Chest Pain and Anxiety in Children: Symptoms and Treatment

Feeling fearful, worried, and nervous are normal emotional responses to stressful events, feelings that can manifest as anxiety. When one experiences anxiety, their body's "fight or flight" response can become activated, leading to a range of physical symptoms, including muscle tension, increased heart rate, and shallow breathing. As a parent of young children or teenagers, however, observing physical anxiety symptoms like these can be especially worrying. 

In some cases, physical responses to anxiety can manifest as chest discomfort and even pain. While anxiety-related chest pain is typically not directly linked to cardiac issues, the sensation can be very unsettling and even mimic the symptoms of more serious medical conditions. What’s more, the uncomfortable physical sensations may worsen if a child doesn’t understand what’s occurring and fears they are having a heart attack. Fortunately, there are ways to help identify and hopefully even prevent this anxiety response in those you love most.

Is Chest Pain a Common Symptom of Anxiety?

It’s normal for children to feel worried or anxious from time to time. Approximately 7% of children ages 3 to 17 experience issues with anxiety each year. In most instances, an individual will begin developing symptoms of anxiety before age 21. A child may have excessive worries about their performance at school or sporting events, starting a new school, as well as added social pressure when trying to “fit in.” Anxiety becomes a challenge when it causes a child disproportionate distress that interferes with their school, home, and social life, and it can show up as these worrisome physical symptoms. 

Symptoms of anxiety are rarely the same for every person and can present in a variety of ways, including physical symptoms. About 25 percent of people will experience chest pain due to anxiety, and while there are different causes of chest pain, a panic attack or anxiety attack can be one of them. Chest pain can also be a sign of more serious medical conditions and should not be ignored. If a child or teenager experiences chest pain, it is crucial to see a doctor to rule out any potentially serious underlying conditions.

How Does Anxiety Cause Chest Pain?

During an anxiety attack, the brain dispatches a surge of stress hormones like adrenaline and cortisol throughout the body, leading to an elevation in both heart rate and blood pressure. This is a person’s fight-or-flight response. A person may experience physical sensations as a result, such as feeling chest tightness or pain. Difficulty breathing during an anxiety attack can also contribute to this sensation by putting excessive strain on a person’s chest wall.

When these symptoms manifest unexpectedly during an anxiety or panic attack, they can be easily confused with a heart attack, or other heart condition, because the feeling is so distressing. For a child or teenager, the fear they experience during an attack can also amplify the perception of pain, making the experience especially upsetting. 

What Does Anxiety Chest Pain Feel Like?

Anxiety chest pain varies among individuals, but does have common characteristics. Especially when it is a symptom of a panic or anxiety attack, the pain can come on quickly and may be particularly distressing for a parent who is observing their child or teenager experiencing these symptoms. 

Common characteristics of anxiety-related chest pain includes:

Pressure or tightness 

Anxiety-related chest pain creates a sensation of pressure or tightness in the chest and may feel like something is squeezing or constricting the chest area.

Burning or tingling sensation

Some individuals experience a burning or tingling sensation in the chest, which can be accompanied by a feeling of warmth or discomfort.

Sharp or stabbing pain. 

Perceived as sharp or stabbing in nature, it can be brief and sharp or more prolonged and stabbing.

Achy or dull pain

Chest pain related to anxiety can sometimes be described as an achy or dull pain and may feel like a persistent, generalized discomfort in the chest area.

Radiating pain

In some cases, anxiety-related chest pain may radiate to other areas, such as the shoulders, arms, neck, or jaw. This can be concerning because it may be mistaken for more medically serious heart-related pain.

Intermittent or continuous

Anxiety-related chest pain can occur intermittently, with episodes of pain coming and going, or it can be continuous and persistent.

Exacerbated by stress or anxiety

One key characteristic is that this type of chest pain tends to be exacerbated by stress, anxiety, or panic attacks and may be more likely to occur during times of heightened emotional distress.

Relief with relaxation

Unlike chest pain related to cardiac issues, anxiety-related chest pain often improves or resolves with relaxation techniques or when the anxiety or stress levels decrease.

Because anxiety symptoms can vary among individuals, it can be difficult to predict exactly how long anxiety chest pain will last. While a child may be concerned they will experience anxiety chest pain all day or for days, many find that anxiety chest pain goes away in about 10 minutes. That said, other anxiety-related symptoms can last up to an hour after the pain improves, and if an anxiety attack is the cause of sudden chest pain, it may be slow to improve. 

Self-Help Techniques for Supporting a Child or Teenager with Anxiety

When a child or teenager is in the middle of a very anxious moment, they may feel frightened, agitated or worried about having worsening symptoms, like a panic attack. The important thing to do in the moment is to help them feel safe and calm down, and while every individual is different, there are some techniques to help a child or teenager cope with an anxious moment. 

These include:

• Breathing slowly and deeply together by counting slowly to five as you breathe in, and then five as you breathe out.
• Sitting with them and offering calm physical reassurance. Feeling a loved one nearby, holding their hand, or having a cuddle can all be soothing.
• Trying to use all five senses together to connect with what they can see, touch, hear, smell, and taste can bring them closer to the present moment and reduce the intensity of their anxiety.
• Reassuring them that the anxiety will pass and that they will be okay. It can be helpful to describe anxiety as a wave that they can ride or surf until it peaks, breaks, and gets smaller.
• Asking them to think of a safe and relaxing place or person in their mind. If this technique is new, identify and agree upon the place or person when they’re feeling more calm.
• Encouraging them to do something that helps them to feel calmer, such as running, walking, listening to music, painting, drawing or coloring, writing in a journal, watching a favorite film, or reading a favorite book.

Anxiety can often manifest as chest pain, and while typically unrelated to heart issues, the sensation can be distressing and mimic more serious medical conditions. Understanding how anxiety, which can include physical symptoms like chest pain, can impact a child or teenager is the first step in helping to manage its manifestation—presenting as pressure, burning or tingling, but the feeling can improve with certain relaxation techniques. 

Parents can support anxious children and teenagers by practicing deep breathing, offering comfort, and suggesting grounding techniques and calming activities, providing vital support during anxious moments.

If you need further support or assistance in helping your child with anxiety-related chest pain, you shouldn’t hesitate to reach out to start with a free consultation from a licensed Handspring Health therapist today, who can offer you and your child the tools and support to overcome these distressing symptoms.