Anxiety and Chest Pain: Is There a Connection?

When you become overly anxious, your brain sends a series of alarm bells to the rest of your body. Sometimes, it’s more subtle, like sweaty palms or faster breathing. Other times, anxiety can cause chest pain.

This can feel alarming, but it’s more common than you think. When your body goes into fight-or-flight-mode, it causes a rush of hormones that can lead to a sharp pain in your chest. 

“The body is very wise,” asserts behavioral health specialist Leopold Pozuelo, MD. “It picks up when there’s a lot of emotional overload going on. When chest pain occurs from anxiety, there’s a heart, brain and body connection happening.”

Here, Dr. Pozuelo explains why anxiety can cause chest pain, and how to identify it.

How does anxiety cause chest pain?

When you start feeling your anxiety in your chest, a couple different things are happening at once. Your body releases adrenaline and cortisol into your bloodstream. This can cause physical symptoms like an increased heart rate and hyperventilation. 

This combined burst of energy puts stress on your muscles and can cause spasms in your chest. “When you feel that pain in your chest area, it’s your intercostal muscles, which are between your ribs, that are getting a workout,” Dr. Pozuelo points out. All of these factors together contribute to a sharp pain in your chest. 

“At the same time, you’re also feeling heart palpitations caused by anxiety, as well,” Dr. Pozuelo continues. “So, you’ve got this storm of energy happening.” Not to mention, the sudden chest pain likely makes you more anxious, making the discomfort worse.

Anxiety-induced chest pain doesn’t only happen when you’re in the middle of a stressful situation. Sometimes, you may feel like you’re having a full-blown panic attack, but other times, you may feel “fine” when the pain suddenly hits.

You may be carrying a lot of stress that you don’t feel on a conscious level, or maybe it’s not at the forefront, notes Dr. Pozuelo. But it can still affect you. That sudden chest pain is your body letting you know that you may be holding onto some stress that you’re not addressing.

What does anxiety chest pain feel like?

Chest pain due to anxiety can feel like a sudden, sharp stabbing in your chest area. The pain can slowly fade but still linger throughout the center of your chest.

It’s also common to experience symptoms alongside the chest pain, including:

• Shortness of breath
• Heart palpitations 
• Dizziness
• Stomach discomfort 
• Sweating or rise in body temperature
• Trouble focusing
• Tingling in the fingers

According to Dr. Pozuelo, it’s hard to pinpoint exactly how long anxiety-related chest pain can last. “The pain can go on for minutes, or even an hour or two,” he points out.

“Because these events of anxiety tend to linger, the symptoms tend to last for a while, too,” says Dr. Pozuelo.

Eventually, the pain should go away on its own. It’s not forever, even if it may feel like it in the moment.

However, if you experience this for the first time, it is a good practice to talk to your doctor first to make sure it’s not a cardiac source of chest pain.

Anxiety chest pain vs. cardiac chest pain

It’s understandable to feel like any kind of chest pain is tied to a heart attack. The combination of symptoms can feel frightening in the moment. But even if you’re feeling an increased heart rate and heart palpitations, it doesn’t necessarily mean you’re having a cardiac event.

Here’s what to keep in mind: “Chest pain due to anxiety is typically a little more of a sharp type of pain rather than a heavy, crushing weight like most people describe cardiac-related pain,” Dr. Pozuelo emphasizes.

He also adds that chest pain due to a heart attack tends to radiate to your arm, shoulder or even jaw area.

How to find relief

You can do a couple of things to find relief from anxiety-induced chest pain. If you’re feeling that sudden sharpness in your chest, here’s what you can do in the moment:

• Find a safe space. The best thing you can do when feeling chest pain from anxiety is to stop what you’re doing. If you’re driving, take a minute to pull over, if you can. If you’re indoors or in the middle of doing something, find a quiet space — ideally outside — where you can regroup.
• Ground yourself. Try not to go into a panic. We know, a sudden stabbing pain in the chest can make your fear go from 1 to 100. But this can actually make the pain more intense. “Naturally, your perceptions of pain will get jacked up,” states Dr. Pozuelo. Instead, try to focus on what you can see, hear and feel in the moment to help ground yourself.
• Take some deep breaths. Breathwork is a great and easy way to bring yourself back to your body when your anxiety is making you feel outside of it. Go for something simple, like box breathing, that allows you to focus on your breath and can help relax your chest muscles.

When to see a doctor

While you may not need to run to the emergency room due to anxiety-related chest pain, it’s still a good idea to get it checked out by your healthcare provider. If your anxiety or stress is causing this intense physical symptom, it may be a sign that your mental health is affecting your physical health. Your healthcare provider can help you by assessing the pain you’re feeling, providing more tools for relief and referring you to a counselor or psychiatrist.