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Can anxiety cuase chest pains?

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I have been having severe anxiety since November. I have a past of health anxiety and what not, but lately it has been worse. I thought I had an ulcer in November, due to frequent acid reflux and stomach pain, but I ruled that out, but then as soon as that was ruled out, I had been scared of heart disease. This got the worst during exams in college. I had a very rough semester and I was under severe stress at exam time. I never had these problems before but my heart tended to beat very fast and pound when under stress and I had some chest pains. Acid reflux added onto my fear of heart disease, thinking this was because of my heart. My other chest pains were not necessarily excruciating pains, but enough to scare me and get my anxiety going, which started a viscious cycle. Also I started taking prevacid recently and my heart burn is pretty much gone but I continue to have indigestion. After researching anxiety on the internet I have seen that it can cause chest pains, and of course and increased pounding heart rate, but this does not solve anything for me. I have a minor heart murmur and I had numerous tests run for palpitations and such when I was much younger (middle school years). They found nothing wrong with me and attributed it to anxiety and caffeine. I used to swim all my life and I quit before going to college. It has been about 2 years since I swam regularly and my body is out of shape. I constantly worry about my heart and check my heart rate. Lately when I exercise I have been getting sort of dizzy, my heart pounds very fast, and I get a tightness in my chest (maybe because of it being very cold outside). I feel fine exercising until I get anxious about it. I start to check my heart rate as I run and I fear a heart attack. I had one palpitation after running, my heart kind of skipped a beat (or had an early beat I guess is the actual thing), and that scared me even more and got my anxiety going even more, so I could not calm down for about 30 minutes afterwards. Is this a sign of any kind of heart disease, or am I just too anxious to begin with? Some sort of exercise phobia with cardiophobia? This fear is seriously taking over my life. Thanks for the help.
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replied January 12th, 2006
Anxiety & Stress Answer A110
Given your age (late teens) and the symptoms you have described most doctors would agree that heart / chest disease or a disease of your internal organs is not highly likely. To be certain, however, you can request an ECG, a chest X-ray, and measurement of your thyroxin blood levels.

For acid reflux and stomach pain, it is appropriate also to request an endoscopic gastroscopia and Helicobacter pylori-serology to detect stomach disease (gastritis, hiatus hernia, peptic ulcer, tumors). An ultrasound and a standard blood/urine analysis can exclude or verify disease of internal organs (liver, kidneys, pancreas…).

If the results of these diagnostic tests are OK and normal, then these types of symptoms may be caused by anxiety. Specifically, "somatoform disorder" (International Classification of Disease Code F45) occurs when anxiety manifests via symptoms of various organic diseases. During somatoform disorder symptoms are not the result of verified organic diseases but are expressions of inner emotional conflicts in personality. Expert help from a mental health professional can help patients identify and resolve inner conflicts.
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