Can anxiety cause physical symptoms?

Yes — chest pain, palpitations, breathlessness, nausea, diarrhoea, muscle tension, headaches, tremor, and tingling are all common. These are real physiological effects, not imagined. New chest pain should still be medically evaluated before being attributed to anxiety.

The mechanism is real: adrenaline and cortisol alter heart rate, muscle tension, breathing depth and gut motility. Hyperventilation alone causes tingling, dizziness and chest tightness.

Anxiety should be a diagnosis of exclusion when symptoms are new, especially chest pain in anyone with cardiac risk factors.