Tightness in the chest can be alarming, especially when it comes on suddenly. It does not necessarily point to a medical problem, but it can. For example, chest tightness can be caused by muscle strain, acid reflux, or heart disease. It can also be caused by COVID-19. Show
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. Verywell / Laura Porter 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. When to Call 911 for Chest TightnessUnexplained chest tightness along with any of the following requires immediate medical attention: · 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 Causes of Chest TightnessTightness in the chest may make you think first of having a heart attack. But that's only one possible reason for chest tightness. Common causes of chest pain and tightness are:
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 TreatmentsTightness 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 StrainTightness 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:
For chest muscle strains that cause pain and tightness, the first line of treatment usually involves the RICE method:
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 FractureTightness 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. When to Call 911Get immediate medical attention if your fracture causes shortness of breath or a rapid heart rate. CostochondritisFeeling 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:
Costochondritis is also common in the chronic pain condition of fibromyalgia. Treatment generally includes:
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 TreatmentsTightness 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. CongestionTightness 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:
Chest congestion is most often caused by a virus. For chest tightness from a respiratory infection:
Antibiotics are ineffective against viruses. They're designed to kill bacteria. Call Your Healthcare ProviderYou should see a healthcare provider if you have chest congestion plus:
PneumoniaTightness 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:
Symptoms of pneumonia include:
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:
Cough SyrupWhile a cough can be unpleasant or even painful, you shouldn't take cough syrup unless it's recommended by a healthcare provider. That's because a cough is your body's way of clearing out an infection. If you need cough treatment so you can sleep, talk to your provider. Get medical help right away if you have chest pain plus:
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-19Tightness in the chest can also be a symptom of COVID-19. You might also have other symptoms, such as:
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:
The CDC recommends getting treatment for COVID-19 within days of when symptoms appear. Treatments include:
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. When to Call 911Get emergency treatment for COVID-19 if you have:
ShinglesA 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. Shingles involves:
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 ConditionsTightness 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. AsthmaTightness 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:
Other telltale symptoms of asthma include:
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. Asthma Inhalers: Choosing the Right Inhaler for Your Symptoms When to Call 911Call 911 or get to an emergency room right away if:
What Is Chest Congestion in Asthma? COPDA 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. 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:
Call 911If you have COPD, get emergency medical attention for:
Why COPD Causes Chest Tightness Pulmonary HypertensionTightness 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:
Symptoms of PH include:
Pulmonary hypertension can't be cured, but medications can help manage it. They include:
You should make an appointment with a healthcare practitioner if:
PleuritisTightness 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:
Symptoms of pleuritis include:
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. When It's An EmergencyGet emergency help for:
PneumothoraxTightness 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:
Pneumothorax can be caused by chest trauma, extreme pressure on the lungs, or lung diseases including:
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 EmbolismYou 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:
Risk factors for pulmonary embolism include:
This condition requires immediate medical attention. Treatments include:
Deep Vein ThrombosisThe clots in pulmonary embolism often come from the legs, possibly due to a condition called deep vein thrombosis (DVT). Symptoms of DVT include:
If you have these symptoms, get urgent medical care. Heart IssuesTightness 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. 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. The Heart: Anatomy, Function, and Conditions Coronary Artery DiseaseA 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:
Risk factors for CAD include:
If you have CAD, your healthcare provider may prescribe drugs that:
Surgery may be an option for more serious cases of coronary artery disease. They include:
Healthy lifestyle habits are also encouraged when you have CAD. Those include:
How Coronary Artery Disease Is Treated Mitral Valve ProlapseTightness 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:
MVP's cause is unknown, but it may have a genetic component. Other conditions may contribute to its development, including:
MVP isn't usually serious and may not require treatment. If it does, treatment may include:
Even if you don't need treatment, your healthcare provider should monitor the condition. PericarditisFeeling 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:
Pericarditis is most common in men between the ages of 20 and 50. The cause is often unknown, but it may be linked to:
Mild pericarditis may clear up on its own. More serious cases require treatment, especially if it becomes potentially life-threatening. Treatments for pericarditis include:
For cases with severe fluid buildup, healthcare providers may perform a procedure to drain the excess fluid. Hypertrophic CardiomyopathyTightness 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:
HCM is generally treated with medications and medical procedures. Treatments may include:
A heart-healthy lifestyle is recommended for managing HCM, as well. Coronary Artery TearTightness 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:
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:
Get Immediate TreatmentA heart attack is always a medical emergency. Call 911 or get to an emergency room right away if you have symptoms. 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 ConditionsTightness 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. GERDA 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:
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:
Lifestyle changes are also recommended for GERD, including:
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:
The 7 Best Antacids Hiatal HerniaTightness 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:
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:
If all else fails, surgery to fix the hernia may be an option. Peptic Ulcer DiseaseTightness 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:
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:
Less common symptoms may be:
Treatment of peptic ulcers varies by cause. It often includes:
Tylenol: A Better ChoiceThe OTC pain reliever Tylenol (acetaminophen) is not an NSAID, so it's often a safe choice for those with NSAID-related peptic ulcer disease. GallstonesA 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:
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:
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:
You can prevent gallstones by reaching and maintaining a healthy weight and eating:
Esophageal DisordersA tightness in your chest might actually be related to a problem in your throat. Some esophageal disorders can cause chest tightness and pain, including:
The causes of these conditions aren't yet fully understood, but they appear to be more common in people who:
Esophageal disorders may be treated with:
As a last resort, surgery may be recommended for some conditions. AnxietyTightness 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:
This can all cause chest tightness and shortness of breath. Other symptoms may include:
Treatments for chest tightness due to anxiety include:
Your healthcare provider may also suggest anti-anxiety medications, mental health counseling, or relaxing activities such as yoga or tai chi. SummaryTightness 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. Frequently Asked Questions
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