When You Need An Imaging Testand When You Dont
A stress test makes the heart work hard so your doctor can see if it is healthy. In a simple exercise stress test, you walk or jog on a treadmill. You are connected to an electrocardiogram , which measures your hearts electrical activity.
Some stress tests use imaging to take pictures of your heart while it is stressed. There are several kinds of imaging stress tests:
- An ultrasound test uses high-pitched sounds that bounce off the heart. Its called an echo test, or echocardiography.
- Another test uses a small amount of radioactive material, called a tracer. The tracer goes into the heart, and a camera takes pictures of it. This test is called a nuclear cardiology test.
In some cases, an imaging test can give your doctor useful information. But if you have a low risk for heart problems, you often dont need the imaging test even if you have chest pain. Heres why:
How To Tell The Difference Between Anxiety Chest Pain And Cardiac Chest Pain
There’s no guaranteed method of knowing whether or not chest pain is caused by anxiety or by a heart problem. But generally the two differ in their overall experience:
Anxiety Chest Pain
- Is usually more localized to a specific area.
- Closer to the middle of the chest, although not necessarily.
Cardiac Chest Pain
- Tends to radiate all around the shoulder and possibly the jaw.
- Tends to be a duller pain, like the heart is being crushed.
- Lasts longer than 10 minutes or more.
There are a lot of similarities between the two. Both may have lightheadedness or dizziness and feel like the heart is being squeezed. Both can make it harder to breathe . It’s not easy to tell the difference, but the differences are there. Furthermore, once you identify what anxiety chest pain feels like for you, in the moment, you may feel more reassured about what your symptoms are indicating .
What Are Anxiety Attacks
Anxiety attacks, also called panic attacks, are episodes of intense fear and emotional distress that usually occur suddenly and without warning, and typically last from several minutes up to an hour.
These attacks may have a discrete trigger, but they also can occur without any identifiable cause. Anxiety attacks are often recurrent and are very distressing to the people who experience them, as well as their loved ones.
People who have panic attacks typically spend a lot of time worrying about having more attacks and often make seemingly unreasonable lifestyle changes in an attempt to avoid circumstances that will trigger future attacks.
They may avoid situations that, they feel, have precipitated previous episodes or environments where they would not be able to escape easily if another attack should occur.
These avoidance adaptations can become quite extensive to the point where a person who suffers from panic attacks can become nearly housebound or otherwise withdraws from normal life experiences. These individuals are said to suffer from agoraphobia.
In addition to an intense feeling of fright, anxiety attacks also commonly produce real physical symptoms. These often include:
- Severe dyspnea
- Abdominal cramping
During an anxiety attack, tachycardia and tachypnea also are often present.
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What Causes Chest Tightness
There is no exact explanation of what causes chest tightness in anxiety sufferers. Nevertheless, it is advised to seek a primary care provider immediately for any sudden or worsening chest pain in order to rule out possible cardiac disease.
Do not by any means feel as if you are bothering anyone when you seek help for chest pain. Once serious health conditions are ruled out, you can begin to tackle your anxiety-induced chest pain.
Rest assured that anxiety can commonly cause chest tightness and chest pain for a variety of reasons. These include:
Chest tightness most often occurs right before or during an anxiety attack. It may also present spontaneously with no anxiety at all in what is known as a limited-symptom panic attack.
Rest assured that chest discomfort caused by anxiety is usually harmless.
Anxiety Chest Pain Vs Heart Attack Chest Pain
Chest pain is a concerning symptom, and its usually best to seek emergency medical attention if youre experiencing it. Even if the chest pain cause is anxiety, its better to know than to risk missing valuable time if youre having a heart attack.
People describe chest pain in a number of ways when theyre having a heart attack. Some examples include:
- chest pain that radiates to other parts of your body, such as down your arms or up to your jaw
- chest pain that worsens with exertion
- nausea along with chest pain
- pressure in the chest, as if someone has put something heavy on your chest
- rapid heart rate
- shortness of breath
- squeezing sensation in the chest
An estimated 30 percent of patients who are having a heart attack dont have chest pain, according to 2020 research. Some people report symptoms like back pain and fatigue as part of their heart attack symptoms.
While doctors know there is a connection between anxiety and chest pain, you still shouldnt ignore your symptoms and seek medical attention.
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How Do I Relieve Chest Pain Felt During A Panic Attack
When someone has a panic attack, chest pain is a common and frightening symptom. It can be so severe, and accompanied by palpitations, difficulty breathing and other physical symptoms of panic attacks, that it makes a person feel as though they are having a heart attack where they worry that they are going to die. Often, it is stress that causes the chest pain.
Signs And Symptoms Of Angina
You may feel pressure, squeezing, burning, or tightness in your chest. You may also have pressure, squeezing, burning, or tightness in your arms, shoulders, neck, jaw, throat, or back.
Some people may have different symptoms, including shortness of breath, fatigue, weakness, and back, arm, or neck pain. This applies particularly to women, older people, and people with diabetes.
You may also have indigestion or be sick to your stomach. You may feel tired. You may be short of breath, sweaty, lightheaded, or weak.
Some people have angina when they are exposed to cold weather. People also feel it during physical activity. Examples are climbing stairs, walking uphill, lifting something heavy, or having sex.
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Broken Heart Syndrome Causes
Itâs thought that when you have broken heart syndrome, your body releases stress hormones that temporarily curb your heartâs ability to pump as well as it should, and a part of your heart called the left ventricle temporarily weakens and stops pumping well. Experts also believe that your coronary arteries, which feed oxygen to your heart muscle, spasm. This can cause chest pain. The momentary “freezing” or “stunning” of your heart can bring circulation problems.
If broken heart syndrome is not treated, it can be as deadly as a heart attack.
When Anxiety Attacks The Body: Physical Symptoms
In some cases, heightened levels of anxiety can cause chest pain to develop. Anxiety is the bodys reaction to a perceived threat, explains Richa Bhatia, MD, FAPA, of the Anxiety and Depression Association of America.
When people are anxious, their blood supply to different parts of the body can be decreased because the body is in a fight-or-flight response and more blood is directed to the muscles, she says. Dr. Bhatia adds that people in a state of heightened anxiety often hyperventilate and breathe in a shallow manner, which can cause dizziness or chest tightness.
What a Panic Attack Feels Like
Experiencing chest pain because of anxiety can be one of the symptoms of a panic attack, which is defined as a feeling of sudden, intense fear and the severe onset of four or more of these symptoms:4
- chest pain
- numbness and tingling
- fear of going crazy or of losing control.
A panic attack can happen when a person is feeling anxious, or it can occur out of the blue. The symptoms described above tend to last for roughly 10 minutes before fading. It is possible to have several panic attacks within a number of hours, which can feel like the attacks are coming in waves. Some people experience panic attacks daily or weekly. A milder variation of panic attacks, known as limited-symptom attacks, feature three or fewer of the symptoms listed above.5
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Natural Treatments And Prevention
1. Quit smoking, especially when your chest pains are related to heart disease or lung disease. Smoking is the leading cause of heart disease and heart attacks. But, when you quit smoking, within 24 hours your risk for a cardiac event starts to decline. And, it just takes nine months for your lungs to heal significantly.
The healing continues and at five years smoke-free, your arteries and blood vessels start to widen again, lowering your risk for clots and a stroke. After 10 years of being smoke-free, your chance of lung cancer is half. And finally, 20 years after your last cigarette, your risk of coronary heart disease is the same as a nonsmoker.
2. Eat for your health. When your chest pains are caused by heart conditions, it is vital that you start following a diet that focuses on heart-healthy foods that help to reduce cholesterol levels and lower your blood pressure. Following a high-blood pressure diet may help to relieve your symptoms and start the healing process.
Central to your diet should be lean proteins like wild-caught salmon and free-range poultry and plenty of fiber-rich foods like oats, leafy green vegetables like kale, sprouted whole grains, artichokes, raspberries, split peas and apples and pears with their skins.
3. Exercise daily: With your physicians approval, exercise daily to help reduce stress, lower blood pressure, improve heart health, and to lose excess weight.
Manage Other Health Conditions
Its important to work with your medical doctor to make sure that other conditions such as asthma are properly managed. Your doctor may also be able to give you resources to help you quit smoking, for example, as well as to manage conditions like GAD. As mentioned above, your medical doctor can help you distinguish serious symptoms from less dangerous ones, so you dont get worked up over anything
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Relief For Chest Pain Caused By A Panic Attack
During a panic attack, the following strategies can help you to manage the symptoms:
- Focus on controlling your breathing breathe in slowly and deeply through your nose for three seconds, hold for two seconds and breathe out for three seconds. You may want to close your eyes to help you focus. By concentrating on your body and your breathing, you can break the panic cycle, calm your hyperventilation and reduce your chest pain
- Remind yourself that this moment will pass panic attacks can be incredibly frightening to experience. There are occasions where some may experience anxiety chest pain all day, but when you are having a panic attack, try to repeat a positive phrase such as: I know this is a panic attack and I know it will pass. This can serve as a reminder that the moment will disappear just as it appeared. Recognising the transience of a panic attack can help to lessen the worry caused by the symptoms, helping the panic attack to subside
- Refocus when you feel a panic attack start to pass, begin to focus on your surroundings rather than on the experience. Think carefully about what you can see, hear, taste, smell and touch. You may also want to hone in on a particular object, and think carefully about its shape, colour and size
There are also preventative measures you can take to avoid panic attacks, which include the following:
What Treatments Are Available For People With Chest Pain
Treatment for chest pain depends on the cause of the pain. If your chest pain is caused by a heart attack, you will get emergency treatment as soon as you seek help. This can include medication and a procedure or surgery to restore blood flow to your heart. If your chest pain is caused by a non-cardiac condition, your healthcare provider will talk to you about treatment options.
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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.
Imaging Stress Tests Have Risks
Imaging stress tests are usually safe and can use little or no radiation. But for people at low risk, the tests may produce false alarms. This can lead to follow-up tests that you dont really need. The extra tests can expose you to more radiation. Inappropriate testing can also lead to unnecessary treatment.
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Utilization Of Medical Services And Functional Morbidity In Panic Disorder
Patients with PD can have extreme anxiety and frequent somatic symptoms as a result of recurrent panic attacks. These patients frequently visit primary care offices and emergency departments with symptoms of their undiagnosed and untreated PD and have difficulties maintaining employment or relationships given the disabling nature of their symptoms. Low rates of physician recognition and treatment of PD can perpetuate high medical service utilization and result in continued functional disability. At least 35% of patients with PD view their physical and emotional health as fair or poor this fact is remarkable given that these patients are frequently young and otherwise healthy.
How Does Sudden Stress Lead To Heart Muscle Weakness
When you experience a stressful event, your body produces hormones and proteins such as adrenaline and noradrenaline that are meant to help cope with the stress.
The heart muscle can be overwhelmed by a massive amount of adrenaline that is suddenly produced in response to stress. Excess adrenaline can cause narrowing of the small arteries that supply the heart with blood, causing a temporary decrease in blood flow to the heart.
Alternatively, the adrenaline may bind to the heart cells directly, causing large amounts of calcium to enter the cells. This large intake of calcium can prevent the heart cells from beating properly. It appears that adrenalines effects on the heart during broken heart syndrome are temporary and completely reversible the heart typically recovers fully within days or weeks.
What should I do if I feel the symptoms of broken heart syndrome?
If you experience heart-attack-like symptoms, call 911 immediately. If your symptoms are mild, please contact your doctor immediately.
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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.
How To Manage Chest Pains Caused By Anxiety
When dealing with chest pains caused by anxiety it is important to be aware of the triggers that are causing you to be anxious. People who experience chest pains and acid reflux often have had recurrent exposure to triggers, resulting in the muscle tension and an increase in stomach activity. Once you are aware of your triggers it is important to take measures to prepare for exposure to the triggers. Counseling can help with learning coping strategies to manage triggers. Two common forms of therapy that help reduce anxiety and relieve the experience of chest pain are:
- Cognitive behavioral therapy is a form of therapy that will help teach you how to handle your triggers through rationalizing and challenging negative thoughts that trigger the stress reaction. Cognitive behavioral therapy pinpoints the harmful effects of negative thoughts on your emotions and behavior. The skills learned in cognitive behavioral therapy will help you experience less anxiety when confronted by a trigger, which will diminish the emotional response. This will lessen the intensity of chest pains caused by anxiety.
- Dialectical behavioral therapy is a form of therapy that teaches distress tolerance skills. With dialectical behavioral therapy you will learn how to cope with high stress situations, how to handle a crisis, and how to use deep breathing, meditation, and mindfulness exercises to relieve anxiety caused by triggers and chronic stress.
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