Covid Chest Pain/Chest Tightness Covid: Coronavirus Complication
Panic disorder – whether you have lived with it for years or have developed it because of the pandemic could cause chest pain, but cardiac and other physiological problems require to be ruled out before treatment could start. And remember, any kind of chest pain needs medical attention.
Chest pain also could be the result of a cardiac problem or because of a non-cardiac cause, for example, gastroesophageal reflux disease, or GERD, a muscle or skeletal problem in the chest, or even a symptom of COVID-19.
When related to a panic attack, chest pain is a common symptom, but how do we know what’s causing chest pain when we feel it? The only way to know for sure is by looking for medical attention.
When Anxiety Attacks the Body: Physical Symptoms
In some cases, heightened levels of anxiety could cause chest pain to develop. Anxiety is the body’s reaction to a perceived threat, explains Doctor Richa Bhatia, MD, FAPA, of the Anxiety and Depression Association of America.
“When people are anxious, their blood supply to different parts of the body could be decreased because the body is in a fight-or-flight response and more blood is directed to the muscles,” she says. Doctor Bhatia adds that people in a state of heightened anxiety usually hyperventilate and breathe in a shallow manner, which could cause dizziness or chest tightness.
What a Panic Attack Feels Like
Experiencing chest pain due to anxiety could be one of the symptoms of a panic attack, which is described as a feeling of unexpected, intense fear and the severe beginning of four or more of these symptoms:
Chest pain/Chest Tightness
Feeling short of breath
Feelings of choking
Feeling dizzy or lightheaded
Numbness and tingling
Fear of going crazy or of losing control
A panic attack could occur when a person is feeling anxious, or it could happen out of the blue. The symptoms described above tend to last for roughly ten minutes before fading. It is possible to have various panic attacks within a number of hours, which could feel like the attacks are coming in waves. Some people go into panic attacks every day or every week. A milder variation of panic attacks, called limited-symptom attacks, features three or fewer of the symptoms listed above.
Sometimes, a state of heightened anxiety could cause people to experience chest pain. “Chest pain is more common in a panic attack, but at times, people might also experience chest pain/pressure from high anxiety without having a full-blown panic attack,” says Doctor Bhatia.
Panic Attack or Heart Attack?
The symptoms of a panic attack could overlap the symptoms of a heart attack, clinically called a myocardial infarction (MI), making it hard for a person to know which one might be happening. People usually go to the emergency room (ER) with chest pain believing they have a heart problem, but research shows that roughly 60 percent to 90 percent of emergency room (ER) patients with chest pain do not have a cardiac cause of the pain.
What makes a panic attack different than a heart attack?
Unfortunately, says Doctor Una McCann, MD, professor of psychiatry and director of the Anxiety Disorders Program at Johns Hopkins School of Medicine, “They could feel similar. People usually are short of breath, feel dizzy, and could feel crushing chest pain. Somebody who is perfectly healthy, with great lungs, undergoing a panic attack could feel really, really short of breath. And then, of course, these symptoms feed on the panic so it builds exponentially at this enormous crescendo.”
Doctor McCann explains that due to the many different ways that people experience symptoms of heart attacks and panic attacks, there is no way to know the cause of those symptoms on your own.
“There are a variety of symptoms that people who are having myocardial infarctions (MI) experience or do not experience, so certainly if someone came in with a panic attack to an emergency room (ER), they would undergo a full workup for a myocardial infarction (MI), no question,” she says.
Doctor Bhatia stresses that people should not self-diagnose their chest pain or assume that it is a panic attack, particularly if they have never had chest pain before nor been diagnosed with panic disorder before. “Anxiety disorders and panic disorder are diagnoses of exclusion, they could only be diagnosed once a physician has done a full medical check-up and ruled out hidden cardiac or other medical causes of chest pain,” she says. “Also, it is worth noting that even people who experience panic attacks could have chest pain of cardiac origin.”
Can My Chest Pain Be Due to the Coronavirus?
Chest pain is a rare symptom of COVID-19 and generally does not happen as the sole symptom. For example, if your chest pain was because of COVID-19, you would most likely have accompanying signs of upper respiratory infection for example coughing and phlegm. And, the pain would not be because of a panic attack, says Doctor McCann. But again, due to the wide range of symptoms that people experience with COVID-19, there is no way to know without getting checked by a healthcare provider. The Centers for Disease Control and Prevention (CDC) lists common COVID-19 symptoms like fever, cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, and sore throat, the new loss of taste or smell.
When it is Panic Disorder: Treatment Options
When the cause of chest pain has been determined to be psychiatric (for example, anxiety) rather than cardiac in nature, patients and their doctors or primary care physicians could discuss treatment. It is crucial to know that panic attacks could happen with any type of anxiety disorder there are five in all:
Generalized anxiety disorder
Obsessive-compulsive disorder, or (OCD)
Post-traumatic stress disorder, or (PTSD)
Social anxiety disorder
A person must have repeated panic attacks and be fearful of having another to the point where it interferes with their routine life in order to be diagnosed with panic disorder. As stated by the American Psychiatric Association, 2 percent to 3 percent of US adults are diagnosed with panic disorder in a given year. Anxiety disorders are more common in women than men.
Doctor McCann says that it is possible for a person with no history of anxiety to develop panic disorder due to the stress of the coronavirus pandemic.
“A person could develop the panic disorder (PD) for the first time in the setting of COVID-19,” she explains. “Although, there are certain ‘criteria’ that must be met for it to be characterized as panic disorder (PD). In particular, symptoms require to be present for at least one month. People require to change their behaviors in maladaptive ways (or have a month of continuous fears about having another panic attack).”
She notes that sleep problems could play a huge role in the development of the panic disorder. “Poor sleep increases the risk of recurring panic attack. Anxiety associated with panic generally leads to poor sleep, resulting in a self-perpetuating negative cycle,” she says. Cognitive-behavioral therapy (CBT) could be an effective treatment for panic disorder. Doctor McCann describes cognitive-behavioral therapy (CBT) as a way to recognize abnormal, irrational thought patterns and the behaviors that one engages in when these thoughts happen. A Cognitive behavioral therapy (CBT) therapist helps patients practice helpful behaviors that could lower panic symptoms. Techniques like breathing retraining, meditation, and yoga could help patients identify and lower the tension in their bodies when they are anxious.
Both Doctor McCann and Doctor Bhatia emphasize that, even with a diagnosis of panic disorder, it is possible for a patient to have cardiac or medical chest pain that should not be ignored.
How to Hold It Together: Dealing with a Pandemic
A poll conducted in mid-April 2020 by the Kaiser Family Foundation (KFF) discovered that fifty-six percent of adults reported that worry and stress due to the pandemic has had a negative effect on their mental health.
“Right now everybody has elevated anxiety, whether you are healthy as a horse, whether you have a psychiatric disease, or not,” says Doctor McCann.
Telemedicine could help by connecting people with their doctors or primary care physicians, and video meeting apps offer a means to keep up a social life as we remain in our homes.
Doctor McCann also recommends exercising together with friends via video chat to support social interaction, while Doctor Bhatia suggests practicing mindfulness to relieve stress.
Symptoms that are associated with anxiety/panic could improve with mindfulness-based breathing exercises,” says Doctor Bhatia.
And remember, if you experience any type of chest pain, it is crucial to look for immediate medical care.
If you or anyone you know is suffering from covid chest pain or chest tightness covid, our expert providers at Post Covid Centers will take care of your health and help you recover.