Chest Pain Caused by Anxiety or Panic Attacks

Is it a heart attack or anxiety?

Chest pain is always alarming. Most of us associate it with cardiac (heart) conditions such as angina (inadequate blood flow to the heart) or myocardial infarction (heart attack).

But chest pain can be caused by myriad conditions that have nothing to do with the heart. One common cause is an anxiety attack.

This article lays out the impact of anxiety attacks, how they cause chest pain, and what to expect when you see your healthcare provider with anxiety-related chest pain.

Verywell / Laura Porter

Impact of Anxiety Attacks

Anxiety attacks, or panic attacks, are episodes of intense fear and emotional distress. They usually strike suddenly and without warning. And they may last several minutes or up to an hour.

These attacks may have a discrete trigger. Sometimes, though, they occur without a known cause.

Anxiety attacks are often recurrent. They're distressing to experience and concerning for friends and family who witness them.

When you've had panic attacks, it's common to worry about having more. Attempts to avoid them can lead to extreme lifestyle changes.

You may find yourself avoiding situations or environments that have triggered previous episodes. You may also get in the habit of checking for escape routes you can take should anxiety strike.

Avoidance strategies can become extensive. At the extreme end is people who become housebound or otherwise withdraw from the world. This is called agoraphobia.

Anxiety attacks aren't just intense fright, though. They can cause physical symptoms including:

  • Severe dyspnea (shortness of breath)
  • Abdominal cramping
  • Diarrhea
  • Muscle contractions and pain
  • Palpitations (irregular heart rate)
  • Tachycardia (fast heart rate)
  • Tachypnea (rapid breathing)
  • Chest pain


Anxiety attacks are intense feelings of fright. They can cause chest pain and make you worry about heart disease. They may have an obvious trigger, but not always.

Avoiding anxiety attacks can make you avoid places or situations that could be triggering. That can become limiting and have a big impact on your life.

Anxiety attacks can also cause shortness of breath, muscle pain, rapid heart rate, and other physical symptoms.

Chest Pain in Anxiety Attacks

Anxiety-related chest pain can be severe and frightening. The pain is often sharp, fleeting, or a sudden “catch” that interrupts a breath.

You're most likely feeling chest wall pain caused by intense muscle contractions. They can leave your chest hurting for hours or days after the attack.

The fear you have during an attack can magnify this kind of chest pain.

Chest pain often sends people having anxiety attacks to the emergency room. While you may be embarrassed if this happens to you, seeking medical help for chest pain is always the right choice.

Evaluating Chest Pain

Healthcare providers can easily distinguish between chest pain from anxiety and from cardiac causes. It usually just takes a good medical history and physical exam.

They may also use an electrocardiograph, which shows how your heart is functioning. During a panic attack, it may show a fast or irregular rhythm. But it won't show changes typically seen in heart attacks or angina.

If you're at high risk for coronary artery disease (CAD), your doctor may want to do more tests to rule it out. Some studies suggest chronic anxiety disorders may be a risk factor for CAD.

Medical providers shouldn't be too quick to write the chest pain off as “just” anxiety. They should at least look at the possibility you could have both disorders and test you accordingly.


Chest pain from anxiety can be fleeting, sharp, and frightening. It's most likely from intense contractions in the muscles of the chest wall.

Healthcare providers can usually tell what's causing your heart pain from your medical history and an exam. They may also use an electrocardiogram. Anxiety attacks may be a risk factor for coronary artery disease.


For heart health, the prognosis after anxiety-related chest pain is very good.

Too often, though, healthcare providers rule out a cardiac emergency and brush you off your anxiety as a minor problem. However, panic attacks should be taken seriously because of how much they can disrupt your life.

Treatment with medication and psychological counseling are often quite effective for anxiety disorders.​


Anxiety attacks can cause chest pain and make you scared about a heart attack. The pain likely comes from intense muscle contractions in the chest wall. Trying to avoid anxiety triggers can make you withdraw and miss out on life.

Healthcare providers can easily distinguish between a heart attack and anxiety-related chest pain. They may order more extensive tests if you're at-risk for coronary artery disease. That's because anxiety may be a risk factor.

Anxiety attacks should be considered a real and significant health condition.

A Word From Verywell

Anxiety isn't life-threatening like a heart attack. Still, it can have a significant impact on your quality of life.

If you've had one or more anxiety attacks, talk to a healthcare provider. You have a variety of treatment and management options for keeping anxiety from ruling your life.

Frequently Asked Questions

  • What are the symptoms of an anxiety attack?

    Symptoms of an anxiety attack may include:

    • Lightheadedness
    • Sweating
    • Nausea
    • Feeling restless
    • Shortness of breath
    • Diarrhea
    • Fatigue

    You may also be overwhelmed by worry, try to avoid stressful situations, develop compulsive actions, or feel irritable.

  • How long does chest pain from anxiety last?

    Anxiety-related chest pain usually lasts about 10 minutes, while other symptoms of a panic attack can linger for up to an hour. Pain related to a heart attack, however, will continue to come in waves.

  • What do I do for chest pain from a panic attack?

    During an attack, it’s important to control your breathing: Take slow, inhale through your nose for three seconds, hold for two seconds, and exhale for three seconds.

    Remind yourself that this will pass and try to relax your body. If you are at-risk of heart disease, go to the ER if the chest pain doesn’t go away within a few minutes. 

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. National Institutes of Health, National Institute of Mental Health. Panic disorder: When fear overwhelms.

  3. Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disordersDialogues Clin Neurosci. 2017;19(2):93-107. doi:10.31887/DCNS.2017.19.2/bbandelow

  4. Tully PJ, Cosh SM, Baune BT. A review of the affects of worry and generalized anxiety disorder upon cardiovascular health and coronary heart disease. Psychol Health Med. 2013;18:627. doi:10.1080/13548506.2012.749355

  5. John Hopkins Medicine. How to help someone with anxiety.

  6. Cleveland Clinic. How to tell the difference between a panic attack and a heart attack.

  7. Cedars Sinai Hospital. Is it a heart attack or a panic attack?

By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.