Anxiety Chest Pain: Symptoms, Causes, and Treatment

Anxiety Chest Pain: Symptoms

Choking sensation, hyperventilation, paresthesias, loss of control of one’s body… are common symptoms of anxiety attacks. But if there is a symptom that especially generates the fear of dying when we have one of these crises is the existence of chest pain.

The fact is that chest pain due to anxiety is a really annoying symptom , being often taken by those who suffer it for the first time as an indication of the beginning of the end. Throughout this article we will talk about this type of pain, indicating some of its causes and how to treat it.

Anxiety Chest Pain: Basic Symptoms

When we talk about anxiety chest pain we refer to the perception of pain generated by the somatization of an anxious state that can occur in the context of an anxiety crisis, as a prodrome of it, or in the face of the perception of a continuous stress without having to reach a crisis.

This pain is usually perceived and classified as stabbing, and is usually in the form of punctures and may appear at different points in the torso. This type of pain usually disappears quickly (it can last up to a quarter of an hour, but most often it does not last more than a few minutes), and it does not change whether we make physical efforts or not.

In addition to the pain itself, it is common for symptoms such as hyperventilation, numbness of the extremities to appear along with it, and usually a feeling of going crazy, dying or losing control over one’s body completely.

Frequent confusion with heart problems

Chest pain is a frequent phenomenon in the somatization of anxiety, but as we mentioned in the introduction, the fact that it is also a typical symptom of heart problems and especially of angina pectoris and myocardial infarction often leads to confusion between the two problems.

There are many similarities but they can be distinguished by the fact that in the case of pain typical of a heart disease, the pain is usually more specific to specific points of the chest and arm (although it should be borne in mind that the typical symptoms of heart attack usually refer to the case of men, being the most widespread location in the case of women), tend to persist over time and worsen with physical effort and unlike anxiety, there are usually neither respiratory disorders nor loss of control.

In any case, it is possible that a heart problem can generate anxiety and it is advisable to go to a medical service as soon as possible to ensure that the problem in question is anxiety and not a real medical problem.


Considering that anxiety chest pain is not a product of a cardiopathy, it is legitimate to ask why it appears. The ultimate cause is a high level of anxiety. However, the reason why the somatization of anxiety appears in the form of pain is due to numerous physiological aspects that can appear as a consequence of the activation produced by it.

Firstly, when we are stressed, afraid or anxious we are generating a high level of adrenaline and cortisol, something that at a physiological level translates into the activation of the sympathetic autonomic nervous system (responsible for activating the body to allow reactions such as fighting or running away). When the anxiety crisis arises, this activation generates a high muscular tension in order to prepare the body to respond quickly. This continuous tension can generate a certain level of pain in different parts of the body, the chest being one of them.

Likewise, fear and nervousness also tend to generate an increase in lung activity, leading to hyperventilation. This hyperventilation also implies a high level of movement of the thoracic muscles and the diaphragm, something that together with the muscular tension favours pain. In addition, the fact that we are constantly taking short, superficial breaths makes the sensation of drowning appear, which in turn will generate more nervous activation and a greater number of breaths.

Another frequent alteration in moments of anxiety and which participates in anxiety chest pain is the alteration of gastric motility and the dilation of the digestive tract , which can even generate a pinching of the nerves in the torso, or the accumulation of gas in the stomach which can rise up into the chest and generate pain.


To treat anxiety chest pain, you will first have to treat the cause of the pain, the anxiety itself.

At a cognitive level, the first thing to assess is why this feeling of anxiety has arisen, and it is necessary to analyse what external or internal factors are stirring and agitating us internally to such an extent that our body needs to express it through the body.

We also have to assess whether we are dealing with something we can act on directly or not. If we can do something to change it, we can try to generate some kind of behavioral modification or develop a strategy to solve the problem in question. In case the anxiety is due to something uncontrollable and unchangeable, we will have to restructure our way of relating to that situation . It would be a matter of relativizing the problem, reducing its importance and assessing whether this or its possible consequences are really so relevant for the subject himself.

Another aspect that can be of great help is the training and practice of different relaxation exercises, which take into account especially breathing, although muscle relaxation techniques are also useful. Yoga, meditation or mindfulness are also very useful practices that make it difficult to establish anxiety and allow us to relativize anxious situations.

If we are in the middle of an anxiety crisis, the first thing to appreciate is that anxiety is not going to kill us and that this pain is something temporary and a product of our own reaction to it. We must try, as far as possible, to calm down (although it is not easy). Likewise , we should try to focus on our breathing , avoiding hyperventilation as much as possible and trying to take slow, deep breaths. The crisis will eventually pass.

Bibliographic references:

  • Barker, P. (2003). Psychiatric and Mental Health Nursing: The Craft of Caring. London: Edward Arnold.
  • Seligman, M.E.P.; Walker, E.F.; Rosenhan, D.L. Abnormal psychology (4th ed.). New York: W.W. Norton & Company.
  • Sylvers, Patrick; Lilienfeld, Scott O.; Laprairie, Jamie L. (2011). “Differences between trait fear and trait anxiety: Implications for psychopathology. Clinical Psychology Review. 31 (1): 122 – 37.
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