Tightness in the chest can result from health issues, such as infection, injury, anxiety, cardiovascular conditions, lung conditions, and digestive issues.
If you feel like your chest is tightening, you may worry that you’re having a heart attack.
Some gastrointestinal, psychological, and pulmonary conditions can also cause a tight chest.
But if you believe you may be having a heart attack, it’s best to get emergency medical attention.
A heart attack can cause chest tightness and is considered a medical emergency. It happens when a sudden blockage causes a lack of blood flow to the heart.
People often describe heart attack pain as a pressure sensation or discomfort in the center of the chest. It can also feel like burning and may happen in or travel to the neck, jaw, shoulder, upper back, or abdomen. It may last minutes or longer.
Other symptoms of a heart attack can include:
- cold sweating
- nausea
- difficulty breathing
- fatigue
If you think you are having a heart attack, call 911 or your local emergency services.
Coronary artery disease
Coronary artery disease occurs when the major blood vessels that supply your heart with blood, oxygen, and nutrients become damaged or diseased. Damage usually results from the buildup of a waxy substance called plaque and inflammation in these arteries. This causes decreased blood flow to the heart.
As the artery is narrowed rather than completely blocked (as with a heart attack), blood can still reach the heart at rest but not with exertion.
Coronary artery disease can cause pain (angina), similar to a heart attack. The pain or discomfort typically occurs in the central chest but may radiate to the neck, jaw, or arm.
You may also experience:
- chest pressure or tightness
- pain that’s worse with exercise and improves with rest
- shortness of breath
Coronary artery disease increases your risk for heart attack, as the plaque can rupture and form blood clots, leading to complete blockage of blood flow to the heart. Angina that is new or worsening needs to be evaluated as a possible heart attack and requires emergency medical treatment.
Treatment can involve lifestyle changes, medications, and procedures, depending on the severity.
Many conditions can cause you to experience a tight chest. These can include:
COVID-19
COVID-19 may cause tightness in the chest for some people. This is an emergency symptom, so you should contact your doctor or medical services if you’re experiencing persistent chest tightness.
Chest tightness may result from inflammation of the heart’s lining (pericarditis) or inflammation of the heart muscle (myocarditis), both of which can lead to serious complications.
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- trouble breathing
- bluish lips
- persistent drowsiness
More commonly, those who have COVID-19 will experience mild symptoms that include fever, dry cough, and shortness of breath.
Anxiety
Chest tightness is one symptom of anxiety. You may also have other symptoms, such as:
- nervousness
- feeling of dread
- shakiness
- breathing rapidly
- pounding heart
- dizziness
- tightening and aching muscles
You may find that your anxiety culminates in a panic attack, which can last for 10 to 20 minutes.
GERD
Gastroesophageal reflux disease, often referred to as GERD, occurs when stomach acid travels back up from the stomach to the esophagus, the tube connecting your mouth and stomach.
Along with a tight chest, symptoms of GERD include:
- a burning sensation in the chest
- difficulty swallowing
- chest pain
- the sensation of a lump in your throat
Most people experience some form of acid reflux from time to time. However, people with GERD experience these symptoms at least twice a week or more severe symptoms once a week.
It’s possible to treat GERD with over-the-counter (OTC) medications and changes to certain behaviors around eating. Surgery and stronger medications may help those with severe GERD.
Muscle strain
Muscle strain, specifically of the intercostal muscles, can cause chest tightness.
These muscles attach your ribs to one another. Muscle strain typically occurs from intense activity, like reaching or lifting when twisting.
Along with muscle tightness, you may experience:
- pain
- tenderness
- difficulty breathing
- swelling
These symptoms typically worsen with certain body movements and positions.
You can try at-home treatments before seeing a doctor and seeking physical therapy. Though strains typically take a while to heal, sticking closely to your physical therapy regimen can support healing.
Learn more about muscle strains.
Pneumonia
Pneumonia is an infection of one or both lungs. Your lungs are filled with small air sacs that help oxygen get into the blood. When you have pneumonia, these small air sacs become inflamed and may even become filled with pus or fluid.
Symptoms can range from mild to severe, with mild symptoms resembling those of the common flu. In addition to chest tightness, other symptoms include:
- chest pain
- confusion, especially if you’re older than 65
- cough
- fatigue
- sweating, fever, chills
- shortness of breath
- nausea and diarrhea
You can develop complications from this infection. Consider talking with a doctor if you may have pneumonia.
Asthma
Asthma is a condition in which the airways in the lungs become inflamed, narrow, and swollen. This, in addition to the production of extra mucus, can make it hard to breathe for those with asthma.
The severity of asthma varies from person to person. Those who have this condition need to manage their symptoms.
Chest tightness is a common sign of asthma, along with:
- shortness of breath
- coughing
- wheezing
- a whistling or wheezing sound when exhaling
Some people may have these symptoms flare up at certain times, like when exercising. You can also have occupational and allergy-induced asthma, where irritants in the workplace or environment can worsen your symptoms.
Prescription medications can help manage asthma symptoms, but if you are feeling short of breath, you may need emergency treatment.
Ulcers
Peptic ulcers occur when a sore develops on the stomach, esophagus, or small intestine lining. While stomach pain is the most common symptom of an ulcer, it’s also possible to experience chest pain. Other symptoms are:
- burning stomach pain
- feeling full or bloated
- burping
- heartburn
- nausea
Treatment for ulcers typically depends on what’s causing them. However, an empty stomach can make your symptoms worse. Eating certain foods that buffer stomach acids may also bring some relief from these painful symptoms.
Hiatal hernia
A hiatal hernia occurs when part of the stomach pushes up through the diaphragm, or the muscle that separates the chest from the abdomen.
In many cases, you may not know you have a hiatal hernia. However, a large hiatal hernia causes food and acid to back up into the esophagus, causing heartburn.
In addition to heartburn and chest tightness, a large hiatal hernia will cause:
- burping
- difficulty swallowing
- chest and abdominal pain
- feelings of fullness
- vomiting of blood or passing of black stools
Treatments usually include medications to reduce heartburn, or, in more severe cases, surgery.
Learn more about hiatal hernia.
Rib fracture
A fractured rib often results from some trauma that causes the bone to crack. Though deeply painful, broken ribs usually heal on their own in 1 or 2 months.
However, it’s important to monitor rib injuries so that complications don’t develop. Pain is the most severe and common symptom of an injured rib. It usually gets worse when you take a deep breath, press on the injured area, or bend or twist your body. Treatment usually involves pain medication and physical therapy, such as breathing exercises.
Learn more about fractured ribs.
Shingles
Shingles is a painful rash that’s caused by a viral infection. It’s possible to get this rash anywhere on your body, but it usually occurs on only one side, either the right or the left. While shingles isn’t life threatening, it can be incredibly painful.
Typically, symptoms only affect the area of the body that’s affected by the rash. Symptoms can include:
- pain, burning, numbness, and tingling
- sensitivity to touch
- red rash
- fluid-filled blisters
- fever
- headache
- fatigue
- itching
If you suspect you have shingles, it’s best to talk with a doctor immediately. While there’s no cure for shingles, prescription antiviral drugs can speed up healing while reducing your risk of complications. Shingles usually lasts between 2 to 6 weeks.
Pancreatitis
Pancreatitis is a condition in which the pancreas is inflamed. The pancreas is located in the upper abdomen, tucked behind the stomach. It produces enzymes that help regulate how your body processes sugar.
Pancreatitis can go away on its own after a few days (acute pancreatitis), or it can be chronic, developing into a life threatening illness.
Acute pancreatitis symptoms include:
- upper abdominal pain
- back pain
- pain that feels worse after eating
- fever
- rapid pulse
- nausea
- vomiting
- tenderness in the abdomen
Chronic pancreatitis symptoms include:
- upper abdominal pain
- losing weight without trying
- oily, smelly stools
Initial treatments may include fasting (to give your pancreas a break), pain medication, and IV fluids. From there, treatment may vary depending on the underlying cause of your pancreatitis.
Learn more about pancreatitis.
Pulmonary hypertension
Pulmonary hypertension (PH) is high blood pressure in the arteries of the lungs and the right side of the heart.
The rise in blood pressure results from changes in the cells lining the pulmonary arteries. These changes cause the walls of the arteries to become stiff, thick, inflamed, and tight. This can reduce or block blood flow, raising the blood pressure in these arteries.
Other symptoms can include:
- shortness of breath
- fatigue
- dizziness
- chest pressure or pain
- chest tightness
- swelling of the ankles, legs, and eventually in the abdomen
- bluish color in the lips and skin
- racing pulse and heart palpitations
While there is no cure for PH, medication and possibly surgery can help to manage the condition. Finding the underlying cause for your PH can be crucial in treatment as well.
Learn more about pulmonary hypertension.
Gallstones
Gallstones are small pieces of solid material that form within the gallbladder, a small organ located under the liver.
The gallbladder stores bile, a green-yellow liquid that helps with digestion. Gallstones typically form when there’s too much cholesterol in the bile. Gallstones may not cause symptoms, and if that’s the case, they usually don’t require treatment.
However, you require treatment if you experience sudden pain in the upper right portion or center of your abdomen, in addition to:
- back pain
- right shoulder pain
- nausea or vomiting
If you have pain, a doctor may recommend surgery to remove the gallbladder. If you can’t have surgery, it’s possible to try to take medications to dissolve the gallstones, though surgery is generally the first course of action.
Costochondritis
Costochondritis is the inflammation of the cartilage in the rib cage. It often affects the cartilage connecting the upper ribs attached to the breastbone, or sternum. Pain associated with this condition usually:
- occurs on the left side of the breast
- is sharp, aching, and feels like pressure
- affects more than one rib
- worsens with deep breaths or coughs
Chest pain can range from mild to severe. In mild cases, your chest will feel tender to the touch. In severe cases, you may also experience shooting pain in your limbs.
Costochondritis has no apparent cause, so treatment focuses on pain relief. The pain usually subsides on its own after several weeks.
Learn more about costochondritis.
Esophageal spasm
Esophageal spasms cause painful contractions in the esophagus. The esophagus is the muscular tube that connects your mouth and stomach. These spasms usually feel like sudden, severe chest pain and can last from a few minutes to hours. Other symptoms include:
- difficulty swallowing
- feeling an object is stuck in your throat
- regurgitation of food or liquids
If this condition prevents you from eating and drinking, you may need help from a doctor. They may recommend:
- avoiding certain foods or drinks
- managing underlying conditions
- medications to relax your esophagus
- surgery
Learn more about esophageal contraction disorder.
Esophageal hypersensitivity
People with esophageal hypersensitivity are extremely sensitive to conditions that may affect the esophagus. They may report more frequent and intense symptoms, such as chest pain and heartburn. Esophageal hypersensitivity isn’t always a problem. However, if it occurs with conditions like GERD, the pain can be debilitating.
The symptoms of esophageal hypersensitivity are typically identical to those of GERD. Initial treatment usually involves acid suppressants. But you may also need other medications or surgery.
Esophageal rupture
A ruptured esophagus is a tear or hole in the esophagus, the tube that connects your mouth to your stomach, where food and liquids pass through.
Though uncommon, esophageal rupture is life threatening. Intense pain is the first symptom of this condition, usually where the rupture occurred, but also in the general chest area. Other symptoms may include:
- trouble swallowing
- increased heart rate
- low blood pressure
- fever
- chills
- vomiting, which may include blood
- pain or stiffness in your neck
Prompt treatment can help prevent infection and other complications. It’s important to prevent the fluid that travels through the esophagus from leaking. It can become trapped in the tissue of your lungs and cause infections and breathing difficulties.
Most people will need surgery to close the rupture. If you’re having trouble breathing or swallowing, seek treatment immediately.
Learn more about esophageal rupture.
Mitral valve prolapse
The mitral valve lies between the heart’s left atrium and left ventricle. As the left atrium fills with blood, the mitral valve opens, and blood flows into the left ventricle. However, when the mitral valve doesn’t close properly, a condition known as mitral valve prolapse occurs.
It’s also called click-murmur syndrome, Barlow’s syndrome, or floppy valve syndrome.
When the valve doesn’t close completely, the leaflets of the valve bulge, or prolapse, in the left atrium, or upper chamber.
Many people with this condition don’t have any symptoms. However, symptoms may occur if blood leaks back through the valve (regurgitation). Symptoms vary greatly from person to person and can worsen over time. They include:
- racing or irregular heartbeat
- dizziness or lightheadedness
- difficulty breathing
- shortness of breath
- fatigue
- chest pain
Only some cases of mitral valve prolapse require treatment. Depending on the severity, a doctor may recommend medications or surgery.
Learn more about mitral valve prolapse.
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) causes the heart muscle to be abnormally thick, or hypertrophied. This typically makes it harder for the heart to pump blood. Many people never experience symptoms and go their whole lives without being diagnosed.
However, if you do experience symptoms, HCM can cause any of the following:
- shortness of breath
- chest pain and tightness
- fainting
- sensation of rapid fluttering and pounding heartbeats
- heart murmur
Treatment of HCM depends on the severity of your symptoms. Medications can help relax the heart muscle and slow your heart rate. A doctor may also recommend surgery or the implantation of a small device, called an implantable cardioverter defibrillator (ICD), into your chest. An ICD continuously monitors your heartbeat and fixes dangerous abnormal heart rhythms.
Learn more about hypertrophic cardiomyopathy.
Pericarditis
The pericardium is a thin, sac-like membrane surrounding the heart. When swelling and irritation occur in this membrane, pericarditis occurs. Pericarditis has different classification types, and the symptoms can vary but may include:
- sharp and piercing chest pain in the center or left side of the chest
- shortness of breath, especially when reclining
- heart palpitations
- low grade fever
- overall sense of weakness, fatigue, feeling sick
- cough
- abdominal or leg swelling
The chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other. This condition can come on suddenly but last temporarily, and it is known as acute pericarditis.
When symptoms are gradual and persist for a long time, you may have chronic pericarditis. It may improve on its own over time. Treatment of more severe pericarditis may include medications and possibly surgery.
Learn more about pericarditis.
Pleuritis
Pleuritis, also known as pleurisy, occurs when the pleura becomes inflamed. The pleura is a membrane that lines the inner side of the chest cavity and surrounds the lungs. Chest pain is the main symptom. Radiating pain in the shoulders and back may also occur. Other symptoms include:
- shortness of breath
- cough
- fever
Several conditions can cause pleuritis. Treatment usually involves pain control and treating the underlying cause.
Pneumothorax
Pneumothorax happens when one of your lungs collapses, leaking air into the space between your lung and chest wall. When air pushes on the outside of your lung, it can collapse.
A pneumothorax often results from a traumatic chest injury. It can also occur from damage from an underlying chest disease or specific medical procedures.
Symptoms include sudden chest pain and shortness of breath. While a pneumothorax can be life threatening, some may heal on their own. If not, treatment usually involves inserting a flexible tube or needle between the ribs to remove excess air.
Learn more about pneumothorax.
Pulmonary embolism
A pulmonary embolism occurs when one of the pulmonary arteries in your lungs is blocked. This can result from blood clots that travel to the lungs from the legs.
If you experience this condition, common symptoms include:
- shortness of breath
- chest pain
- cough
You may also have additional symptoms.
While pulmonary embolisms can be life threatening, early detection and treatment greatly increase your chances of survival. Treatment usually involves surgery and medication. Doctors may also recommend medications that prevent further clots from forming.
Chest tightness isn’t a symptom to take lightly. See a doctor immediately if you experience chest tightness with other concerning symptoms. Chest tightness could be a symptom of a serious health condition, like a heart attack.
If your chest tightness has another cause, a doctor can recommend treatment or lifestyle changes that may help.
