How To Tell Where Your Chest Pain Is Coming From
Heres a quick cheat sheet with the differences between anxiety chest pain and a heart attack.
- When: Anxiety chest pain happens most often when at rest, and heart attack chest pain often happens during activity. Anxiety chest pain tends to start and end faster. Heart attack chest pain builds up and continues to increase in pain .
- Where: Anxiety chest pain usually stays in the chest, while heart attack chest pain can radiate through to the arms, shoulders, and jaw .
- What: Anxiety chest pain often feels much sharper with reports of a stabbing-like pain, and heart attack chest pain usually feels more heavy, aching, and with squeezing pressure .
- Who: Anxiety disorders, including panic attacks, are more common in women and heart attacks are more common in men .
When To Call 911 For Chest Tightness
Unexplained chest tightness along with any of the following requires immediate medical attention:
· Burning feeling
- Gastrointestinal problems
- Psychological concerns
In the United States each year, more than 7 million people seek emergency care for chest pain. The vast majority of these cases are not caused by a heart or lung condition.
What Should I Do When Chest Pain Strikes
If you feel badly enough to wonder if youre having a heart attack, you should go to the emergency room.
Thats because there are no single defining characteristics that will tell you if youre having a heart attack, says, Gary Weeks, M.D., chief of cardiology at the Heart Institute at UW Medical Center â Northwest.
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What Else Can Cause Your Chest To Feel Tight
Causes of chest tightness run the gamut from the relatively benign like indigestion to a gallbladder attack to a potentially life-threatening heart attack or a pulmonary embolism , says Dr. Cazabon. Thats why its such a tricky diagnosis to make.
Why is chest tightness associated with so many ailments? The chest and upper abdomen are integrated from one nerve, explains Dr. Cazabon. The vagus nerve travels from the brain all the way to the gastrointestinal tract, but it just registers nonspecific pain. You need to know more of the story to zero in on a reason.
Panic Attack Or Heart Attack
The symptoms of a panic attack can overlap the symptoms of a heart attack, clinically termed myocardial infarction , making it difficult for a person to know which one may be occurring.6 People often go to the emergency room with chest pain believing they have a heart issue, but research shows that roughly 60% to 90% of ER patients with chest pain do not have a cardiac cause of the pain.
How does a panic attack feel different from a heart attack?
Unfortunately, says Una McCann, MD, professor of psychiatry and director of the Anxiety Disorders Program at Johns Hopkins School of Medicine, They can feel identical. People often are short of breath, feel dizzy, and can feel crushing chest pain. Somebody who is perfectly healthy, with great lungs, undergoing a panic attack can feel really, really short of breath. And then, of course, those symptoms feed on the panic so it builds exponentially to this enormous crescendo.
Dr. McCann explains that because of the many different ways that people experience symptoms of heart attacks and panic attacks, theres no way to know the cause of those symptoms on your own.
There are a variety of symptoms that people who are having myocardial infarctions experience or dont experience, so certainly if someone came in with a panic attack to an emergency room, they would undergo a full workup for an MI, no question, she says.
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Ways To Reduce Chest Pressure
When you are experiencing chest pressure and/or tightness, the key is to try to figure out the potential causes. Once you deem anxiety to be the cause of the symptom, the next goal is to stop it. See the following examples:
- Hyperventilation: Try to get your breathing under control by taking slower, deeper breaths and not trying to over-breathe or breathe too fast. When youre experiencing hyperventilation, you may feel as though youre not getting enough air, but hyperventilation occurs when you have expelled more CO2 than you make. So breathing more slowly helps to rebuild those CO2 levels.
- Bloating/Heartburn: If you can potentially reduce/prevent any gas, do so. You may also want to consider taking an antacid or drinking water, which may help with bloating or heartburn. Heartburn can be improved by eating more slowly, decreasing the amounts of spicy foods you consume, and staying upright for at least 30 minutes after eating. Also, avoid heartburn-inducing foods like peppermint, chocolate, coffee or caffeinated beverages, tomatoes, alcohol, and citrus fruits
- Muscle Strain: Be mindful of lifting or carrying items that are too heavy. Make sure to stretch and warm up your muscles before doing any strenuous activities.
These are only temporary fixes. Remember that your chest pressure and/or tightness is often related to some type of anxiety issue or anxiety disorder. That means that the only way to prevent the chest pressure from returning is to learn to manage your anxiety.
Tightness And Pain Radiating From The Stomach And Digestive System
Stomach and digestive system upset can present pain, shooting pain, radiating pain, pressure, fullness, tightness, and discomfort that can be felt in the chest area and may be perceived as heart-related, as well. Stomach and digestive symptoms are also common for stress and anxiety, and can emulate chest tightness, pressure, and pain.
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How Do I Relax My Chest Muscles
5 Stretches to Loosen Tight Chest Muscles Floor Chest Roll. Lie on the floor with a large foam roller under your shoulder blades, perpendicular to your body. Doorway Roll. Stand facing a wall to the right of a doorway. Doorway Stretch. Stand in a doorway and extend right arm down and at a 45-degree angle from your legs. Ball Stretch. Corner Stretch.
Can Anxiety Cause Chest Tightness
Panic disorder is a type of anxiety disorder in which people may frequently experience chest pain as a symptom during a panic attack. Panic attacks are described as periods of intense fear in which you might develop some of the following symptoms:
-
Difficulty regulating temperature
When a group of people described their worst panic attacks, over three-quarters mentioned chest tightness as a symptom.²
Experiencing chest tightness as part of a panic attack can cause further distress and worry. You may believe that youre having a heart attack, which can further lead to increased anxiety, fear, or panic.
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What Should You Do If You Experience Anxiety Chest Pain
Always seek medical care to get your chest pain checked out. Symptoms of anxiety/panic attacks and heart attacks overlap a bit. Its best to have yourself evaluated in the emergency room under the guidance of an experienced healthcare professional.
If you are diagnosed with anxiety chest pain or non-cardiac chest pain, seek professional healthcare to manage your anxiety. Treatments can include cognitive behavioral therapy to manage your anxiety and, if needed, medications .
Here are some steps to manage an anxiety attack or panic attack, even with chest pain :
- Breathe deeply, slowly, and steadily.
- Count to 10 and keep repeating until the feeling passes.
- Monitor your chest painanxiety chest pain doesnt last long compared to a heart attack .
- Focus on a calming favorite image while counting.
Those are useful, though temporary, fixes. While you may not reduce anxiety completely, lifestyle changes can help you reduce the severity of your physical symptoms of anxiety. Try these strategies to manage your anxiety :
- Eat rightIncrease your vegetables and decrease your sugar intake.
- ExerciseAim for at least 150 minutes a week. Bodily movement helps reduce anxiety.
- Get enough sleepMost people need at least 7 hours.
- Avoid alcohol or tobacco.
- Some people are sensitive to its effects.
Heart Attack First Heart Failure Second
One out of every four people who suffer a heart attack will eventually develop heart failure, according to a new study from a research team led by Dr. Johannes Gho, a cardiology resident at the University Medical Center Utrecht, in Utrecht, the Netherlands.
The research was presented at the World Congress on Acute Heart Failure.
Using data from 24,745 adults who experienced their first heart attack between 1998 and 2010, researchers found just under 25 percent of those patients had developed heart failure within four years.
Overall, researchers found for every 10 years in age a patient was, their risk of heart failure increased by 45 percent. Those in lower socioeconomic brackets also had a 27 percent higher risk factor for heart failure following a heart attack.
Some co-existing health conditions greatly increased a persons risk of heart failure, namely atrial fibrillation and diabetes.
Identifying these prognostic factors in heart attack patients could help us predict their risk of developing heart failure and allow us to give treatments to reduce that risk, Dr. Gho said in a press release.
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How To Hang On: Coping During A Pandemic
A poll conducted in mid-April 2020 by the Kaiser Family Foundation found that 56% of adults reported that worry and stress because of the pandemic has had a negative effect on their mental health.
Respondents reported adverse effects such as trouble sleeping, poor appetite or overeating, frequent headaches or stomachaches, difficulty in controlling their temper, or increasing alcohol/drug use, and worsening chronic conditions like diabetes or high blood pressure. This is up from 45% reporting that stress over coronavirus had negatively affected their mental health in a KFF poll conducted in late March 2020.9
Right now everybody has increased anxiety, whether youre healthy as a horse, whether you have a psychiatric illness, or not, says Dr. McCann.
Telemedicine can help by connecting people with their doctors, and video meeting apps provide a means to keep up a social life as we remain in our homes. More on how to access telemedicine.
Dr. McCann also suggests exercising together with friends via video chat to support social interaction, while Dr. Bhatia recommends practicing mindfulness to ease stress.
Symptoms that are related to anxiety/panic can improve with mindfulness-based breathing exercises, says Dr. Bhatia.10 More on this technique from Dr. Bhatia.
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Living And Coping With Anxiety
Learning to cope with and manage episodes of anxiety attacks is important to your well-being. You can control and decrease anxiety symptoms and frequency of recurrences by practicing slow, deep breathing and relaxing your chest and other muscles, or by other relaxation techniques.
The Relaxation Response is a powerful relaxation technique developed at Harvard Medical School that you can learn and use anytime necessary. Practice this technique so you can easily use it if you feel an impending attack or to reverse an attack. There are also other relaxation techniques that can reduce symptoms and improve your ability to cope.
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Treatment For Chest Tightness Caused By Anxiety
It is essential to identify chest tightness caused by anxiety and to differentiate it from other respiratory causes to provide appropriate treatment for the same. Treatment for chest tightness caused by anxiety includes:
Anxiety Chest Pain Vs Heart Attack
Anxiety chest pain is so alarming because we associate chest pain with heart attacks. And its fair to feel concernedabout 735,000 people in the U.S. have heart attacks each year, and chest pain is one of the common symptoms.
But studies show that 80% of people who go to the emergency room with chest pain are not having a heart attack, and 58% of that group suffer from moderate to severe anxiety.
Though pain related to a heart attack and anxiety chest pain can feel similar, there are several differences between the two that can help you determine which you may be experiencing.
For example, while anxiety chest pain can feel different from person to person, it tends to limit itself to just the chest.
Most people experiencing heart attack chest pain, on the other hand, explain it as a squeezing, heavy, and/or aching pain that radiates outwards from the chest to the arms, shoulders, and jaw .
There are also differences when it comes to when the pain starts, and how long it lasts.
Anxiety chest pain tends to start when the body is at rest, and, as previously mentioned, lasts for approximately 10 minutes .
Conversely, heart attack chest pain typically starts slowly when the body is active, and the pain gradually increases in intensity. Chest pain during a heart attack also tends to get worse with exertion and lasts longer than pain related to anxiety.
If you think you are experiencing a heart attack, seek medical attention as soon as possible.
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Recognition Of Panic Disorder In Patients With Chest Pain
Panic disorder often goes undiagnosed. In one study, none of the 26% of patients with panic disorder who presented to the emergency department with chest pain were correctly diagnosed.18 A similar study in a family practice setting found that only 4 of 26 patients with panic attacks were accurately identified, while 2 were diagnosed with CAD. However, twelve were recognized as having chest pain due to anxiety or stress.9 Because primary care physicians have been shown to be capable of differentiating between panic disorder and cardiac disease,80 failure to recognize panic disorder in patients seeking care for chest pain may be due to the variability of chest pain17,81 or its clustering with other symptoms during panic attacks.81,82 Are there patterns in the chest pain seen in patients with panic disorder that could facilitate recognition?
Characteristics of chest pain associated with panic disorder.
Some Possible Reasons Behind Chest Pain Due To Anxiety Are:
- Tachycardia in patients with panic disorders, tachycardia is seen. Tachycardia results in increased oxygen demands and less blood supply.
- Coronary Artery Disease a certain amount of co-relation was found to exist between panic disorder and coronary artery disease.
Researchers have raised a possibility that sudden attacks of anxiety can result in development of coronary artery disease through its relationship with cardiac risk factors. Asymptomatic Mitral Valve Prolapse in seen in nearly 10-20% patients having chest pain due to anxiety.
It has been observed in a large group of patients having chest pain due to anxiety that they are convinced that they have some major disease. Patients with anxiety disorders having chest pain are reportedly more distressed than patients who actually have a cardiac illness.
The complaint of chest pain compels patients to seek treatment for their anxiety. This is the reason why nearly 9% of patients having anxiety disorders seek cardiologists help for chest pain. Conversely, panic disorder can be noticed in patients having both cardiac and non-cardiac type of chest pain.
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What Does It Mean When My Chest Feels Tight
Does your chest feel tight and heavy and youre not sure why? Does your chest feel tight only at certain times of the day and not others? Are you concerned about whether its a medical problem? Having chest pains can be a concerning experience but it does not mean its a serious medical problem.
Most people experiencing chest pain assume they are having a heart attack. Many times after ruling out any medical explanations, if your chest feels tight, it may be related to anxiety or high levels of stress. Chest tightness is a symptom of anxiety along with others that may occur simultaneously.
The chest tightness can be located in one or a few spots in the chest area, or move all over the chest area. If you experience chest tightness it varies by the person how often it occurs. It could occur persistently, rarely, or frequently. Chest pain can feel sharp, dull, stabbing, piercing tightness or pain, and/or as persistent tightness, pressure, fullness, or numbness.
Sometimes chest tightness occurs on its own and other times it may follow or accompany episodes of anxiety, high stress, or fear. Occasionally, anxiety culminates into a panic attack, which can last for 10 to 20 minutes.
When It Is Panic Disorder: Treatment Options
When the cause of chest pain has been determined to be psychiatric rather than cardiac in nature, patients and their doctors can discuss treatment. It is important to know that panic attacks can occur with any type of anxiety disorderâthere are 5 in all:8
A person must have recurring panic attacks and be fearful of having another to the point where it interferes with their everyday life in order to be diagnosed with panic disorder. According to the American Psychiatric Association, 2% to 3% of US adults are diagnosed with panic disorder in a given year. Anxiety disorders affect women more than men.8
Dr. McCann says that it is possible for a person with no history of anxiety to develop panic disorder because of the stress of the coronavirus pandemic.
A person can develop panic disorder for the first time in the setting of COVID-19, she explains. However, there are specific criteria that must be met for it to be characterized as PD. In particular, symptoms need to be present for at least 1 month. People need to change their behaviors in maladaptive ways .
Both Dr. McCann and Dr. Bhatia emphasize that, even with a diagnosis of panic disorder, its possible for a patient to have cardiac or medical chest pain that should not be ignored.
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