Physical Symptoms

Heart Pounding From Anxiety? Yes. Heart Attack? No.

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Heart Pounding From Anxiety? Yes. Heart Attack? No.

It's one of the first ways in which we learn about death as children: when people are sick or old, their hearts stop and they die. So, when you start to feel like there your heart is behaving a bit abnormally, it's no wonder that your mind thinks only the worst.

You may or may not have a heart condition, but you can still experience that scary sense of your heart pounding in your chest. Often, this happens during an anxiety attack and it's one of the most common, but also most frightening symptoms of anxiety.

The Cycle of Pounding Heartbeats

Most people have experienced an increased heartbeat as a result of nervousness. But there are times when you're convinced that something is wrong and you believe that this pounding heartbeat represents something more ominous. You may also experience other symptoms, such as chest pain or lightheadedness, and these further reinforce your belief that you're having a heart attack.

But that's what anxiety does to you - you’re led to believe that you’re in danger even when this isn’t actually the case. While only a doctor can rule out heart related disorders, the truth is that a pounding heartbeat is often the result of anxiety and is not going to cause you to drop down dead!

Anxiety - especially panic attacks - are a frequent cause of a rapid heartbeat. Unfortunately, they are also accompanied by a "feeling of doom." Your body erroneously tells you that something is seriously wrong, and so you experience profound fear and dread that you're about to die. This creates the following cycle:

  • Your heartbeat increases.
  • You notice that this heartbeat feels different and scary.
  • You experience severe anxiety and sometimes even a panic attack.
  • You experience other symptoms associated with heart disease, like chest pains.
  • You recover from the pounding heartbeat.
  • You worry that you may have a heart problem.
  • Your worries cause anxiety over your health.
  • Your heartbeat increases as a result of this worry.

This is a common cycle in people suffering from anxiety attacks and panic attacks. During a panic attack, it can also be made worse by how you breathe. When your heartbeat speeds up you may try to take more breaths than you need, as a way of trying to calm yourself down.

This effect is caused by hyperventilation. It occurs when you feel as though you're not getting enough air (even though you are), so you take in more air. Your body then gets too much oxygen, and your heart has to pump harder, leading to other symptoms as well, such as chest pain.

Going to the doctor is important, but it doesn't always help. The experience of a pounding heartbeat, along with the feeling of impending doom, are both very real, so it becomes too easy to convince yourself that the doctor might have missed something.

Identifying that you experience panic attacks is an important step towards taking control; but that this is not always sufficient. People who experience panic attacks may develop a modified version of the cycle we described above:

  • You worry that you may have another panic attack.
  • Your heartbeat increases because of that anxiety.
  • You get severe anxiety because you believe you're going to suffer from another panic attack.
  • You start to hyperventilate.
  • Your pounding heart increases further, and the chest pains come.
  • You start to worry about your health again, or worry that you may have another panic attack.
  • Your heartbeat increases because of that anxiety.

A rapid heartbeat is a symptom that is often self-sustaining unless you know how to handle it. When it is accompanied with that feeling of "something is wrong" that occurs during anxiety attacks, your heartbeat can escalate further in tandem with your anxiety, making you feel worse and worse. Often, however, all you need to do is take a simple step to interrupt this cycle.

How to Control Pounding Heart From Anxiety

Controlling your pounding heart requires an understanding of what is causing it and what it takes to bring it under control. Remember that while an anxiety attack may feel like a heart attack, they're not the same thing; and suffering from a panic attack is not dangerous even if it feels very scary. In the midst of a pounding heartbeat, consider the following:

  • Deep Breathing Start with deep breathing exercises, structured to ensure you're no longer hyperventilating. Remember that although you may feel like you're not getting a deep breath, the truth is that you're actually breathing fine and have taken in too much oxygen. Give yourself time to take slow, controlled breaths deep into your stomach (not through your chest). Hold your breath in for a few seconds before breathing out, just as slowly.
  • Walk In some cases, a pounding heartbeat can make you feel dizzy. But if you're not feeling too dizzy and if you’re in an appropriate environment, go for a gentle stroll. Just focus on moving slowly. This will change your heart-rate, breathing patterns and stress levels, often bringing your panic symptoms under control.
  • Call Someone Talking on a cell phone to someone that you feel safe with can be beneficial as well. For starters, it calms any worries you have that you're going through your pounding heartbeat alone. When you call someone on the phone, you're also distracting your mind away from the pounding heartbeat. This can reduce some of those persistent negative thoughts that make it hard to recover.
  • Try “Grounding” One solution you may also want to add is called grounding. This is where you identify 5 things you can see, 4 things you can hear, 3 things you can touch/feel, 2 things you can smell and one positive thought about yourself. This works by shifting your attention away from your symptoms (which can be triggering) and toward your environment instead.

Panic attacks tend to peak about 10 minutes in and then begins a slow recovery process. So, the pounding heartbeat will usually subside on its own, but the severity can be reduced using the above tools and tips.

It is also useful to retrain your body. In order to make the above recommendations effective, it's necessary to practice the techniques we have discussed above so that they become second nature and can be employed automatically, no matter how much panic you’re sitting with.

Once you've reduced the severity of your panic attacks, the next step is to stop them from coming back. This is a process that involves a significant amount of practice because you essentially need to retrain your body to overcome the severe anxiety you experience during these attacks.

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

Ask Doctor a Question


Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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