You’ll need to find out what is causing tightness in your chest, as the treatment will depend on the cause. In some cases, you might need immediate medical attention.
This article covers what causes a tight feeling in the chest, what other symptoms to watch for, and when it’s time to book a medical appointment or call 911.
What Causes Chest Tightness?
Tightness in the chest, also called chest pressure or chest pain, can be defined as any discomfort between your lower neck and upper abdomen.
How chest tightness feels and how often you feel it can vary. You might feel it all through your chest, in one spot, or in several spots around the chest.
Some people describe it as a feeling of fullness or like there’s weight on their chest. Some may experience it only once while people with certain conditions, like asthma, may have it often.
Causes of Chest Tightness
Tightness in the chest may make you think first of having a heart attack. But that’s only one possible reason for chest tightness.
· Burning feeling
· Cold sweats
· Crushing feeling of weight on your chest
· Difficulty breathing
· Nausea
· Pain that radiates to your jaw, shoulder blades, or left arm
· Shortness of breath after inactivity
Common causes of chest pain and tightness are:
Musculoskeletal (muscle and bone) issuesInfectionsRespiratory conditionsCardiovascular (heart) diseaseGastrointestinal (digestive) problemsPsychological concerns
In the United States each year, more than 7 million people seek emergency care for chest pain. The vast majority of these cases are not caused by a heart or lung condition.
Musculoskeletal Causes and Treatments
Tightness in your chest can have causes that aren’t related to your heart. About half of all people who see a healthcare provider for chest pain are diagnosed with a muscle and/or bone (musculoskeletal) condition. Several of them can cause chest pain and tightness.
Muscle Strain
Tightness in your chest can be muscular. If you’ve pulled a muscle—particularly in your chest, abdomen, or upper to middle back area—you may experience chest tightness and pain when you’re active. In some cases, the strain may be severe enough to cause pain when you breathe.
Strain in the muscles of the chest wall can be caused by:
Overstretching while playing sports or working outMuscle fatigueRepetitive or forceful motionsContact injury, such as from a football tackleNot warming up muscles before exercise
For chest muscle strains that cause pain and tightness, the first line of treatment usually involves the RICE method:
Rest: Take a break from activity. You can return to light activity after a few days but return to resting if tightness and pain return. Ice: Apply an ice pack to the strained muscle for up to 20 minutes three times a day. This reduces inflammation. Compression: Wrap a compression bandage around your torso. It can help reduce inflammation and may provide relief. Elevation: Sit upright and maintain good posture. Use extra pillows to prop up your chest at night while you sleep.
You may also want to take over-the-counter (OTC) medications such as non-steroidal anti-inflammatory drugs (NSAIDs). They include Advil/Motrin (ibuprofen) and Aleve (naproxen).
See a healthcare provider if you have severe pain, inflammation, or bruising from a chest injury, or if symptoms don’t get better within two weeks.
Rib Fracture
Tightness in the chest can be a sign of a broken rub. A rib fracture is a common injury that occurs when one or more bones in your rib cage crack or break. Rib fractures can cause severe chest pain that sometimes makes your chest feel tight.
Rest is important when nursing a rib fracture. Your healthcare provider may also suggest icing and elevation (e.g., reclining to sleep). Providers used to use compression wraps for broken ribs. Most have stopped doing this because it increases your risk of pneumonia or a collapsed lung.
Most rib fractures heal on their own in about six weeks. The primary treatment is pain control, such as with NSAIDs or prescription painkillers (opioids) like Vicodin (hydrocodone/acetaminophen) or OxyContin (oxycodone).
Be sure you don’t overdo it while healing. Always get medical care for a fracture and follow your healthcare provider’s advice.
Costochondritis
Feeling tightness in the chest can be a symptom of costochondritis, which is inflammation of the cartilage in the rib cage. It causes chest pain and sometimes chest tightness, often in the middle and upper rib areas. The pain may get worse if you breathe deeply, move, or stretch.
Causes of costochondritis include:
Severe coughingChest injuryInfectionPhysical strain from repetitious motions or sudden exertion
Costochondritis is also common in the chronic pain condition of fibromyalgia.
Treatment generally includes:
NSAIDs Stretching exercises For severe pain, opioids or antidepressants for pain control
If your chest hurts more when you lie flat, you may want to prop yourself up on extra pillows or sleep in a recliner.
See your healthcare provider if your costochondritis doesn’t improve with home treatment.
Infectious Causes and Treatments
Tightness in the chest can also be caused by infections like the common cold. Chest tightness can also have more serious infectious causes, like shingles. You might also have tightness in your chest from mucus/fluid build-up, inflammation, or other problems.
Congestion
Tightness in the chest when you have a cold or the flu can be from chest congestion. Excess mucus in your airways can restrict breathing and cause:
CoughingWheezingChest tightness
Chest congestion is most often caused by a virus. For chest tightness from a respiratory infection:
Drink fluids: This thins out mucus. Warm fluids (tea, soup broth, hot water) are especially helpful. Use a humidifier or take a hot shower: The steam can help clear up congestion. Try using it at night so you can sleep better. Peppermint essential oil in your humidifier helps, too. Take a decongestant: These OTC drugs help break up mucus and clear congestion. Common ones are Sudafed (pseudoephedrine) and Sudafed PE (phenylephrine). Take an expectorant: These help break up mucus so you can cough it up. Common ones are Robitussin (dextromethorphan) and Mucinex (guaifenesin). Use a vapor rub on your chest/throat: Most rubs have a menthol-based ingredient that may help you feel less congested.
Antibiotics are ineffective against viruses. They’re designed to kill bacteria.
Pneumonia
Tightness in the chest can also happen with more serious lung infections. In pneumonia, your lung’s air sacs become inflamed, which can cause them to fill with fluid or pus. Pneumonia can be caused by viral, bacterial, or fungal infections. In the U.S., the most common causes include:
A fever (temperature of 100. 4 degrees Fahrenheit or higher)Coughing up bloody mucusShortness of breath or difficulty breathingSymptoms that linger for more than three weeks
Influenza (flu) COVID-19 Streptococcus pneumoniae
Symptoms of pneumonia include:
Fever and chillsCoughMucus that’s greenish, yellow, or bloodyShortness of breathChest pain and/or tightness
The chest pain of pneumonia may be sharp and get worse with deep breaths or coughing.
Treatment for pneumonia depends on the cause, severity, your age, and your overall health. If it was caused by a bacteria, you’ll likely be given an antibiotic. For viral causes, an antiviral medication may help.
Symptom management consists of:
Fever reducers like NSAIDs or Tylenol (acetaminophen) Fluids, especially warm ones, to break up mucus A humidifier or hot shower Avoiding smoke and other airborne substances that can irritate your lungs Getting lots of rest
Get medical help right away if you have chest pain plus:
Difficulty breathingBluish lips and fingertipsA high feverCough with mucusSymptoms are severe or getting worse
Pneumonia can be life-threatening, especially in children two and under, adults over 65, people with a weak immune system, and people in poor health.
COVID-19
Tightness in the chest can also be a symptom of COVID-19. You might also have other symptoms, such as:
FeverDry coughRunny noseCongestionLoss of tasteShortness of breathSometimes, tightness in the chest
According to the Centers for Disease Control and Prevention (CDC), you should seek immediate medical attention if your COVID-19 symptoms include chest tightness along with:
Trouble breathingBluish lipsMental confusionAn inability to stay awake
The CDC recommends getting treatment for COVID-19 within days of when symptoms appear. Treatments include:
Antiviral drugs or monoclonal antibodies (which help the body recognize and fight the virus better) for very sick or high-risk people Immunosuppressant drugs (if you’re hospitalized) A ventilator (if you’re hospitalized) An inhaler OTC fever reducers (NSAIDs or Tylenol) Staying hydrated Rest
The sooner you start treatment, the more effective it will be. However, chest tightness may linger in some people with a COVID-19 diagnosis. One study found that COVID chest pain lasts up to two months in 22% of people treated for COVID-19. Research continues into “long COVID” and related post-COVID health impacts.
Shingles
A feeling of tightness in the chest can also be a symptom of shingles. Shingles is an infection caused by the varicella-zoster virus—the same virus that causes chickenpox. The virus stays in your system forever and in certain circumstances—such as illness, a weakened immune system, or times of high stress—it can reactivate to cause shingles.
Trouble breathingPersistent chest pain/pressureConfusionInability to wake up, stay awakePale, gray, or bluish skin, lips, or nails
Shingles involves:
A painful rash, usually on the torsoFeelings of tightness in the chest (if the pain is severe)Burning, shooting painsTingling, itching, or numbness in affected areasFever and chillsHeadacheUpset stomach
Your healthcare provider may give you antiviral medications and tell you to take NSAIDs or Tylenol to help with shingles pain. Antibiotic creams for the skin are often prescribed to prevent a bacterial infection. Ask your provider before you use any other kinds of lotion or cream on your rash.
Get urgent medical help if you have shingles blisters on your face, especially near your eyes. That can lead to serious complications, such as blindness, facial paralysis, or encephalitis (brain inflammation).
Lung Conditions
Tightness in the chest can be a sign of a problem with the lungs. Asthma and chronic obstructive pulmonary disease (COPD) may immediately come to mind when you think of lung conditions that may cause chest tightness, but there are others—some of which require urgent medical attention.
Asthma
Tightness in the chest is common in people with asthma. If you have asthma, exposure to lung irritants or allergens can cause your airways to constrict and narrow. This leads to:
Chest tightnessPainPressure
Other telltale symptoms of asthma include:
Shortness of breathWheezingCough
Asthma treatments come in two types: immediate rescue treatment for asthma attacks and long-term control medications that prevent attacks. Both types of treatment are usually given via inhalers. Some prescription medications are also available.
A big part of asthma treatment is avoiding the things that set it off. Your healthcare provider can help you identify triggers and work with you on an asthma action plan.
COPD
A feeling tightness in your chest can happen if you have COPD. Shortness of breath from constricted airways is the main symptom of COPD, but you may feel chest tightness or like something is wrapped around your chest—even while at rest. You could also have a cough and a lot of mucus.
Your lips or nails look blueYour nostrils flare when you inhaleThe skin of your throat or between the ribs looks stretched when you inhaleYou’re breathing rapidly (30 or more breaths per minute)It’s hard to talk or walk at a normal pace
COPD is the result of irritation and damage to your lungs and airways, which is often caused by long-term exposure to problem substances such as cigarette smoke, air pollution, or chemical fumes.
COPD is often treated with:
Inhalers Nebulizers (machines that deliver medication as a mist) Corticosteroids such as prednisone, hydrocortisone, and methylprednisolone Phosphodiesterase-4 inhibitors such as Otezla (apremilast), Eucrisa (crisaborole), and Daliresp (roflumilast)
Pulmonary Hypertension
Tightness in the chest can be a sign of a chronic lung disorder. Pulmonary hypertension (PH) is a progressive lung disease in which the arteries that carry blood from the heart to the lungs become narrow. It can be caused by many things, including:
Chest painBreathing or talking difficultyFeverRacing heartbeatBlue lips or nailsSlurred speechConfusion or disorientationDizzinessDifficulty waking up
Autoimmune diseases that damage your lungs Birth defects Blood clots in the lung (pulmonary embolism) Heart disease HIV Lung disease Obstructive sleep apnea
Symptoms of PH include:
Shortness of breath from everyday activities, like walking up the stairsFatigueDizzinessChest painChest tightness when strain is placed on the heart during activitySwelling (edema) in the legs and anklesWeaknessBlue lips or skin
Pulmonary hypertension can’t be cured, but medications can help manage it. They include:
Calcium channel blockers to decrease blood pressure Diuretics to rid the body of excess fluid that puts pressure on the heart In some cases, oxygen
You should make an appointment with a healthcare practitioner if:
You notice worsening shortness of breath during activityYou have chest painYou have other symptoms that suggest pulmonary hypertension
Pleuritis
Tightness in your chest can be a sign of inflammation. Pleuritis (also called pleurisy) is inflammation of the pleura—the large, thin layer of tissue that separates your lungs from your chest wall. It’s caused by various things, including:
Viral or bacterial infection Asbestos-related disease Some cancers, such as lung cancer, lymphoma, and mesothelioma Chest trauma Blood clot in the lung Rheumatoid arthritis Lupus
Symptoms of pleuritis include:
Sudden and sharp pain in the chest when breathingPain with coughing or deep breathsOngoing chest pain and tightnessShortness of breathFeverBody aches
Pleuritis generally clears up when the cause is successfully treated, such as by clearing up an infection with antibiotics or antivirals. To manage pain from pleuritis, your healthcare provider may suggest NSAIDs or, for severe pain, steroid drugs to reduce inflammation.
You should make an appointment with a healthcare provider if you have symptoms that could be from pleuritis, especially if you have a condition that could cause it.
Pneumothorax
Tightness in the chest can have serious, even life-threatening, causes. Pneumothorax (collapsed lung) occurs when a hole in the lung allows air to escape and fill the space between the lung and chest wall. The trapped air puts pressure on the lung, so it cannot expand as it should when you take a breath. This can cause:
Severe chest painCoughing up bloodNauseaExcessive sweating
Chest tightnessSudden, sharp chest pain that’s worse when you cough or breath deeplyShortness of breathBeing easily fatiguedRapid heart rateBluish skin (due to lack of oxygen)
Pneumothorax can be caused by chest trauma, extreme pressure on the lungs, or lung diseases including:
COPD Asthma Cystic fibrosis Tuberculosis Whooping chough
A minor collapsed lung can resolve on its own in a few weeks. In larger ones, the air needs to be removed. A healthcare provider can place a chest tube between your veins to drain the air and let the lung expand properly.
Other treatments include oxygen therapy and surgery to prevent a future collapse.
Pulmonary Embolism
You may feel tightness in your chest if you have a blood clot. Pulmonary embolism is a sudden blockage of an artery in the lungs, most often caused by a blood clot that forms somewhere else and travels to the artery. It can cause low oxygen levels in your blood, which may damage your lungs and other organs.
Not everyone has symptoms of pulmonary embolism. Those who do may experience:
Sudden shortness of breathChest pain and tightness that’s usually worse with breathingAnxietyDizziness or faintingIrregular heartbeat or racing heartCoughing up bloodSweatingLow blood pressure
Risk factors for pulmonary embolism include:
Genetic conditions that raise the risk of blood clots Family history of clotting disorders Injury (especially to the legs) Surgery, especially orthopedic procedures Limited mobility (from things like bed rest, long-distance air travel, paralysis) Previous clots Getting older Cancer and some cancer treatments Some medical conditions (e. g. , heart failure, COPD, high blood pressure, stroke) Pregnancy Obesity Varicose veins Smoking cigarettes
This condition requires immediate medical attention. Treatments include:
Blood-thinning medications such as Coumadin (warfarin) Intravenous (IV) “clot buster” medications (called thrombolytics or fibrinolytics) A filter in the vena cava (a large blood vessel carrying blood to the heart) to keep clots out Surgery to remove the clot (pulmonary embolectomy) Percutaneous thrombectomy (a hollow tube in the blood vessel is used to remove or dissolve the clot)
Heart Issues
Tightness in your chest might make you think you have a heart problem, and it’s true that it can be a sign of something wrong in your cardiovascular system.
Pain and swelling in one leg Redness or discoloration Warmth
If you have these symptoms, get urgent medical care.
Chest pain and tightness may be caused by a number of heart-related conditions, some of which are serious. It’s important to see your healthcare provider, who can help to determine if you have any of the following concerns.
Coronary Artery Disease
A tightness in your chest can be a sign of coronary artery disease (CAD). CAD is caused by a build-up of cholesterol and other substances in the coronary arteries (large blood vessels of the heart). That makes the arteries narrow or can block them entirely. This can cause a heart attack, which is often the first sign of CAD.
Narrowed arteries can cause:
Angina (chest pain, tightness, heaviness, pressure, fullness, or squeezing) Pain or discomfort in the arms or shoulders Weakness Light-headedness Nausea Cold sweat Shortness of breath
Risk factors for CAD include:
Family history of heart disease, especially before age 50Excess body weightUnhealthy dietSmoking
If you have CAD, your healthcare provider may prescribe drugs that:
Help to improve blood flowWiden arteriesPrevent blood clotsLower your cholesterolLower your blood pressureEase chest pain
Surgery may be an option for more serious cases of coronary artery disease. They include:
Percutaneous coronary intervention (PCI): Opens narrowed or blocked arteries, usually by using a stent to prevent future narrowing Coronary artery bypass grafting (CABG or “heart bypass”): Re-routes blood through other blood vessels to bypass the blockage; usually done in severe CAD involving multiple arteries Transmyocardial laser revascularization or coronary endarterectomy: For angina from CAD; reserved for when other treatments don’t work or the risk of those treatments is too high
Healthy lifestyle habits are also encouraged when you have CAD. Those include:
Reaching/maintaining a healthy weight Eating a heart-healthy diet Being physically active Lowering and/or managing stress Not smoking Getting enough quality sleep
Mitral Valve Prolapse
Tightness in the chest can occur if there’s a problem with the heart valves. In mitral valve prolapse (MVP), the valves between the left atrium and left ventricle of your heart develop a bulge (prolapse). That means they can’t close correctly and blood can flow backward through the valves.
MVP can cause a heart murmur (a “swooshing” sound when listening to the heartbeat) and a number of other symptoms, including:
Chest tightness or pain, which can be recurrent and incapacitating, and may occur even at restFast and/or irregular heartbeatIn severe cases, blood clots, heart attack, or stroke
MVP’s cause is unknown, but it may have a genetic component. Other conditions may contribute to its development, including:
Inherited connective tissue diseases such as Marfan’s syndrome Coronary artery disease Heart attack (myocardial infarction) Rheumatic heart disease Hypertrophic cardiomyopathy (an enlarged left ventricle)
MVP isn’t usually serious and may not require treatment. If it does, treatment may include:
Beta-blocker drugs: Control fast heart rhythms; Tenormin (atenolol), Lopressor/Toprol XL (metoprolol), Bystolic (nebivolol) Blood thinners: For atrial fibrillation or severe enlargement of the left atrium; Coumadin (warfarin), aspirin Surgery: mitral valve repair or replacement
Even if you don’t need treatment, your healthcare provider should monitor the condition.
Pericarditis
Feeling tightness in your chest can be a sign of inflammation. Pericarditis is inflammation of the protective membrane surrounding the heart (the pericardium). This thin tissue allows the heart to change in size with each heartbeat.
When inflamed, the membrane can rub against the heart and cause chest tightness pain that:
Feels sharp and stabbingIs felt in the neck, shoulder, back, or abdomenMay be worse when lying down or taking deep breathsMay be relieved by leaning forwardIf caused by infection, is associated with fever, chills, or sweatingSwelling of the feet, ankles, and legsAnxietyDry coughFatigue
Pericarditis is most common in men between the ages of 20 and 50. The cause is often unknown, but it may be linked to:
Viral infections that cause a chest cold or pneumonia Bacterial infections (less common) or fungal infections (rare) Cancer Autoimmune disease HIV/AIDS Hypothyroidism (underactive thyroid) Kidney failure Rheumatic fever Tuberculosis Heart attack or trauma to the heart or chest Radiation therapy to the chest area Some cancer drugs or immunosuppressants
Mild pericarditis may clear up on its own. More serious cases require treatment, especially if it becomes potentially life-threatening. Treatments for pericarditis include:
NSAIDs Corticosteroids to lower inflammation Antibiotics for bacterial infections Antifungals for fungal infections Diuretics to remove excess fluid, which may contribute to inflammation
For cases with severe fluid buildup, healthcare providers may perform a procedure to drain the excess fluid.
Hypertrophic Cardiomyopathy
Tightness in your chest could be a sign that you have a heart condition. For example, hypertrophic cardiomyopathy (HCM) involves abnormally thick walls of the left ventricle, one of the heart’s four chambers. The thickness makes it harder for the heart to pump blood. This is believed to be due to abnormal genes affecting the heart muscle.
HCM can be obstructive (blocking or reducing the flow of blood) or nonobstructive. Most people have the obstructive type.
Symptoms of HCM often get worse with exertion. They may include:
Chest pain and tightnessShortness of breathAbnormal and/or rapid heartbeatDizziness, lightheadedness, and faintingSwelling in the feet, ankles, legs, and abdomenFatigue
HCM is generally treated with medications and medical procedures. Treatments may include:
Medicines that correct the abnormal heart rhythm Blood thinners to reduce blood-clot risk A pacemaker to control the heart rhythm An implanted defibrillator that corrects life-threatening heart rhythms
A heart-healthy lifestyle is recommended for managing HCM, as well.
Coronary Artery Tear
Tightness in your chest can be a medical emergency that requires immediate medical attention. For example, chest tightness can be a sign of a rare condition called spontaneous coronary artery dissection (SCAD), which happens when there is a sudden tearing of a blood vessel in the heart.
When the artery wall tears, blood can get trapped between the layers of the wall and cause a bulge that restricts or blocks the flow of blood. That can cause a heart attack.
The causes of SCAD are unknown. It happens most often in biological females who:
Are otherwise healthyHave few or no heart-disease risk factorsRecently gave birth (30% of cases)Are having a menstrual period
When SCAD happens in biological males, it’s usually after extreme exertion, such as a chest that feels tight when you run. About 80% of SCAD cases are in people who are young, healthy, and active. For that reason, it’s important for everyone to know the signs of a heart attack:
Chest pain, tightness, or discomfort, usually in the center or on the left side of the chest Pain that lasts for more than a few minutes, or goes away and comes back Pain that’s described as uncomfortable pressure, squeezing, or fullness Pain that radiates to the jaw, neck, back, arm(s), or shoulder(s) Weakness, lightheadedness, or fainting Shortness of breath
Treatment of a SCAD heart attack is generally more conservative than for other types of heart attacks. For example, it’s more likely to involve medication and blood-pressure control than stent placement or bypass surgery.
If you have SCAD once you’re at high risk of having it again. It’s important to adopt a heart-healthy lifestyle and see a cardiovascular specialist for regular monitoring.
Gastrointestinal Conditions
Tightness in your chest can also be caused by conditions in other parts of your body. Some gastrointestinal (digestive) issues can cause tightness in the chest and pain in the chest area. The pain is felt near the heart but actually comes from digestive organs in that area, including the stomach and esophagus.
GERD
A tight feeling in your chest could be a sign of acid reflux. Gastroesophageal reflux disease (GERD) involves chronic acid reflux, which is when the acid-containingntents of your stomach push back up into your esophagus (the tube that runs from your throat to your stomach).
Acid reflux is caused by problems with a structure called the lower esophageal sphincter (LES). The LES opens when you swallow, then is supposed to shut tightly so stomach contents stay out of the esophagus. When it’s weak or doesn’t close properly, reflux occurs.
GERD symptoms include:
Heartburn Regurgitation (stomach contents rising up into the throat or mouth) Chest tightness that may feel like a weight on your chest or a crushing pain Nausea Problems swallowing Chronic cough Hoarseness
Over time, stomach acids can damage the esophagus and lead to complications.
GERD is treated with over-the-counter (OTC) or prescription medications such as:
Antacids: Alleviate heartburn symptoms; not for long-term use; OTC; Tums, Rolaids Proton pump inhibitors (PPIs): Lower stomach-acid production, heal esophageal damage; OTC or prescription; Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Aciphex (rabeprazole), Protonix (pantoprazole) H2 blockers: Older drugs that are used less often now; OTC and prescription; Tagamet (cimetidine), Pepsid/Zantac (famotidine), Axid (nizatidine)
Lifestyle changes are also recommended for GERD, including:
Reaching and maintaining a healthy weightNot smokingChanging your diet and eating habitsElevating your head while you sleep
Some surgeries may help, but due to a greater risk of complications than medications, they’re usually reserved for when symptoms don’t improve with medications and lifestyle changes. Common procedures include:
Fundoplication: The surgeon sews the top of the stomach around the end of the esophagus. This adds pressure to the LES and helps prevent reflux. Bariatric surgery: Can reduce GERD symptoms and help with weight loss. Usually reserved for people with GERD and obesity.
Hiatal Hernia
Tightness in the chest can be caused by a hiatal hernia. This condition happens when the top part of your stomach bulges through an opening in the diaphragm muscle that separates your chest and abdomen. That causes upward pressure that can lead to chest tightness, acid reflux, and GERD.
Not every hiatal hernia causes symptoms. When they do, symptoms may include:
HeartburnProblems swallowingDry coughBad breathNausea and/or vomitingBreathing problemsErosion of your tooth enamel
Hiatal hernias can be caused by injury, birth defects, or weakness of muscles surrounding the area. Your risk of one increases as you age, if you smoke, or if you have obesity.
If you don’t have symptoms, your hiatal hernia doesn’t need to be treated. For symptomatic cases, treatments include:
Eating small mealsAvoiding foods that trigger symptomsNot smokingAvoiding alcoholWeight loss, if you have obesityAntacidsGERD medications
If all else fails, surgery to fix the hernia may be an option.
Peptic Ulcer Disease
Tightness in your chest can mean you have peptic ulcer disease, which causes painful ulcers (sores) in the lining of the stomach or duodenum (the first part of the small intestine). They’re caused by stomach acids damaging the lining of these organs.
Those acids are naturally present and don’t usually cause damage. Something has to change in order for the acid to become a problem. The mechanism is different depending on the cause:
Long-term use of NSAIDs: These drugs reduce your body’s production of an enzyme that protects the stomach lining from acid. Heliobacter pylori (H. pylori) infection: These bacteria irritate the stomach and duodenum and also damage their protective mucus coating. Zollinger-Ellison syndrome: This rare condition causes tumors in the pancreas and duodenum that release large amounts of the hormone gastrin, which triggers the production of excess stomach acid.
The primary symptom of peptic ulcer disease is burning pain in the stomach, which can sometimes feel like chest tightness and pain. The pain typically:
Starts between meals or overnight, when your stomach is emptyLast for minutes or hoursStops briefly if you take antacids or eatComes and goes for several days or weeks
Less common symptoms may be:
BloatingBurpingNauseaPoor appetiteVomitingUnintended weight loss
Treatment of peptic ulcers varies by cause. It often includes:
Antacids and/or proton pump inhibitors for acid suppressionGoing off of NSAIDsAntibiotics for H. pylori infectionProcedures to stop bleeding from ulcers
Gallstones
A tight feeling in your chest could be a sign of gallstones, which are like pebbles that form in your gallbladder. The gallbladder releases bile to help with digestion, but gallstones can block the ducts it travels through. That makes bile build up and causes a gallbladder attack.
Gallbladder attacks can include pain in your upper right abdomen after eating, which may feel like chest tightness in some cases. The pain can be severe and may last for several hours. Attacks are more common after heavy meals, which makes them most likely in the hours after you eat dinner.
Gallstones form when the bile:
Contains too much cholesterol or bilirubin Doesn’t contain enough bile salts Isn’t emptied completely or often enough
Experts don’t yet understand exactly what leads to those conditions. You should get immediate medical care for a gallbladder attack that causes any of these symptoms:
Upper abdominal pain lasting for several hours Nausea and vomiting Fever or chills (even a low-grade fever) Jaundice (yellowing of the skin or whites of the eyes) Tea-colored urine Pale stools
Left untreated, blocked bile or pancreatic ducts can be life-threatening.
If your gallstones don’t cause symptoms, they may not need treatment. However, if you’ve had one gallbladder attack, you’re likely to have more, so let your healthcare provider know about it.
The most common treatment for gallstones is removing the gallbladder. This surgery is called a cholecystectomy. If your health makes surgery too risky for you, your provider may suggest:
A procedure called endoscopic retrograde cholangiopancreatography to remove a gallstone that’s stuck in a bile duct Medications including Actigall (ursodiol) or Chenix (chenodiol) that break up gallstones; this may take months or years A procedure called shock-wave lithotripsy to break up stones into small pieces; sometimes used along with medications
You can prevent gallstones by reaching and maintaining a healthy weight and eating:
More fiber More healthy fats Fewer refined carbohydrates Less sugar
Esophageal Disorders
A tightness in your chest might actually be related to a problem in your throat. Some esophageal disorders can cause chest tightness and pain, including:
Esophageal contraction disorder (muscle problems that affect swallowing) Esophageal hypersensitivity (sensations that are similar to GERD) Esophageal rupture (a tear in the esophagus)
The causes of these conditions aren’t yet fully understood, but they appear to be more common in people who:
Are young Drink a lot of alcohol Smoke frequently Have a lot of anxiety Have functional GI disorders such as irritable bowel syndrome (IBS) or functional bloating
Esophageal disorders may be treated with:
Proton pump inhibitors Antidepressant medications Theophylline (a drug used that relaxes the throat) For some people, cognitive behavioral therapy
As a last resort, surgery may be recommended for some conditions.
Anxiety
Tightness in the chest can also be related to your mental health. When you feel anxious, it can trigger a stress response in the body known as fight-or-flight mode:
Heart rate and blood pressure riseBlood vessels constrictChest muscles tightenLevels of the stress hormone cortisol increase
This can all cause chest tightness and shortness of breath. Other symptoms may include:
Abdominal crampingDiarrheaMuscle painRapid, irregular heartbeatRapid breathing
Treatments for chest tightness due to anxiety include:
Breathing exercises: Taking slow, deep breaths can help you to relax. Grounding techniques: Bring your attention to the present moment. Focus on how your body feels and try to slow your thoughts and breathing. This can keep you from getting lost in anxious thoughts. Exercise: Can help offset the fight-or-flight response. Try walking, running, or using a punching bag.
Your healthcare provider may also suggest anti-anxiety medications, mental health counseling, or relaxing activities such as yoga or tai chi.
Summary
Tightness in the chest can be caused by conditions in different parts of the body, not just your heart and lungs. Many of these causes are related to lung or heart conditions or injury, but an infection, musculoskeletal problems, or digestive disorders can also cause tightness in the chest. Even anxiety or emotional upset can cause chest tightness.
You can take steps to relieve chest tightness at home, but many of these conditions need to be diagnosed and treated by a healthcare provider.
Perhaps the most important thing to know about chest tightness is that it can be a sign of a life-threatening emergency, such as a heart attack or a pulmonary embolism. Get emergency medical help if you have chest tightness plus difficulty breathing, nausea, or sweating.
