Can Stress Cause Heart Pain

Impact Of Anxiety Attacks

Anxiety attacks, or panic attacks, are episodes of intense fear and emotional distress. They usually strike suddenly and without warning. And they may last several minutes or up to an hour.

These attacks may have a discrete trigger. Sometimes, though, they occur without a known cause.

Anxiety attacks are often recurrent. They’re distressing to experience and concerning for friends and family who witness them.

When you’ve had panic attacks, it’s common to worry about having more. Attempts to avoid them can lead to extreme lifestyle changes.

You may find yourself avoiding situations or environments that have triggered previous episodes. You may also get in the habit of checking for escape routes you can take should anxiety strike.

Avoidance strategies can become extensive. At the extreme end is people who become housebound or otherwise withdraw from the world. This is called agoraphobia.

Anxiety attacks aren’t just intense fright, though. They can cause physical symptoms including:

• Severe dyspnea
• Abdominal cramping
• Chest pain

If Ive Had One Episode Of Broken Heart Syndrome Am I Likely To Have More

Most people dont. Only up to about 5% have more than one episode of broken heart syndrome.

A note from Cleveland Clinic

Its common to hear people talk about a heartache or a broken heart when they are talking about their emotions. Although its mostly meant in a figurative sense, broken heart syndrome is real! In fact, for many years, its been an under-recognized and misdiagnosed condition. Broken heart syndrome isnt limited to sudden emotional stressors sudden physical stress can cause it too.

The good news is that once its recognized, its a temporary condition that doesnt cause any permanent heart damage. However, because its symptoms mimic a heart attack, never try to self-diagnose and convince yourself that you have broken heart syndrome. Always get checked at an emergency care center. Only tests can determine if your heart symptoms are a heart attack, broken heart syndrome or some other health problem.

Last reviewed by a Cleveland Clinic medical professional on 02/10/2021.

References

Does Anxiety Cause Heart Palpitations

Anxious feelings engage your bodys fight-or-flight response. Fight-or-flight triggers a series of events in your body, including the release of certain hormones. Experts believe this response was helpful in ancient civilizations when humans had to fight or run from threats to survive.

Today, your fight-or-flight response works the same as it always has. It just doesnt know the difference between a grizzly bear attack or an upcoming work presentation. So those same hormones like adrenaline kick in to protect you.

The fight-or-flight response speeds up your heart rate, so your body gets more blood flow, explains Dr. Bibawy. The increased blood flow gives you a burst of energy to fight or run from danger. Thats why many people notice palpitations when theyre scared, nervous or anxious and its completely normal. It doesnt mean theres something wrong with your heart.

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Appetite Changes And Weight Gain

Changes in appetite are common during times of stress.

When you feel stressed out, you may find yourself with no appetite at all or overeating without noticing.

One small 2006 study of 272 female college students found that 81 percent reported that they experienced changes in appetite when they were stressed out, with 62 percent stating they had an increase in appetite .

Changes in appetite may also cause fluctuations in weight during stressful periods. For example, a study involving 1,355 people in the United States found that stress was associated with weight gain in adults already living with extra weight .

A third study from 2017 found that individuals with higher cortisol and insulin levels and higher levels of chronic stress were more likely to gain weight in the future . However, the study was limited in the scope of research in that participants were predominantly white females.

While these studies show an association between stress and changes in appetite or weight, more studies are needed to understand other possible factors are involved and how stress impacts different people.

How To Manage Stress And Reduce Your Heart Attack Risk

Reducing and managing stress through mindfulness, exercise, and hobbies is an important part of overall health, and it may improve cardiac health.

However, making lifestyle changes to reduce stress is extremely difficult for people. Because of that, Gilstrap recommends her patients take a realistic look at the stressors in their lives and adjust what they can, without worrying too much about whats out of their control.

Life is complicated and people have demands from a variety of places, Gilstrap says. Its about fixing the ones that can be fixed, building on that success, and empowering the patient to make even more positive change in that direction.

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Chest Pain Caused By Anxiety Or Panic Attacks

• Prognosis

Is it a heart attack or anxiety?

Chest pain is always alarming. Most of us associate it with cardiac conditions such as angina or myocardial infarction .

But chest pain can be caused by myriad conditions that have nothing to do with the heart. One common cause is an anxiety attack.

This article lays out the impact of anxiety attacks, how they cause chest pain, and what to expect when you see your healthcare provider with anxiety-related chest pain.

Verywell / Laura Porter

Can Anxiety Cause Chest Pain Every Day

The answer is unfortunately yes.

Its hard to believe that intense fear can cause such physical pain, sometimes constant pain, but until you relieve your extreme stress levels it may keep causing pain in your chest.

However:

In this case, you must get checked by your doctor to rule out any heart problem or other conditions that cause daily chest pain.

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When Palpitations Trigger Anxiety

Fight-or-flight isnt the only time heart rate and anxiety may overlap. Some people notice their heart speeding up or fluttering, which triggers fear or anxiety.

People who have an arrhythmia an abnormal heart rhythm might experience sudden palpitations, says Dr. Bibawy. They understandably get nervous because they dont know why these palpitations happen. The palpitations may cause anxiety, and anxiety causes more palpitations. This creates a cycle thats hard to break.

Anxiety And Heart Disease

The association between anxiety and heart disease has not been as fully studied as the relationship between depression and heart disease.

However, Una D McCann, M.D., director of the Anxiety Disorders Program at Johns Hopkins Bayview Medical Center, believes the connection is strong.

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Stress Can Cause Broken Heart Syndrome Which Feels Like A Heart Attack

One of the most dramatic ways stress can affect your heart is by causing takotsubo cardiomyopathy, also known as stress-induced cardiomyopathy or broken heart syndrome.

This feels just like a heart attack, with symptoms including chest pain and shortness of breath, but it is a different condition altogether, says Lauren Gilstrap, MD, a cardiologist at Dartmouth Hitchcock Medical Center.

Those symptoms come on suddenly, triggered by a stressful emotional event, such as the sudden death of a loved one. Its presentation isnt subtle, Gilstrap says. People think theyre having a heart attack.

However, thats not the case. A heart attack occurs when an artery to the heart is blocked. Takotsubo cardiomyopathy has no underlying blockages. Its exact causes arent known but are thought to be tied to a sudden hormonal surge from the bodys fight or flight response.

Takotsubo cardiomyopathy is a fundamentally different phenomenon than a heart attack, Gilstrap says. The arteries are completely fine and the blood supply is completely normal, but all of a sudden, the heart doesnt squeeze.

Takotsubo cardiomyopathy is most common in women aged 58 to 75, who make up more than 90% of cases. Doctors arent entirely sure why, but one study found that women experience higher rates of emotional stress. About 5% of women who think theyre having a heart attack are actually experiencing stress-induced cardiomyopathy.

Is My Chest Pain A Symptom Of Anxiety Or Covid

It can be scary experiencing chest pain or tightness, especially when the cause is not obvious. Many different conditions can cause chest pain including COVID-19 or anxiety.

Chest pain is a well-documented symptom of COVID-19, the respiratory disease that has spread to almost every country in the world since it was first discovered in 2019.

The Centers for Disease Control and Prevention lists persistent pain or pressure in your chest as an emergency symptom of COVID-19 that requires immediate medical attention.

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Anxiety can lead to changes in your body that cause the muscles around your chest to constrict. People who experience panic attacks often develop chest pain and other symptoms that can be similar to those of a heart attack.

Read on as we examine how you can determine if your chest pain is caused by anxiety, COVID-19, or another condition. We also compare the symptoms and typical treatments of each.

How anxiety causes chest pain

According to a 2017 criterion-standard study involving 965 randomly sampled patients across 15 U.S. primary care clinics, anxiety disorders affected about 1 in 5 participants.

Generalized anxiety disorder is characterized by excessive worrying about common situations and life events.

When you feel anxious, your body activates its fight or flight sympathetic nervous system. This causes changes in your body that lead to symptoms like:

• muscle tightness

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COVID-19

Anxiety

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Is Stress A Leading Cause Of Chronic Pain In The Body

Based on research studies, chronic pain does not just happen due to physical injury. It also happens because of stress.

Physical pain due to stress is most familiar with people who have experienced a severe level of trauma and even had Post-Traumatic Stress Disorder . These people are at higher risk of experiencing chronic pain.

What Are The Symptoms Of A Heart Attack

According to the US Centers for Disease Control and Prevention , the major symptoms of a heart attack are

We are especially wary of the shooting pain and pressure in the chest symptom. So, when unexpectedly you notice a shot of pain go across your rib cage, you go numb for a second. Could it be a heart attack? Relax, says an article by the Cleveland Clinic. Take a deep breath. Oftentimes, the situation isnt what you fear. Most chest pains may send alarm bells ringing in your mind, but dont conclude either way. Dont ignore it as Nothing to worry about! nor jump out of your skin with fright.Most chest pains are unlikely to signal a heart attack, reassures the Cleveland Clinic but walk the reader through those indicators and what they might mean with cardiologist Dr Curtis Rimmerman, MD.

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Chronic Stress Can Cause Heart Trouble Too

Initially, takotsubo cardiomyopathy was identified in patients who experienced sudden, extreme stress. But doctors now recognize that it can also occur in people who have more prolonged stressors such as a major project at work or relationship stress at home, Gilstrap says.

Chronic stress is also linked to heart disease in a number of ways. Experiencing chronic stress, including that from racial biases, poverty, or relationship troubles, increases your risk of hypertension, according to a 2013 study in Current Hypertension Reports. Hypertension is a major risk factor for heart disease.

Stress can also contribute to unhealthy habits like smoking, drinking or overeating, all of which are tied to adverse effects on heart health, according to the American Heart Association.

Other Lung Problems That Can Make Your Heart Hurt

Collapsed lung. Pneumothorax, or a collapsed lung, can cause sudden sharp pains that feel as if your heart is aching. According to Dr. Jaqueline Payne on Patient.info, a lung collapse can put pressure on the heart, causing stabbing pains on the left side of the chest.16

Pulmonary hypertension. Doctors from the Cleveland Clinic say that high blood pressure in the arteries that carry blood from the heart to the lungs can cause chest pain. This puts a lot of strain on the heart and can cause symptoms similar to those of angina.17

Pulmonary embolism. Doctors from the Mayo Clinic, say that a blood clot that gets into your lungs can cause your heart to hurt so much that it can feel like a heart attack. The chest pain in the heart area may get worse when you breathe. You may also have shortness of breath, cough up blood, and sweat excessively.18

To prevent complications from a pulmonary embolism, its important to reduce your risk of developing deep vein thrombosis.

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Stress And Heart Health

“In a person with a healthy cardiovascular system, this surge shouldn’t be a problem,” says Rami Doukky, MD, a cardiologist at Rush.

However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack.

The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat.

“There is no solid evidence that stress can directly cause a heart attack,” says Doukky. “However, chronic stress the kind of stress that’s due to ongoing situations like a bad relationship or difficult job can lead to risk factors that affect heart health.”

Chronic stress has been linked to overeating , poor sleep habits and tobacco and alcohol use practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes.For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says.

Stress And Silent Reflux

When stomach acids can flow all the way up to the throat, we talk about silent reflux .

Many people with LPR dont experience heartburn at all. The typical symptoms are:

• lump in throat
• hoarseness

According to Cleveland Clinic, being overstressed is one of the risk factors of silent reflux.

This study found that depression is also common in people with silent reflux: LPR was significantly more frequent in those with depression than in those without.

The study examined depression in people with silent reflux symptoms and not the other way around. This raises the question: can reflux cause stress?

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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.

What Anxiety Chest Pain Feels Like

Anxiety symptoms are rarely the same from person to person. Some days, symptoms arent even the same for the same person. Anxiety presents itself in a variety of ways, and that makes detecting or understanding symptoms difficult.

Chest pain associated with anxiety feels different for each person. Some people may experience chest pain on a gradual basis. For others, the pain may be sudden and unexpected. Anxiety chest pain can be described as:

• sharp, shooting pain
• an unusual muscle twitch or spasm in your chest
• burning, numbness, or a dull ache
• stabbing pressure
• chest tension or tightness

If you dont have a history of chest pain with anxiety, you may be alarmed. Many people assume theyre having a heart attack and go to the hospitals emergency department for treatment.

An estimated 25 to 50 percent of patients who come to the emergency department with low risk chest pain experience moderate to severe anxiety, according to 2018 research.

If you visit a hospital emergency room and the doctors dont find a specific cause for your chest pain, consider consulting with your doctor about other possible causes, including anxiety.

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What Are Heart Palpitations

When youre resting, you usually dont feel your heart beating, says Dr. Bibawy. When you can feel your heartbeat, youre having palpitations. Sometimes theyre expected, like after exercising. But other times, palpitations hit without warning.

You might feel palpitations in your chest, neck or throat, and they feel like your heart is:

• Fluttering.
• Skipping.

How To Stop Palpitations From Causing Anxiety

Nearly everyone faces an anxiety-provoking situation at some point. Maybe youre about to meet your future mother-in-law, or you have a performance evaluation at work. Whatever it is, there are some ways to help calm that fight-or-flight response and slow your heart rate:

• Start with breathing: When your heart speeds up, your breathing will, too. But you can hijack this process by taking control of your breath. Take slow, deep breaths in through the nose and out through the mouth. Do this at least 10 times, preferably for several minutes.
• Focus your mind: When your heart is racing, your mind might follow. Try focusing on an image, phrase or sound that makes you feel peaceful. Keep taking your slow, deep breaths as you meditate on this one thing. Tip: Do this even when youre not stressed to help with everyday well-being.
• Take a walk: If you can, go for a short walk. Down the hall is good, but outdoors in nature is even better. Dont make it too fast, or your heart wont have a chance to slow down.
• Hydrate: Dehydration can make palpitations worse. Have a glass of water or if youve been exercising heavily, try a sports drink with electrolytes. Avoid caffeinated drinks, which can trigger more anxiety and palpitations.

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