Here’s a cardiologist’s explanation for how sudden stress can sometimes cause chest pain.

It can feel like a heart attack, especially when you remind yourself that there’ve been cases in which a heart attack indeed was set off by an acute episode of severe stress.

“Acute stress can lead to chest pain by causing the muscles of the chest wall, the back, the neck or the face to contract and tighten, leading to a sensation of pain,” says Donna P. Denier, MD, of The Cardiology Center with the Appalachian Regional Healthcare System.

“Acute stress can also raise your blood pressure which can place an increased burden on your heart, causing pain.

“When stress happens suddenly, the body is not prepared for it. Even a normal response to stress can feel very abnormal.”

Do chest muscles spasm?

“Any muscles can spasm, especially when under stress,” says Dr. Denier. “The chest muscles can do this, causing pain. The diaphragm and the esophagus can also spasm which sometimes mimics heart pain.”

The esophagus’s composition includes striated and smooth muscle, so it definitely has the capacity to spasm.

“Acute stress and release of catecholamines can trigger spasm of the esophagus,” says Dr. Denier.

“Most often, esophageal spasm occurs while someone is eating or drinking something. It is more common in women and people with reflux disease or anxiety.

“Sometimes specific foods can trigger it. The important thing is that the symptoms can be exactly the same as a heart attack and should always be reported to your doctor.”

To minimize the harmful effect of stress on your heart, you should take up some form of intense exercise at least twice a week.

As for the benign chest pain, strength training and yoga would be a great combination to help keep the musculature less vulnerable to uncomfortable tensing up.

donna denier, md

Dr. Denier has been practicing medicine for over 15 years and is board certified by the American Board of Internal Medicine – Cardiovascular Disease.