All About Anxiety

Physical Symptoms of Stress: Chest Pain

In this series of articles, we shed light on the many (sometimes surprising) physical symptoms of stress and anxiety.

Stress and anxiety can lead to a host of physical symptoms, many of which are easily mistaken for serious illnesses. This in turn can lead to additional stress and anxiety, potentially worsening physical symptoms in a vicious self-reinforcing cycle.


Chest Pain

Of all the possible physical symptoms of stress and anxiety, chest pain is one of the most troubling due to its association with heart attacks. Understanding your chest pain will help you find symptom relief, as well as recognize non-cardiac (i.e. anxiety-induced) from cardiac chest pain.


Symptoms of Anxiety-Induced Chest Pain

Symptoms can vary a great deal from person to person, and from occurrence to occurrence. They may occur in one spot persistently, or they may migrate. Sometimes they are accompanied by other anxiety sensations, and sometimes not. The pain is often described as a:

  • stabbing pressure
  • tightness
  • dull ache
  • numbness
  • burning sensation
  • shooting pain
  • sharp pain

Anxiety-Induced or Heart Condition/Heart Attack?

Here are the key differences between anxiety chest pain and pain due to heart conditions and heart attack:

  • Anxiety chest pain typically occurs while resting, whereas cardiac chest pain typically occurs while or is exacerbated by being active.
  • Anxiety chest pain often appears quickly and then fades rapidly (3 – 10 min), whereas cardiac chest pain often starts slowly and builds in intensity.
  • Anxiety chest pain is often described as being sharp/stabbing, whereas cardiac chest pain is often described as a heavy pressure (e.g. elephant sitting on your chest).
  • Anxiety chest pain typically stays within the chest, whereas cardiac chest pain often moves to other areas such as arm, shoulder or jaw.

If you are experiencing frequent chest pain and it is causing you concern, the most important first step is to visit your doctor and rule out any heart conditions. You must be confident that your heart is healthy to overcome non-cardiac chest pin. Any uncertainty as to the source of your chest pain will only become an additional source of anxiety, likely worsening your symptoms.

After learning from your doctor that your heart is healthy, symptoms should begin to recede gradually. It can take days, weeks and sometimes even months for recurring episodes to subside . The key at this stage is to disengage from thoughts about chest pain – the less attention you pay, the faster they will go away.

Further steps can be taken to reduce levels of stress and anxiety, helping bring your symptoms under control and preventing recurrence.

  • Exercise (particularly aerobic exercise) has been shown repeatedly in studies to reduce levels of stress and anxiety.
  • Meditation is a reliable and effective means to reduce stress levels and promote relaxation. Mindfulness meditation can help to increase awareness and control over thought patterns, allowing one to overcome anxiety at the root of the issue.
  • Medication may be helpful for some individuals in the sort-term, however it is generally a poor long-term solution due to side effects and risk of dependency, tolerance and withdrawal upon cessation.

Finally, if you are experiencing non-cardiac chest pain know that you are not alone. In one study out of Northern Ireland, 58.7% of all chest pain presentations at an emergency department resulted in a non-cardiac diagnosis. This is extremely common, having affected even the author of this article. Understanding the nature of this type of chest pain will help ease your mind when experiencing it. In time, you may find you rarely if ever experience these sensations anymore.












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