Can Anxiety Cause Chest Pain? Yes, But Chest Pain Drives Anxiety More Than the Other Way Around
Up to half of people who show up to an emergency room or cardiology clinic with low-risk or non-cardiac chest pain have significant anxiety or a diagnosable anxiety disorder. That number is striking. But here's the part most people get wrong: the relationship between anxiety and chest pain isn't a one-way street. Prospective data from people with coronary heart disease show that chest pain strongly increases later anxiety and depression, while anxiety only modestly predicts future chest pain, and mainly in the short term. The two feed each other, but chest pain is the more powerful driver. None of this means anxiety chest pain isn't real. It is. It can feel identical to heart pain, and it sends people to the ER repeatedly. But understanding which direction the cycle runs changes how you think about fixing it.