Heart Health Heart Disease Chest Pain & Angina Chest Pain Caused by Anxiety or Panic Attacks By Richard N. Fogoros, MD facebook linkedin Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Richard N. Fogoros, MD Medically reviewed by Medically reviewed by Yasmine S. Ali, MD, MSCI on November 28, 2019 facebook twitter linkedin Yasmine S. Ali, MD, MSCI, is a board-certified preventive cardiologist and lipidologist. Dr. Ali is also an award-winning writer. Learn about our Medical Review Board Yasmine S. Ali, MD, MSCI Updated on December 07, 2019 Print Table of Contents View All Anxiety Attacks Chest Pain in Anxiety Attacks Evaluating Chest Pain Prognosis Chest pain is always an alarming symptom, because most of us (appropriately) associate it with cardiac conditions, in particular, angina or myocardial infarction (heart attack). However, chest pain can also be caused by a number of conditions that have nothing to do with the heart. One of the more common non-cardiac problems that frequently produces chest pain is an anxiety attack. What Are Anxiety Attacks? Anxiety attacks, also called panic attacks, are episodes of intense fear and emotional distress that usually occur suddenly and without warning, and typically last from several minutes up to an hour. These attacks may have a discrete trigger, but they also can occur without any identifiable cause. Anxiety attacks are often recurrent and are very distressing to the people who experience them, as well as their loved ones. People who have panic attacks typically spend a lot of time worrying about having more attacks and often make seemingly unreasonable lifestyle changes in an attempt to avoid circumstances that will trigger future attacks. They may avoid situations that, they feel, have precipitated previous episodes or environments where they would not be able to escape easily if another attack should occur. These avoidance adaptations can become quite extensive to the point where a person who suffers from panic attacks can become nearly housebound or otherwise withdraws from normal life experiences. These individuals are said to suffer from agoraphobia. In addition to an intense feeling of fright, anxiety attacks also commonly produce real physical symptoms. These often include: Severe dyspnea (shortness of breath)Abdominal crampingDiarrheaMuscular painPalpitationsChest pain During an anxiety attack, tachycardia (fast heart rate) and tachypnea (rapid breathing) also are often present. Chest Pain in Anxiety Attacks The chest pain experienced by people who are having panic attacks can be quite severe and frightening. The pain is often fleeting and sharp, and it can even be experienced as a “catch” that interrupts a breath. It is most likely a form of chest wall pain caused by the muscle contractions that may occur with anxiety. In fact, because of these intense muscle contractions, the chest can remain sore for hours or days after a panic attack. The severity of chest pain is often magnified by the intense fear associated with a panic attack. Not surprisingly, chest pain is the symptom that often sends people having panic attacks to the emergency room. Evaluating Chest Pain The fact that the chest pain is caused by an anxiety attack, and not by angina, is usually not difficult for a doctor to determine. A careful medical history and a good physical examination usually tell the story. The electrocardiograph in a person with panic attacks often shows tachycardia but does not usually show any of the changes typically seen in people with heart attacks or angina. However, if significant risk factors for cardiovascular disease are present, a noninvasive evaluation to rule out coronary artery disease (CAD) may sometimes be a good idea. In fact, some studies have suggested that people with chronic anxiety disorders have an increased prevalence of CAD—that is, chronic anxiety may be a risk factor for CAD. So, doctors should not be too quick to simply write the chest pain off as being “simply” due to anxiety. They should at least entertain the possibility that both disorders may be present and should do an appropriate evaluation. When Is Chest Pain a Serious Emergency? Prognosis From a cardiac standpoint, unless coincident heart disease is also present, the prognosis after having chest pain due to an anxiety attack is very good. However, all too often—especially in an emergency room setting where people who have chest pain due to anxiety attacks often wind up—doctors who rule out a cardiac emergency are likely to brush the patient off as having a minor problem of no significance, but panic attacks should not be brushed off. Anxiety attacks are often extremely disruptive to a person’s life. And the people who suffer from these attacks should be regarded as having a medical problem that needs to be addressed seriously. Treatment, with medication and psychological counseling, is often quite effective in returning people with anxiety disorders to more normal, happier lives. The Top Treatment Options for Panic Disorder A Word From Verywell Anxiety attacks are a common cause of chest pain that is not due to heart disease. While it is useful to know that your chest pain has not been caused by CAD, if you have been told you have anxiety attacks—or if you suspect it from your own symptoms—it is important for you to seek out competent medical care. Was this page helpful? Thanks for your feedback! Did you know the most common forms of heart disease are largely preventable? Our guide will show you what puts you at risk, and how to take control of your heart health. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Soares-Filho GL, Arias-Carrión O, Santulli G, et al. 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