Updated: Apr 26
Having chest pains? Do you currently suffer from an anxiety disorder? Are you worried that you're having a heart attack? Maybe you're like I was, you're obsessing about it so much so that it's starting to ruin your life. Hopefully this post will help you realise that you aren't alone and what you're experiencing is a very common phenomenon for people who suffer from anxiety, as well as provide you with a technique for overcoming the fear and symptoms via a CBT method I developed. I suffered with heart attack anxiety all day every day for a decent period of time so if I was able to overcome it, I believe anyone can. P.S If you're reading this and you don't have heart attack anxiety or any anxiety disorder but you wish to help a loved one or just learn more about anxiety, welcome!
If at this moment you have any doubt whatsoever (even 5%) about whether you are experiencing the onset of a heart attack, please seek medical assistance. Even if if turns out you are physically fine after being tested, you have NOT wasted their time.
Heart Attack Symptoms Mimicked by Anxiety
The main reason why people with anxiety are often convinced they are having a heart attack is because they experience physical symptoms that mimic those of a heart attack. To make matters worse, and terrifying, often these physical symptoms are not accompanied by worry or panic in their minds. Often they will experience frightening symptoms of a heart attack that in turn cause them to panic, rather than the other way around. This can be very confusing and debilitating and can take over peoples lives so much so that they can't leave their house and have constant insomnia, like it did my own.
Physical symptoms of Heart Attacks I experienced caused by anxiety:
2. Chest pains (from mild to severe stabbing pains)
3. Tightness of chest
4. Arm pain (Left arm, or both) (sometimes tingling sensation, sometimes it hurts)
5. Localised pain on one side of chest
6. Sinking feeling in chest (as though your heart suddenly becomes dislocated)
7. Feels like heart skips a beat
8. Feels like one beat is very strong
9. One particular beat causes a sudden strong wave of pain across the whole chest
10. Chest hurts when breathing in
11. Sudden hot flushes
12. Excessive sweating
13. Fear of having a heart attack and fear of death
14. Your pulse feels irregular
15. Your heart hurts or aches
16. Smelling burning (if you already knew this happens during a HA)
17. Chest flutters (sounds beautiful, it's not)
18. A sudden sense and fear of death
These symptoms often manifest themselves even when people aren't anxious and sufferers often describe them as coming "out of the blue".
Speaking from my own experience, these symptoms can last for hours. This is especially true if you weren't panicking at their onset. A full-blown panic attack may not happen but you can feel the physical symptoms and feel anxiety about them for a long time; you could also find it impossible to sleep meaning an episode can last all night. The cruel irony of anxiety means that the next morning you are likely to have a "hangover" from the stress of the previous day/night, so prepare for some more heart attack symptoms!
If the particular physical symptom you experience isn't in this list or isn't described quite as you experience it, this doesn't mean it isn't caused by anxiety. Everyone experiences slightly different sensations and describes them slightly differently. In fact, tell me what it is and I will amend the list! This may sound strange but this list is non-exhaustive; the list is certainly much much longer than you will find on any medical website or is longer than the list provided by any doctor or therapist.
If you like, see my previous posts "Physical Anxiety" and "DIY-CBT" for my theory on why you experience physical symptoms even when you are not currently anxious
Anxiety v Heart Attack
What's the difference?
Looking at the symptoms won’t usually help. The physical symptoms are very similar in nature, in fact, anxiety mimics the symptoms of a heart attack. I wouldn't recommend researching the differences in symptoms because if you find some symptoms of a heart attack that you haven’t experienced yet, sure enough, you will think about them so much that they will actually happen. E.g. I once read up about heart attacks and how people can often smell burning during them, what do you know, I imagined smelling burning the next time I had a panic attack!
A very important reminder on time limits
It is normally said that panic attacks last for around 10 minutes before fizzling out. However, due to the fact that you may not have been panicking in the first place and you may be very anxious but not experiencing a full-blown panic attack, this can last for hours! If it lasts for hours, this generally isn't a cause for concern. (You can experience these symptoms without suffering from panic attacks)
How can I know if I am experiencing anxiety or a heart attack?
Despite possessing much cross-over in terms of physical symptoms, there are some clearer indicators which may help you determine whether you are experiencing a heart attack or anxiety; the emotions someone experiences can differ slightly and there are also a few symptoms which could be argued are particular to heart attacks that aren't experienced with anxiety and visa versa. (I know this goes back on what I just said but bear with me!) See table below
Note: The only way to ever know for certain at the time of the symptoms is by seeking immediate medical attention. If you aren't currently experiencing symptoms synonymous with a heart attack but you think there may be an underlying issue with your heart or are in any doubt whether there may be, please go see your GP.
This table may help you believe that the symptoms you are experiencing are that of anxiety:
If you are currently feeling "funny", light-headed or experiencing chest pains as a result of reading this, it's anxiety!
Panic attacks cannot cause heart attacks.
It’s easy, and very rational, to fear and assume that palpitations/severe chest pains could be doing real damage to your heart, but they don’t. An important thing to tell yourself if you’re having a panic attack is that it is not going to cause a heart attack. Even if your heart rate is really fast, it does not lead to a heart attack.
How to Overcome Heart Anxiety
1. Get the medical all-clear from your doctor.
This is an absolute must; please don't take my word for it. Get professional advice. Your doctor can administer blood tests to check for levels of certain proteins in your blood that are reliable indicators for heart attacks and they will also examine your heart using an ECG/EKG. You can also request to be given a 24 hour (or longer) ECG monitor. Each time your heart flutters/chest hurts etc., you press a button so a specialist can analyse it to check for heart issues. Even if you don't believe them, it is essential that you be cleared medically before trying this technique, not only for obvious safety reasons but also because for you to feel the full benefit. A big part of recovery involves being cleared of any chance of heart problems.
For some, getting the medical all clear can be enough to overcome these symptoms, once they know why they are experiencing the symptoms (anxiety) and that they are not in danger, it can provide reassurance and get them back on track; however, for many others, in which I was previously included, even after getting the all clear from a doctor, the symptoms can persist and even worsen. "Why?" How long have you got?
You don't believe your doctor
You didn't feel anxious at the time you got tested or saw the doctor so don't think the tests were accurate
You think the doctor made a mistake
You might think your doctor overlooked your heart problem because they know of your anxiety disorder.
Your symptoms may have worsened since you got checked.
You might have experienced new physical sensations that have caused you concern.
You might think you know your own body better than a doctor.
Maybe it just definitely feels like you're having a heart attack and there can be no other plausible explanation.
You may be questioning whether little old anxiety could ever cause so much physical pain and discomfort.
You feel calm in your mind yet your body is displaying physical symptoms of a heart attack, therefore you believe, rationally, that if you're not worrying then surely you have a heart problem.
You may feel like the only reason you are anxious is because of your physical symptoms, not the other way around.
If this is you, you are me; see the points below for what to do. As usual, this list is non-exhaustive.
2. Read and take in everything from this post, hopefully much of it will provide some much needed reassurance (This can go a long way to overcoming your anxiety)
3. For the majority of people whose symptoms STILL persist, Try this 4-step process, it may just change your life!
Whenever you feel a scary chest pain or physical symptom that makes you fear a heart attack, say these 4 things to yourself out loud and quite slowly:
The 4-step process:
1. “This is just anxiety.”
2. “These stabbing chest pains/palpitations/arm pains are not dangerous.”
3. “I have been fully cleared by the doctor.”
4. “This will pass.”
Repeat. If you feel like you need to say it again or that it didn’t quite sink in the first time, do it again. Try emphasise the words in bold. Remember it's important to say them relatively slowly and out-loud.
Be as specific as possible in point 2 e.g. this fluttering feeling in my chest, this tingling down my left arm (point to it if you need) describe it in as much detail as you can.
After a few weeks, potentially longer, of trying this technique you will eventually have trained yourself to no longer fear these physical symptoms and in turn will be able to prevent a panic attack from occurring. Don't worry if this takes much longer, this will probably depend on how long and to what severity you have been experiencing these symptoms. Think about how long and how certain you were that the symptoms were dangerous, it will take time to convince yourself the complete opposite! A good rule of thumb may be the longer you have had them and the longer you have told yourself they are dangerous and scary and a heart attack, naturally the longer it will take to convince yourself and your body that it isn't a heart attack or dangerous, but it will vary person to person. At first, just having the presence of mind to try out the technique is a huge success.
Once you stop fearing the physical symptoms, they will start to disappear. I.e. once you have overcome the fear of your chest hurting or feeling like your heart skips a beat, it will stop actually happening in the first place. Lose the fear, lose the symptom.
Note: This can take a while. This is not an overnight cure. Give it time, persevere. You may still experience the symptoms even after you have overcome the fear of them, don’t worry, they may linger for a while but eventually they will fizzle out and disappear. This can be quite confusing and I know from experience how easy it is to think "well if I'm no longer scared and the symptoms are still manifesting themselves then I really must have something wrong with my heart, I was right all along!" No, it's still anxiety! Our bodies normally take longer to overcome it than our minds, this may be annoying but it is certainly better than having a panic attack!
After Reading This
Get your heart checked by a doctor. Get EKG/ECG exam done. Request a 24hr (or longer) heart monitor.
Try the 4-step technique I described above. Hopefully after several weeks up to a month or so, you will have overcome these very scary and debilitating symptoms, and hopefully this is a huge step on the road to recovery from your current anxiety disorder.
If before reading this post you felt fine but after having read it, it has made you feel funny or you have chest pain, it’s anxiety. Sorry! This is very normal, whether you currently have an anxiety disorder or not.
Thank you so much for reading! Give it a go, let me know how you get on!