Chest pain right now? Stop reading and call 999, or open Emergency mode.
Why anxiety causes chest pain
When you’re anxious, your body releases adrenaline. Your heart speeds up, your muscles tense, and you breathe faster and higher in your chest. Tight chest muscles ache, and over-breathing changes the balance of gases in your blood, causing tingling, dizziness and a feeling that you can’t get enough air. All of that is real. None of it is imagined.
Panic attack or heart attack?
| More typical of a panic attack | More typical of a heart attack | |
|---|---|---|
| Start | Sudden, often with a wave of fear | Often builds over minutes, can start with exertion or at rest |
| Pain | Sharp or stabbing, or tightness, often moving around | Pressure, heaviness or squeezing in the centre, may spread to arm, jaw or back |
| Other signs | Tingling fingers or lips, trembling, racing thoughts, feeling unreal | Cold sweat, grey skin, feeling sick, breathlessness |
| How long | Peaks within about 10 minutes, usually settles within 20 to 30 | Lasts more than a few minutes and doesn’t go away with calming down |
You can’t reliably tell them apart at home. The features overlap, and a heart attack can itself cause intense fear. If it’s the first time, if it feels different from your usual panic attacks, or if you have heart risk factors, call 999. If it turns out to be a panic attack, that’s a good result, and nobody will think less of you.
If you’ve been told you have panic attacks
If a doctor has confirmed your symptoms are panic attacks, and this one feels the same as usual, these can help it pass:
- Slow your breathing.Breathe in gently through your nose for a count of 4, then out slowly through your mouth for a count of 6. Keep going for a few minutes. Breathing out for longer than in calms the body.
- Stay where you are.Sit down if you can. Remind yourself: this is a panic attack, it will peak and it will pass.
- Ground yourself.Name five things you can see, four you can touch, three you can hear. It pulls your attention out of the spiral.
- Give it time.Most panic attacks ease within 20 to 30 minutes. If it doesn’t, or it feels different, call 999.
Health anxiety after a heart scare
After a heart attack, a hospital visit or a frightening episode of chest pain, it’s very common to become hyper-aware of every twinge in your chest. That fear can itself cause chest tightness, which feeds the fear. Around one in three people feel anxious or low after a heart attack. It usually improves over a few months, and it responds well to support. Cardiac rehabilitation is a good place to talk about it.
Getting help for anxiety
- Your GP can talk through your symptoms, check for physical causes and discuss treatment.
- NHS Talking Therapies: in England you can refer yourself online without seeing a GP. Cognitive behavioural therapy (CBT) works well for panic disorder. In Scotland, Wales and Northern Ireland, ask your GP.
- If you’re struggling right now, call Samaritans free on 116 123, any time, or text SHOUT to 85258.
Having an anxiety disorder doesn’t protect you from heart disease. If you have chest pain that is different from your usual pattern, get it checked like anyone else.
Sources
This page is based on the published guidance below. It was last updated on 30 September 2026. Read how we write our content, or email hello@chestpain.org.uk to report a mistake.