Anxiety as a symptom of Heart Attack

Heart Attack Symptoms.. A Medika Life Series on Heart Health

This article is part of Medika’s series on heart health and seeks to educate patients about the symptoms of heart disease and how these symptoms present.

Anxiety, in particular, anxiety disorders, enjoy a complex relationship with coronary health. There are studies and evidence to suggest that abnormal and continued levels of extreme anxiety can contribute to heart conditions and then there is the anxiety and depression experienced by patients with heart disease as a direct result of the disease itself.

If you haven’t been diagnosed with a heart condition, heart disease, or high blood pressure and you feel occasional anxiety, stress, or get panicky once in a while, this isn’t likely to be your heart, and this type of anxiety won’t cause damage to your heart. However, if you exist in a constant state of anxiety and stress, then this will impact your blood pressure and by association, affect your heart.

Anxiety disorder is a chronic condition characterized by disproportionate and persistent anxiety. The five major types include generalized anxiety disorder, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder. It is one of the most common diagnoses in the US, with one in five adults receiving treatment for the condition.

For the purposes of this article, we will assume the anxiety described below is that felt by patients not diagnosed with or suffering from any heart-related diseases or conditions.

What does heart related anxiety feel like?

There isn’t a huge amount of distinction to be made between normal anxiety and attacks of anxiety triggered by your heart. You need to be aware of other heart-related symptoms that may accompany the feelings of anxiety. Anxiety can cause your heart to race (tachycardia) and can be accompanied by sweating, increases in blood pressure, and affect your sleep patterns, which negatively impacts blood pressure and heart health. Common physical symptoms experienced include

  • Pounding heart
  • Sweating
  • Headaches
  • Stomach upset
  • Dizziness
  • Frequent urination or diarrhea
  • Shortness of breath
  • Muscle tension or twitches
  • Shaking or trembling
  • Insomnia

The link between your heart and anxiety

Anxiety activates the body’s autonomic nervous system (ANS), also known as the “fight or flight response.” The ANS helps regulate the functions of the

  • heart
  • lungs
  • digestive system
  • various muscles throughout the body

Anxiety relating to or caused by your heart can often be self-inflicted. A patient may worry about dying from heart failure if they have already experienced a heart attack. Many patients do this subconsciously and aren’t even aware of it. Surviving a heart attack can be very traumatic and lead to anxiety that is similar to PTSD.

While there have been multiple studies that link depression to heart disease, the relationship between anxiety and cardiovascular disease seems to be a little more complex. Due to the high prevalence of anxiety in cardiovascular patients, researchers are further investigating if anxiety is a direct cause of heart disease or simply a correlation.

Accompanying symptoms

Both conditions include:

  • Chest Pain
  • Difficulty Breathing or Shortness of Breath
  • Intense Feeling of Doom
  • Lightheadedness or Feeling Faint
  • Rapid Heartbeat
  • Weak or Tingling Feeling in Limbs

Its easy to see why it is so difficult to distinguish the root cause for these symptoms without proper medical diagnosis. If you are experiencing these symptoms please consult your doctor as soon as possible.

Gender prevalence for anxiety

After the age of six, women are twice as likely to experience anxiety as men.

Several studies have examined sex differences in different anxiety disorders. Females are repeatedly found to be more likely than males to suffer from anxiety in general and to be diagnosed with most anxiety disorders, including agoraphobia (AG), panic disorder (PD), separation anxiety (SA), specific phobia (SP), social anxiety disorder (SAD) and generalised anxiety disorder (GAD)

Are there clear signs it’s your heart?

While not as accurate as a professional diagnosis, there are subtle differences between anxiety and heart problems which you may be able to determine at home.

  • The chest pain from an anxiety attack is sharper and more localized, while the pain from a heart attack is duller and radiates more
  • Anxiety attacks stem from a mental and not a physical cause
  • Anxiety attacks rarely cause vomiting
  • Heart attack pain may occur in the back or shoulders, while anxiety pain does not

And remember – anxiety and heart problems can happen to people who have never had issues with either.

Treating frequent anxiety

If you experience anxious feelings frequently or if you find yourself experiencing anxiety and you’re not sure why, tell your primary care physician or seek out a mental health professional for help. You may have an anxiety disorder that could be managed with a combination of therapy and medication.

Diagnosing an anxiety disorder often starts with a physical examination by a doctor. Certain conditions may cause anxiety, such as:

  • heart disease
  • thyroid disease
  • respiratory disorders
  • withdrawal from drugs or alcohol

When to call your Doctor or 911

If you are experiencing chest pain of any kind, especially if it travels to your jaw or down your arm, and are having associated symptoms of nausea, dizziness, sweating, or shortness of breath, call 911 right away.

If you are in an at-risk group for heart disease (elderly, diabetic, obese, overweight, smoker, or high blood pressure) then you should treat any chest pain very seriously. The more prolonged the discomfort or pain is, the faster you should seek medical care. Dial 911 or visit your nearest ER


Medika Life has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by Medika Life

Dr. Hesham A. Hassaballa
Dr. Hesham A. Hassaballa
Dr. Hesham A. Hassaballa is a NY Times featured Pulmonary and Critical Care Medicine specialist in clinical practice for over 20 years. He is Board Certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine, and Sleep Medicine. He is a prolific writer, with dozens of peer-reviewed scientific articles and medical blog posts. He is a Physician Leader and published author. His latest book is "Code Blue," a medical thriller.
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