If you have ever ended up in A&E convinced you were having a heart attack, only to be sent home with a clean ECG and the words "it was probably anxiety", you are not imagining things. You are also not alone — anxiety attacks account for a significant share of emergency cardiac assessments every single day.
This article explains the three symptoms that drive most of those visits: chest pain, rapid heartbeat and tingling.
1. Chest pain during an anxiety attack
The chest pain people describe is real. The cause, however, is not cardiac.
When the fight-or-flight response fires, the intercostal muscles between the ribs tighten dramatically. Hyperventilation drops carbon dioxide levels and constricts coronary arteries momentarily. The result is a sharp, stabbing or crushing sensation that can last seconds or minutes — and feels indistinguishable from cardiac pain.
A common pattern: anxiety chest pain may worsen with focused attention and ease with distraction or movement, while cardiac pain typically does not behave that way. This is a pattern, not a diagnostic test. Any new, severe, or persistent chest pain — especially with shortness of breath, sweating, jaw or arm pain, or radiating to the back — must be assessed by a doctor or A&E. A clean cardiac work-up is reassuring; a hunch is not.
2. Rapid heartbeat (palpitations and tachycardia)
Adrenaline is doing its job. It is preparing your body to sprint or fight. The heart rate elevates from a resting 60–80 to anything from 110 to 180 beats per minute within seconds.
This is not dangerous in a healthy heart. Athletes hit the same numbers during exercise without harm. The reason it feels alarming is the context: you are sitting still on the sofa.
3. Tingling in fingers, toes, lips and face (paresthesia)
This is hyperventilation in action. When you over-breathe — even subtly — carbon dioxide drops and blood pH rises. Calcium becomes less available to nerve endings, causing the classic anxiety tingling, often combined with a feeling that your hands or face are "stiff".
Re-breathing into cupped hands or simply slowing the exhale resolves it within a minute.
Why understanding the mechanism is half the cure
Once you understand that these symptoms are generated by a sensitised anxiety response rather than indicative of disease, the secondary fear — the fear of the symptoms themselves — begins to dissolve. That secondary fear is what keeps the anxiety response sensitised. Break that loop, and recovery is no longer a slow process. It is the natural endpoint.
The Linden Anxiety Recovery approach
LAR Coaching does not teach you to tolerate these symptoms. It guides you through the precise process of de-sensitising the anxiety response so the symptoms genuinely stop occurring. Over 650,000 recoveries across 42 countries.
The next step
If any of this resonates, book a free 30-minute Recovery Call with one of our LAR Coaches. No pressure, no obligation — just a real conversation about what is happening to you and whether the LAR programme is the right fit. Sessions are delivered worldwide via Zoom, Phone or FaceTime.
