Anxiety-Related Chest Pain: Symptoms, Causes, and Solutions
Chest pain, such as shooting pain, stabbing pains, persistent pain, chest pressures, fullness, and tension can be a terrifying anxiety symptom, especially if you fear it’s a heart problem. Having lived through and recovered from severe anxiety myself, I understand the fear it creates.
This guide explains what anxiety-related chest pain feels like, its main causes (including hyperventilation and costochondritis), evidence-based relief strategies, prevalence, and how to tell it apart from heart-related pain. Whether you’re experiencing a sudden panic attack or ongoing discomfort, these steps can help you find calm and clarity.
Key Takeaway: Anxiety, chronic stress, and hyperventilation can cause chest pain that mimics a heart attack but is manageable with breathing techniques, therapy, and lifestyle changes. Always seek medical care for new, severe, or persistent pain to rule out heart conditions.
Quick Summary / Fast Facts
- Common but alarming: Anxiety-related chest pain is frequent in panic disorder and chronic anxiety [4].
- Feels like: Tightness, sharp stabbing, burning, tingling, or pressure in the chest.
- Main triggers: Stress hormones [1], hyperventilation [2][3], muscle tension [5], posture [8], and esophageal spasms [6].
- Relief: Breathing techniques [17], grounding exercises [18], muscle relaxation [18], CBT [8], and posture correction [4].
- When to get help: Severe, persistent pain or pain radiating to arms/jaw/back requires urgent evaluation [9].
What Does Anxiety-Related Chest Pain Feel Like?
Anxiety-related chest pain, also called non-cardiac chest pain (NCCP), is common in anxiety disorders — especially panic disorder [4]. It may feel like:
- Constriction or heaviness: Tight, heavy pressure in the chest.
- Sharp or stabbing pains: Sudden, brief discomfort near the sternum.
- Burning or tingling: Sometimes spreading to arms or hands [3].
- Muscle spasms: Twitching or trembling in chest muscles.
- Squeezing with swallowing: Often linked to esophageal spasms [6].
- Dull ache in chest or back: Can be posture-related [8].
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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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.
Anxiety can cause chest pain through a mix of physical, psychological, and environmental factors:
- Stress Response: Fight-or-flight hormones tighten chest muscles [1].
- Hyperventilation: Low CO₂ causes muscle spasms, tingling, and tightness [2][3]. Hyperventilation affects 50–60% of panic disorder cases [4].
- Chronic Stress (Hyperstimulation): Keeps muscles tense and inflamed; may raise heart disease risk [5].
- Digestive Issues & Esophageal Spasm: Pain from reflux or spasms radiates to the chest — up to 20% of NCCP cases [6].
- Costochondritis: Inflammation in rib cartilage causes sharp pain — 10–30% of NCCP cases [7].
- Postural Strain: Slouching or tense shoulders stress chest and back muscles [8].
- Autonomic Nervous System Dysregulation: Causes irregular sensations perceived as pain [9].
- Psychological Amplification: Worry intensifies awareness of normal sensations [10].
- Chronic Pain Syndromes: Fibromyalgia or myofascial pain can include chest symptoms — 20–30% of cases [11].
- Environmental Triggers: Noise, crowds, heat, or cold can spark pain [12].
Other Factors
Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:
- Medication
- Recreational drugs
- Stimulants
- Sleep deprivation
- Fatigue
- Hyper and hypoventilation
- Low blood sugar
- Nutritional deficiencies
- Dehydration
- Hormone changes
- Pain
Select the relevant link for more information.
Who Is at Risk?
- Panic disorder: 50% experience chest pain [4].
- Women: Twice as likely as men to have panic-related chest pain [14].
- Comorbid conditions: Depression or PTSD increase risk [15].
Anxiety vs. Heart-Related Chest Pain
Seek emergency help if pain lasts for longer than 10 minutes, radiates, or is accompanied by nausea, cold sweats, fainting, or severe shortness of breath [9].
Distinguishing anxiety from heart issues is critical. This table compares key features:
Feature |
Anxiety Chest Pain |
Heart Attack Pain |
Quality |
Sharp, tight, stabbing, burning |
Heavy, squeezing, crushing |
Duration |
Often <10 minutes, may recur |
>10 minutes, persistent or worsening |
Location |
Chest-only, or with tingling in arms/hands |
Radiates to arms, jaw, shoulders, back |
Other Symptoms |
Dizziness, rapid heartbeat, air hunger |
Nausea, cold sweats, severe shortness of breath |
Common Triggers |
Stress, panic, hyperventilation, posture, eating |
Physical exertion, may occur at rest |
Risk Factors |
Younger age, no cardiac history |
Age >60, hypertension, diabetes, smoking |
Anxiety Tests
Relief Strategies for Anxiety-Related Chest Pain
Acute (Panic-Driven) Chest Pain
- Controlled breathing (4-4-6 pattern) [17]
- Grounding techniques [18]
- Progressive muscle relaxation [18]
- Cool compress [19]
- Soothing self-talk [10]
Chronic (Hyperstimulation-Related) Chest Pain
- Daily deep relaxation [8]
- Exercise (150 minutes/week) [8]
- Cognitive Behavioral Therapy (CBT) [8]
- Biofeedback training [19]
- Anti-inflammatory measures for costochondritis [7]
Prevention
Therapy
While breathing exercises, relaxation, and posture changes can relieve symptoms, lasting freedom from anxiety and anxiety-related chest pain usually requires therapy to address the root cause.
Therapy helps by:
- Changing anxious thought patterns that keep the stress response active [8].
- Building coping strategies for uncertainty, stress, and physical sensations [8].
- Desensitizing triggers like hyperventilation or health fears [8].
- Developing emotional regulation skills to prevent escalation into panic [8].
Effective options include:
- Cognitive Behavioral Therapy (CBT): The gold standard for anxiety disorders, proven to reduce both anxiety and physical symptoms like chest pain [8].
- Mindfulness-Based Stress Reduction (MBSR): Improves body awareness and reduces hyperarousal [19].
- Exposure therapy (when appropriate): Helps retrain your brain so chest sensations no longer signal danger.
- Trauma-focused therapy: Essential when PTSD or unresolved trauma fuels symptoms [15].
Why our therapists are different: Anxietycentre.com recommended therapists have personally experienced and fully overcome anxiety disorder. This lived experience gives them unique empathy and insight into what clients are going through. Combined with professional training, certifications, and many years of clinical experience, they not only understand the science of recovery but also the personal journey — offering both expertise and genuine understanding.
Bottom line: Therapy provides the tools to break the anxiety–chest pain cycle permanently — turning short-term relief into lasting recovery.
Frequently Asked Questions
Q: Can anxiety cause chest pain every day?
Yes. Chronic stress, or “hyperstimulation,” can keep chest muscles tense and inflamed for days or weeks at a time. Reducing stress and addressing the underlying anxiety can stop the cycle [8].
Q: How long does anxiety chest pain last?
If caused by a panic attack, it often fades in 10–20 minutes once the stress response ends. Chronic anxiety chest pain can last much longer until stress levels are reduced [4].
Q: Will anxiety chest pain go away on its own?
It might ease temporarily, but if the root anxiety isn’t addressed, symptoms may return. Therapy is the most reliable way to resolve it long-term [8].
Q: How can I tell if it’s anxiety or a heart problem?
Anxiety chest pain is often sharp or tight, sometimes with tingling, and may be triggered by stress or panic. Heart pain is usually heavy, squeezing, and can radiate to the arms, jaw, or back. If in doubt, seek urgent medical care [9].
Q: Is anxiety chest pain dangerous?
While anxiety chest pain itself isn’t life-threatening, the stress response can impact your health over time. Always get new or severe chest pain checked by a doctor to rule out heart issues [9].
Prevalence
In an online poll we conducted, 81 percent of respondents said they had chest pain and tightness symptoms due to anxiety. Studies estimate:
- 21–58% of NCCP patients in emergency settings have anxiety disorders [15].
- 50–60% of panic disorder patients experience hyperventilation-related chest pain [4].
- 10–30% linked to costochondritis [7].
- Up to 20% due to esophageal spasms [6].
- Women are twice as likely to experience panic-related chest pain [14].
Final Thoughts
Anxiety-related chest pain can be frightening — but it doesn’t have to control your life. By learning how it works, practicing proven relief strategies, and addressing the root cause through therapy, you can reduce symptoms and regain your sense of calm.
Outgrowing anxiety disorder is possible with the right information, help, effort, and support — and we’ve seen it happen for thousands of people. To begin your own recovery, visit our Recovery Support Area or explore our Anxiety Symptoms Guide.
Common Anxiety Symptoms
Additional Resources
- For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
- Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
- How to stop an anxiety attack and panic.
- Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
- Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.
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. Johns Hopkins Medicine. (2023). Anxiety and heart disease.
2. Lum, L. C. (1975). Hyperventilation: The tip of the iceberg. Journal of Psychosomatic Research, 19(5–6), 375–383.
3. Gardner, W. N. (1996). The pathophysiology of hyperventilation disorders. Chest, 109(2), 516–534.
4. Schwarz, J., Prandoni, J. R., & Winker, M. A. (2015). Prevalence of severe anxiety in chest pain patients. Critical Pathways in Cardiology, 14(4), 148–151.
5. Woodlands Heart and Vascular Institute. (2023). Anxiety and chest pain.
6. Mayo Clinic. (2024). Esophageal spasms: Causes and symptoms.
7. Cleveland Clinic. (2023). Costochondritis: Symptoms and treatment.
8. Healthline. (2025). Posture and musculoskeletal pain.
9. Panic Disorder and Chest Pain: Mechanisms, Morbidity, and Management. (2002). Primary Care Companion to the Journal of Clinical Psychiatry, 4(2), 54–62.
10. Kumar, Vijaya, et al. Somatosensory amplification, health anxiety, and alexithymia in generalized anxiety disorder. Industrial Psychiatry Journal.
11. VeryWell Health. (2025). Fibromyalgia and chest pain.
12. Patiala Heart. (2022). Environmental stressors and anxiety symptoms.
13. AnxietyCentre.com. (2023). Additional resources. https://www.anxietycentre.com/anxiety-disorders/symptoms/
14. Medical News Today. (2022). Chest pain and anxiety.
15. Musey, P. I., Oberfoell, S., Kline, J. A., & Russell, F. M. (2018). Anxiety about anxiety: A survey of emergency department provider beliefs and practices regarding anxiety-associated low risk chest pain. BMC Emergency Medicine, 18(1), 10.
16. Right as Rain by UW Medicine. (2018). Is your chest pain a heart attack or anxiety?
17. Healthline. (2025). Diaphragmatic breathing for anxiety.
18. Charlie Health. (2023). Grounding techniques for anxiety.
19. Zafeiri, Eleftheria, et al. Managing anxiety disorders with the neuro-biofeedback method of Brain Boy Universal Professional. Healthy Psychology Research.
20. Cleveland Clinic. (2023). Physical therapy for chronic pain.
21. Charlie Health. (2023). Social support for anxiety.
22. Schwarz, J., Prandoni, J. R., & Winker, M. A. (2015). GAD-7 scale in ED settings. Critical Pathways in Cardiology, 14(4), 148–151.
23. MEDvidi. (2024). Prevalence of panic disorder in chest pain patients.
24. Patiala Heart. (2022). Anxiety chest pain: Causes, symptoms, treatment.
25. Statistics Canada. (2015). Anxiety disorders.
26. Charlie Health. (2023). Health literacy and anxiety symptoms.