Educational reference
About this symptom
Chest pain, tightness or discomfort occurs commonly during panic attacks and is one of the main reasons people attend emergency departments during a first attack.
Chest pain always warrants medical assessment. It has physical causes, including cardiac ones, that need to be considered before it is attributed to anxiety. This is true even for someone with an established diagnosis of panic disorder, and particularly true where the pain is new, different from previous episodes, severe, or accompanied by breathlessness, sweating, nausea, or pain spreading to the arm, neck or jaw.
Where a physical cause has been excluded, understanding the sensation can reduce its power. Muscle tension in the chest wall during intense fear, together with rapid shallow breathing, can produce genuine discomfort that is not dangerous.
Being told an attack is "just anxiety" is unhelpful when the sensation is severe. The distress is real, and so is the need for proper assessment.