You’re sitting at your desk or walking down the street when suddenly, your chest tightens. Your heart races. Breathing feels harder. A sharp or aching pain grips your chest—and the first thought that hits is: Am I having a heart attack?
While it’s always important to take chest pain seriously, many people experiencing these symptoms may actually be suffering from anxiety-related chest pain, not a cardiac event. The sensations can be terrifying, but understanding the root cause—anxiety—can be the first step toward healing.
In this article, we’ll explore why anxiety can feel like a heart attack, how to tell the difference, and what you can do to manage these overwhelming symptoms.
Why Anxiety Can Cause Chest Pain
Anxiety is more than just a mental experience; it has physical effects on the body, especially during episodes of acute stress or panic attacks. The connection between anxiety and chest pain is often related to the “fight-or-flight” response, your body’s natural reaction to perceived danger.
When your brain senses a threat—real or imagined—it triggers a chain reaction:
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Your body releases stress hormones like adrenaline and cortisol.
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Your heart rate increases to pump more blood to your muscles.
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Your breathing becomes faster to supply oxygen.
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Your muscles, including those in your chest, tighten.
This combination can cause a variety of physical sensations, including:
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Sharp or stabbing chest pain
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Chest tightness or pressure
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Heart palpitations
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Shortness of breath
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Lightheadedness or dizziness
These symptoms closely resemble those of a heart attack, which is why many people rush to the ER—only to find out the cause is severe anxiety or a panic attack.
Chest Pain from Anxiety vs. Heart Attack: How to Tell the Difference
While the symptoms of anxiety and a heart attack can overlap, there are a few key differences:
| Symptom | Anxiety-Related Chest Pain | Heart Attack Chest Pain |
|---|---|---|
| Pain Location | Often sharp, localized in one area of chest | Usually pressure-like and spreads (to arm, jaw) |
| Onset | Often occurs suddenly during stress or panic | Can occur during rest or physical exertion |
| Duration | Usually lasts a few minutes | Lasts longer, often 10+ minutes |
| Other Symptoms | Sweating, dizziness, rapid heartbeat, tingling | Nausea, cold sweats, shortness of breath, fatigue |
| Relief | Eases with calming down or breathing exercises | Typically does not improve with rest or deep breaths |
However, never assume chest pain is harmless. If you have any doubts, it’s essential to seek medical attention immediately to rule out a cardiac event. Once cleared, you can then focus on addressing the psychological roots of your symptoms.
What Triggers Anxiety-Related Chest Pain?
Chest pain from anxiety often occurs during:
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Panic attacks
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Periods of intense stress
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Chronic generalized anxiety
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Post-traumatic stress disorder (PTSD) episodes
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Health anxiety (hypochondria)
Even without an obvious trigger, people with anxiety disorders may experience chest tightness as a background symptom, especially when anxiety is untreated or poorly managed.
How Therapy Helps: Treating Anxiety to Reduce Physical Symptoms
If you’ve ruled out heart conditions, the next step is understanding and treating your anxiety. At Resilient Mind Psychotherapy, we help clients explore how their mental health affects their physical well-being—especially when symptoms like chest pain become a daily concern.
Common Therapeutic Approaches Include:
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Cognitive Behavioral Therapy (CBT): Helps identify and challenge the thought patterns that lead to anxiety and physical tension.
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Mindfulness and Somatic Techniques: Teach body awareness and relaxation methods to reduce physical symptoms like chest tightness.
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Exposure Therapy: For those with panic disorders or health anxiety, this method helps reduce fear of physical sensations.
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Ketamine-Assisted Psychotherapy (KAP): For treatment-resistant anxiety, this innovative approach may help reduce both mental and physical symptoms.
Therapy is also a great space to learn breathing techniques, grounding exercises, and stress-reduction strategies that help calm the nervous system and ease your body’s response to anxiety.
When to Seek Emergency Help
It’s crucial to understand that anxiety-related chest pain should never be self-diagnosed without medical evaluation. Always call 911 or visit the emergency room if:
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The pain is sudden and intense.
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It radiates to your arm, jaw, or back.
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It is accompanied by nausea, cold sweats, or severe shortness of breath.
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You have a personal or family history of heart disease.
Once medical causes are ruled out, then it’s time to explore psychotherapy and anxiety management as part of your healing journey.
You’re Not Alone—and You’re Not Imagining It
Anxiety-related chest pain is real. It’s not “in your head”—it’s your body’s way of expressing distress. But the good news is, you don’t have to live in fear of your symptoms.
At Resilient Mind Psychotherapy in Brooklyn, we’re here to help you understand the why behind what you’re feeling—and give you tools to take control of your mental and physical health. With compassionate, evidence-based care, our therapists guide clients toward lasting relief and resilience.
We extend our warm welcome to Cigna, Aetna, Fidelis Care and 1199SEIU insurance plans, enabling you to focus on your mental well-being without additional financial strain.
References:
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American Psychological Association. (2023). Anxiety Disorders. https://www.apa.org
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Cleveland Clinic. (2022). Anxiety Chest Pain vs. Heart Attack. https://my.clevelandclinic.org
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Harvard Health Publishing. (2020). Panic attacks and anxiety: How to tell the difference from heart problems. https://www.health.harvard.edu
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National Institute of Mental Health (NIMH). (2022). Panic Disorder: When Fear Overwhelms. https://www.nimh.nih.gov
