Heart Concerns, Heart Symptom Worries

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated March 11, 2025

feeling of impending doom anxiety symptom

Heart concerns and worries about chest discomfort, pain, pressure, fullness, and tightness are common anxiety symptoms, including anxiety and panic attack symptoms.

Many anxious people concern themselves and worry about heat-related symptoms.

This article explains the relationship between anxiety and heart concerns and worries.

Heart Concerns Common Anxiety Symptom Descriptions

  • Chest discomfort, pain, shooting pains, tightness, fullness, pressure, or some type of chest irregularity that has you concerned.
  • Difficulty breathing or catching your breath.
  • You feel like you have to force yourself to breathe or else you might suffocate.
  • Chest flutters, skipped heartbeats, racing heart, numbness in the arms or hands, or shooting pains in the chest that radiate to one or both shoulders.
  • It also might feel like your heart is beating too hard, too loud in your chest, or that your heart won’t slow or quiet down.
  • After numerous visits to the doctor or hospital or numerous medical tests, your doctor has ruled out any problems with your heart. Yet your persistent chest symptoms still have you concerned.
  • Become concerned about the possibility that your doctor might have missed a problem with your heart. This concern makes you obsessed about how your heart or chest feels.
  • Continually “testing” or “checking” your heart or chest area to see if your symptoms, pain, or discomfort is still there. You might also regularly check to make sure your heart is okay.
  • Some people constantly check their pulse to ensure their heart is functioning normally.
  • Some people constantly check their Fitbit or Apple Watch readings to ensure their heart is okay. Some people also continually scare themselves when their readings aren’t what they think they should be.

And so on.

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

Heart concerns can:

  • Occur occasionally, frequently, or persistently.
  • Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
  • Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" for no reason.
  • Range in intensity from mild, to moderate, to severe.
  • Come in waves where it’s strong one moment and eases off the next.
  • Occur for a while, subside, and then return for no reason.
  • Change from day to day, moment to moment, or remain as a constant background during your struggle with anxiety disorder.

All the above combinations and variations are common.

Chest and heart-related symptoms can seem more disconcerting when undistracted, resting, doing deep relaxation, or when trying to go to sleep or waking up. Therefore, worrying about these types of symptoms can also be more prevalent during these times.

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.

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Causes

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.

Additional Medical Advisory Information.

If your chest symptoms are solely related to stress, including anxiety-caused stress, here are the leading causes of this symptom:

1. The stress response

Anxious behavior activates the body’s stress response, which 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 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].

Visit the “Stress Response” article to learn how it can affect the body.

The stress response causes many body-wide changes, including:

  • Tightens muscles so the body is more resilient to harm, including those in the chest and abdomen.
  • Shunts blood to parts of the body that are more important for survival, such as the brain and muscles, and away from those less important, such as the skin and digestive system. It accomplishes this shunting action by constricting blood vessels in certain parts of the body, which forces blood away, and dilating blood vessels in other parts of the body, which allows more blood to flow in.
  • Stimulates the body to have more energy to deal with a threat.
  • Increases respiration and heart rate to accommodate the increase in energy.
  • Suppresses the digestive system so most of the body’s resources are made ready for emergency action.
  • Heightens most of the body’s senses.

To name a few.

Any of these changes or combinations can cause the feelings associated with this symptom.

Over the years, the media and healthcare professionals have conditioned us to be on the lookout for potential heart problems. These messages reinforce the importance of seeking immediate help if specific chest symptoms appear.

Consequently, those who are medically sensitive can become overly anxious about heart concerns, which can cause increased sensitivity to symptoms that occur in the chest and near the heart.

For example, when chest symptoms occur, many anxious people quickly imagine the worst and then rush themselves to the doctor or hospital, believing they are having a heart attack.

Unfortunately, this reaction is as common as the symptoms themselves. Every year doctor’s offices and hospital emergency rooms are filled with anxious people fearing they are having a serious medical emergency with the heart, such as a heart attack.

If you are medically anxious, the more sensitive and anxious you are about chest and heart-like symptoms, the more reactive you’ll most likely be.

2. Hyperstimulation

When stress responses occur infrequently, the body recovers relatively quickly from its changes. However, frequently activated stress responses, such as from overly anxious behavior, can prevent the body from completely recovering. Incomplete recovery can leave the body in a state of semi-stress-response-readiness, which we call “stress-response hyperstimulation” since stress hormones are powerful stimulants.

Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation” [3][4][5][6].

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.

Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated.

Just as an active stress response can cause acute heart related symptoms, hyperstimulation can cause chronic heart-related symptoms.

Having chest tension, pressures, and pains are common indications of hyperstimulation (chronic stress).

As long as the body is hyperstimulated, it can create symptoms of hyperstimulation, including heart-related symptoms.

But that’s not all. Hyperstimulation can cause this symptom in other ways. For instance, hyperstimulation can cause:

  • Nervous System Excitation and Dysregulation: A chronically stimulated nervous system can act erratically and cause all kinds of nervous, somatic, circulatory, muscular, and sensory system problems and symptoms, such as those associated with the heart.
  • Homeostatic Dysregulation: Homeostasis is the body’s ability to automatically maintain a stable internal environment despite changes in the external environment. Hyperstimulation can cause homeostatic dysregulation, leading to internal regulation problems, which can affect the nervous, sensory, circulatory, skeletal, muscular, somatic, and vestibular systems, causing problems and symptoms associated with the heart.
  • Hormone changes: Hormones play a crucial role in homeostasis and many bodily functions, which can affect the nervous, sensory, and vestibular systems. Since stress hormones affect other hormones, hyperstimulation can cause nervous, somatic, circulatory, muscular, and sensory system problems and symptoms, including those involving the heart.
  • Sleep disruption and fatigue: Hyperstimulation can interfere with sleep and tax the body’s energy resources harder and faster than normal. Sleep disruption and fatigue can affect the nervous, somatic, circulatory, muscular, and sensory systems, causing symptoms associated with the heart.

As long as the body is hyperstimulated, it can exhibit chronic heart-related symptoms.

The above combination of factors can cause many unusual sensations and symptoms, including tension, pressures, and pains in the chest and heart area.

3. Stomach and digestive system problems

Stomach and digestive problems can also cause these types of tensions, pressures, and pains in the chest. For more information, visit our “Stomach Problems” symptom.

4. Behavior

Worrying about heart symptoms is a common anxiety symptom. It stems from many of the underlying factors that drive anxious behavior. Some of these factors include:

  • Fear of pain and suffering
  • Fear of death
  • Fear of what’s beyond death
  • Fear of leaving loved ones behind
  • All or nothing thinking
  • Catastrophizing
  • Uncontained worry
  • Perfectionism
  • Intolerance of discomfort
  • Emotional reasoning
  • Fear of loss of autonomy

To name a few.

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5. Other Factors

Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:

Select the relevant link for more information.

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Treatment

When other factors cause or aggravate this anxiety symptom, addressing the specific cause can reduce and eliminate this symptom.

When an active stress response causes this symptom, ending the active stress response will cause this acute anxiety symptom to 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 needn’t be a cause for concern.

When hyperstimulation (chronic stress) causes heart concerns, eliminating hyperstimulation will end this anxiety symptom.

You can eliminate hyperstimulation by:

  • Reducing stress.
  • Containing anxious behavior (since anxiety creates stress).
  • Regular deep relaxation.
  • Avoiding stimulants.
  • Regular light to moderate exercise.
  • Eating a healthy diet of whole and natural foods.
  • Passively accepting your symptoms until they subside.
  • Being patient as your body recovers.

Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.

Recovery Support members can view chapters 5, 6, 7, 14 and more for more detailed information about recovering from hyperstimulation and anxiety disorder.

As the body recovers from hyperstimulation, it stops sending symptoms, including this one.

Symptoms of chronic stress subside as the body regains its normal, non-hyperstimulated health.

However, eliminating hyperstimulation can take much longer than most people think, causing symptoms to linger longer than expected.

As long as the body is even slightly hyperstimulated, it can present symptoms of any type, number, intensity, duration, frequency, and at any time, including symptoms that involve the heart, causing concern about the heart.

Since worrying and becoming upset about anxiety symptoms stress the body, these behaviors can interfere with recovery.

Passively accepting your symptoms – allowing them to persist without reacting to, resisting, worrying about, or fighting them – while doing your recovery work will cause their cessation in time.

Acceptance, practice, and patience are key to recovery.

Keep in mind that it can take a long time for the body to recover from hyperstimulation. It's best to faithfully work at your recovery despite the lack of apparent progress.

However, if you persevere with your recovery work, you will succeed.

You also have to do your recovery work FIRST before your body can recover. The cumulative effects of your recovery work will produce results down the road. And the body's stimulation has to diminish before symptoms can subside.

  • Reducing stress.
  • Increasing rest.
  • Faithfully practicing your recovery strategies.
  • Passively accepting your symptoms.
  • Containing anxious behavior.
  • Being patient.

These will bring results in time.

When you do the right work, the body has to recover!

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Short-term strategies

Even though eliminating hyperstimulation will eliminate chronic anxiety symptoms, including heart related symptoms, some people have found the following strategies helpful.

However, keep in mind that each person can have a unique symptom experience since each person is somewhat physically, chemically, psychologically, and emotionally unique. What might work for one person might not for another.

  • Taking a warm bath – can relax the body and nervous system, which can help reduce muscle tension-related symptoms.
  • Have a massage – can help the body and nervous system relax, which can help muscles release and relax, as well as help the nervous system become less reactive.
  • Listening to soothing music – can help the mind, body, nervous system, and muscles relax.
  • Going for a leisure walk - can help the body, nervous system, and muscles relax.
  • Going for a leisure swim - can help the body, nervous system, and muscles relax.
  • Floating on a water device – lying down on an inflatable water raft can be soothing and relaxing, and so can leisurely floating in a boat. Some people find the gentle rocking of the waves enjoyable and relaxing.
  • Not reacting to this symptom – can help the nervous system disengage and relax, which can help tight and spasming muscles relax.
  • Muscle relaxants – can help spasming muscles release and relax.
  • Pain management – if the pain has become great, which can further stress the body and aggravate pain, over-the-counter pain medication can be helpful.
  • Tens machine – if you have a specific muscle or muscle group causing persistent pain or pressure, using a Tens machine can help reduce muscle-related pain and pressure. It can also help diffuse the pain and pressure, so the nervous system stops engaging them.
  • Any type of stress reduction strategy – can reduce nervous system reactivity and muscle-related symptoms.
  • Talk with your doctor – if the shooting pains and pressures become too painful, talk with your doctor about a prescription pain reliever or muscle relaxant to help ease these types of symptoms when they are strong or greatly debilitating.

I (Jim Folk) had numerous chest-related symptoms, too, during my struggle with anxiety disorder. I also initially became overly concerned about my heart.

However, as I eliminated hyperstimulation, they completely subsided. I’ve not had the same number, intensity, and frequency of this symptom since.

Containment:

Once you have the medical evidence that proves your heart is healthy, you will need to develop the skill of containing your irrational fears about your chest and heart.

Learning to contain may take some work initially since most anxious people are notorious worriers, which demonstrates their inability to contain.

But developing the skill of containing will set you free from continually worrying about your chest and heart (containing will also set you free from needless worry). This is why containing is one of the Seven Principles to Overcoming Anxiety Disorder (in Chapter 7 in the Recovery Support area).

Remember, it’s our uncontained worry habit that undermines our health. Recovery, as well as lasting success, requires that we LEARN TO CONTAIN OUR FEARS RATHER THAN FUEL THEM.

Recovery Support

The Recovery Support area of our website contains thousands of pages of important self-help information to help individuals overcome anxiety disorder, hyperstimulation, and symptoms.

Due to the vast amount of information, including a private Discussion Forum, many of our Recovery Support members consider it their online recovery support group.

Therapy

Unidentified and unaddressed underlying factors cause issues with anxiety. As such, they are the primary reason why anxiety symptoms persist.

Addressing your underlying factors (Level Two recovery) is most important if you want lasting success.

Addressing Level Two recovery can help you:

  • Contain anxious behavior.
  • Become unafraid of anxiety symptoms and the strong feelings of anxiety.
  • End anxiety symptoms.
  • Successfully address the underlying factors that so often cause issues with anxiety.
  • End what can feel like out-of-control worry.

All our recommended anxiety therapists have had anxiety disorder and overcame it. Their personal experience with anxiety disorder and their Master's Degree and above professional training give them insight other therapists don't have.

If you want to achieve lasting success over anxiety disorder, any one of our recommended therapists would be a good choice.

Working with an experienced anxiety disorder therapist is the most effective way to treat anxiety disorder, especially if you have persistent symptoms and difficulty containing anxious behavior, such as worry [7][8][9].

In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.

Research has shown that therapy is the most effective treatment for anxiety disorder, and distance therapy (via phone or the Internet) is equally, if not more effective, than face-to-face in-person therapy [10][11][12].

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Prevalence

In an online poll we conducted, 78 percent of respondents said they had and worried about chest and heart-like symptoms because of their anxiety.

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 concerns about the heart and heart-related anxiety symptoms.

References

1. Chu, Brianna, et al. “Physiology, Stress Reaction.” StatPearls, 7 May 2024.

2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.

3. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018.

4. 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.

5. Z, Fatahi, et al. "Effect of acute and subchronic stress on electrical activity of basolateral amygdala neurons in conditioned place preference paradigm: An electrophysiological study." Behavioral Brain Research, 29 Sept. 2017.

6. 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.

7. 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.

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

9. 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.

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

11. Markowitz, John, et al. “Psychotherapy at a Distance.” Psychiatry Online, March 2021.

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