Q. Is the constant pain in the sternum related to heart problems or anxiety?

Answered by
Dr. Prashant Valecha
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 26, 2022

Hi doctor,

I am a 23-year-old female; I have dull sternal ache on both sides of the sternum but preferably on the left, and it worsens when laying down. I have severe anxiety disorder and panic disorder and suffer from many panic attacks. I have no history of heart problems and do not get tachycardia during panic attacks. My heart rate during panic attacks is around 60 - 70. I have a stress test done with negative results four years ago. My incidental RBBB on EKG during a panic attack is QRS 121ms, RSR (regular sinus rhythm) in V1 & V2, PCP EKG indicated no RBBB 110ms, QRS duration with RSR pattern in V1 only. I want to know if my constant sternal pain is something related to my heart or anxiety. My PCP does not think I need to see a cardiologist. I have no other health problems and no symptoms of POTS or presyncope. I exercise and get my heart rate up to 170. RHR is 50-60, blood pressure, lipid panel, was normal, and no diabetes. Currently, I am taking Lexapro 10mg. I took Zoloft, Welbutrin, Prozac, and Effexor for this same issue. Please help me.



Welcome to

Your ECG (electrocardiogram) is normal, with no significant ST - T (ST-segment and T wave) changes. Blood work-up is good. No need to worry. Yes, panic attacks can be associated with precordial pain. I suggest continuing treatment for panic attacks. You can repeat TMT (treadmill test) or stress test, it will be mostly negative, but it will give relief. At your age and for the female gender, chances of CAD (coronary artery disease) are rare.

Thank you.

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