Panic Disorder Symptoms Chest Pain From Heart Problems and Panic Disorder By Sheryl Ankrom, MS, LCPC Sheryl Ankrom, MS, LCPC LinkedIn Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. Learn about our editorial process Updated on March 20, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print Istockphoto.com/Stock Photo©Daisy-Daisy Table of Contents View All Table of Contents Typical vs. Atypical Pain Pain With Heart Problems Pain With Panic Disorder Mitral Valve/Panic Disorder Heart Disease/Panic Disorder About 40 percent of people with panic disorder experience pain in their chest. Chest pain symptoms are listed in the Diagnostic and Statistical Manual of Mental disorders, DSM-5 under the symptoms associated with a panic attack. Whether or not you have panic disorder, pain in the chest area sounds an alarm. The first thought, and rightfully so, is that you are experiencing a possible heart attack or other cardiac event. This possibility sends many people to the nearest emergency room for help. But, often chest pain symptoms associated with panic disorder are not related to the heart and are not, generally, considered serious. Typical vs. Atypical Chest Pain Professionals have divided chest pain under the headings of “typical” and “atypical.” Typical chest pain is thought to be more likely related to a cardiac event. Atypical chest pain, on the other hand, is thought to decrease the likelihood that the pain has cardiac origins. But, defining what is “typical” and what is “atypical” is not set by clear boundaries. And, although atypical chest pain reduces the likelihood of heart trouble, some people do, indeed, have atypical chest pain with a heart attack or other cardiac episode. This may be even more common in women, as heart disease in women often has different symptoms than heart disease in men. The following provides a general overview of what is usually considered the characteristics of typical chest pain indicative of heart trouble and atypical chest pain often associated with panic disorder. It is not intended to serve as a tool for self-diagnosis. All chest pain should be evaluated by a physician for proper diagnosis. Keep this in mind even if you've had a panic disorder related chest pain in the past. People with panic disorder may have heart disease just as those who do not have panic disorder, and, as noted later on, may be even more likely to develop heart disease Typical Chest Pain Associated With Heart Problems "Typical" symptoms of heart-related chest pain include: Escalating chest pain reaching maximum severity after a few minutesConstant pain, pressure, or achingPain in the substernal area (beneath the breastbone) or left chest areaPain that travels or radiates from the chest to other areas, such as one or both arms, the shoulders or the jawPain that is brought on by exertion (although unstable angina may bring about pain without exertion) Atypical Chest Pain Associated With Panic Disorder "Atypical" chest pain may include: Sharp or stabbing chest pain (note that sharp or stabbing chest pain can also be a symptom of serious conditions such as pulmonary embolism)Chest pain that is fleetingPain that is localized to a small areaPain that occurs without exertionChest Pain that accompanies anxiety or a panic attackPain that is relieved or worsened when you change positionsPain that can be reproduced or worsened by pressing over the area of pain Mitral Valve Prolapse and Panic Disorder Mitral valve prolapse (MVP) is a fairly common disorder, affecting approximately four to five percent of the general adult population. Basically, MVP involves an abnormal heart valve that “prolapses” or flops backward, allowing blood to leak back through the valve opening. Many people with MVP have no symptoms. Some may have complaints of fatigue, heart palpitations, chest pain, anxiety, and migraine headaches. For the majority of people, MVP causes no lasting negative effects and does not interfere with any life functions. Research has shown some evidence of a correlation between MVP and panic disorder. Much of this research suggests that MVP occurs more frequently in those with panic disorder or other anxiety disorders. There is some controversy, however, as to whether or not this connection actually exists. Future studies will, hopefully, give us a more definitive answer. Heart Disease and Panic Disorder There have been several studies that have attempted to show a correlation between anxiety disorders and heart disease. A recent study by the Women’s Health Initiative of postmenopausal women suggested that those who reported a full-blown panic attack within six months of being interviewed had a three-fold risk of having a heart attack, heart-related death or stroke over the next five years. This study also found that those who reported panic attacks were nearly twice as likely to die from any cause in the five years following the study. But this study, like others that have attempted to show a correlation between panic disorder and heart disease, has not provided the final answer. The participants of this study answered two screening questions about experiencing a "sudden attack of feeling frightened, anxious, or extremely uncomfortable" and "sudden episode of rapid or irregular heartbeats." This led to interviewers asking these participants questions about twelve panic attack symptoms within the past six months. Some symptoms associated with panic attacks are very similar to cardiac problems but are unrelated to heart function. The participants of this study who reported these "panic attack" symptoms within the past six months were not distinguished between a single panic attack, a few panic attacks or recurring panic attacks indicative of panic disorder. It is possible that some of those who answered positive to the screening questions about panic attacks may have actually been experiencing an undiagnosed heart problem. It is difficult, at best, to prove a correlation between heart disease and panic attacks. Statistically, people with panic disorder have higher incidences of smoking, alcohol use, lack of exercise, obesity, high blood pressure, and increased cholesterol. These are known risk factors for heart disease. Whether or not you have panic disorder, most professionals will agree: Reduce your known risk factors and reduce your risk of developing heart disease. Bottom Line It's clear that panic disorder is associated with chest pain, but less clear whether those with panic disorder are more likely to suffer from heart disease. Symptoms of chest pain related to panic attacks versus that related to heart attacks can differ in general, but among individual people, there is much overlap. At the same time, we know that seeking immediate medical care can make a difference for those who have cardiac-related chest pain. Until we know more, those living with panic disorder should seek medical attention immediately for chest pain. This may lead to unnecessary emergency room visits at times but pales in comparison to the risk of missing heart attack related pain by dismissing it as a panic attack. Medical care for those with heart attacks has improved dramatically in recent years but relies on people getting to that care in time. Whether you have panic disorder or not, check out how to survive a heart attack in those first hours. Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Foldes-Busque G, Fleet RP, Denis I, et al. Nonfearful panic attacks in patients with noncardiac chest pain. Psychosomatics. 2015;56(5):513-520. doi:10.1016/j.psym.2014.07.005 Foldes-Busque G, Hamel S, Belleville G, et al. Factors associated with pain level in non-cardiac chest pain patients with comorbid panic disorder. BioPsychoSocial Med. 2016;10(1):30. doi:10.1186/s13030-016-0081-5 Tully PJ, Wittert GA, Turnbull DA, et al. Panic disorder and incident coronary heart disease: a systematic review and meta-analysis protocol. Syst Rev. 2015;4(1):33. doi:10.1186/s13643-015-0026-2 By Sheryl Ankrom, MS, LCPC Sheryl Ankrom is a clinical professional counselor and nationally certified clinical mental health counselor specializing in anxiety disorders. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Panic Disorder Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.