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Persistent retrosternal chest pressure + dull jaw discomfort, anxiety
34M, moderate smoker.
Since Nov 2025, after taking metoclopramide + fluoxetine, I had what felt like a panic-like episode. Shortly after that, I started developing symptoms that have not fully resolved.
Main symptoms:
Persistent or recurrent retrosternal squeezing/pressure-like chest pain
Occasional electric shock-like sensation in the left chest
Dull discomfort in the jaw/teeth area (no dental cause found)
Jaw sometimes feels mildly tender when touched
Symptoms occur both at rest and during exertion
Chronic symptoms without full remission
No shortness of breath, nausea, dizziness, or sweating
The chest sensation feels more like angina-type discomfort than a typical panic attack.
Mental health / medication background:
After the initial episode in November 2025, I switched from fluoxetine to escitalopram, and also used a short course of benzodiazepines because fluoxetine was suspected to be too activating.
Following this change, I felt noticeably better for about 1–2 weeks.
However, in December 2025, I suddenly developed a stronger episode of retrosternal squeezing chest pain, which triggered significant fear and panic. Since then, the chest pressure has persisted as part of the ongoing symptoms.
I am also currently being treated for panic/anxiety disorder with escitalopram.
Even with my history of anxiety, I have never experienced symptoms like this before, which is why I’m confused about the cause.
Cardiac workup:
Resting ECG: normal
Echocardiogram: normal
Exercise stress test: achieved 12.4 METs, interpreted by the cardiologist as clinically and electrically normal, with no ischemia and no symptom reproduction
Blood tests including troponin: normal
➡️ Overall, cardiac causes were considered very unlikely.
Gastroenterology workup (endoscopy):
Grade 1 sliding hiatal hernia
Distal esophageal erythema / reflux esophagitis
Mild chronic gastritis
H. pylori infection (currently under eradication treatment)
Current issue:
Despite treatment, I still experience persistent retrosternal chest pressure and dull jaw discomfort, and I’m struggling to understand what is causing it.
Possible explanations I’ve considered:
GERD / reflux-related non-cardiac chest pain
Hiatal hernia–related discomfort
Esophageal hypersensitivity or spasm
Musculoskeletal chest wall pain
Referred or nerve-related pain affecting the jaw area
Anxiety/stress amplifying physical symptoms
Main question:
What could explain this combination of:
retrosternal squeezing chest pressure
dull jaw discomfort
normal cardiac workup (including stress test and troponin)
mild but real GI findings
absence of classic cardiac-associated symptoms
and symptoms that feel very different from my usual panic/anxiety episodes?
Has anyone experienced something similar or found an explanation for this kind of symptom pattern?
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Question—can stress cause one to clench the jaw and cause jaw discomfort ?
Yeah, I’ve started wondering about that too honestly.
Because my jaw discomfort is more of a dull/tension-like feeling rather than sharp pain, and sometimes the jaw feels mildly sore when touched. No dental cause was found either.
Considering I already have panic/anxiety disorder, plus the fact this all started after a major panic-like episode and medication changes (fluoxetine → escitalopram), I’m beginning to wonder if jaw clenching/tension could be contributing to that part of the symptoms.
Especially since the cardiac workup was reassuring and the GI findings (hiatal hernia, reflux esophagitis, gastritis, H. pylori) already explain part of the chest symptoms.
Iam a teeth clencher, not grinder while sleeping. It does cause left jaw and neck pain, but I have never experienced chest pain because of it. Esophageal spasms could be something to look into.
That actually makes sense and is helpful context.
I also do clench my jaw (especially during stress), and I’ve noticed it can definitely contribute to the dull jaw/neck discomfort I sometimes get alongside the chest tightness. But like you said, it doesn’t really explain the main symptom I’m dealing with, which is the deep, squeezing retrosternal pressure.
That’s why esophageal causes seem to fit better in my case. The combination of findings — inflamed lower esophagus, H. pylori gastritis, and a small hiatal hernia — plus the way symptoms can come on unpredictably (rest, walking, sometimes post-meal, sometimes not) does make esophageal spasm or hypersensitivity a strong possibility.
The “angina-like” quality is what makes it so confusing mentally, but I’ve read that esophageal spasm can closely mimic cardiac pain because of shared nerve pathways in the chest. Even normal cardiac testing (which I’ve had extensively — ECGs, echo, and a strong stress test) helps rule out the dangerous stuff, but doesn’t always fully explain the sensation itself.
I think at this point I’m trying to separate what is structural/medical (which seems to be GI inflammation + H. pylori) from what might be functional (spasm/hypersensitivity/anxiety amplification), because all of them can overlap and reinforce each other.
I appreciate you mentioning it though — jaw/neck tension definitely seems to be an additional layer in my case, just not the primary driver of the chest pain.
Still sounds like a heart issue...did they give you a 24 hour heart monitor or MRI ?
@jemimapuddled
I understand why it can sound cardiac from the description — honestly that’s exactly why it has been so mentally difficult for me too.
I haven’t had a cardiac MRI, but I did have a very extensive cardiology evaluation including multiple resting ECGs, a normal echocardiogram, and a high-level stress test where I reached 12.4 METS at 18% incline with a peak HR of 185 bpm (117% predicted) without ischemic changes or abnormalities. My cardiologist felt very reassured by those results and did not think additional cardiac imaging was necessary at this stage.
I also had GI findings that could realistically explain the symptoms: lower esophageal inflammation, H. pylori gastritis, and a small hiatal hernia. So right now the working theory is more esophageal irritation/spasm/hypersensitivity rather than a primary heart issue.
That said, I won’t pretend it’s easy psychologically — because the squeezing pressure can still feel extremely “cardiac” in the moment, especially during walking or when it radiates toward the jaw/neck area. So even with reassuring tests, it’s been hard emotionally to fully disconnect the sensation from fear of the heart.