If you feel like your chest is tightening, you may worry that you’re having a heart attack. However, gastrointestinal, psychological, and pulmonary conditions can also cause a tight chest.

When to see a doctor about a tight chest
You should see a doctor immediately if you suspect that you’re having a heart attack. Symptoms of a heart attack include:

pain
squeezing
burning
pain that lasts for several minutes
continual pain in the middle of your chest
pain that travels to other areas of the body
cold sweating
nausea
difficulty breathing
Other conditions that can cause a tight chest
Many conditions can cause you to experience a tight chest. These conditions include:

COVID-19
Making headlines in 2020, COVID-19 is a viral disease that can 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. According to the Centres for Disease Control and Prevention (CDC)Trusted Source, other emergency symptoms of COVID-19 include:

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
Anxiety is a common condition. About 40 million adults in the United States have an anxiety disorder. Chest tightness is one symptom of anxiety. There are others that may occur simultaneously, including:

breathing rapidly
difficulty breathing
pounding heart
dizziness
tightening and aching muscles
nervousness
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 oesophagus, 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 medications and lifestyle changes. Surgery and stronger medications are options for those who experience debilitating GERD.

Muscle strain
Muscle strain is a common cause of tightness in the chest. Straining of the intercostal muscles, in particular, can cause symptoms.

In fact, 21 to 49 percent of all musculoskeletal chest pain comes from straining the intercostal muscles. These muscles are responsible for attaching 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
There are a number of at-home treatments to try before seeing your doctor and seeking out physical therapy. Though strains typically take a while to heal, sticking closely to your physical therapy regimen can help alleviate some of the stress of the healing process.

Pneumonia
Pneumonia is an infection of one or both of your 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, depending on your infection, 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
lower than normal body temperature
shortness of breath
nausea and diarrhoea
It’s possible to develop a variety of complications from this infection. You should seek out your doctor as soon as you suspect you have pneumonia.

Learn more about pneumonia.

Asthma
Asthma is a condition in which the airways in your lungs become inflamed, narrow, and swollen. This, in addition to the production of extra mucus, can make it hard to breathe for those who have asthma.

The severity of asthma varies from person to person. Those who have this condition need to manage their symptoms.

Chest tightness is an incredibly common sign of asthma, along with:

shortness of breath
coughing
wheezing
a whistling or wheezing sound when exhaling
It’s common in some people for these symptoms to flare up at certain times, like when exercising. You can also have occupational and allergy-induced asthma, where irritants in the workplace or environment make the symptoms worse.

Asthma symptoms can be managed with prescription medications. Talk to your doctor about ways to determine if you need emergency treatment when feeling short of breath.

Ulcers
Peptic ulcers occur when a sore develops on the lining of the stomach, oesophagus, or small intestine. While stomach pain is the most common symptom of an ulcer, it’s possible to experience chest pain as a cause of this condition. Other symptoms are:

burning stomach pain
feeling full or bloated
burping
heartburn
nausea
Treatment for ulcers typically depends on what’s causing them in the first place. However, an empty stomach can make your symptoms worse. Eating certain foods that’ll buffer stomach acids can also bring you some relief from these painful symptoms.

Hiatal hernia
A hiatal hernia is a condition in which part of the stomach pushes up through the diaphragm, or the muscle that separates the chest from the abdomen.

In many cases, you may never even notice that you have a hiatal hernia. However, a large hiatal hernia will cause food and acid to back up into the oesophagus, 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.

Rib fracture
In most cases, a fractured rib is caused by some sort of trauma, causing 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 symptoms 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.

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 wraps around one side of your chest. 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. Other symptoms include:

pain, burning, numbness, and tingling
sensitivity to touch
red rash
fluid-filled blisters
fever
headache
sensitivity to light
fatigue
itching
If you suspect that you have shingles, you’ll want to see a doctor immediately. While there’s no cure for shingles, prescription antiviral drugs can speed up the healing process 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. Its role is to produce enzymes that help regulate the way 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.

Pulmonary hypertension
Pulmonary hypertension (PH) is a type of high blood pressure within the arteries of the lungs and the right side of the heart.

The rise in blood pressure is caused by changes in the cells that line 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.

This condition may not be noticeable for many years, but symptoms usually become apparent after a number of years. Other symptoms include:

shortness of breath
fatigue
dizziness
chest pressure or pain
chest tightness
swelling of the ankles, legs, and eventually in the abdomen
bluish colour in the lips and skin
racing pulse and heart palpitations
While PH can’t be cured, medication and possibly surgery can help to manage your condition. Finding the underlying cause for your PH can be crucial in treatment as well.

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. In most cases, gallstones form when there’s too much cholesterol in the bile. Gallstones may or may not cause symptoms, and usually those that don’t require treatment.

However, you may have a gallstone that requires treatment if you experience sudden pain in the upper right portion or centre of your abdomen, in addition to:

back pain
right shoulder pain
nausea or vomiting
In these cases, you may need to have surgery to remove the gallbladder. If you can’t undergo 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. In most cases, the condition affects the cartilage that connects 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 that results from this condition 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.

There’s no apparent cause for costochondritis, so treatment focuses on pain relief. The pain usually subsides on its own after several weeks.

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. In most cases, this damage results from the build-up of a waxy substance, called plaque, and inflammation in these arteries.

This build-up and inflammation narrows your arteries, decreasing the blood flow to the heart. This can cause pain and a number of other symptoms, including:

chest pressure or tightness
chest pain (angina)
shortness of breath
If your artery becomes completely blocked, it’s possible to have a heart attack as a result of coronary artery disease. In this case, you need to seek immediate medical treatment.

A variety of lifestyle changes can both prevent and treat coronary artery disease. However, a number of medications and procedures are also available, depending on the severity of your case.

Oesophageal contraction disorder
Oesophageal contraction disorder is characterized by painful contractions in the oesophagus. The oesophagus is the muscular tube that connects your mouth and stomach. These spasms usually feel like sudden, severe chest pain, and they can last anywhere from a few minutes to a few hours. Other symptoms include:

difficulty swallowing
the feeling that an object is stuck in your throat
regurgitation of food or liquids
If your oesophagus spasms only occasionally, you may not want to seek treatment. However, if this condition prevents you from eating and drinking, you may want to see what your doctor can do for you. They may recommend that you:

avoid certain foods or drinks
manage the underlying conditions
use medications to relax your oesophagus
consider surgery

Oesophageal hypersensitivity
People with oesophageal hypersensitivity are extremely sensitive to conditions that may affect the oesophagus. They may report more frequent and intense symptoms, such as chest pain and heartburn. In many cases, oesophageal hypersensitivity isn’t a problem. However, if it occurs simultaneously with conditions like GERD, the pain can be debilitating.

The symptoms of oesophageal hypersensitivity are typically identical to those of GERD. Initial treatment usually involves acid suppressants. Other medications or surgery may be necessary.

Oesophageal rupture
A rupture of the oesophagus is a tear or a hole in the oesophagus. The oesophagus is the tube that connects your mouth to your stomach, where food and liquids pass through.

Though uncommon, oesophageal rupture is a life threatening condition. Intense pain is the first symptom of this condition, usually where the rupture occurred, but also in your general chest area. Other symptoms 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 oesophagus 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. Seek treatment immediately if you’re having trouble breathing or swallowing.

Mitral valve prolapse
The mitral valve lies between the left atrium and left ventricle of the heart. 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.

This condition is also known as 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, which is the upper chamber.

Many people with this condition don’t have any symptoms, though some may occur if blood is leaking 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 light-headedness
difficulty breathing
shortness of breath
fatigue
chest pain
Only some cases of mitral valve prolapse require treatment. However, your doctor may recommend medications or surgery, depending on the severity of your condition.

Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a disease that 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 can 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. You can use medications to relax the heart muscle and slow your heart rate, undergo surgery, or implant a small device, called an implantable cardioverter defibrillator (ICD), into your chest. An ICD continuously monitors your heartbeat and fixes dangerous abnormal heart rhythms.

Pericarditis
The pericardium is a thin, sac-like membrane surrounding the heart. When swelling and irritation occurs in this membrane, a condition called pericarditis occurs. Pericarditis has different classification types, and the symptoms vary for each type of pericarditis you have. However, symptoms for all types include:

sharp and piercing chest pain in the centre 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 happens when the irritated layers of the pericardium rub against each other. This condition can come on suddenly but last temporarily. This is known as acute pericarditis.

When symptoms are gradual and persist for a long time, you may have chronic pericarditis. Most cases will improve on their own over time. Treatment of more severe cases include medications and possibly surgery.

Pleuritis
Pleuritis, also known as pleurisy, is a condition in which 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
A number of conditions can cause pleuritis. Treatment usually involves pain control and treating the underlying cause.

Pneumothorax
Pneumothorax happens when one of your lungs collapses, and air leaks into the space between your lung and chest wall. When air pushes on the outside of your lung, it can collapse.

Most of the time, a pneumothorax is caused by a traumatic chest injury. It can also occur from damage from an underlying chest disease or certain 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.

Coronary artery tear
A coronary artery tear is an emergency situation where a blood vessel that supplies oxygen and blood to the heart spontaneously tears. This can slow or block blood flow to the heart, causing sudden heart attack and even sudden death. A coronary artery tear can cause:

chest pain
rapid heartbeat
pain in the arm, shoulder, or jaw
shortness of breath
sweating
extreme tiredness
nausea
dizziness
When you experience a coronary artery tear, the main priority through treatment is to restore blood flow to the heart. If this doesn’t occur naturally, a doctor repairs the tear through surgery. Surgery involves either opening the artery with a balloon or stent, or bypassing the artery.

Pulmonary embolism
A pulmonary embolism occurs when one of the pulmonary arteries in your lungs is blocked. In most cases, this is caused by blood clots that travel to the lungs from the legs.

If you experience this condition, you’ll feel shortness of breath, chest pain, and a cough. Less common symptoms include:

leg pain and swelling
clammy and discoloured skin
fever
sweating
rapid heartbeat
light-headedness or dizziness
While pulmonary embolisms can be life threatening, early detection and treatment greatly increase your chances of survival. Treatment usually involves surgery and medication. You might also be interested in medications that prevent further clots from forming.

Treating a tight chest
Your doctor will conduct tests to determine the cause of your chest tightness. If the tests for a heart attack come back negative, your symptoms may be caused by anxiety.

You should discuss your symptoms with your doctor to determine when to seek immediate medical attention if you experience chest tightness again. It may be possible to link your chest tightness to other symptoms that’ll help you identify anxiety versus a cardiac event.

Home treatments
Once you can link your chest tightness with anxiety, there are several ways you can combat the symptom at home. Several lifestyle adjustments can help you reduce stress and relieve anxiety, including:

regular exercise
avoiding stress
avoiding caffeine
avoiding tobacco, alcohol, and drugs
eating a balanced diet
using relaxation methods like meditation
finding hobbies outside of school or work
socializing regularly
You shouldn’t ignore feelings of anxiety or avoid medical treatment for the condition. It may be that home-based treatments alone can’t help reduce your anxiety. See your doctor to determine other treatment methods for anxiety.

What is the outlook for a tight chest?
Chest tightness isn’t a symptom to take lightly. If you experience chest tightness with other concerning symptoms, see a doctor immediately. Chest tightness could be a symptom of a serious health condition, like a heart attack.

If your chest tightness is the result of anxiety, you should discuss the symptoms with your doctor. Anxiety should be treated early to keep it from getting worse. Your doctor can help you implement a plan that’ll reduce anxiety and chest tightness. This may include lifestyle adjustments that help you manage the anxiety from home.

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