Is It Anxiety Or Angina?

Anxiety or angina: how do you tell the difference?

Angina and anxiety attacks can both be overwhelming experiences. Both attacks leave your chest area feeling depleted of oxygen. This is because of the reduced blood supply flowing to the chest area, leaving you struggling to breathe. 

If you have never suffered from an anxiety or angina attack before, the natural reaction might be to think you are having a heart attack.

Here are some common signs of an angina attack:

• The chest pains are often sharper than an anxiety attack
• Unstable or fast heart rhythm
• You have a medical history of suffering from heart conditions
• Angina attacks are more likely to cause vomiting
• Pain from an angina attack is restricted to one part of the chest area
• Sometimes, the pain is also felt around other parts of the upper body, like the jaw, neck and back. 

What does anxiety chest pain feels like?

Anxiety attacks are an unpleasant experience, leaving you feeling like you are struggling to breathe. You might feel sweaty during an attack, dizzy and fearful. Usually, during a panic attack, you experience what is called a fight or flight response.¹ This means you might have the urge to run away or freeze on the spot.

Signs of a panic attack:

• Feeling like you might collapse
• Feeling like you are losing control of your body and/or mind
• Feeling like you are choking
• Sweating profusely
• The desire to run away or freeze on the spot
• Feeling like you are outside of your body (dissociation) 
• Heart palpitations
• Thinking that you are having a heart attack
• Shortness of breath 
• Feeling like everybody is watching you (when they are not)

What does angina chest pain feels like?

Angina pectoris translated from Latin means 'the choking of the chest’.² This is how angina chest pain feels for a lot of people. An angina attack usually lasts for around 10 - 15 minutes. If the pain persists for longer, you must seek medical attention because there is a possibility it could be a heart attack.³

The symptoms of angina vary with each person. The pain can feel sharp, dull or heavy. Some people say that angina pain feels like their chest is being squeezed tightly. 

What causes anxiety chest pain?

The feeling of an anxiety attack has been described to feel very similar to the feeling of chest pain from angina or even a heart attack. Panic attacks are often linked to mental health disorders, such as social phobia, social anxiety disorder, agoraphobia, and generalised anxiety disorder (GAD).⁴ 

Panic attacks can be triggered by many different things, such as events, places, and situations. Some examples are getting on a plane, a busy shopping mall or an overwhelming family gathering.

There is also a strong genetic link associated with panic disorders.⁵ 43% of panic attack sufferers also have family members that have experienced panic attacks. Data shows that people assigned female at birth are twice as likely to suffer from panic attacks as people assigned male. 

The average age a person suffers from their first panic attack is between the teenage and early adult years, although adults can experience a later onset. This could be triggered by a recent traumatic event that they are struggling to deal with.

What causes angina chest pain?

Even though angina is not life-threatening, research suggest that people who have had angina attacks are more at risk of a stroke or a heart attack in the future. Hence, when you have been diagnosed with angina, it is even more important to nurture your heart health by taking care of your body.

A diagnosis of angina often indicates that there may be an underlying issue with your heart, such as ischaemic disease. This is a common artery prognosis caused by the narrowing of arteries, reducing the supply of oxygen and blood sent to the heart. 

Treatment of chest pain

The treatment of chest pain is different for every person, depending on their needs and diagnosis. 

Sometimes treating chest pain can be as simple as needing an inhaler or could be as complex as surgery. One common medication for treating chest pains is beta-blockers. These medications help to lower blood pressure and reduce the heart rate. Beta-blockers are often used for angina, anxiety disorders and other chest problems.

Treating chest pain caused by angina

There are several types of angina. Here are some of the more common ones:

• Stable angina
• Unstable angina
• Microvascular angina

There are different treatments for each type of angina, alongside other medical factors to take into account, such as other health issues and medications that are already being taken.

Nitroglycerin sprays are typically used during an angina attack, and other medications are taken on a long term basis.

Living a balanced and healthy lifestyle is recommended for avoiding any further angina attacks. Also, avoiding emotional turmoil or other triggers can prevent an attack.

Can an anxiety attack feel that bad?

Yes, an anxiety attack can feel that bad because you are struggling to breathe. It is important that people become more aware of anxiety attacks, so they know what is happening. 

Once your GP is aware of you having panic attacks, they are likely to refer you to counselling, CBT, hypnosis or other psychological therapies. Even though panic attacks do not always completely disappear, professional support can help you cope with them more positively.

Alongside therapy, your health care provider might discuss anti-anxiety medications (SSRIs) with you if they feel it is appropriate to your needs.⁶

Other causes of chest pain

• Asthma
• Peptic ulcers
• Pericarditis caused by inflammation of the heart
• COVID or long COVID
• Allergic reaction
• Ischaemic heart disease
• Other underlying medical conditions

How can I safely rule out a heart attack?

Heart attacks are mainly more persistent than angina or panic attacks - without the pain fading or stopping. If you have any concerns about a heart attack, you must seek emergency support quickly.

To safely rule out a heart attack, you will undergo blood tests and an electrocardiogram (ECG).⁷ These tests will be carried out as soon as you arrive at the hospital because the faster the tests are completed, the more likely you are to prevent any damage to the heart tissue or other complications.

How do heart attack symptoms differ in people assigned female at birth?

Heart attacks for people assigned female at birth (AFAB) differ from people assigned male. People AFAB are less likely to suffer from intense pain in the chest area, so they are less likely to seek medical intervention. Also, they are more likely to put their discomfort down to indigestion. People AFAB have also been reported to present with more uncommon symptoms, like nausea and vomiting. Heart attacks are one of the main causes of death for women living in the UK.

Conclusion:

While both Anxiety attacks and Angina attacks seem similar, there are some key differences such as with Angina, you are more likely to have stronger chest pains. It is key to keep an eye on symptoms and contact GP so a treatment plan can be organised. Once the condition is identified they can be managed or treated.