Anxiety Chest Pain

Anxiety chest pain is very understandable, whichever comes first - the anxiety or the pain. Anxiety can tighten muscles which may be sore already, and put an extra load on our heart by speeding it up, bringing on angina.

A diagnosis of life threatening disease of any sort, is a recipe for anxiety +++

I am always very impressed with people who genuinely are not afraid of death, for whatever reason.

Modern advances in the care of heart disease, fortunately have dramatically reduced the risk of death from it.

If angina pain attacks make you understandably anxious, this may well prolong the attack. A little visualization exercise now may help you compose yourself and end the attack.

Sit down and close your eyes, then imagine you are somewhere quiet and peaceful, such as in a park. In your imagination, fill in some details of the scene and have something happening there for you to watch.

Another effective method for dealing with such anxiety chest pain, needs a clock with a second hand in sight. Watch the second hand and breath in steadily over 5 seconds, and out over the next 5 seconds. Continue this, putting all your attention on the air coming in and going out of your lungs.

Anxiety symptoms from muscles

People can be so used to having tight muscles, that they regard how they feel as normal.

In his book "Killing Pain Without Prescription," Harold Gelb describes a young patient who complained of numb areas, which turned out to be the only parts where she had no pain.

Tight muscles can be bordering on painful all the time. Any little extra tension, from even a fleeting anxious thought, can then produce an immediate pain (here anxiety chest pain, but also very commonly headache.)

Soldier's heart syndrome, or Da Costa's syndrome, has sharp left sided anxiety chest pain from such muscles (tight because of problems in cervical and thoracic spine usually.)

Precordial Catch Syndrome (PCS) also called Texidor's twinge, in young people, is the same condition, with the anxiety a secondary effect of the pain.

The next two pages of this site are to do with these muscles.

Another typical symptom of anxiety is a twitching in the corner of one's eye. This is a very good indicator of a dietary deficiency of the element magnesium, and responds rapidly to supplementation with chelated magnesium 500mg.

Some other treatments for anxiety chest pain

Bach flower rescue remedy drops can be rapidly effective, The Schussler biochemic tissue salts, potassium and magnesium phosphate also can help.

Anxiety + the second diagnosis

Anxiety is like apprehension or fear - an emotional feeling.

Whatever other symptom is occurring with an anxiety disorder, there will have to be a physical basis for that symptom.

One anxious person will have headache, another diarrhea. There will be something wrong with upper body or bowel respectively, to produce their particular local symptoms.

That physical problem will usually have multiple factors contributing to it, which may be manageable.

We always need to look beyond the immediate presenting complaint, for both psychological and physical factors. Wheels within wheels.

I have seen very dramatic changes in people's level of pain and anxiety when they have changed employment, leaving bad situations.

Anxiety chest pain that isn't

If you have chest pain and palpitations of your heart, it might be anxiety, but it might be a tachyarrhythmia . This is an abnormal, very rapid heart rhythm.

At the front of your wrist, there is an obvious tendon passing down to your thumb. Your pulse is just beside this, between it and the bone on that side of your wrist.

Gently place the index finger of your other hand on the pulse, and count the beats in 5 seconds. Five beats is 60/minute, well over fifteen is too fast for ordinary heart beat (180/min.)

It's too fast for your heart to function properly, too. There isn't time between beats for it to fill with blood. This can produce heart pain, but it isn't anxiety chest pain.

Reactive hypoglycemia

On an individual level, one's body chemistry has an enormous effect on emotions.

Our brain needs a constant supply of fuel. Glucose sugar is its’ only fuel. This is stored in the liver as a starch called glycogen.

Low blood sugar (hypoglycemia) causes low brain sugar (neuroglycopenia,) a very dangerous emergency. Our brain tells the adrenal glands to secrete the hormone Adrenaline.

Adrenaline tells our liver to release sugar into the bloodstream, but is also the hormone responsible for our “fright, fight, flight” response.”

You may have had a fright and noticed 30 seconds later your heart nearly jumping out of your chest. That’s adrenaline!

Reactive hypoglycemia can follow eating "high glycemic index" foods which are rapidly digested and absorbed into our blood stream.

graph blood glucose and glycemic index

Blood sugar control is a problem in perhaps 10% of people without diabetes or impaired glucose tolerance.

Foods such as potato crisps, biscuits and sugar containing drinks are commonly involved.

The blood sugar rises and falls rapidly, over shoots the fasting level and can stay lower for some time.

Hypoglycemia symptoms occur during the rapid drop and when the level is too low.

In other people, symptoms occur when it has been a long time since last eating. The sugar is low for a different reason, but the effects are the same.

Do you ever feel unwell when you are hungry? People can then get symptoms like headache, palpitations, fine tremor (shake,) irritability and hunger pains in their stomach.

Symptoms such as these, relieved fairly rapidly after eating, can be due to functional reactive hypoglycemia.

This is regarded as a non-entity in conventional medical circles. You can read about this at, but my experience is that it is a very real thing and can be usefully treated. I think the investigators worked with the wrong patients.

When I first learned of this condition in the 80's, I drove our pathology provider mad, ordering 5 hour glucose tolerance tests to diagnose this condition.

These days I just use a questionnaire from an excellent little book by Emanuel Cheraskin, called "Psychodietetics."

In early (occult) diabetes the same symptoms can occur, due to the glucose level dropping abnormally low.

A prologued glucose tolerance test is needed to pick up this late symptomatic hypoglycemia of early diabetes. The glucose level only drops abnormally low about 4 or 5 hours after the glucose dose is swallowed.

Treatment of hypoglycemia in management of anxiety chest pain

Snacking on foods which are more slowly digested, including boiled egg, sausage, cheese and salad vegetables.

A long drink made with a teaspoon of glycerine, lemon juice and water may relieve symptoms without a let down afterwards.

Folic acid (vitamin B9) 5mg three times a day, can improve our liver's ability to manufacture glucose. This was described by Fred Hofeldt and others years ago, but hasn't caught on.

It is very important to rule out deficiency of vitamin B12 , before this is used. This will require a check by your doctor. The level of vitamin B12 in your blood isn't enough on its own.

Measurement of homocysteine is needed as well, as one is more suspicious of a low normal B12 when homocysteine is high normal. Homocysteine goes up when B12 goes down.

In this circumstance, I conduct a therapeutic trial of vitamin B12, before giving folic acid.

Neuroglycopenia ( ie brain-sugar-lack )

This can happen even when blood sugar levels are normal.

Here exactly the same types of symptoms happen, as our brain runs short of glucose due to insulin resistance. There is plenty of sugar in the blood but it can't get into the brain cells.

Chromium supplements may be of use now.

It is so important to maintain adequate blood sugar levels, that we have 4 hormones involved as back up. Adrenaline as was mentioned above, glucagon, growth hormone and cortisol...

Adrenal insufficiency

As well as adrenaline, our adrenal gland also produces cortisol hormone to help keep our blood sugar level stable.

People get low blood sugar symptoms when they have adrenal insufficiency, when the adrenal glands cannot produce enough cortisol.

This condition can be due to disease of your adrenal glands, but can also happen because they have been working hard and not supplied with enough nutrition.

Reduction of stress levels and vitamin C supplementation are good starters.

Sex hormones and emotions

Hormone replacement therapy has become another dirty word in medicine. The Womens Health Initiative trials turned ideas on their head.

When the WHI trials were stopped early because of side effects of the hormones used, many women decided to stop their HRT.

Some of the good effects previously attributed to the HRT, from evidence such as the Nurses health study, were shown to be due to other lifestyle choices made as well as the HRT.

The excess ill effects matched the excess good effects, in the WHI. Both were 18 per 10,000 per 5 years. The problem was that the bad effects included breast cancer from the synthetic progestin.

Breast cancer was not the reason the oestrogen only arm of the study, was ceased.

When women come to see me with their emotions every which way, along with hot flushes, at the age when menopause could be expected, oestrogen is a very useful treatment to try.

Blood levels of hormones are not particularly useful now, and the therapeutic trial will give a quick answer and treatment.

It is not the best long term answer, but in the absence of a tendency to blood clots, is OK short term.

Synthetic progesterone is exactly the same as our body makes, and may be a very good addition.

A lot of people believe that testosterone deficiency affects (grumpy) middle aged men. I dunno, maybe.

relief by treating muscles involved in your anxiety chest pain

From anxiety chest pain page to home page

Books for anxiety chest pain page

Anxiety chest pain or any anxiety, Dr. Claire Weekes little book, "Peace From Nervous Suffering," (Hawthorn Books) is likely to be very helpful.

References for anxiety chest pain page

Greene HL, Stifel FB, Herman RH: "Ketotic hypoglycemia" due to hepatic fructose-1,6-diphosphatase deficiency-Treatment with folic acid. Am J Dis Child 124:415-418, Sep 1972

Greene HL, Stifel FB, Herman RH: Hypoglycemia due to fructose-1,6-diphosphatase deficiency and the treatment of two patients with folate. Pediatr Res 6:432/172, Apr 1972

Fructose-1,6-diphosphatase deficiency, hypoglycemia, and response to folate therapy in a mother and her daughter. Taunton OD, Greene HL, Stifel FB, Hofeldt FD, Lufkin EG, Hagler L, Herman Y, Herman RH. Biochem Med. 1978 Apr;19(2):260-76.

Hofeldt, F. D., "Reactive Hypoglycemia," Endocrinology and Metabolism Clinics of North America, 18 (March 1989): 185-201.


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