Published on: 5/21/2025
Anxiety can cause chest pain by increasing muscle tension, creating a feeling of tightness or pressure in the chest, and making you more aware of normal bodily sensations.
When you are anxious, your body reacts by releasing stress hormones like adrenaline. This response can make your heart beat faster and cause your muscles, including those in your chest, to tense up. The increased tension and rapid breathing during anxiety or panic attacks can create a sensation of chest tightness or even pain. People with anxiety disorders might also be more sensitive to bodily sensations, meaning they notice even mild discomfort more than usual. This hypervigilance can make normal muscle strain or minor changes in your chest feel painful. Research has shown that anxiety is associated with changes in the way the coronary arteries function in some people, even when there is no blockage, which may contribute to a feeling of chest pain. In summary, anxiety-related chest pain is generally non-cardiac, meaning it is not typically caused by heart disease. However, because chest pain can be a sign of more serious conditions, it’s important to talk with your doctor if you have frequent or severe symptoms.
(References)
Sara JDS, Ahmad A, Toya T, Suarez Pardo L, Lerman LO, Lerman A. Anxiety Disorders Are Associated With Coronary Endothelial Dysfunction in Women With Chest Pain and Nonobstructive Coronary Artery Disease. J Am Heart Assoc. 2021 Sep 7;10(17):e021722. doi: 10.1161/JAHA.121.021722. Epub 2021 Aug 28. PMID: 34459240; PMCID: PMC8649259.
Carter CS, Servan-Schreiber D, Perlstein WM. Anxiety disorders and the syndrome of chest pain with normal coronary arteries: prevalence and pathophysiology. J Clin Psychiatry. 1997;58 Suppl 3:70-3; discussion 74-5. PMID: 9133495.
Hamel S, Denis I, Turcotte S, Fleet R, Archambault P, Dionne CE, Foldes-Busque G. Anxiety disorders in patients with noncardiac chest pain: association with health-related quality of life and chest pain severity. Health Qual Life Outcomes. 2022 Jan 10;20(1):7. doi: 10.1186/s12955-021-01912-8. PMID: 35012545; PMCID: PMC8751105.
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