Chest pain caused by anxiety is a common symptom that many people experience. Anxiety chest pain can be frightening, but it is not dangerous. Understanding the typical duration of anxiety chest pain can provide relief and help distinguish it from more serious causes of chest pain.
What causes chest pain with anxiety?
Anxiety chest pain is caused by the body’s natural stress response. When someone is feeling anxious or having a panic attack, their body goes into fight-or-flight mode. This triggers the release of stress hormones like cortisol and adrenaline. It also causes rapid breathing and increased heart rate and blood pressure.
The stress response prepares the body to respond to immediate physical threats. But with anxiety, there is no real physical danger. The changes that happen are out of proportion to the actual risk.
As part of the stress response, the muscles tense up, including those in the chest area. This muscle tension can lead to chest tightness, pressure, and pain. The rapid breathing of anxiety also causes chest symptoms. And people experiencing anxiety and panic attacks often become very focused on physical sensations, which makes the chest pain feel more intense.
How long does an anxiety attack last?
An anxiety or panic attack typically reaches its peak within 10 minutes. Most anxiety attacks last for 20 to 30 minutes, though they can sometimes be shorter or longer. The average duration is around 25 minutes.
After an attack peaks, symptoms usually start to subside over the next few minutes. Chest pain and other physical symptoms fade as the body’s stress response calms down and cortisol/adrenaline levels decrease. However, it’s common for some mild anxiety and unease to linger for several hours after an attack.
How long does anxiety chest pain last?
Since chest pain is one of the primary symptoms of anxiety attacks, its duration is similar. The chest pain usually lasts for 10 to 30 minutes as the attack runs its course. Some people may only have chest discomfort for a few minutes at the peak of anxiety.
In rare cases, anxiety chest pain can come and go over a longer period, like several hours. This can happen with very high anxiety or panic disorder. After the main anxiety attack ends, some residual chest discomfort might fade in and out as anxiety remains high.
Average and range of anxiety chest pain duration
| Duration | Timeframe |
|---|---|
| Average duration | 10 to 30 minutes |
| Peak intensity | Around 10 minutes |
| Range | 2 minutes to a few hours |
Does the duration of chest pain indicate a heart problem?
Chest pain lasting only a few minutes is very unlikely to indicate a heart problem like a heart attack. Angina or heart attack chest pain usually lasts for several minutes to hours.
According to the American Heart Association, heart-related chest pain that comes and goes in less than 5 minutes is not characteristic of heart disease. Angina pain typically lasts for 2-10 minutes before subsiding. And heart attack chest pain persists for 30 minutes or longer before improvement.
So when chest pain only lasts for the short timeframe of an anxiety attack, it is very unlikely to signify a physical heart issue. The less than 30 minute duration is a useful way to help differentiate the chest pain of anxiety from more serious causes.
Anxiety chest pain vs. heart attack or angina
There are some key differences between anxiety chest pain and heart-related chest pain:
Duration
– Anxiety chest pain: Usually less than 30 minutes
– Heart attack pain: Persists for 30 minutes or longer
– Angina pain: Lasts 2-10 minutes
Onset
– Anxiety chest pain: Comes on suddenly and peaks quickly
– Heart attack pain: Symptoms start slowly and intensify
– Angina pain: Comes on gradually, often triggered by activity
Location
– Anxiety chest pain: Usually more generalized chest tightness and pressure
– Heart attack pain: Tends to feel like pressure, tightness, or squeezing on the left side, but can be variable
– Angina pain: Often occurs in center of chest or left side
Context
– Anxiety chest pain: Associated with a period of high anxiety, panic attack, or stressful event
– Heart attack pain: Not usually related to obvious anxiety or stress
– Angina pain: Often occurs with exertion or exercise
Cause
– Anxiety chest pain: Caused by muscle tension, rapid breathing, and anxiety arousal
– Heart attack pain: Caused by blocked heart artery limiting oxygen to the heart muscle
– Angina pain: Caused by inadequate blood and oxygen supply to the heart
Risk factors
– Anxiety chest pain: More likely with history of anxiety, panic attacks, or high stress
– Heart attack pain: Associated with traditional cardiac risk factors like smoking, high cholesterol, obesity, etc.
– Angina pain: More common with risk factors like coronary artery disease, high blood pressure, diabetes, etc.
Other tips for distinguishing anxiety vs. heart chest pain
- Anxiety chest pain often involves tingling or numbness in the arms, fingers or hands. Heart pain usually doesn’t cause these symptoms.
- Anxiety pain is relieved by anti-anxiety medication or supplements. Heart chest pain will not resolve with anti-anxiety management.
- Heart attack pain may be associated with other symptoms like shortness of breath, sweating, or nausea. Anxiety doesn’t usually cause these additional symptoms.
- Changing positions does not affect anxiety chest pain but can sometimes relieve pain from angina.
- Heart problems are very unlikely in younger people with good cardiovascular health. Anxiety can cause chest pain in anyone.
- Feelings of doom, derealization, or detachment point more to anxiety than heart conditions.
Why does anxiety chest pain sometimes come and go?
In some cases, anxiety chest pain can last longer or reoccur during a period of high stress. This often happens when someone has very severe anxiety or panic disorder. It can also occur with long-lasting panic attacks, which are sustained high anxiety episodes lasting several hours.
The chest pain may briefly fade between anxiety spikes and then reappear as the surge of adrenaline resumes. So the pain seems to come and go based on your anxiety levels.
The chest discomfort may also linger at lower intensity after the initial anxiety attack peak passes. Any subsequent worry about the pain can provoke more anxiety and muscle tension, recreating the chest symptoms.
How long should you wait and watch anxiety chest pain?
It’s advisable to have any recurring, persistent, or worsening chest pain evaluated by a doctor. This is the safest approach.
But in general, anxiety-related chest discomfort that comes and goes but only lasts up to 30 minutes during any single episode is less concerning. If you have been evaluated for heart problems in the past and they were ruled out, this pattern likely represents anxiety.
A good guideline is to wait 1 full hour from the start of chest pain to see if it resolves or changes. If the pain lasts longer than 1 hour, recurs at the same intensity, or becomes more severe, then medical evaluation is recommended.
If the chest pain clearly starts to improve within an hour or less, it is less likely to indicate any serious heart conditions.
How long should anxiety chest pain last before seeking emergency care?
It’s always best to err on the side of caution with chest pain. Calling 911 or seeking emergency care is recommended if:
- The chest pain or pressure is severe.
- The chest pain does not begin to diminish at all after 30 minutes.
- The chest pain is accompanied by shortness of breath, sweating, nausea or pain radiating down an arm.
- You have risk factors for heart disease like smoking, obesity, high blood pressure, etc.
- You have a family history of early heart disease or heart attacks.
- The anxiety attack and chest pain feel clearly different from your normal anxiety episodes.
- You are over age 50.
For high-risk individuals or very atypical presentations, it’s recommended to seek medical care for chest symptoms lasting more than 15 to 20 minutes. Call 911 immediately for severe chest pain or pressure.
For most people under 50 with no risk factors and typical anxiety symptoms, chest discomfort from anxiety will usually resolve within 30 minutes. Seeking emergency care is less urgent if that resolution timeframe is met.
How to stop anxiety chest pain
Anxiety chest pain can be scary in the moment. But there are things you can do to help relieve it:
Deep breathing
Deep, slow breathing from the diaphragm can help lower anxiety and chest discomfort. Breathe in through your nose while counting to 5. Pause, then breathe out through pursed lips to a count of 6 or 7. Repeat for several minutes.
Calming statement
Say a calming, coping statement to yourself like “This will pass” or “I’ve been through this before and was okay.” Repeating a mantra can help abort anxiety and panic.
Get up and walk around
Light activity and walking can help work off adrenaline and make anxiety chest pain go away faster. Just avoid strenuous exercise.
Stretch
Gently stretch your chest muscles when you feel anxiety chest discomfort. Reach both arms back or out to your sides and hold for 15-20 seconds.
Distract yourself
Shift your focus to something unrelated like calling a friend, watching television, working on a hobby or household chore, or listening to music.
Take anti-anxiety medication
If prescribed anti-anxiety medication like a benzodiazepine, take your dose as needed for severe symptoms.
Other tips for coping with anxiety chest pain
- Avoid caffeine, which can make anxiety and chest symptoms worse.
- Practice relaxation techniques like deep breathing, visualization, or meditation regularly to lower overall anxiety.
- Exercise often to reduce stress and body tension that leads to anxiety chest pain episodes.
- Talk to your doctor or mental health provider if anxiety and chest discomfort are happening frequently.
- Have your doctor evaluate your heart health for reassurance about any physical causes of chest pain.
When to see a doctor for anxiety chest pain
Make an appointment with your doctor if you experience repeated episodes of anxiety chest pain, especially if:
- Your chest pain and anxiety symptoms have changed or worsened recently.
- Your chest pain lasts longer than 30 minutes.
- You have risk factors for heart disease.
- Your anxiety chest pain disrupts your daily functioning.
- You want evaluation or reassurance that your chest discomfort is anxiety-related.
A doctor can check for any underlying heart conditions and refer you to a psychiatrist or therapist for help managing anxiety. Treatment often includes anti-anxiety medication, therapy, and stress management techniques.
When to call 911 for anxiety chest pain
Call 911 or emergency medical services if:
- Your chest pain is severe.
- The chest pressure or tightness does not start to improve after 30 minutes.
- Your chest pain is accompanied by shortness of breath, sweating, nausea, or pain in the arms.
- You have risk factors for heart disease like smoking, obesity, or high blood pressure.
- Your chest pain feels different or worse than previous anxiety episodes.
It’s always best to err on the side of caution and call 911 with any severe unexplained chest pain lasting over 15-20 minutes. Get emergency care for symptoms that seem like a possible heart attack, whether or not you have diagnosed anxiety.
Conclusion
Anxiety chest pain often lasts around 10 to 30 minutes but can persist longer in some cases. While anxiety-related chest discomfort is scary, it is not dangerous like heart-related causes of chest pain.
Knowing the typical short duration of anxiety chest pain can provide some reassurance. However, it’s still important to have any new or worsening chest symptoms evaluated by a doctor to rule out cardiac causes. Treatment for anxiety is available and can help prevent recurring episodes of anxiety chest pain.