Quick Answer
The chest pain associated with anxiety is often felt in the center of the chest, under the breastbone. However, it can also radiate to the left side of the chest or left arm. The pain is usually described as tightness, pressure, squeezing, or aching. While anxiety chest pain can be scary, it is not life-threatening.
What causes chest pain with anxiety?
Anxiety chest pain is caused by the body’s natural stress response. When we feel anxious or stressed, the body releases stress hormones like adrenaline and cortisol. These hormones speed up breathing and heart rate to prepare the body to respond to perceived danger.
Faster breathing and a racing heart rate can make the chest feel tight or painful. The hormones also tense muscles, which can create chest tightness and discomfort. In people with anxiety disorders, this stress response is triggered in non-threatening situations. The chest pain is the result of the body reacting as if in crisis mode.
Other factors contributing to chest pain with anxiety:
- Hyperventilation: Anxiety often causes rapid, shallow breathing known as hyperventilation. This can lead to chest tightness and lightheadedness.
- Muscle tension: Anxious people often unconsciously tense muscles in the chest area, causing soreness or pain.
- Esophageal spasms: Stress and anxiety can cause the esophagus to spasm, creating chest pain and discomfort.
- Gastroesophageal reflux disease (GERD): Stress and anxiety may worsen GERD symptoms like chest pain and heartburn.
- Mitral valve prolapse: This minor heart valve issue can sometimes cause occasional chest pain and palpitations during times of stress.
What does anxiety chest pain feel like?
Anxiety chest pain can feel similar to heart pain, making it scary for those experiencing it. Some common descriptions of what anxiety chest pain feels like include:
- Tightness
- Squeezing or crushing sensation
- Pressure or heaviness
- Aching
- Burning feeling
- Stabbing pain
- Sharp pain
The pain may be mild and come and go, or it can be more persistent and severe. It often starts suddenly and is usually worse during periods of peak anxiety or panic.
Where is anxiety chest pain located?
With anxiety, chest pain is most often felt:
- In the center of the chest behind the sternum (breastbone).
- On the left side of the chest.
- Radiating from the chest to the left arm, neck, or jaw.
- Sometimes on the right side of the chest as well.
Is anxiety chest pain serious?
Anxiety chest pain can feel frightening, but it is not dangerous or life-threatening on its own. However, it’s important to rule out medical causes. Anyone experiencing severe or persistent chest pain should be evaluated by a doctor.
Possible heart-related causes like a heart attack, angina, or pericarditis should be ruled out, especially in those at risk with a history of heart disease. Tests like an EKG, chest x-ray, bloodwork, and cardiac stress testing can help diagnose heart conditions.
Once heart disease and other serious medical issues are ruled out, anxiety is often found to be the root cause of unexplained chest pain.
Warning signs of a potential heart issue:
- Chest pain that radiates to the left arm or jaw
- Chest pain accompanied by shortness of breath, sweating, or dizziness
- Persistent, crushing chest pain lasting more than a few minutes
- Risk factors like smoking, obesity, high cholesterol, or family history of heart disease
- Chest pain with exercise that goes away with rest
If experiencing any of these red flags, seek emergency medical care right away.
How to tell the difference between anxiety and heart chest pain
Distinguishing anxiety chest pain from heart-related chest pain can be difficult, but paying attention to the details and timing of the symptoms can help tell them apart. Compare anxiety and heart pain:
| Anxiety Chest Pain | Heart-Related Chest Pain |
|---|---|
| Comes and goes | Tends to be consistent and persistent |
| Lasts for short periods, usually minutes to hours | Can last for long periods depending on condition |
| Often described as tightness or squeezing | Described as crushing, pressure, heaviness |
| No associated symptoms like shortness of breath | May have symptoms like radiating pain, shortness of breath, nausea |
| Usually worst during times of stress | Can occur anytime, including at rest |
| Goes away with relaxation or anti-anxiety techniques | Does not resolve with rest or anti-anxiety techniques |
| Usually in younger individuals with no heart disease risk factors | More common in older adults with cardiac risk factors |
If your chest pain is fleeting, brought on by stress, and improves when you relax, anxiety is likely the culprit. But have it evaluated to be safe.
Anxiety disorders that cause chest pain
Any type of anxiety disorder can manifest physical symptoms like chest pain due to the body’s stress response. But chest pain and panic attacks are hallmarks of certain disorders:
Generalized anxiety disorder (GAD)
GAD involves chronic worrying about everyday things. Individuals have anxiety and tension most days for at least 6 months. Chest pain and discomfort are common physical symptoms.
Panic disorder
Panic disorder causes sudden, repeated panic attacks marked by chest pain, heart palpitations, dizziness, and shortness of breath. Chest discomfort is one of the defining symptoms of a panic attack.
Social anxiety disorder
Social anxiety involves extreme fear of being embarrassed or judged in social situations. Sufferers may experience chest tightness when forced into feared social situations.
When to seek emergency care for anxiety chest pain
Severe or persistent chest pain should be evaluated immediately to rule out heart attack and other potential medical emergencies. Seek emergency care for:
- Sudden, crushing chest pain spreading to the arm, neck, or jaw
- Chest pain with shortness of breath, sweating, nausea, or lightheadedness
- Chest pain unaffected by anti-anxiety techniques and medication
- Inability to breathe deeply due to chest tightness
- Fainting or collapsing along with chest discomfort
Call 911 or have someone drive you to the ER if experiencing any of these signs. It’s better to be safe and have it checked out than to ignore potentially dangerous chest pain.
When to see a doctor for anxiety chest pain
Make an appointment with your doctor if you have any of the following:
- Frequent chest pain and discomfort associated with stress and anxiety
- Daily or near-daily chest tightness and anxiety interfering with your life
- Worsening anxiety with panic attacks and chest pain
- Chest pain alongside felt heart palpitations or shortness of breath
- Chest discomfort that keeps coming back but has no clear medical cause
A doctor can help determine if your chest pain is related to anxiety, heart problems, or another medical issue. Your doctor can also refer you to mental health professional to help treat anxiety disorders contributing to your chest pain.
9 ways to relieve anxiety chest pain
Chest pain caused by anxiety, stress, or panic attacks can be managed through lifestyle changes, therapy, medication, and self-help techniques. Here are some tips for getting relief:
1. Deep breathing
Taking slow, deep breaths can lower stress hormones and relieve chest tightness. Try inhaling deeply through the nose, holding for 5 seconds, and exhaling slowly.
2. Progressive muscle relaxation
This technique involves tensing and relaxing muscle groups to reduce tension. Help relax chest muscles by lying down and squeezing muscles for 5-10 seconds, then releasing.
3. Guided imagery
Imagining a peaceful, calming place can shift focus away from anxiety and discomfort. Close your eyes and visualize somewhere comforting, like a beach.
4. Meditation
Meditation teaches controlled breathing and quieting the mind, which can minimize anxiety and body tension.
5. Cognitive behavioral therapy (CBT)
CBT helps identify negative thought patterns fueling anxiety. A therapist teaches coping skills to change unhelpful thoughts.
6. Exposure therapy
This involves facing anxiety-provoking situations in a gradual, controlled way to decrease fear. It helps treat panic and social anxiety.
7. Medications
Anti-anxiety meds like SSRI antidepressants can be used short or long-term to manage anxiety disorders.
8. Lifestyle changes
Getting enough sleep, reducing caffeine, eating a healthy diet, and exercising regularly can all reduce anxiety.
9. Stress management
Learning healthy ways to cope with daily stress, like talking with friends, helps minimize anxiety and associated chest pain.
When to see a therapist for anxiety chest pain
Seeing a mental health professional is recommended if:
- Your chest pain causes frequent panic attacks
- Anxiety and worry are disrupting your daily activities
- Self-help measures aren’t easing your anxiety chest pain
- You experience suicidal thoughts related to anxiety and depression
- Anxiety runs in your family suggesting a biological component
- You abuse alcohol or drugs to cope with anxiety symptoms
A therapist can provide personalized counseling and teach coping strategies tailored to your specific anxiety disorder and symptoms. Therapy gives long-term anxiety relief.
Coping with anxiety and chest pain
Living with anxiety chest pain can be frightening. Implementing some coping strategies can make symptoms more bearable when they flare up:
- Distract yourself – Shift focus by calling a friend, watching TV, or doing a puzzle.
- Use relaxation techniques – Try deep breathing, meditation, or progressive muscle relaxation.
- Change positions – Sitting hunched over can worsen chest pain. Stand up or lay down to relieve tension.
- Stretch – Gentle chest and shoulder stretches can help reduce muscle tension.
- Use anti-anxiety essential oils – Oils like lavender and frankincense can have a calming effect.
- Diffuse anxiety – Splash cold water on your face or hold an ice pack to your chest to “shock” the body out of anxiety mode.
- Get moving – A brief walk or jog can stimulate feel-good endorphins to reduce anxiety.
- Stay hydrated – Dehydration can increase anxiety. Sip water and limit caffeine and alcohol which have diuretic effects.
Having go-to coping skills can help you manage flare-ups. Avoiding avoidance – or continuing normal activities instead of avoiding them – also helps decrease anxiety long-term.
When to see a doctor for anxiety chest pain: summary
Seeking prompt medical care is crucial for chest pain to rule out dangerous heart conditions and get proper treatment. In an emergency, call 911 or go straight to the ER. Otherwise, make an appointment with your doctor for evaluation. Seek care if chest pain:
- Comes on suddenly and severely
- Radiates to your arm, neck or jaw
- Is accompanied by shortness of breath, sweating or lightheadedness
- Happens during exercise
- Doesn’t improve with rest or anti-anxiety techniques
- Is persistent and interfering with your daily life
Getting the right diagnosis and treatment is key to relieving scary anxiety-related chest pain and allowing you to live symptom-free.
The bottom line
Chest pain is a common symptom of anxiety and panic attacks. Though not life-threatening, it can feel scary before being diagnosed. The chest pain associated with anxiety is typically felt behind the sternum but may radiate to the left side. While it should be evaluated by a doctor to rule out heart conditions, anxiety chest pain is not dangerous and usually goes away with anxiety treatment and self-help measures.
