Chest Pain Caused By Anxiety Or Panic Attacks
Is it a heart attack or anxiety?
But chest pain can be caused by myriad conditions that have nothing to do with the heart. One common cause is an anxiety attack.
This article lays out the impact of anxiety attacks, how they cause chest pain, and what to expect when you see your healthcare provider with anxiety-related chest pain.
Verywell / Laura Porter
Complications Of Anxiety And Heart Disease
A person with heart disease and anxiety is more likely to experience worse outcomes, such as severe disability or death, than people with heart disease who do not have anxiety.
Anxiety can also lead to fear and uncertainty about your health. Your fears might keep you from following your treatment plan.
Though the research is mixed, people who experience anxiety appear to be less likely to engage in healthy behaviors that could help with heart disease. Anxious individuals tend to have increased dietary cholesterol intake, eat more food, live a sedentary lifestyle, and exercise less.
Anxiety is also associated with a lower likelihood of following risk-reducing recommendations after a heart attack, including smoking cessation, social support utilization, and stress reduction.
People with anxiety disorders are also less likely to attend and complete cardiac rehabilitation programs. These behavioral factors in people with anxiety disorders can increase the likelihood of cardiovascular morbidity and mortality.
A Patient’s Anxiety Or Heart Disease
One patient I saw, who was over age 70, had a lifelong history of anxiety and panic attacks. She’d stopped leaving her home out of fear of another attack after she’d tried multiple anxiety medications without benefit. But when I saw her, we found that each episode of her anxiety was caused by a rapid heart rhythm. It was easily corrected by a simple procedure called an ablation.
Shortly after the ablation, she attended a close relative’s wedding free of anxiety. This was the first time she’d participated in a large family activity in nearly 40 years.
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I Cant Tell If I May Be Having A Heart Attack Or A Panic Attack
I have been told that I have anxiety before but for the past 4 days Ive been experiencing a fast heart rate, fatigue, sharp pain near the middle of my chest, random pain somewhere around my body that comes and goes and heart palpitations. Im really scared if anything might happen to me. Im only a teenager and Ive recently been experiencing these types of symptoms. Im guessing it has to do with my grandfathers funeral but its been a few day later and and I feel a bit relaxed after the funeral however these symptoms just pop out of nowhere its making me go crazy. Ive tried explaining to my family that something may be wrong with me but they just dismiss it as anxiety or a panic attack. I know Reddit isnt the most ideal place to ask these types of questions but still I need answers
Why Some People Think Their Panic Attack Is A Heart Attack:
Not only do panic attacks and heart attacks feel similar, people who are prone to panic attacks particularly those who have cardiophobia often have a hard time trusting that their symptoms are coming from panic and not from a heart attack, even if theyve been through it before. Thats because panic disorder makes you believe you need absolute certainty that youre NOT having a heart attack for you to feel relief, says Wilson. Even if youve gone to the ER three times thinking you were having a heart attack, and been tested to rule out a physical condition, a person with panic disorder may see a new episode as a distinct event. They think, that was then, this is now what if it is a heart attack this time and Im missing it? he explains.
One more time, with feeling: If youre having ambiguous symptoms that scare you especially if they feel different from your last panic attack call 911.
But if you are in good health and think theres a decent chance that your brain is messing with you especially if it has in the past and youve been reassured that you dont have a heart problem you may need practice sitting with these symptoms so they can pass, and not escalating them with your fear. At some point you have to say to yourself, heres my tendency, heres my pattern, says Wilson. I need to start trusting in what others have said to me, because I cant trust what my mind is doing in those moments.
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How Common Are Heart Palpitations Caused By Anxiety
Anxiety is the most common cause of palpitations that are not related to a heart problem. Its very common to have moments of anxiety, especially during stressful situations. These situations may include job interviews, public speaking or airplane flights. Most times, these anxious feelings and heart palpitations come and go quickly.
If you have feelings of anxiety often or for long periods, talk to your healthcare provider. You may have an anxiety disorder or a panic disorder. Treatment with medication, therapy or both can help relieve your symptoms.
How To Reduce Anxiety And Chest Pain
The best way to manage chest pain is with prevention and by reducing your overall anxiety symptoms. The less you experience anxiety, the less risk you’ll have for chest pain.
If you’re currently experiencing anxiety and chest pain, the best things to do are the following:
- Control Your Breathing Recall that this type of chest pain is often caused by hyperventilation, and even if you’re not hyperventilating, getting your breathing under control is a great way to calm the nerves. Take slow, controlled breaths using deep breathing techniques that take at least 15 seconds and you’ll quickly see a difference. Try to breathe in through your nose and out through your mouth, breathing deep from your diaphragm rather than shallow from your chest.
- Control Your Thoughts One of the reasons I recommend going to a doctor first is because understanding that your chest pain is anxiety related reduces the severity of the experience. If you know that your heart is in good health, don’t let your thoughts spiral out of control because that may make the chest pain worse.
- Control Your Environment Chest pain caused by thoughts or anxiety is often made worse when you sit and focus on the experience. See if you can give yourself a healthy coping distraction, and much of the chest pain will fade away. Some suggestions for this include changing your location , listen to relaxing or happy music, talk on the phone with a trusted friend, or use grounding techniques to focus on the present.
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Heart Attack Chest Pain
So what are heart attack symptoms?
A heart attack is when the blood flow or blood supply that feeds the heart itself is blocked. Heart attack symptoms include :
- Chest pain that continues to get worse with exertion
- Chest pain that radiates to your arms or jaw
- Heavy pressure in the chest area and a squeezing sensation
- Fast heart rate and shortness of breath
Some people feel exhausted or say they have back pain, and close to 30% of people having a heart attack dont even report chest pain .
What Causes Chest Pain
It is always a good idea to visit a doctor at least once to rule out any potential heart health issues. Anxiety can cause chest pain, but an important factor in reducing the stress of that chest pain is by making sure you are confident that your heart is in good health. Visiting a doctor is never a bad thing!
Often those living with anxiety and panic attacks will experience chest pain caused by any number of different factors. Some of these include:
- Hyperventilation – Those with panic attacks and anxiety are prone to hyperventilation, or breathing in too much oxygen. It is often due to rapid muscle contractions and excess air in the lungs. Hyperventilation contracts blood vessels and causes considerable chest pain.
- Bloating – anxiety can be connected to excess gas or bloating. Hyperventilation disorder can contribute to this as well. Bloating can cause an increased amount of pressure on the lungs, which in turn leads to chest pain.
- Psychosomatic – most people don’t like to believe the idea that the problem is in their head, but those with extreme anxiety and panic attacks, that are worried about their health, may feel genuine pain even though no cause of pain is present. Psychosomatic means that a physical ailment is aggravated or caused by their thoughts. The anxious mind actually convinces the body that there is a symptom, in this case chest pain.
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Anxiety Attack: The Most Common Symptoms
- Insane, overwhelming strike of panic
- Dizziness, feeling faint or light headed.
- Accelerated heartbeat or heart palpitations
- Numbness, particularly in your feet and hands.
- Feeling detached and unreal. Basically, you feel like you are going crazy.
- Fearing youre dying.
An anxiety attack can roll in with most of the above or just a few symptoms, coming one after another or all at once.
The symptoms can last from a few seconds to a terrible half an hour, though the average number is 10 minutes says, Doctor Merav Gur.
Will My Healthcare Provider Be Able To Rule Out Other Causes Of Heart Palpitations
Your provider will want to verify that anxiety-related palpitations arent dangerous. They may recommend other tests, such as:
- Chest X-ray to look at your heart and lungs.
- Echocardiogram or to examine your hearts overall function.
- Electrocardiogram to check your heart rate.
- Exercise stress test to see how your heart performs with increased activity.
- Holter monitoring to record your hearts activity over 24 to 48 hours.
If a Holter monitor doesnt show unusual heart rhythms, your provider may give you an event recorder. You can wear this recorder for weeks. You press a button to record any heart sensations that you experience.
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Limit Alcohol Caffeine And Smoking
While smoking cigarettes and drinking alcohol and caffeine can feel like theyre helping quell your anxiety, studies show that all three can actually make it worse.
If you dont want to quit any of them completely, take note of which you have consumed before you feel anxious to try to pinpoint which may be negatively impacting you, and limit your intake accordingly.
Symptoms Of Anxiety Attacks
It is normal to feel anxious in response to certain situations or experiences. Our bodies have a natural fight-or-flight response when faced with danger or stress. Anxiety attacks go beyond feeling butterflies in your stomach when youre nervous and extend to an overwhelming feeling of helplessness.
The signs and symptoms of an anxiety attack can vary from person to person but are generally experienced as both physical and psychological indicators. Many times the symptoms occur in response to a trigger that the person perceives as a threat or possible danger. Other times, the symptoms can occur spontaneously.
A person experiencing an anxiety attack could have any number of the following signs and symptoms:
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Are Heart Palpitations From Anxiety Dangerous
Although heart palpitations can be alarming, most arent dangerous. They usually go away after the anxiety-causing situation passes.
Less commonly, heart palpitations can be a sign of a serious health problem, such as arrhythmia . These heart palpitations may feel like they cause anxiety rather than follow it. If you have palpitations along with chest pain, trouble breathing, dizziness or confusion, seek medical help right away.
Panic Attack Vs Heart Attack: How To Tell The Difference
Your heart suddenly begins racing. You feel pain in your chest and you are short of breath.
Are you having a heart attack? Or could it be a panic attack?
Although they share a number of similarities, the two conditions result from very different disease processes. Panic attacks arise when stress hormones trigger the body’s “fight or flight” response, often resulting in racing heart, chest pain and shortness of breath.
In the case of a heart attack, a blockage in a coronary artery may result in the same symptoms. “Chest pain, rapid heartbeat and breathlessness may result when an insufficient amount of blood reaches the heart muscle,” says Tung.
One of the key distinctions between the two is that a heart attack often develops during physical exertion, whereas a panic attack can occur at rest.
A heart attack is more likely to develop when the work load of the heart increases, for example while a person is shoveling snow or running up the stairs, especially in people who do not routinely engage in physical exertion.
Another difference is duration: Panic attacks tend to gradually subside and resolve on their own within about 20 minutes. A heart attack, however, will often continue and may worsen over time.
When Your Heart Skips a Beat
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Panic Attacks Dont Last As Long As They Feel Like They Do
Panic attacks feel like an eternity to the sufferer, but the reality is that your body cant sustain them for very long. The brain goes into fight or flight mode when people experience panic attacks.
Panic attacks typically reach their peak within ten minutes and resolve within thirty minutes. They rarely last more than an hour. That thirty-minute period is so physically and emotionally overwhelming, however, that it feels like much longer and requires a significant recovery period after. Panic attacks are very draining and its difficult to jump right back into school, work, or family fun immediately following an attack.
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Stress Can Cause Broken Heart Syndrome Which Feels Like A Heart Attack
One of the most dramatic ways stress can affect your heart is by causing takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken heart syndrome.
This feels just like a heart attack, with symptoms including chest pain and shortness of breath, but it is a different condition altogether, says Lauren Gilstrap, MD, a cardiologist at Dartmouth Hitchcock Medical Center.
Those symptoms come on suddenly, triggered by a stressful emotional event, such as the sudden death of a loved one. Its presentation isnt subtle, Gilstrap says. People think theyre having a heart attack.
However, thats not the case. A heart attack occurs when an artery to the heart is blocked. Takotsubo cardiomyopathy has no underlying blockages. Its exact causes arent known but are thought to be tied to a sudden hormonal surge from the bodys fight or flight response.
Takotsubo cardiomyopathy is a fundamentally different phenomenon than a heart attack, Gilstrap says. The arteries are completely fine and the blood supply is completely normal, but all of a sudden, the heart doesnt squeeze.
Takotsubo cardiomyopathy is most common in women aged 58 to 75, who make up more than 90% of cases. Doctors arent entirely sure why, but one study found that women experience higher rates of emotional stress. About 5% of women who think theyre having a heart attack are actually experiencing stress-induced cardiomyopathy.
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Information For Carers Friends And Relatives
If you are a carer, friend or relative of someone who hears voices, you can get support.
How can I get support?
You can do the following.
- Speak to your GP about medication and talking therapies for yourself.
- Speak to your relatives care team about a carers assessment.
- Ask for a carers assessment from your local social services.
- Join a carers service. They are free and available in most areas.
- Join a carers support group for emotional and practical support. Or set up your own.
What is a carers assessment?A carers assessment is an assessment of the support that you need so that you can continue in your caring role. To get a carers assessment you need to contact your local authority.
How do I get support from my peers?You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. Or you can contact the Rethink Mental Illness Advice Service and we will search for you.
How can I support the person I care for?
You can do the following.
- Read information about anxiety disorders.
- Ask the person you support to tell you what their symptoms are and if they have any self-management techniques that you could help them with.
- Encourage them to see a GP if you are worried about their mental health.
- Ask to see a copy of their care plan, if they have one. They should have a care plan if they are supported by a care coordinator.
- Help them to manage their finances.
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Tachycardia Can Cause Anxiety
Abnormal heart rhythms of more than 100 beats per minute that come from the upper heart chambers are called supraventricular tachycardias . These can occur in healthy hearts as well as in people who’ve had prior heart injuries or problems. In most people, SVTs are random events not triggered by exercise or other activities. SVTs cause symptoms of heart palpitations, lightheadedness, chest discomfort, shortness of breath, and, at times, they may cause you to pass out. The mind responds and can cause further symptoms of anxiety and panic.
Most of the time, I encounter people who’ve had anxiety for a few years and for whom medications haven’t worked which prompted their doctors to look for additional potential causes.
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