Cause of pain:
Anxiety or panic attacks are characterized by repeated episodes of intense anxiety and fear that occur without warning and generally without an identifiable cause. Panic attacks are often accompanied by chest pain, most likely caused by muscle contractions in the chest wall.
Characteristics of pain:
The pain is usually localized to the chest wall, and can be fleeting and sharp, or can be a sharp "catch" that interrupts a breath. The chest wall can remain "sore" for hours or days after a panic attack. The severity of the chest pain is often magnified by the panic disorder itself.
Evaluation:
This condition is usually apparent after taking a careful history. However, if the patient has risk factors for coronary artery disease, a noninvasive evaluation to rule out cardiac disease is often necessary. Anxiety disorders are often highly disruptive to an individual's life, and are highly treatable. Unfortunately, doctors all too often brush off patients presenting with chest pain who are found to have anxiety disorders. Patients with this diagnosis should seek active medical treatment from an understanding doctor.