Chest Tightness: Causes and Finding Relief

A tight chest has many causes, some minor and some serious

A tight feeling in your chest can be scary, especially when it comes on suddenly. The symptom of chest tightness itself doesn’t necessarily point to a serious medical problem, but it could.

Tightening of the chest can have many causes, including heart disease, acid reflux, muscle strain, and anxiety. This article details possible causes of a tight feeling in the chest, what other symptoms to watch for, and when it's time to get a medical appointment—or call 911.

Relieving Chest Tightness From Respiratory Infection - Illustration by Laura Porter

Verywell / Laura Porter

What Is Chest Tightness?

Chest tightness, 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 Tightness

Unexplained 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 Tightness

When you have chest tightness, you may immediately suspect a heart attack. But that's only one possible reason for this symptom.

Common causes of chest pain and tightness are:

  • Musculoskeletal (muscle and bone) issues
  • Infections
  • Respiratory conditions
  • Cardiovascular (heart) disease
  • Gastrointestinal (digestive) problems
  • Psychological 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

About half of all people who make 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 

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 out
  • Muscle fatigue
  • Repetitive or forceful motions
  • Contact injury, such as from a football tackle
  • Not 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) like Advil/Motrin (ibuprofen) or 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

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 911

Get immediate medical attention if your fracture causes shortness of breath or a rapid heart rate.

Costochondritis

Costochondritis 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 coughing
  • Chest injury
  • Infection
  • Physical strain from repetitious motions or sudden exertion

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 Treatments

Infections like the common cold or something more serious, like shingles, can cause chest tightness due to mucus/fluid build-up, inflammation, or other concerns.

Congestion

If you’ve come down with a cold or the flu, you may be experiencing chest congestion from excess mucus in your airways. It can restrict breathing and cause:

  • Coughing
  • Wheezing
  • Chest tightness

Chest congestion is most often caused by a virus. For chest tightness from a respiratory infection:

  • Drink fluids: 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.

Call Your Doctor

You should see a healthcare provider if you have chest congestion plus:

  • A fever (temperature of 100.4 degrees Fahrenheit or higher)
  • Coughing up bloody mucus
  • Shortness of breath or difficulty breathing
  • Symptoms linger for more than three weeks


Pneumonia

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:

  • Fever and chills
  • Cough
  • Mucus that's greenish, yellow, or bloody
  • Shortness of breath
  • Chest 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

Cough Syrup

While 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:

  • Difficulty breathing
  • Bluish lips and fingertips
  • A high fever
  • Cough with mucus
  • Symptoms 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

COVID-19 is a viral infection that causes symptoms such as:

  • Fever
  • Dry cough
  • Runny nose
  • Congestion
  • Loss of taste
  • Shortness of breath
  • Sometimes, 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 breathing
  • Bluish lips
  • Mental confusion
  • An inability to stay awake

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.

When to Call 911

Get emergency treatment for COVID-19 if you have:

  • Trouble breathing
  • Persistent chest pain/pressure
  • Confusion
  • Inability to wake up, stay awake
  • Pale, gray, or bluish skin, lips, or nails


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:

  • A painful rash, usually on the torso
  • Feelings of tightness in the chest (if the pain is severe)
  • Burning, shooting pains
  • Tingling, itching, or numbness in affected areas
  • Fever and chills
  • Headache
  • Upset 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

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

If you have asthma, exposure to lung irritants or allergens can cause your airways to constrict and narrow. This leads to:

  • Chest tightness
  • Pain
  • Pressure

Other telltale symptoms of asthma include:

  • Shortness of breath
  • Wheezing
  • Cough

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.

When to Call 911

Call 911 or get to an emergency room right away if:

  • Your lips or nails look blue
  • Your nostrils flare when you inhale
  • The skin of your throat or between the ribs looks stretched when you inhale
  • You're breathing rapidly (30 or more breaths per minute)
  • It's hard to talk or walk at a normal pace

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 911

If you have COPD, get emergency medical attention for:

  • Chest pain
  • Breathing or talking difficulty
  • Fever
  • Racing heartbeat
  • Blue lips or nails
  • Slurred speech
  • Confusion or disorientation
  • Dizziness
  • Difficulty waking up


Pulmonary Hypertension

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:

  • Shortness of breath from everyday activities, like walking up the stairs
  • Fatigue
  • Dizziness
  • Chest pain
  • Chest tightness when strain is placed on the heart during activity
  • Swelling (edema) in the legs and ankles
  • Weakness
  • Blue lips or skin

Pulmonary hypertension can't be cured, but medications can help manage it. They include:

You should make an appointment with a healthcare practitioner if:

  • You notice worsening shortness of breath during activity
  • You have chest pain
  • You have other symptoms that suggest pulmonary hypertension

Pleuritis

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:

  • Sudden and sharp pain in the chest when breathing
  • Pain with coughing or deep breaths
  • Ongoing chest pain and tightness
  • Shortness of breath
  • Fever
  • Body 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.

When It's An Emergency

Get emergency help for:

  • Severe chest pain
  • Coughing up blood
  • Nausea
  • Excessive sweating

Pneumothorax

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:

  • Chest tightness
  • Sudden, sharp chest pain that's worse when you cough or breath deeply
  • Shortness of breath
  • Being easily fatigued
  • Rapid heart rate
  • Bluish skin (due to lack of oxygen)

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 Embolism

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 breath
  • Chest pain and tightness that's usually worse with breathing
  • Anxiety
  • Dizziness or fainting
  • Irregular heartbeat or racing heart
  • Coughing up blood
  • Sweating
  • Low 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)

Deep Vein Thrombosis

The clots in pulmonary embolism often come from the legs, possibly due to a condition called deep vein thrombosis (DVT). Symptoms of DVT include:

  • Pain and swelling in one leg
  • Redness or discoloration
  • Warmth

If you have these symptoms, get urgent medical care.

Heart Issues

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

Coronary artery disease (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 50
  • Excess body weight
  • Unhealthy diet
  • Smoking

If you have CAD, your healthcare provider may prescribe drugs that:

  • Help to improve blood flow
  • Widen arteries
  • Prevent blood clots
  • Lower your cholesterol
  • Lower your blood pressure
  • Ease 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:

Mitral Valve Prolapse

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 rest
  • Fast and/or irregular heartbeat
  • In 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:

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.

Pericarditis

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 stabbing
  • Is felt in the neck, shoulder, back, or abdomen
  • May be worse when lying down or taking deep breaths
  • May be relieved by leaning forward
  • If caused by infection, is associated with fever, chills, or sweating
  • Swelling of the feet, ankles, and legs
  • Anxiety
  • Dry cough
  • Fatigue

Pericarditis is most common in men between the ages of 20 and 50. The cause if 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

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 tightness
  • Shortness of breath
  • Abnormal and/or rapid heartbeat
  • Dizziness, lightheadedness, and fainting
  • Swelling in the feet, ankles, legs, and abdomen
  • Fatigue

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

Spontaneous coronary artery dissection (SCAD) is a sudden tearing of a blood vessel in the heart. Emergency medical attention is required for this uncommon condition.

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 healthy
  • Have few or no heart-disease risk factors
  • Recently gave birth (30% of cases)
  • Are having a menstrual period

When SCAD happens in biological males, it's usually after extreme exertion. 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

Get Immediate Treatment

A 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 Conditions

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

Gastroesophageal reflux disease (GERD) involves chronic acid reflux, which is when the acid-containing contents 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:

Lifestyle changes are also recommended for GERD, including:

  • Reaching and maintaining a healthy weight
  • Not smoking
  • Changing your diet and eating habits
  • Elevating 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 added 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

When you have a hiatal hernia, 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:

  • Heartburn
  • Problems swallowing
  • Dry cough
  • Bad breath
  • Nausea and/or vomiting
  • Breathing problems
  • Erosion 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 meals
  • Avoiding foods that trigger symptoms
  • Not smoking
  • Avoiding alcohol
  • Weight loss, if you have obesity
  • Antacids
  • GERD medications

If all else fails, surgery to fix the hernia may be an option.

Peptic Ulcer Disease

In peptic ulcer disease, you have 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 empty
  • Last for minutes or hours
  • Stops briefly if you take antacids or eat
  • Comes and goes for several days or weeks

Less common symptoms may be:

  • Bloating
  • Burping
  • Nausea
  • Poor appetite
  • Vomiting
  • Unintended weight loss

Treatment of peptic ulcers varies by cause. It often includes:

  • Antacids and/or proton pump inhibitors for acid suppression
  • Going off of NSAIDs
  • Antibiotics for H. pylori infection
  • Procedures to stop bleeding from ulcers

Tylenol: A Better Choice

The OTC pain reliever Tylenol (acetaminophen) is not an NSAID, so it's often a safe choice for those with NSAID-related peptic ulcer disease.

Gallstones

Gallstones 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 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:

Esophageal Disorders

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:

As a last resort, surgery may be recommended for some conditions.

Anxiety

When you feel anxious, it can trigger a stress response in the body known as fight-or-flight mode:

  • Heart rate and blood pressure rise
  • Blood vessels constrict
  • Chest muscles tighten
  • Levels of the stress hormone cortisol increase

This can all cause chest tightness and shortness of breath. Other symptoms may include:

  • Abdominal cramping
  • Diarrhea
  • Muscle pain
  • Rapid, irregular heartbeat
  • Rapid 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

Chest tightness has myriad possible causes. Many are related to lung or heart conditions or injury, but an infection, musculoskeletal problems, or digestive disorders can also be to blame. Even anxiety or emotional upset can cause chest tightness.

You can take steps to relieve symptoms 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

  • What causes heavy lungs?

    The feeling of heavy lungs could be caused by a collapsed lung. This occurs when a hole in the lung allows air to escape and fill the area between the lung and chest wall. Chest tightness and difficulty breathing are common symptoms.

  • What does COVID-19 chest pain feel like?

    Chest pain caused by COVID-19 can be described as persistent pain or pressure. Other warning signs associated with COVID-19 include difficulty breathing, fever, altered consciousness, lost sense of taste and/or smell, and bluish lips or face.

  • Why does my chest hurt when I eat?

    Pain or tightness in the chest after eating could be due to a gastrointestinal problem such as GERD. It can cause stomach acid to travel into the esophagus, causing throat inflammation and chest pain.

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