Chest Pain Caused by Anxiety or Panic Attacks

Chest Pain Caused by Anxiety or Panic Attacks

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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 situations that have nothing to do with the heart. One of the more common non-cardiac problems that frequently produce 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 happen 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.

In addition to an intense feeling of fright, anxiety attacks also commonly produce real physical symptoms. These often include:

  • Muscular pain
  • Palpitations
  • Chest pain
  • Severe dyspnea (shortness of breath)
  • Abdominal cramping
  • Diarrhea

Chest Pain and 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 happen 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.

Evaluating Chest Pain

The fact that the chest pain is caused by an anxiety attack, and not by angina, is generally not hard for a doctor to determine. A careful medical history and a good physical examination generally tell the story.

An electrocardiograph is a person with panic attacks that 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.


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.

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