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Experiencing a sudden wave of chest pain can feel alarming, even anxiety-inducing. If you’ve ever worried you might be having a heart attack or other heart problem during an anxiety or panic attack, you’re not alone.

Chest pain may happen as a symptom of potentially life threatening medical events like heart attacks, but it can also occur as a symptom of anxiety in people with no heart conditions.

A coronary artery spasm is another potential (though somewhat rare) cause of chest pain. It has a complex relationship with anxiety. Coronary artery spasms can result from anxiety, but they can also cause it.

You can learn more about this link and how to tell the difference between chest pain caused by anxiety and other heart conditions.

A coronary artery spasm is a temporary tightening of an artery wall. This tightening constricts blood flow through that artery and causes a type of chest pain called angina, which occurs when the heart doesn’t get adequate blood flow.

Coronary artery spasms may be responsible for about half of all angina cases.

A 2019 population-based study found that coronary artery spasms are uncommon, with just under 0.01% of the general population experiencing one. People over age 50 may have a higher risk of experiencing a coronary artery spasm.

You also have a higher risk if you live with:

Specific factors that may also trigger a coronary artery spasm include:

While coronary artery spasms often cause severe chest pain, they can also occur without symptoms. Sometimes they lead to a condition called cardiac ischemia, which can cause heart attacks.

Both anxiety and depression can increase your likelihood of experiencing a coronary artery spasm. While anxiety is linked to a higher risk, its role in causing coronary artery spasms remains somewhat unclear.


It is relatively rare for people with anxiety to have a coronary artery spasm, even though they may have a higher chance of experiencing it. It is possible that occasional anxiety is less likely to cause a heart attack.

What’s more, anxiety, panic attacks, and Stress. — sudden, extreme Stress. as well as chronic Stress. — can all trigger coronary artery spasms.

Research suggests a few potential reasons Stress. and anxiety may cause them:

  • When anxiety activates the sympathetic nervous system, it can set off a chain reaction in the body that leads to coronary artery spasms.
  • Anxiety may increase inflammation and oxidative Stress. and lead to coronary artery spasms.
  • High blood Pressure. caused by chronic Stress. may also bring on coronary artery spasms.

Two kinds of coronary artery spasms exist: obstructive, which involves plaque buildup, and non-obstructive, which does not involve plaque buildup.

Anxiety is more strongly linked with non-obstructive chest pain than obstructive pain. In other words, anxiety-induced chest pain doesn’t necessarily mean you have heart disease.

The main symptom of a heart attack is chest pain. This pain might be very bad.

  • Pressure.
  • tightness
  • squeezing
  • There is more than enough.

The pain may spread to other parts of your body.

The coronary arteries might have spasms.

They often happen when you’re at rest during the middle of the night and early morning, or with exercise first thing in the morning. A coronary artery spasm might last anywhere from several seconds to 15 minutes.

It is not always easy to tell if you are having a coronary artery spasm due to anxiety or another underlying condition.

The signs of a heart attack are obvious.

The pain associated with heart attacks tends to occur in specific regions of the body. It’s best to seek emergency care if you experience severe pain in:

It is a good idea to get medical attention for persistent or severe illnesses.

Just keep in mind that anxiety and panic attacks can also cause these physical symptoms.

Are you worried about what your chest pain could mean? It may be helpful to consider the following.

  • Do you have a history of anxiety?
  • Do you live with risk factors of heart attacks?
  • Have you ever had chest pain that was linked to anxiety, and have a healthcare professional ever linked it to that?

If you are under 30 years old, your chances of having a heart attack are fairly low.

All the same, if you have any doubts over whether your chest pain relates to anxiety or a heart attack, the safest option involves checking in with a doctor or seeking emergency care. When it comes to a potential heart attack, erring on the side of caution could save your life — and it’s OK to be wrong.

Chest pain doesn’t always suggest a heart attack

Sometimes a heart attack can be caused by Coronary artery spasms. These heart attacks can be caused by anxiety.

“In many cases, chest pain doesn’t mean a heart attack.”

  • Anywhere from 22% to over 70% of panic attacks may involve chest pain.
  • About 1 in 3 people who seek medical treatment for chest pain live with panic disorder.
  • Up to 80% of people who report to the emergency room with chest pain aren’t having a heart-related health emergency.

If you think your chest pain is related to anxiety, you can take steps to ease it in the moment, and lower your chances of experiencing it again in the future.

What you can do in the moment

These solutions could help you in a panic.

  • Practice deep breathing: Deep breathing, sometimes called belly breathing, may ease chest pain caused by panic because it can help relax your chest muscles and stop Hyperventilation., which can make the pain worse.
  • Mindfulness: Mindfulness-enhancing exercises, including meditation, progressive muscle relaxation, and mindfulness-based Stress. reduction, could help you disconnect from thoughts that increase anxiety and chest pain and ground yourself in the present moment, according to a 2017 research review.
  • Try mantras: A 2018 review of studies on meditation involving mantras found that mantra meditation helped reduce anxiety and Stress. for many people who tried it, although more high quality studies are needed to confirm its effectiveness.

Here you can find more anxiety management techniques.

Long-term solutions

If you know you are likely to experience anxiety-inducing chest pain and you have already ruled out any other medical conditions, these strategies could help.

  • Physical activity: Exercise can help you manage anxiety, and it can also reduce your risk of developing heart disease, which may also help reduce anxiety. Research suggests the increased heart rate and sweating during exercise may also help your body adjust to these feelings, reducing your chances of experiencing a panic spiral due to a higher heart rate.
  • Therapy: According to 2015 research, therapy approaches like cognitive behavioral therapy (CBT) could help manage anxiety-induced chest pain.
  • Medication: A psychiatrist might recommend medications like selective serotonin reuptake inhibitors (SSRIs) to help treat ongoing anxiety symptoms. They may also recommend a benzodiazepine for short-term use, while waiting for the SSRI to take effect, or occasional treatment of panic attacks. Benzodiazepines typically are not recommended for long-term treatment.

If you regularly experience episodes of chest pain that seem to be linked to anxiety, depression, or Stress., therapy could be beneficial. A therapist can help you work on managing emotional symptoms, which could help reduce your pain over time.

If you have anxiety or have panic attacks, you might experience chest pain as a symptom of anxiety, and it can be added to by unexplained chest pain.

It may help to know that in many cases, chest pain relates to anxiety, not a coronary artery spasm or heart attack. In-the-moment coping skills, like deep breathing and grounding techniques, may help ease feelings of anxiety and soothe physical symptoms like chest pain and nausea.

But when anxiety management techniques don’t seem to relieve chest pain, an irregular heartbeat, or nausea after about 20 minutes, it’s a good idea to get medical attention right away.

“A writer namedCourtney Telloian has work published on Healthline, Psych Central, and Insider. She worked on the editorial teams of GoodTherapy and Psych Central. Her areas of interest include mental health and women’s health.”