Literally yesterday I treated a patient who has had 4 presentations this year to emergency with chest pain that sounds cardiac enough, except it lasts for several hours sometimes and sometimes she can 'feel it coming on' and heD it off by relaxing. Still, it could always be a heart attack and until a through work up is done to exclude it (acutely, ECG and troponins, as outpatient, stress test), it is worth investigating.

In her case the deeper I delved into her personal life the more it became apparent that this was a clear cut case of stress/anxiety related pain- that was having physical manifestations.

for her, we discussed exactly what you are describing: that anxiety leads to the pain, which then leads to fear about it being a heart attack, which worsens it etc. we went through the work up we had planned and after her second troponin was negative we sent her home to have an outpatient stress test to see if she may have some partial blockages. If that is clear, we as medical personnel feel comfortable knowing that her episodes are non-cardiac in nature- and referral to psychologist for CBT (which she had previously undertaken to good effect) was recommended. I think she will do well, she appears willing to seek help.

I hope you are also seeking help for your anxiety, and that you have had at least one good work up for your chest pain to exclude a cardiac cause.