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Chest Pain: COVID-19 or Anxiety?

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Michael  W. Smith, MD - Blogs
By Michael W. Smith, MDBoard-certified internistApril 8, 2020
From the WebMD Archives

One of the biggest questions people have had the last few weeks is whether a symptom they’re having is COVID-19 or something else. A runny nose … sore throat … chest pain.

First off, you should never ignore chest pain from any cause. If you have sudden onset of chest pain, call 911. Chest pain from a heart attack typically feels like pressure or a squeezing sensation, but it can vary from person to person.

The challenge is that chest pain from anxiety and even COVID-19 can feel similar to heart pain – but with important differences.

Anxiety-related chest pain typically comes out of the blue. You’ll likely have a racing heart rate as well. You may even feel like it’s hard to breathe. The sudden nature of this type of pain suggests anxiety. However, as I mentioned earlier these same symptoms can occur with heart pain. Sudden chest pain that lasts longer than a minute deserves an immediate call to your doctor or 911. Let your doctor figure out if it’s anxiety or heart related.

The chest pain from COVID-19 would not come on suddenly. The symptoms of COVID-19 develop typically over a few days, similar to other viral infections. So if you feel fine otherwise, it’s unlikely coronavirus. But if you’ve been sick for a few days and feel really bad now, your chest pain could very well be COVID-19. If you’re having shortness of breath, call your doctor right away.

It bears repeating. Any time you have persistent chest pain and you’re not sure what it is, there’s no question what to do. Get immediate medical help. Don’t spend time trying to figure out what’s causing it.

And lastly, don’t forget to breathe. There are plenty of reasons to be anxious right now, but there’s also a lot you have control over. If the stress is getting to you, take a few minutes each day (several times a day) to practice deep breathing exercises – what I call mini-meditation. Take a slow, deep breath, filling your lungs completely, hold for a couple of seconds, and then let it go. Inhale for 4 seconds, hold for 2, then exhale for 4 seconds. And repeat.

Now is not the time to keep your feelings to yourself. Find a trusted friend that is good at calming you down. Someone that can lift you up – not commiserate in your anxiety. Take a break from the news. If it gets to be overwhelming, seek professional help. Many therapists are offering telehealth sessions right now from the comfort of your home. And remember, we will get through this.


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About the Author
Michael W. Smith, MD

Michael Smith, MD, CPT, is a board-certified internal medicine doctor and WebMD’s Chief Medical Editor. He is also an American Council on Exercise certified personal trainer with a passion for helping people live a healthy, active lifestyle. He appears regularly as an expert on national and local broadcast media.

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