person’s activities and emotions.

A high HRV indicates that a person’s heart rate shifts efficiently throughout the day, based on what they are doing. It is also a sign that their autonomic nervous system is working well.

A low HRV means a person’s heart does not switch gears as efficiently. Some studies associate a low HRV with an increased risk of heart disease.

In the researchers’ analysis of studies looking at HRV in people who were diagnosed with various types of anxiety disorder, including panic disorder, the results indicated the participants had a lower HRV than those without an anxiety disorder.

It is crucial to understand that having a panic attack does not mean someone will have a heart attack. A person with panic disorder may experience repeated panic attacks, but more research is needed to determine if having panic disorder increases the risk of developing heart disease.

As the symptoms of panic attacks and heart attacks are similar, it is always best to seek immediate medical attention when in doubt.

It is vital to seek emergency medical treatment if any of the following symptoms develop:

  • sudden, severe chest pain
  • pressure in the chest lasting more than 2 or 3 minutes
  • chest pain radiating down the arm or into the jaw

According to the Woman’s Heart Foundation, doctors sometimes mistake symptoms of heart disease for panic attacks in females. Medical tests, such as an electrocardiogram (ECG) and blood tests, can help a doctor make an accurate diagnosis.

Anyone who believes they may be having a heart attack should seek prompt treatment. If it is a heart attack, treatment will improve their chance of a good outlook and full recovery. If it is not a heart attack the person may benefit from treatment for anxiety.

The outlook will vary, depending on whether a person has experienced a heart attack or a panic attack.

Although a panic attack may feel very uncomfortable, it is not life-threatening. People should still seek appropriate treatment for panic attacks, which can interfere with their quality of life.

A doctor can help treat anxiety and panic attacks with various techniques, including lifestyle modifications, medication, and counseling.

In some cases, a heart attack can be life-threatening. Following a heart attack, a person will also need to take steps to manage the underlying heart disease.

Heart attack and panic attack: how to tell the difference?

The difference between a heart attack and a panic attack worries many people. It is especially acute in persons who, with persistent periodicity, experience discomfort in the chest, increased sweating, dizziness, shortness of breath and trembling.

Medical examination is the only way to determine the type of attack, since it is difficult to identify a person's condition by subjective indicators. However, understanding the symptoms and risk factors can point to the root of the problem. nine0003

Panic attacks are a characteristic manifestation of panic-type disorders, but they can also be associated with other psychiatric conditions such as obsessive-compulsive disorder or social anxiety disorder.

The main risk factor for panic attacks is mental health, and in the case of heart attacks, physical health plays a large role. Among the main indicators: age, cholesterol level, body weight, blood pressure level, diet, etc. nine0003

Many doctors note that the nature of the pain can help determine the type of attack it accompanies. Sharp pain behind the sternum or pain concentrated in one small area is associated with panic attacks. This pain is stabbing in nature and usually lasts 5-10 seconds.

According to Dr. MaryAnn McLaughlin, cardiologist at Mount Sinai Hospital, USA, patients with a heart attack in most cases report a feeling of tightness in the chest rather than pain. This sensation is comparable to the sensation that occurs when wearing a tight bra or as if something is constricting in the chest. nine0003

"There are certain types of heart attacks that are accompanied by a feeling of intense pain, but in general they begin with a feeling of squeezing, squeezing, which can spread towards the arms," ​​explained M. McLaughlin.

The duration of the attack is also one of the key differences. Typically, panic attacks last up to 10 minutes, and heart attacks can usually last longer. If a person experiences the above symptoms for more than 5 minutes, seek immediate medical attention. nine0003

There are some studies that indicate that heart attacks are often accompanied by intense physical exertion or feelings of anger or frustration. For example, if an older person is not used to exercise, they may be at risk of having a heart attack after exercising.

In contrast, panic attacks can occur both in a state of anxiety and in a state of calm.

However, if the person is unsure of what may have triggered the attack, it is best to seek immediate medical attention. Health professionals warn that the symptoms of a heart attack can often be overlooked, especially among women. nine0003

Based on

Panic attacks - symptoms, causes and treatments

What is a panic attack?

A panic attack is a severe attack of fear and anxiety for no apparent reason, which is accompanied by bodily reactions: rapid heartbeat and pulse, increased pressure, chills or fever, shortness of breath, dizziness.

Seizures can last from a couple of minutes to half an hour, occur suddenly and as if for no reason. You cannot die from a panic attack, but these attacks worsen a person's life and his psychological state. nine0003

Why do panic attacks occur?

There are many reasons for panic attacks. An attack can start due to stress, extreme fatigue, or excessive exercise. Causes can also be hormonal disruptions, somatic (i.e. bodily, not mental) diseases or pathologies of the central nervous system. A conflict situation, abuse of alcohol, coffee can provoke an attack. If a person is prone to avoiding negative emotions and is predisposed to a depressive state, he is also at risk. nine0003

To find the cause of panic attacks in a particular person, it is worth consulting a doctor. The doctor will take a medical history, prescribe tests and help with the appropriate treatment.

Symptoms of panic attacks

    How does a panic attack start? It becomes difficult to breathe, limbs begin to tremble and darken in the eyes. Other symptoms include:
  • cold sweat;
  • feeling of causeless fear and panic;
  • chest pain;
  • increased pulse; nine0048
  • nausea;
  • dizziness.

If you feel fear or panic and there is a reason for it - for example, before an important exam or job interview, this is normal and understandable. This is how your body reacts to a significant event for you.

Experiencing more than 4 symptoms at the same time without a good reason is most likely the beginning of a panic attack.

Have you experienced similar symptoms of panic attacks and have questions? nine0003

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Panic attacks in adolescents

Panic attacks can occur in adolescents in the same way as in adults. The causes of seizures also coincide - stress and strong emotional experiences.

In adolescence, hormonal levels change in adolescents, which makes them less mentally stable. The nervous system undergoes a great load and reacts to it with panic attacks. nine0003

What to do if a teenager has a panic attack? Take the child by the hand and ask to breathe deeply, offer to drink a glass of water. Explain what's happening - it's an attack, but it will pass, you're safe. Offer to name objects of a certain color or play on the phone to distract.

What to do if a teenager has a panic attack? Take the child by the hand and ask to breathe deeply, offer to drink a glass of water. Explain what's happening - it's an attack, but it will pass, you're safe. Offer to name objects of a certain color or play on the phone to distract. nine0003

How to deal with panic attacks? 5 Easy Panic Attack Advice - Neurologist's Tips

    Panic Attack First Aid is a series of simple steps that can be taken wherever the attack strikes.
  1. 1. Breathe. Slow and deep inhalations and exhalations relax the body and help to recover.
  2. 2. "Ground yourself." Take off your shoes and feel the floor with your feet. Touch objects with your hands. Pet a cat or dog if they are nearby.
  3. nine0047 3. Drink some water.
  4. 4. Stomp your feet or march in place to help release stress hormones.
  5. 5. Switch your attention - look around and name 5 objects near you. This will distract you and help you think more calmly.

You can stop an attack yourself. To understand the problem and the causes of panic attacks, we recommend that you consult a doctor. If this is not the first time this has happened, it is imperative to contact a specialist. nine0003

What to do in case of a panic attack at night

At night, the human body is relaxed and cannot maintain self-control, so stress seems to “catch up” with the body. Because of this, panic attacks can also occur at night.

To stop a panic attack in the middle of the night, do the following: normalize breathing, drink water, distract yourself.

Panic attacks as a complication after covid

After the coronavirus, the human body is severely depleted. In addition, isolation, uncertainty, economic difficulties have become a test that people have been struggling with for a long time. Panic attacks appear as one of the consequences of COVID-19as a reaction to stress and excessive emotional stress.

How to treat panic attacks after covid? You can stop the attack with the help of the already described actions - breathing, switching attention.

Since the body is weakened after an illness, it is not recommended to postpone a visit to a specialist. The doctor will determine the possible causes and help choose the treatment so as not to aggravate the condition of a person who has been ill with COVID-19.

Panic attacks: treatment in Kyiv

To start treating panic attacks, you need to contact a doctor - a neurologist and an endocrinologist. Doctors will ask the patient about complaints and prescribe the necessary tests to rule out other diseases that cause similar symptoms. nine0003

Diagnosis is carried out by experts from the Time+ Clinic for Neurology and Orthopedics.

Learn more