Anxiety Chest Pain: Symptoms, Causes And Treatment

A type of discomfort that has to do with physiological activation in stressful situations.

Chest pain from anxiety

Feeling of suffocation, hyperventilation, paresthesias, loss of control of one’s own 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, it is the existence of chest pain.

And is that chest pain from anxiety is a really annoying symptom, being often taken by those who suffer for the first time as indicative of the beginning of the end. Throughout this article we are going to 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 chest pain due to anxiety, 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 before the perception of continuous stress without having why reach a crisis.

This pain is usually perceived and classified as stabbing, being usual that it occurs in the form of punctures and that can appear at different points of the torso. The pain of this type usually disappears quickly (they can reach a quarter of an hour, but the most common is that they do not last more than a few minutes), in addition to not changing whether or not we make physical efforts.

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

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 angina pectoris and myocardial infarctions makes the two problems are often confused.

The similarities are many but they can be distinguished by the fact that in the case of pains typical of heart disease, the pain is usually more specific to specific points on the chest and arm (although it must be taken into account that the typical symptoms of heart attack usually refer to the case of men, being the most generalized location in the case of women), they tend to persist over time and worsen with physical effort and, contrary to anxiety, there is usually neither respiratory disturbance nor loss of control .

In any case, it is possible that a heart problem can lead to 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.


Taking into account that chest pain due to anxiety is not the product of heart disease, it is legitimate to ask why it appears. The ultimate cause is suffering from a high level of anxiety. However, the reason that the somatization of anxiety appears in the form of pain is due to numerous physiological aspects that may appear as a consequence of the activation produced by it.

In the first place, when we are stressed, we are afraid or we are 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 (in charge of activating the body to allow reactions such as those of fight or flight). 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 supposes a high level of movement of the thoracic muscles and the diaphragm, something that together with the muscular tension favors pain. In addition, the fact of constantly taking short and shallow inhalations causes the sensation of drowning to appear, something that in turn will generate more nervous activation and a greater number of inhalations.

Another frequent alteration in moments of anxiety and that participates in chest pain due to anxiety is the alteration of gastric motility and the dilation of the digestive tract, which can even cause a pinching of the torso nerves, or the accumulation of gases in the stomach that can rise to the chest and cause pain.


To treat chest pain due to anxiety, the cause that generates it will have to be treated first, that is, the anxiety itself.

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

We must also assess whether we are dealing with something that we can or cannot act directly on. If we can do something to change it, we can go on to try to generate some type of behavioral modification or develop a strategy to solve the problem in question. In the event that 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 especially take into account breathing, although muscle relaxation techniques are also useful. Yoga, meditation or mindfulness are also very useful practices that make it difficult for anxiety to set in and make it possible to relativize anxiety situations.

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

Bibliographic references:

  • Barker, P. (2003). Psychiatric and Mental Health Nursing: The Craft of Caring. London: Edward Arnold.
  • Seligman, MEP; Walker, EF; Rosenhan, DL Abnormal psychology (4th ed.). New York: WW 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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