Chest Pain in Panic Attacks

By Eileen Bailey

Chest pains are frequently a part of anxiety attacks. The Diagnostic and Statistical Manual (DSM-IV) lists chest pains as a symptom of panic disorder and is common in other types of anxiety disorders as well.

Chest pains, as a part of anxiety, are not normally considered to be dangerous. But chest pains can also signal a heart attack and require immediate medical care. For someone experiencing a sudden panic attack, complete with chest pains, it may be difficult to know the difference and to know whether or not to seek medical care.

What is Chest Pain?

Chest pain or discomfort occurs between the neck and the upper abdomen and is located in the front of the body. It can be caused by both serious and benign reasons. There are a number of organs and tissues in the chest area that can cause pain or discomfort in addition to the heart. The lungs and esophagus as well as the ribs, various muscles and tendons which can become inflamed due to illness or injury and cause pain.

Typical vs. Atypical Chest Pain

Chest pains are often seen as either 'typical" or "atypical". Typical chest pains are "a painful sensation in the breast accompanied by a strangling sensation, anxiety and occasional radiation of pain to the left arm." [1] All other chest pains are classified as atypical. Typical chest pains are considered to be closely associated with cardiac problems. Atypical chest pains, however, are not always specific. Sometimes people have atypical chest pains from severe cardiac problems. Other times, atypical pains can significant a less serious problem.

When to Seek Medical Attention

Heart attacks can begin suddenly and leave little doubt that someone is having a heart attack and requires immediate medical attention. Some heart attacks, however, begin much slower, with pressure and pain building up, leaving someone wondering if they are having a heart attack or if something else may be happening.

According to the American Heart Association [2], the following are warning signs of a heart attack and all signal a reason to seek immediate medical attention:

  • Chest discomfort: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain

  • Discomfort in other areas of the upper body: Symptoms can include pain or discomfort in on or both arms, the back, neck, jaw or stomach.

  • Shortness of breath with or without chest discomfort.

  • Other signs may include breaking out in a cold sweat, nausea or lightheadedness.

For any of these signs, call 911 to receive immediate medical care. The sooner a heart attack is treated, the better chance of a full recovery.

Chest Pain in an Anxiety Attack

During a panic or anxiety attack, adrenaline levels rise, breathing becomes faster and the heart beats quicker. These are all the result of the "fight or flight" response to a situation that is part of a panic attack. These symptoms can bring about chest pain, making someone experiencing a panic attack believe they are having a heart attack.

The best way to avoid a panic attack is to seek treatment. Treatment for panic attacks often involves medication and cognitive-behavioral therapy. In addition, there are some things you can do to help reduce anxiety and panic attacks:

  1. See a doctor to determine if your symptoms are not caused by any physical illness or injury. If you experience chest pains, it is important to rule out any heart disease or condition that may be contributing to your pain or discomfort.

  2. Eat a healthy diet.

  3. Incorporate exercise into your daily routines. Experts agree that daily exercise helps to reduce anxiety symptoms.

  4. Learn relaxation techniques and strategies such as deep breathing or meditation to help you relax and reduce a panic attack.

If your anxiety symptoms are stopping you from doing what you want to do, limiting your activities or interfering with your daily life, contact your doctor or another medical professional. Anxiety is a treatable condition and many people with anxiety live healthy, happy and satisfying lives.


Treatment of Panic Disorder, Peter Ham, M.D., David B. Waters, PhD, M. Norman Oliver, M.D., 2005, American Academy of Family Physicians

[1] Values and Limitations of Chest Pain History in the Evaluation of Patients With Suspected Acute Coronary Syndromes, Clifford J. Swap, M.D., John T. Nagurney M.D. MPH, 2005, Nov 23, Journal of the American Medical Association

[2] Heart Attack, Stroke and Cardiac Arrest Warning Signs, 2008, American Heart Association