Chest Pain Anxiety Symptoms

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated March 11, 2022

chest pain anxiety

Chest pain, such as shooting pain, stabbing pains, persistent pain, chest pressures, fullness, and tension are common anxiety disorder symptoms.

Chest pain symptoms are especially common for higher degree anxieties, such as with anxiety and panic attacks, and chronic and high intensity social anxiety, generalized anxiety, and obsessive-compulsive disorder.

This article explains what the anxiety chest pain symptoms can feel like, why anxiety can cause chest pains, what’s required to stop persistent anxiety chest pain, and short-term remedies you can use right away to stop this common anxiety symptom.

Chest Pains Anxiety Symptoms common descriptions

  • You feel an unusual tightness or pressure in your chest.
  • You feel an unusual pain or shooting pains in your chest.
  • You are experiencing sharp stabbing pains in your chest.
  • It feels like your chest muscles are unusually tight.
  • It feels like a chest muscle or muscles are twitching or trembling.
  • You feel a burning, numbness, an uneasiness, or fullness in the chest area.
  • You feel a “heaviness” in your chest.

The chest area includes the diaphragm (a sheet of internal muscle that extends across the bottom of the rib cage), sternum (often referred to as the breastbone in the center of the chest), breast muscles, and rib cage.

This symptom can affect one area of the chest only, can shift and affect another area or areas, can migrate and affect many areas of the chest, or affect the entire chest area.

This symptom can occur rarely, frequently, or persistently.

This symptom can precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.

It can also precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur “out of the blue” and for no apparent reason.

Anxiety chest pain can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and eases off the next.

This symptom can change from day to day, moment to moment, or persist throughout your anxiety disorder.

All the above combinations and variations are common.

This symptom can seem more disconcerting when undistracted, resting, doing deep relaxation, or when trying to go to sleep or when waking.

These symptoms are often misconstrued as heart problems or a sign of a heart attack.

This symptom is often referred to as Non-cardiac Chest Pain (NCCP).

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

---------- Advertisement - Article Continues Below ----------


---------- Advertisement Ends ----------

Follow us on YouTube

We regularly post helpful and informative videos. Subscribe now!
Subscribe

What causes chest pain anxiety symptoms?

Medical Advisory

Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.

Click the link for Additional Medical Advisory Information.

1. Stress Response

As part of the body’s survival mechanism, the moment we believe we could be in danger, the body secretes stress hormones into the bloodstream where they travel to targeted spots to bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat—to either fight or flee. This survival reaction is the reason why the stress response is often referred to as the fight or flight response, the emergency response, or the fight, flight, or freeze response (some people freeze when they are afraid like a “deer caught in headlights”).[1][2][3]

The stress response causes muscles to contract and tighten. Since there are many muscles and groups of muscles in the chest and rib cage areas, these muscles can be affected too.

anxiety chest muscles

Tight muscles can produce symptoms such as tightness, pressure, pain, shooting pains, fullness, uneasiness, burning, numbness, muscle twitching, and muscle spasms.

These symptoms might cause you to become concerned that there might be something wrong with your heart and might even cause you to believe you are having a heart attack.

The concern and fear of having a heart problem might cause more stress responses, causing an increase in pain as well as other symptoms similar to that of a heart attack, such as profuse sweating, light-headedness, and numbness in the arms, feet or face. These increased symptoms might reinforce your belief that you are having a heart attack, which can cause even more fear, symptoms, and even panic.

Tight and painful muscles in the chest and rib cage areas are common symptoms of stress and anxiety, especially when this stress is caused by apprehensive behavior, including anxiety and panic attacks.[4][5][6][7][8]

2. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly from the physiological, psychological, and emotional changes the stress response brings about. When stress responses occur too frequently and/or dramatically, however, such as from overly apprehensive behavior, the body has a more difficult time recovering, which can cause it to remain in a state of semi stress response readiness. We call this state “stress-response hyperstimulation” since stress hormones are stimulants (also often referred to as "hyperarousal").[9][10][11] A body that becomes hyperstimulated can exhibit all of the changes of an active stress response even though a stress response hasn’t been activated. Experiencing "chest pain" is a common indication of stress-response hyperstimulation.

3. Stomach and digestive problems

Stomach and digestive symptoms (pain, shooting pain, radiating pain, pressure, fullness, discomfort) also can be felt in the chest area and may be perceived as heart-related. Stomach and digestive symptoms are also common for stress and anxiety.

---------- Advertisement - Article Continues Below ----------


---------- Advertisement Ends ----------

4. Other Factors

Other factors can stress the body, causing and contributing to this symptom, such as:

Medication

Prescription and over-the-counter (OTC) medications can mimic, cause, and aggravate anxiety symptoms.

Talk with your doctor and pharmacist about your medication if you aren't sure if its playing a role in your symptoms, including this one.

Visit our Medication article for more information.

Recreational Drugs

Many recreational drugs can cause and aggravate anxiety symptoms. Especially those that affect the nervous system.

Visit our Recreational Drugs article for more information.

Stimulants

Stimulants bring about their stimulating effect by secreting stress hormones.

Increasing the body’s stimulation can cause and aggravate existing anxiety symptoms.

Visit our Stimulants article for more information.

Sleep Deprivation

Going without adequate sleep can affect the body in many ways, such as:

  • Prevents the body from sufficiently refreshing itself
  • Stresses the nervous system
  • Impairs brain function
  • Increases blood pressure
  • Increases blood sugar
  • Increases moodiness
  • Increases cortisol to compensate for feeling tired (cortisol is a powerful stress hormone)

These effects can cause and aggravate anxiety symptoms.

Visit our Sleep Deprivation article for more information.

Fatigue

Fatigue can cause and aggravate many anxiety-like symptoms, such as:

To name a few.

Visit our Fatigue article for more information.

Hyper and Hypoventilation

Over and under breathing can also cause anxiety-like symptoms and aggravate existing symptoms, including anxiety-caused chest pains.

Visit our Hyper And Hypoventilation article for more information.

Low Blood Sugar

Low blood sugar, even within the normal range, can cause anxiety-like symptoms. Low blood sugar can also aggravate existing anxiety symptoms.

Visit our Low Blood Sugar article for more information.

Nutritional Deficiency

Nutritional deficiencies, such as low vitamin B and D, can cause anxiety-like symptoms. Nutritional deficiencies can also aggravate existing anxiety symptoms.

Visit our Nutritional Deficiency article for more information.

Dehydration

Dehydration can also cause anxiety-like symptoms and aggravate existing anxiety symptoms, such as:

To name a few.

Visit our Dehydration article for more information.

Hormone Changes

Hormones affect the body in many ways and can affect each other. Hormone changes can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Hormone Changes article for more information.

Pain

Pain stresses the body, especially chronic pain. If the pain is in the high degree range, it can cause and aggravate hyperstimulation.

If you are anxious, hyperstimulated, and symptomatic, pain can aggravate them all.

Visit our Pain article for more information.

---------- Advertisement - Article Continues Below ----------


---------- Advertisement Ends ----------

How to get rid of chest pain anxiety symptoms?

1. Address the other factors

When other factors cause or aggravate anxiety symptoms, such as chest pains,  addressing the specific factor(s) can reduce and end this symptom.

2. End the stress response

When this symptom is caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and shouldn’t be a cause for concern.

3. Eliminate hyperstimulation

When chest pain anxiety symptoms are caused by hyperstimulation, it often takes a lot more time for the body to recover and for the chest pain symptoms to subside. We explain the challenges of recovering from hyperstimulation in the Recovery Support area of our website.

When the body has recovered from being anxious and hyperstimulated, chest pain anxiety symptoms subside. Therefore, anxiety chest pain needn’t be a cause for concern.

You can speed up the recovery process by reducing your stress, practicing relaxed breathing, increasing your rest and relaxation, and not worrying about this chest pain symptom. Again, when your body has recovered from the stress response or the effects of hyperstimulation, anxiety chest pain symptoms disappear.

If your anxiety chest pain is caused by stomach and/or digestive system upset, there are some over-the-counter digestive aids that can relieve anxiety-caused stomach and digestive upset while your body is recovering from stress-response hyperstimulation.

If these remedies aren’t working, you may want to connect with Liliana Tosic, a Registered Holistic Nutritionist for nutritional support. Diets often play a contributing role, if not entirely causing digestive problems. Making healthy dietary change can make a significant difference.

---------- Advertisement - Article Continues Below ----------


---------- Advertisement Ends ----------

4. Short-term strategies:

While the overall goal is to eliminate hyperstimulation so that the body stops producing chest tightness and pain symptoms, some people have found some relief by some of the following:

  • Reduce stress – reducing stress can reduce stress-caused muscle tension.
  • Regular mild to moderate exercise – can help loosen tight chest and abdomen muscles. As fitness level increases, issues with tight muscles diminish.
  • Have a massage – massages are relaxing, which can help loosen tight muscles.
  • Relaxed breathing – can relax tight chest muscles.
  • Stretching – can relax tight chest muscles.
  • Deep relaxation – deeply relaxing the body can help unclench tight stomach and chest muscles.
  • Warm to hot bath – soaking in the tub can be relaxing, which can help relax tight muscles.
  • Steam bath or sauna – moderately warm steam baths or saunas can also relax tight muscles, including those in the stomach and chest areas.
  • Take a leisure walk – leisure walking can reduce stress and tight chest muscles.
  • Increase rest – resting helps the body to relax, which can also relax tight muscles.
  • Relax chest and stomach muscles – some people tense their stomach and chest muscles, which becomes a habit. Learning to keep them relaxed can help loosen tight stomach and chest muscles.
  • Avoid foods that irritate the stomach and digestive system – if certain foods upset your digestive system, avoid them until your body has recovered.
  • Be sure you are well hydrated – dehydration can cause muscle tension and pain. Drinking enough fluids so that your urine is almost clear is a way to tell if your body is well hydrated.
  • Avoid stimulants – Hyperstimulation means your body is overly stimulated. Ingesting stimulants will just aggravate hyperstimulation and its symptoms, including muscle tension and pain.

5. Therapy

The number one reason why anxiety disorder and its symptoms persist is because of unidentified and unaddressed underlying factors that cause issues with anxiety. This is why dealing with your anxiety issues is the most important overall.

Since the majority of stress comes from behavior (the ways we think and act), addressing the core reasons for anxiety disorder can reduce and eliminate the unhealthy stress that often leads to hyperstimulation and symptoms, including this one.

Keep in mind that eliminating anxiety symptoms doesn’t necessarily mean you’ve overcome issues with anxiety. Anxiety symptoms are symptoms of stress. Eliminating anxiety symptoms means you’ve eliminated the unhealthy stress that is causing your symptoms. But if the underlying factors that cause issues with anxiety aren’t addressed, it’s just a matter of time until the body is overly stressed and symptomatic again.

Rebounds of symptoms and a return to a struggle with anxiety are caused for this very reason: the core issues that cause problematic anxiety haven’t been successfully addressed.

To eliminate issues with anxiety and symptoms once and for all, we need to eliminate the cause of problematic anxiety – the underlying factors that cause issues with anxiety. When you eliminate the cause of the problem, you eliminate the problem and the problem's symptoms.

If you have been struggling with anxiety and symptoms, we recommend connecting with an experienced anxiety disorder therapist to help you overcome your anxiety issues. Research has shown that working with an experienced therapist is an effective treatment for anxiety disorder.[12][13]

All of our recommended anxiety disorder therapists have personally experienced anxiety disorder and have overcome it. Their personal experience with anxiety disorder combined with their Masters Degree and above professional training makes them a good choice when desiring to overcome anxiety disorder and its symptoms.

Moreover, getting therapy via teletherapy, distanced therapy, or e-therapy (telephone or online therapy) is as effective, if not more so, than in-person therapy.[14][15]

All of our recommended therapists are experienced at working with clients via distanced therapy and new technologies. We’ve found distanced therapy to be especially effective when working with anxious clients.[16]

NOTE: If you are experiencing chest tightness or pain and aren’t sure of the cause, definitely seek immediate medical attention. It’s far better to be certain about the cause than wonder and be experiencing a true heart-related symptom.

Prevalence

In an online poll we conducted, approximately 81 percent of respondents said they experienced this symptom because of their struggle with anxiety. As you can see, chest pain is a common stress- and anxiety-caused symptom.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including anxiety chest pain.

References

1. Selye H. Endocrine reactions during stress. Anesthesia & Analgesia. 1956;35:182–193. [PubMed]

2. "Understanding the Stress Response - Harvard Health." Harvard Health. N.p., n.d. Web. 23 May 2016.

3. "The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis." DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.

4. Lundin, Ulrika. “Unexplained chest pain can be due to stress.” Göteborgs Universitet, 3 Feb. 2009.

5. Huffman, Jeff, et al. “Panic Disorder and Chest Pain: Mechanisms, Morbidity, and Management.” US National Library of Medicine, 2002,

6. Demiryoguran, N. S., Karcioglu, O., Topacoglu, H., Kiyan, S., Ozbay, D., Onur, E., … Demir, O. F. (2006, February). Anxiety disorder in patients with non‐specific chest pain in the emergency setting. Emergency Medicine Journal: EMJ, 23(2), 99-102

7. Mayo Clinic Staff. (2014, November 26). Chest pain: Causes.

8. Healthline Staff. “Anxiety Chest Pain: Symptoms, Home Remedies, and More.” Healthline, Healthline Media.

9. Selye, H. (1956). The stress of life. New York, NY, US: McGraw-Hill.

10. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.

11. Yaribeygi, Habib, et al. “The Impact of Stress on Body Function: A Review.” EXCLI Journal, Leibniz Research Centre for Working Environment and Human Factors, 2017.

12. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.

13. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.

14. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.

15. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.

16. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.