Chest pain is always an alarming symptom, because most of us (appropriately) associate it with cardiac conditions, in particular  angina or a myocardial infarction (heart attack). However, chest pain can also be caused by a number of conditions that have nothing to do with the heart. And one of the more common non-cardiac problems that frequently produces chest pain is an anxiety attack.
While everyone experiences brief episodes of intense anxiety from time to time, and a great many people experience one or two anxiety attacks over the course of their lifetime, anxiety attack disorder occurs when these attacks become frequent or persistent, begin interfering with or restricting normal lifestyle, or when the individual becomes afraid of them. Once established, anxiety attack disorder can be very debilitating.
Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.
As is true for other mood and anxiety disorders, the use of Selective Serotonin Reuptake Inhibitors (SSRI's; e.g.., Paxil, Prozac, Zoloft), Benzodiazepines (e.g., Xanax, Lorazepam), and Selective Norepinephrine Reuptake Inhibitors (SNRI's; e.g., Cymbalta, Effexor, Pristiq) are common medical treatments for panic disorder. Additionally, D-cycloserine is a medication that is now being explored as a way to enhance effects of CBT (e.g., Hofmann et al., 2013). These medications may have side effects and taking them can lead to tolerance, withdrawal symptoms, and dependence, so it is important that you consult with a physician before starting or stopping these medications. There is evidence that taking one of these medications in addition to receiving behavioral therapy (e.g., CBT) can significantly benefit patients with panic disorder, although seeking psychotherapy in itself is largely effective (Arch et al., 2017).
Physical symptoms of an anxiety disorder can be easily confused with other medical conditions, like heart disease or hyperthyroidism. Therefore, a doctor will likely perform an evaluation involving a physical examination, an interview and lab tests. After ruling out an underlying physical illness, a doctor may refer a person to a mental health professional for evaluation.
“Anxiety attack” is not a formal, clinical term, but one that is used by many people to describe all sorts of things, from feeling worried about an upcoming event to intense feelings of terror or fear that would meet the diagnostic criteria for a panic attack. In order to understand what someone means by “anxiety attack,” it is necessary to consider the context in which the symptoms occur.
Singers Ariana Grande, Lady Gaga, and Selena Gomez are just a few celebrities who have spoken out about their mental health struggles. But by learning to recognize their symptoms of anxiety, depression, and other issues, and in many cases seeking professional help, these celebs are not only able to better deal with their conditions, but to continue to thrive in spite of them.
This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. We encourage you to reproduce it and use it in your efforts to improve public health. However, using government materials inappropriately can raise legal or ethical concerns, so we ask you to use these guidelines:
Panic disorder affects 2-3% of people every year in the United States and Europe, with varying rates depending on race and ethnicity. On average, Native American Indian populations experience panic disorder at higher rates than non-Latino white Americans. In contrast, African Americans, Latinos, Caribbean Blacks, and Asian Americans all experience the disorder at lower rates than non-Latino white Americans. In addition, it has been well established than females are twice as likely to be diagnosed with panic disorder than males (Asnaani, Gutner, Hinton, & Hofmann, 2009; McLean, Asnaani, Litz, & Hofmann, 2011). A number of factors (e.g., biological influences, temperament, exposure to stressors and trauma, cognitive factors, and environmental factors) have been identified as possibly influencing sex differences in rates of panic disorder (McLean & Anderson, 2009). However, no one theory has been determined so the underlying reason for sex differences in rates of panic disorder remains unknown.
Cognitive behavioral therapy has been shown to help with treating panic disorder and agoraphobia. According to a study published in December 2013 in the journal Behaviour Research and Therapy, its effects lasted as long as two years after the initial treatment. And a study published in August 2017 in the Journal of Consulting and Clinical Psychology suggested that it may be superior to traditional psychotherapy in the treatment of this condition.
Anxiety is becoming increasingly prolific in today’s society, particularly among young people. While everybody feels anxious at some point in their lives, anxiety disorders can be all-encompassing unless you seek help. But what exactly is anxiety, and how do you treat it? The main type of anxiety is referred to by health specialists as generalised anxiety disorder (GAD), which is characterised by continued feelings of worry, fear and unease that are present for much of the time and not restricted to specific situations.

A nurse with a master's or doctoral degree in mental health disorders. A psychiatric nurse can diagnose and treat mental health disorders. They mainly provide psychotherapy but in some states that can also prescribe medications. Psychiatric nurses also serve as patient advocates and provide case-management services. They often work in private practices, hospitals and schools.
Because symptoms are so severe, many people who experience a panic attack may believe they are having a heart attack or other life-threatening illness and may go to a hospital ER. Panic attacks may be expected, such as a response to a feared object, or unexpected, apparently occurring for no reason. The mean age for onset of panic disorder is 22-23. Panic attacks may occur with other mental disorders such as depression or PTSD.
Some people have only one or two attacks and are never bothered again. Panic attacks can occur with other psychiatric disorders. In panic disorders, however, the panic attacks return repeatedly and the person develops an intense fear of having another attack. Without help, this "fear of fear" can make people avoid certain situations and can interfere with their lives even when they are not having a panic attack. Therefore, it is very important to recognize the problem and get help.
Anxiety disorders are the most commonly diagnosed mental disorders in the United States. The most common type of anxiety disorder are called “simple phobias,” which includes phobias of things like snakes or being in a high place. Up to 9 percent of the population could be diagnosed with this disorder in any given year. Also common are social anxiety disorder (social phobia, about 7 percent) — being fearful and avoiding social situations — and generalized anxiety disorder (about 3 percent).
Once the panic attack is over and the person has returned to a calm state, encourage them to seek help from a mental health professional at their earliest convenience, if they haven’t already. You can help them further by assisting with the search for a licensed professional, researching coping techniques online, and looking for self-help books that might be useful.

Almost everyone experiencing symptoms of a panic attack needs evaluation. Unless the person has a history of having panic attacks, is otherwise healthy, and is experiencing a typical attack, they must be evaluated promptly by a doctor. The level of evaluation depends on many factors. Err on the side of safety when deciding whether to go to a hospital's emergency department.
I had the biggest panic attack to date today, managed to get into the car with my friends to take my son for a hospital appointment, felt very unsafe and thought I was going to fall out of the car when it went around a corner. Talked to myself all through the journey telling myself I’d been round hundreds of corners and never fallen out out a car yet…got the hospital, got out the car, got half way across the carpark and had what I can only describe as the most hysterical panic/anxiety attack I have ever had. I,d dropped to the floor by now as I was with my friend Kay and I knew she wouldnt be able to run after me….I was screaming, pleading for help for what felt like forever, 2 paramedics came over and it took them a good 10 minutes to convince me I should stand up and go into A&E, I can only explain the whole thing as being hysterical, a Crisis nurse and doctor came to see my and gave me 4 diazepam, even after taking one – 5mg – I was hysterical and wouldnt then leave the hospital…I,m now at home and a lot calmer, the Crisis team are coming to see me between 10am and 1pm tomorrow to discuss meds, even the nurse said to the doctor ‘this isnt depression, this is severe anxiety..’ all I need is a tiny pinprick of light to look at to keep me hopeful. I honestly thought I could handle today but I didnt, I,m angry and disappointed with myself as this time a month ago I was fine
Heredity, other biological factors, stressful life events, and thinking in a way that exaggerates relatively normal bodily reactions are all believed to play a role in the onset of panic disorder. Some research suggests panic attacks occur when a “suffocation alarm mechanism” in the brain is activated, falsely reporting that death is imminent. The exact cause or causes of panic disorder are unknown and are the subject of intense scientific investigation.
A helpful approach to distinguishing normal anxiety from an anxiety disorder is to identify the cause of the anxiety, and then assess whether the anxiety symptoms are a proportional response to it. Worries, fears, and intrusive thoughts that are extreme, unrealistic, or exaggerated and interfere with normal life and functioning could constitute an anxiety disorder. For instance, being concerned about getting sick and taking steps to avoid germs, like using hand sanitizer and avoiding touching door handles, does not necessarily constitute an anxiety disorder; however, if the concern about sickness makes it difficult to leave the house, then it is possible that the person suffers from an anxiety or anxiety-related disorder.
If you, or someone you know, has symptoms of anxiety disorder, visit a clinician, who can help determine whether the symptoms are due to an anxiety disorder, medical condition or both. Frequently, the next step in getting treatment for an anxiety disorder is referral to a mental health professional such as a psychiatrist, psychologist, social worker or counselor.
How do you know if you're having a panic or anxiety attack? Panic attacks and anxiety attacks share some symptoms, but they differ in intensity, duration, and whether or not there is a trigger. Some treatments are similar and include therapy, stress management, and breathing exercises. Learn more about the differences between a panic attack and an anxiety attack here. Read now
Don’t panic. That’s a phrase we hear countless times in a day. We hear it in conversation, on TV, in the movies. We say it to ourselves. Why? Because when we panic– experience an intense sensation of fear or anxiety in response to an actual danger—we are more likely to lose control and react to potentially unsafe even life-threatening events in a frantic or irrational way. Panic inhibits our ability to reason clearly or logically. Think about the explosion of fear, the borderline hysteria you felt the day you momentarily lost sight of your six-year-old in the mall. Or the time your car skidded violently on a rain-soaked road. Even before you registered what was happening, your body released adrenaline, cortisol and other hormones that signal danger. Those hormones cause physical reactions: heart pounding, shallow breathing, sweating and shivering, shaking, and other unpleasant physical sensations.
It is not unusual to experience only one or two symptoms at a time, such as vibrations in their legs, shortness of breath, or an intense wave of heat traveling up their bodies, which is not similar to hot flashes due to estrogen shortage. Some symptoms, such as vibrations in the legs, are sufficiently different from any normal sensation that they clearly indicate panic disorder. Other symptoms on the list can occur in people who may or may not have panic disorder. Panic disorder does not require four or more symptoms to all be present at the same time. Causeless panic and racing heartbeat are sufficient to indicate a panic attack.[9]
Mitral valve prolapse (MVP), also called "click murmur syndrome" and "Barlow's syndrome," is the most common type of heart valve abnormality. Usually, people with mitral valve prolapse have no signs and symptoms; however, if the prolapsed valve is severe, symptoms may appear. When symptoms of severe mitral valve prolapse do appear, they may include, fatigue, palpitations, chest pain, anxiety, migraine headaches, and pulmonary edema. Echocardiography is the most useful test for mitral valve prolapse. Most people with mitral valve need no treatment. However, if the valve prolapse is severe, treatment medications or surgery may be necessary to repair the heart valve.
A panic attack is an abrupt surge of intense fear or discomfort that reaches a peak within minutes, and during which time a variety of psychological and physical symptoms occur. These symptoms include rapid heart rate, sweating, shaking, shortness of breath, hot flashes, and lightheadedness—as well as a sense of impending doom, chills, nausea, abdominal pain, chest pain, headache, and numbness or tingling.
The physical symptoms of a panic attack can include fast breathing, severe perspiration, trembling, nausea, dizziness, numbness or tingling, chills or sensations of heat, and increased heart rate. In addition to extreme fear, there may be feelings of disconnection from oneself, loss of control, imminent danger, and a strong desire to flee or avoid the situation. These symptoms, which often resemble the symptoms of a heart attack or respiratory disorder, may be accompanied by a fear of dying. The onset of symptoms is sudden and can develop from either a calm or anxious state. Some people experience limited-symptom panic attacks, which consist of less than four of the common symptoms listed above. Panic attacks last from about five to 20 minutes, generally peaking within 10 minutes. A panic attack can occur several times within a few-hours span and, for some people, can occur every day or once a week. Those who have frequent panic attacks often come to recognize the situations that trigger an attack and can learn to be prepared.
Panic attacks can occur due to number of disorders including panic disorder, social anxiety disorder, post traumatic stress disorder, drug use disorder, depression, and medical problems.[2][4] They can either be triggered or occur unexpectedly.[2] Smoking, caffeine, and psychological stress increase the risk of having a panic attack.[2] Before diagnosis, conditions that produce similar symptoms should be ruled out, such as hyperthyroidism, hyperparathyroidism, heart disease, lung disease, and drug use.[2]
Some research suggests that people who have panic disorder might be very sensitive to sensory experiences (such as sunlight, smells and changes in the weather), but there's not enough evidence yet to say for sure. Also it's not clear whether having a high level of sensitivity to these sorts of things is something that might cause you to develop panic disorder, or whether it may be an effect of having it.

If you're having lots of panic attacks at unpredictable times and there doesn't seem to be a particular trigger or cause, you might be given a diagnosis of panic disorder. It's common to experience panic disorder and agoraphobia (a type of phobia) together. People who experience panic disorder may have some periods with few or no panic attacks, but have lots at other times.
Hey I don’t know you but I’m going through the same exact thing I lost my son at 7 months just a hour after hearing his heartbeat strong and loud I have a four year old daughter and I’m trying to cope wit the reality and now scared that I might have health problems all this within two months it’s very very hard and I never had to deal with sadness and anxiety until now and it’s scarey
It is common for a person with one anxiety disorder to also have another anxiety disorder. Anxiety disorders are also frequently accompanied by depression or substance abuse. Anxiety disorders can coexist with physical health conditions as well. In such instances, these physical health conditions will also need to be treated. Before undergoing any treatment, it is important to have a thorough medical exam to rule out other possible causes.

Antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly used as first-line treatments for anxiety. Less-commonly used — but effective — treatments for anxiety disorders are older classes of antidepressants, such as tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).

×