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So back to your question: 1  Your chest hurts when you're emotionally sad because your brain processes physical and social pain in the same brain regions (dACC and AI) (the affective aspects of the pain). The fact that both pains overlap means the factors that decrease physical pain also decrease emotional pain.
Anxiety is very common, but so is heart disease. Chest pain due to anxiety is most likely caused by muscle contractions in the chest wall, where the pain tends to be localized, and is often a sharp pain that is either fleeting or interrupts a breath.