How long can chest pain from anxiety last

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.

What Can a Stress Test Tell Me?

When you have symptoms suggesting a heart problem, it’s essential to find the problem and begin treatment as soon as possible. A stress test is one of several in-office diagnostic procedures that quickly target the problem.

The Dangers of Hypertension

If you don’t have your blood pressure checked, you won’t know you have hypertension. Living with untreated hypertension puts your health at risk. The dangers of high blood pressure range from vision loss and dementia to stroke and heart attacks.

Is Atrial Fibrillation a Life-Threatening Condition?

Atrial fibrillation alone may not be life-threatening, but it seldom occurs alone, and it frequently causes deadly strokes. Here’s what you need to know about the dangerous complications of atrial fibrillation and the factors that increase your risk.

The Important Link Between Sleep Loss and Heart Disease

More than one-third of adults don’t get the sleep they need every night, putting all of them at a higher risk of developing heart disease. If you don’t get enough sleep, don’t wait to take steps to protect your heart.

Five Foods That Promote Positive Heart Health

Your diet has the power to prevent heart disease and relieve the stress on your heart after you’re diagnosed with a cardiovascular condition. We share five exceptional foods and how they can help promote a healthy heart.

What Can You Learn From an Echocardiogram?

If you have symptoms of a heart problem, chances are you’ll need an echocardiogram. Echocardiograms are safe and fast, quickly providing exceptional images used to diagnose heart problems and make treatment decisions.

I have Chest Pain: Is It a Heart Attack or Anxiety?

Mar 01, 2020

Chest pain is alarming, and most times we tend to relate it with a heart-related problem, and appropriately so considering chest pain is a primary symptom of heart attacks. However, cardiac conditions are not the only cause of chest pain, you can still experience it when you have an anxiety attack. Although these two incidents have similar symptoms, there are different and here is how you can tell the difference.

How a Heart Attack and Anxiety Occurs?

A heart attack occurs when the blood supply has been cut short or blocked and the heart can’t get enough oxygen. If the blood flow is not restored, that section of the heart will begin to die. Plaque buildup in the arteries and blood vessels can cause the blockage.

A heart attack is a medical emergency so go to the nearest emergency room when you notice any of the warning signs.

Anxiety attacks, on the other hand, occurs when you have a fear that something bad is going to happen. Anxiety is a non-medical situation, but it can cause muscle tension.

Anxiety attacks have been linked to stress. The irony is, although it can’t cause a heart attack, stress plays a role in coronary artery disease development. Plus, people with heart attacks may also experience anxiety.

Take note; anxiety and panic attacks are different, though they are usually used interchangeably. In most cases, anxiety relates to a specific event or situation. Panic attack, on the other hand, can happen without a trigger. Furthermore, panic attacks are severe than anxiety symptoms.

How Can You Tell the Difference?

Heart attack symptoms include:

Chest pain
Tightness or aching sensation in your arm that spreads to the jaw, neck, and back
Shortness of breath
Sweating
Nausea and vomiting

Anxiety attack symptoms include:

Sharp pain
Shortness of breath
Racing heart
Shaking and sweating

Both of these conditions can have at least two overlapping symptoms, and knowing how the symptoms occur can be a lifesaver.

1. The pain severity
For a panic attack, the chest pain is sharp and localized to the center of the chest. During a heart attack, you will feel pressure and a squeezing sensation starting from the center of the heart spreading to the arm, jaw, and shoulder blades.

2. Duration of the symptoms
Although for both heart attack and anxiety the symptoms may appear suddenly, the duration can tell you which is which.

Most anxiety attacks last for 20 to 30 minutes, while for heart attacks the symptoms can last longer and worsen with time.

When to Call the Doctor?

Since most of the heart attack and anxiety symptoms overlap, it is important to seek urgent care near you, and let the doctor make a diagnosis. However, call for emergency support when you develop any of the following:

Sudden and severe chest pain or pressure that lasts for more than three minutes
Chest pain that spreads to the arm (left) or into the jaw.

How to Manage Heart Attack and Anxiety?

When you notice any of the warning signs of heart attack or anxiety, you need to first call for the emergency response team. Additionally, in an event of a heart attack begin CPR if the patient is unconscious. If you are not trained on CPR, then the chest compression will do.

Taking deep breaths for five minutes and relaxing techniques can help relax you when you have an anxiety attack. However, if the symptoms are still present, it’s better to seek emergency care to rule out heart attack episode.

Take Away

The severity of the symptoms will vary depending on whether you have experienced a heart attack or panic attack. There’s no specific treatment for panic attacks. However, the doctor can recommend various remedies such as medication, counseling, and, lifestyle modifications.

Although panic attacks can disrupt your lifestyle, they are not life-threatening, but you should still seek treatment. Heart attacks, on the other hand, are serious and need urgent treatment. Therefore, contact Express ER 24-hour emergency room for assistance and treatment.

Heart alarm - For a healthy lifestyle! - Articles - Center of Modern Cardiology

Very often people complain of pain in the heart, but it turns out that the stomach hurts, suffers from osteochondrosis or stress has led to the development of depression. And the development of a heart attack is not recognized, they are attributed to the same stomach, osteochondrosis or even toothache. How to figure it out? Let's try to help.

angina pectoris. That was the name in the old days of the disease that we now call angina pectoris. A heart attack usually begins with a pressing or burning pain in the center of the chest (doctors say "behind the sternum") during exercise or stress, although it can develop at rest.

The pain is quite intense, can radiate to the lower jaw, shoulders and arms (more often to the left, but possibly both), to the neck, throat and back. Sometimes it disguises itself as bursting pains in the same areas or pains in the stomach (upper abdomen - epigastrium), simulating an intestinal disorder. The pain disappears at rest in a few minutes, and if you put a nitroglycerin tablet under the tongue (or spray a spray containing nitroglycerin) - almost instantly.

If such pain lasts longer than 20-30 minutes and its intensity increases, the development of a heart attack is not excluded. Timely assistance significantly reduces the risk of dying from a heart attack, so you need to call an ambulance team as soon as possible. Recording an ECG in a heart attack almost always helps to make a diagnosis.

Heart attack cancelled. Very often, young women come to the doctor with complaints of pain in the heart. How could it be otherwise, because through the heart we pass all our troubles, worries and joys. In this case, there is usually no cause for alarm.

In young women, "heart pain" is often functional, meaning it is not caused by angina pectoris. Female sex hormones protect blood vessels from the formation of atherosclerotic plaques. And if you look, “heart” pains bother women not in the area where “angina pectoris” likes to settle, but in the left half of the chest, in the armpit or under the left breast. They are, as a rule, in the nature of discomfort, stabbing or aching pain, and can last from half an hour to several hours or even days.

These feelings arise for various reasons. Stress, sleep deprivation, overwork, premenstrual periods…and, as a result, an anxiety or depressive disorder. The skeletal muscles are tense, on the shoulders they are compacted into painful lumps - “lumps of nerves”! Sometimes it is enough to have a short, but good rest, pleasant emotions.

In more serious cases, you have to seek help from a neurologist , a psychotherapist. Remember: the longer the depression lasts, the more difficult it is for the doctor to completely rid you of discomfort, sleep disturbances and bad mood. However, in addition to stress, other reasons can lead to pain in the “heart area”.

"Bouquet of diseases". Osteochondrosis, a disease of sedentary people, leads to pinching of the nerve roots and the development of pain. If the thoracic spine is involved, then it is the heart that falls under the patient's suspicion - it pricks and pierces, lies on the chest with a lump or stone, catches with inhalations and sharp turns of the body, and aches for hours.

If such sensations occur during strong excitement, then the full impression of a heart attack can be formed. But the true cause of the pain in this case is the tension of the muscles of the neck and back. Unlike an attack of angina, which is quickly relieved by nitroglycerin, pain medications, massage, kneading the back with hydromassage jets can help, shock wave therapy. During examination, changes in the vertebrae can be found on an x-ray of the spine. But the ECG, even at the time of the most intense neuralgic pain, will be normal.

Chest pain may occur during a cold if it is complicated by bronchitis. Coughing can add discomfort, since already on the second day of a hacking cough, in addition to the bronchi, pectoral muscles will add to the pain. If the cold is complicated by pneumonia and pleurisy, then with a deep breath and exhalation, changes in pain can be noticed. The pain increases with inhalation, when the lungs straighten and “rub” against the inflamed pleura, and decreases with exhalation.

The doctor will recommend an x-ray of the lungs, listen with a phonendoscope for wheezing in the lungs.

Do not forget about the stomach, pancreas and gallbladder. A common cause of chest pain is intercostal neuralgia, herpes zoster, and in women - mastopathy. Regular palpations of the mammary glands must be carried out by women after 30-35 years of age, and if there is pain or induration, consult a doctor who will most likely refer you to an ultrasound of the mammary glands and mammography.

Gender matters, because it is in women that “heart pain” during examination turns out to be a mask of other diseases, and in men over 40 any “gastritis, osteochondrosis attack or sore tooth” may turn out to be a first-time developed heart attack. A timely visit to the doctor is necessary if the heart is at risk.

On the other hand, all the pains in the chest should not be blamed on the poor heart either.

Let's try to figure it out, analyze our feelings and try to distinguish between an attack that can threaten health and functional pain.
- Stitching or aching pain in the left side of the chest, which does not give anywhere?
- The pain begins and goes away gradually, lasts a long time, for hours, and even days, if you are stressed?
- Physical activity does not cause or increase discomfort in the heart area, and sometimes even relieves it?
- The pain does not go away after taking nitroglycerin, but subsides with sedatives?

If you answered “yes” to most of the questions, you probably don't have to worry about your heart. If so, complete the Hospital Anxiety and Depression Scale (HADS) and the CES-D questionnaire. Perhaps the stresses in your life have led to the development of depression and the consultation of a psychotherapist will relieve your "heart anxiety".

Causes of heaviness in the chest

Chest pain can be caused by various causes: diseases of the cardiovascular, respiratory or endocrine system, diseases of the stomach, spine, intercostal neuralgia, panic attack, autonomic dysfunction. Some of them are unpleasant, but not dangerous, others are a threat to life. But if it hurts in the heart area and it's hard to breathe, you need medical help.

Causes

Chest pain and difficulty breathing may occur:

with myocardial ischemia - it can occur in a person who has not previously complained of diseases of the cardiovascular system after physical exertion, stress, if not helped, a heart attack may develop;
in case of a heart attack - similar symptoms often appear in people suffering from heart disease, an urgent need to take the medicine recommended by the doctor;
with asthma - the main symptom that bothers the patient is suffocation, it seems that the chest is squeezing, an urgent need to take medicine to relieve asthma attacks;
with pulmonary embolism - the patient feels a lack of air due to blockage of the trunk or branches of the pulmonary artery, the mucous membranes and skin become pale with a bluish tint, an ambulance must be urgently called or the person taken to the hospital.

Myocardial ischemia

With a chronic lack of oxygen, the muscle tissue of the heart - the myocardium - is destroyed. Some people feel chest pain and complain that it is difficult to breathe. Others do not feel any unpleasant symptoms for a long time or feel rare pricks in the chest. But the disease is progressing. After physical exertion or stress, a sharp deterioration in the condition may occur: myocardial infarction, death.

Ischemic diseases are a common cause of sudden death. It is necessary to regularly visit a cardiologist for people who:

are overweight;
lead a sedentary lifestyle;
suffer from arterial hypertension, diabetes mellitus;
smoke, abuse alcohol.

If myocardial damage is diagnosed, medical or surgical treatment is prescribed: bypass surgery, coronary angioplasty. The patient should be observed by a cardiologist, follow a diet and a physical activity regimen recommended by the doctor, give up bad habits (you can use Nicorette tablets, sprays).

Heart attack

People suffering from myocardial ischemia may develop a heart attack, when the pain and heaviness in the chest becomes very strong, it is difficult to breathe. The condition is rapidly deteriorating. Up to 45% of people who have not received effective medical care die within 15 minutes.

The pathological process develops in four stages:

acute – acute pain appears, strong heartbeat, chills, pallor;
necrosis - the muscle tissue of the heart dies;
subacute - the most dangerous stage, it is difficult for the patient to breathe, his temperature rises, he experiences severe fear, coordination of movements is disturbed;
scarring - the manifestations of dangerous symptoms are reduced, a scar is formed.

A heart attack may develop unexpectedly, but more often it is preceded by heaviness in the chest, shortness of breath, aching or stabbing pain. Even if the chest pricks no more than 1-2 times a month, you need to see a cardiologist, do an ECG.

Cardiac asthma

Cardiac asthma - asthma attacks that occur against the background of pathologies in the left side of the heart. It develops in patients suffering from heart defects, cardiosclerosis, ischemic disease, glomerulonephritis. With these diseases, blood circulation in the pulmonary circulation is disturbed. Pulmonary edema develops. X-rays of patients show that the volume of the heart is enlarged, and the tissues of the lungs contain fluid.

Seizures may start for no apparent reason. The patient, waking up during day or night rest, feels pressure in the chest, he is seized with fear. But breathing problems can also arise due to stress, when playing sports, physical work, trying to catch up with outgoing vehicles.

How to relieve an attack?

A person should not be left alone during an attack of cardiac asthma. You need to calm him down, prevent panic, which will put an additional burden on the cardiovascular system. When there is pressure in the chest, it is difficult to breathe, you do not need to put a person to bed, on the contrary, air passes better into the lungs in a standing position. It is enough to support the patient, give him something to lean on, open a window, provide fresh air.

An attack may last a few minutes or 2-3 hours. With a prolonged lack of oxygen, the veins in the neck and arms swell, the skin acquires a gray tint, and pressure drops. The attack is stopped by taking Nitroglycerin or similar antianginal agents. The hospital uses oxygen concentrates, stationary devices for supplying oxygen to the lungs, respiratory analeptics.

Pulmonary embolism

Thromboembolism is the blockage of blood vessels by a thrombus, which causes life-threatening disorders in the cardiovascular and respiratory systems. The condition may worsen gradually or rapidly, when the symptoms of suffocation appear within 10-15 minutes after the onset of heaviness in the chest. Pulmonary embolism is the cause of 0.1% of deaths.

Patients with a tendency to form blood clots are advised to use venotonics, and be sure to see a doctor:

in violation of blood flow - with varicose veins or compression of blood vessels by tumors, in patients suffering from phlebothrombosis, when the valves of the veins are destroyed;
in case of blood clotting disorders - after injuries, operations, when drugs are prescribed to increase clotting, installation of intravascular catheters.

Symptoms

Taking good care of your health can help prevent life-threatening conditions. A doctor should be consulted at the first alarming symptoms, which may be mild: short-term sharp pain, periodic injections in the chest, on the left or in the middle, a feeling that occurs after stress or physical exertion that squeezed the chest. You should also consult a doctor if you need to be examined if it is difficult for you to breathe deeply.

When the condition worsens, these symptoms are accompanied by tinnitus, visual disturbances (double vision), discoloration of the skin and mucous membranes (pallor, gray or blue tint), fever, weakness, vomiting. Possible severe cough, sputum with blood. With these symptoms, you need to call an ambulance.

First aid

If a person has a prick in the heart area, compresses the chest, you need to give him first aid. Such symptoms may indicate the development of deadly diseases in people who have not previously complained of pain in the heart.

You need to call an ambulance if:

a person has difficulty breathing, he cannot take a deep breath;
the temperature rises sharply above 38 degrees;
there is a sharp pain in the left or in the middle of the chest, which cannot be tolerated;
there is a strong cough, sputum, blood;
skin, mucous membranes turn pale, acquire a gray or blue tint;
increased perspiration;
coordination of movements is disturbed, the patient complains of tinnitus, double vision, severe headache;
a person loses consciousness, speech becomes slurred or inadequate.

What to do before the ambulance arrives?

When there is pressure in the chest, there is a strong pain in the heart, breathing is disturbed, many feel great fear, turning into panic. Muscle tone increases, which makes breathing even more difficult. Do not leave the person himself, speak to him in a calm, confident voice, do not show your concern, keep him from sudden movements.

Provide free access to fresh air. If the room is stuffy, open the window. If the attack happened on the street on a hot sunny day - take him to the shade or to a cool room.

If breathing is difficult, chest tight, heart hurts - do not lay the person on his back or stomach. It is better to offer him a semi-sitting position, and for those suffering from cardiac asthma - vertical.

Nitroglycerin tablets can be placed under the tongue to relieve acute heart pain. If diseases of the cardiovascular system were diagnosed earlier, you need to take the medicines prescribed by the doctor to relieve acute attacks.

Diagnosis

A cardiologist cannot determine why the heart hurts based on the patient's complaints, examination, pressure measurement, pulse rate. Diseases have similar symptoms. Patients do not always accurately describe the nature and location of pain. In heart disease, it can be felt on the left or in the middle, in the back, in the left forearm or in the stomach.

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