How to identify chest tightness due to anxiety ?

Chest tightness can be responsible for various clinical conditions. Anxiety is one of them. Therefore correct identification of anxiety attacks is important to avoid unnecessary mental and health care burden. Anxiety associated with chest tightness also has specific features that clearly define it from other conditions.

The specific features of anxiety

  • Rapid breathing
  • Difficulty in breathing
  • Tightening of muscles in other areas of the body
  • Dizziness
  • Nervousness

Anxiety is a relatively common psychological condition. There are about 40 million people from the United States who have been diagnosed with anxiety. Anxiety can be very mild to very severe degrees which can limit a person’s lifestyle.

What are the other conditions that cause chest tightness?

COVID19mild symptoms like fever, dry cough, and shortness of breath
Bluish discoloration of lips, troubled breathing, drowsiness
GERD or gastroesophageal reflux diseaseburning sensation on the chest, a sensation of a lump in the throat, difficulty in swallowing.
Muscle strainpain and tender area, difficulty in breathing, and swallowing.
Pneumoniafever, cough, fatigue, shortness of breath, confusion, nausea, and diarrhea.
Asthmacough, wheezing, history of asthma, family members with asthma, occupational or environmental exposure to allergens, history of allergy.
Peptic ulcersheartburn, nausea, burping, bloating
Rib fracturesevere pain and tenderness, history of trauma to the chest.
Shinglessevere pain. Extreme sensitivity to touch, red rash, fluid-filled blisters confined one side on the chest, fever, fatigue.
Pancreatitisupper abdominal pain, pain worse with fatty meals, nausea, vomiting, back pain, history of alcohol usage for a long period of time.
Gall stonesnausea, vomiting, back pain, and shoulder tip pain, passing out poorly absorbed stool
Costochondritissharp pain, tenderness over the sternum or breast bone. Pain when deep breathing
Coronary artery diseaseshortness of breath, chest pain may radiate to the arm, neck, or jaw, nausea, vomiting, sweating, headache.
Pericarditissharp chest pain especially on reclining, shortness of breath, mild fever.
Pneumothoraxsudden shortness of breath and chest pain, most of the time associated with a chest injury.
Pleuritisfever, cough, shortness of breath
Pulmonary embolismleg pain and swelling, history of long-standing immobility, dizziness, clammy skin.
Conditions causing chest tightness except anxiety and their features

Why anxiety occurs?

Anxiety happens as a normal physiological response. There is a human mechanism called the “fight or flight” response. From evolution itself, we humans are designed to respond to unpleasant situations by fighting against it or going out from it.

This happens due to the human neuro-hormonal mechanism. Both the sympathetic nervous system and adrenaline rush are contributing to this situation.

The reason the anxiety situations differ from person to person is it mostly depending on their psychological status which s mostly determined by the environment they were raised in from childhood.

What are the types of anxiety?

There are a spectrum of conditions in anxiety disorders

Panic disorder: experiencing recurrent panic attacks in unexpected situations. These people live in fear for their next panic attack.

Phobias: there are certain fears for specific things. Eg: animals, places, etc.

Social anxiety: the fear of being judged by other people.

Obsessive-compulsive disorder: doing specific activities repetitively as a response to recurring irrational thoughts.

Separation anxiety: fear of being away from family or loved ones.

Post-traumatic stress disorder: anxiety following a traumatic incident.

How to resolve chest tightness associated with anxiety?

People with anxious personalities are more prone to get chest tightness related to anxiety. If the condition is troublesome for the daily works, it’s better to consult a doctor. There are medical treatments and psychological treatments as well.

However, in mild situations following simple steps might be effective.

  • Concentrate on the breath in and breath out.
  • Do deep abdominal breathing
  • Count breathing times about 5 to 10 minutes.
  • Concentrate on a nearby object which is not causing anxiety.

Sources :

  1. Jeff C. Huffman, M.D., Mark H. Pollack, M.D., and Theodore A. Stern, M.D.(2002). Panic Disorder and Chest Pain: Mechanisms, Morbidity, and Management
  2. Andreas Ströhle, Prof. Dr. med., Jochen Gensichen, Prof. Dr. med. Dipl.-Päd. MPH, and Katharina Domschke, Prof. Dr. Dr. med.(2018). The Diagnosis and Treatment of Anxiety Disorders

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Sapumal Edirisinghe
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