What Does It Mean When Your Chest Feels Tight?

Medically reviewed by Jeffrey S. Lander, MD

When your chest feels tight, it's easy to be concerned since chest tightness and pain can have various causes, such as infections, acid reflux, and heart attacks. Chest pain also accounts for approximately 5% of all emergency room visits in the U.S.

Depending on the cause, sensations can be described as dull or sharp, can feel like squeezing or stabbing, or may be considered deep. The location of the pain—which can vary from localized to less pronounced—can also help determine the cause. Here's what else you need to know about chest tightness.

Chest Tightness Symptoms

There are two main types of chest pain: visceral and somatic. The pain types can be described by their sensation and location.

Visceral pain can be described as dull or deep and can feel like pressure or squeezing. This type of pain usually isn’t localized as it spans larger surface areas—like into the shoulders, jaw, or left arm—as a result of nerves traveling near the spinal cord. Other symptoms, such as nausea and vomiting, often accompany visceral pain.

Somatic pain is more specific and can be characterized by sensations that are sharp, stabbing, or poking. People who experience this type of pain can usually pinpoint the exact location of the pain. The pain is rare beyond areas other than the chest.

Depending on the cause, other symptoms that may accompany chest tightness include:

• Calf pain or swelling

• Cough
  

• Excessive fluid retention (often in the feet, ankles, and legs)

• Excessive sweating

• Fever

• Nausea and vomiting

• Recent illness

• Shortness of breath

• Upset stomach
  

What Causes Chest Tightness?

Tightness in the chest can result from multiple issues. The most common occurrences include:

Cardiovascular Disease

Cardiovascular disease is an umbrella term describing diseases that affect the heart or blood vessels. Among the most common is coronary artery disease (CAD). CAD is the leading cause of death in the U.S., accounting for approximately 610,000 deaths annually, as well as the leading cause of heart attack.

CAD occurs when plaque—fat, cholesterol, calcium, and other substances in the blood—clogs the arteries and forms blood clots. The clots block blood and oxygen from reaching the heart. When there is poor blood flow through the blood vessels of the heart muscle, a type of chest tightness called angina can occur.

In addition to tightness, angina might feel like pressure, squeezing, or burning in your chest. That discomfort may radiate to your arms, shoulders, neck, jaw, throat, or back. Of note, cold weather or physical activity, such as going upstairs or having sex, might bring on angina.

With either a chest cold or pneumonia, you can develop pericarditis. Pericarditis is inflammation of the pericardium, the sac-like membrane surrounding the heart. It can also cause chest pain, which can be sharp and worsen when breathing or swallowing.

Acid Reflux

Acid reflux occurs when stomach acid repeatedly flows back into the esophagus, the point where the mouth and stomach connect. This sensation is called heartburn. Because of how close the chest and esophagus are, heartburn can mimic the symptoms of angina.

Besides chest tightness, other signs of acid reflux include:

• A bitter or acidic taste in the mouth

• A burning sensation in the chest, usually after eating or at night

• Pain that worsens when lying down or bending over
  

Musculoskeletal Issues

Chest pain may be due to a musculoskeletal issue, meaning that the pain is due to a problem affecting the muscles, bones, tendons, ligaments, joints, or cartilage. Often described as tenderness, this type of chest discomfort can stem from a wide range of issues, including rheumatic diseases—like fibromyalgia—or rib fractures.

Musculoskeletal chest pain typically starts gradually and lasts hours to days. It may get worse when you take a deep breath, turn, or move your arms.

Asthma

Asthma is a condition that causes your airways to become inflamed. When these tubes that carry air in and out of your lungs narrow, you can experience chest tightness.

Other symptoms of asthma include:

• Coughing, especially at night or in the early morning

• Shortness of breath

• Wheezing

Chest tightness and other asthma symptoms can worsen when you have an asthma attack. A wide range of triggers, including allergies, smoke, and exercise, can bring on asthma attacks.

Respiratory Conditions

Some viral infections can cause a chest cold, also known as acute bronchitis. A chest cold is when the lungs’ airways get inflamed and mucus develops. One of the major symptoms of the condition is coughing, which can be accompanied by chest soreness.

Viral infections may also cause pneumonia, which is inflammation of your lungs' air sacs called alveoli. The sharp or stabbing chest pain can get worse as you breathe deeply or cough.

Infections

The skin, muscles, bones, and other tissues between the neck and abdomen form a protective barrier known as the chest wall. The chest wall protects the heart, liver, lungs, and other vital organs. When the immune system becomes compromised, the chest wall can become infected.

Infections that can cause sharp or dull chest pain, worsened by breathing, can include:

• Costochondritis: Inflammation of the cartilage between the ribs and breastbone

• Empyema: The rare development of pus between the lungs and the lung lining

• Pleurisy: Swelling of the lung lining

Mental Health Disorders

Panic disorder and generalized anxiety disorder are the two most common psychiatric disorders associated with chest pain. Unlike a heart attack, chest pain as a result of anxiety is usually brought on by stress and subsides when the panic episode comes to an end.

Other signs that your chest tightness may be due to a mental health issue include:

• Chills

• Difficulty breathing

• Pounding or racing heart

• Tingly or numb hands

• Trembling

• Stomach pain or nausea

• Sweating

• Weakness or dizziness

Treatments

Treatment for chest tightness can vary depending on the cause. The pain can sometimes improve on its own or over time with assistance. Before trying any remedies on your own, it's best to check with a healthcare provider.

Chest pain that is severe, continuous, or worsens over time should receive immediate medical attention. Get emergency help if light-headedness, cold sweats, nausea, or unusual tiredness accompany the pain. Seeking care is especially essential if you or your loved one has a history of cardiovascular disease.

If the tightness isn't an immediate concern, there are actions that can help reduce discomfort. For instance, if your chest pain is from anxiety, you can partake in mental health therapy to learn how to cope best. You can also take acid-blocking drugs called proton pump inhibitors or H2-blockers to help reduce acid reflux if the pain is from heartburn.

Should You Be Concerned About Chest Tightness?

Not all chest tightness is a cause for concern. Common causes of chest pain that aren’t life-threatening include gastrointestinal reflux disease, musculoskeletal issues, and anxiety.

The most likely indication of a cardiac-related—or heart-related—episode is pain or discomfort in the center or side of the chest that continues or worsens over time. The pain may also subside and return.

Chest tightness might also be heart-related if you experience symptoms like light-headedness, cold sweats, nausea, or unusual tiredness. These symptoms can indicate a heart attack, so immediately dial 9-1-1.

A Quick Review

While the discomfort or pain may be disconcerting, the cause behind the tightness is not always a medical emergency of the heart. Instead, tightness may be due to asthma, acid reflux, anxiety, or muscle strain. When the cause is not heart-related, the discomfort often subsides on its own.

Depending on the cause, there might also be steps you can take to manage the discomfort. Signs that your chest tightness may signal something serious affecting the heart include pain that radiates to your arm, shoulders, or jaw and pain that continues or worsens—especially if the pain follows physical activity or if you have a history of cardiovascular disease. 

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