What Is Chest Tightness in Asthma?

In This Article
Table of Contents

You may experience occasional chest tightness if you have asthma. These episodes are usually accompanied by wheezing, shortness of breath, and a chronic cough. Chest tightness can also be anxiety-provoking, and it is often a sign of worsening asthma control and/or an impending asthma attack.

If you haven't experienced it before, it's especially important that you seek medical care right away for chest tightness or chest discomfort—even if you have already been diagnosed with asthma.

Chest Tightness in Asthma Symptoms

When you have chest tightness due to your asthma, you may feel like you can't easily push air in and out of your chest. With asthma, mild chest tightness can be present all or most of the time, but it may worsen in response to asthma triggers and in the hours or minutes before an asthma exacerbation.

Not all people who have asthma experience chest tightness. But there is a type of asthma described as chest tightness variant asthma (CTVA) in which this symptom is especially frequent.

Symptoms of chest tightness include:

  • Your chest feels constricted, as if there's a band around it
  • A sense that you're trying to push against your chest from the inside as you breathe
  • A struggle to fully exhale (breathe out)
  • Difficulty inhaling (breathing in)

When the feeling of chest tightness increases anxiety, your sense of not being able to move air through your lungs can worsen.

When to See a Doctor

Whether you have been diagnosed with asthma or not, it is important that you get medical help for your chest tightness.

Consider going to an emergency room if:

  • The discomfort is severe
  • You have associated chest pain, tachypnea (rapid breathing), nausea, sweating, dizziness, or fainting
  • The sensation is localized to a specific area of your chest
  • Your chest tightness is associated with physical activity or progressively worsens
  • You have a feeling of impending doom or that something is horribly wrong

Call your doctor's office for an appointment if:

  • You experience mild chest tightness at the same time every day or when your asthma medicine is wearing off
  • You only experience chest tightness along with your other asthma symptoms
  • You started having occasional chest tightness when you had a change in your asthma medication
  • Your chest tightness improves when you use your asthma rescue treatment, but is recurrent

Causes

Chest tightness is one of the manifestations of asthma. The sensation occurs as a result of several asthma-induced physical changes.

Asthma is an obstructive lung disease, which means that difficulty exhaling is the main problem. As you exhale, your bronchi (airways) trap air inside your lungs. Even though it is an obstructive disease, you struggle to inhale when you have asthma as well.

When asthma acts up, your bronchi constrict (narrow), and your lungs become inflamed and produce excess mucus. This results in airway limitation that makes it hard for air to pass through, even as you put all your effort into breathing.

All of these effects of asthma can lead to the sensation of chest tightness.

A number of triggers can lead to worsened chest tightness when you have asthma:

A Warning Sign

Recurrent episodes of chest tightness may indicate that your asthma isn't well controlled. When you have sudden chest tightness with asthma, it can be a sign that your symptoms are on the way to escalating into an asthma attack if you do not follow your asthma action plan.

Diagnosis

When chest tightness is one of your most noticeable symptoms, it may take your medical team longer to determine whether your asthma is to blame. (The same goes for those who have asthma, but have not yet been diagnosed.) This is because chest tightness is an especially concerning sign of life-threatening issues including heart disease or pulmonary embolus (PE).

Urgent Assessment

If you seem to be in distress, your medical team will rapidly assess you to determine if you are experiencing a medical emergency, such as a heart attack or a lung emergency (like a PE or a pneumothorax). Often, people who have chest tightness due to these and other emergencies are visibly short of breath.

Your medical team will check your pulse, respiratory rate, and blood pressure. Depending on your symptoms, you may have an electrocardiogram (EKG) to check your heart rhythm and pulse oximetry to check your oxygen saturation as well.

Diagnostic Tests

If your chest tightness is not a sign of an emergency, your doctor may order further tests to help determine whether asthma or another lung disease is the cause.

The list of chronic conditions that can cause chest tightness along with other symptoms similar to those of asthma is long and includes chronic obstructive pulmonary disease (COPD), lung cancer, and pulmonary sarcoidosis.

Tests you may need include:

Treatment

If you have an established diagnosis of asthma with chest tightness, it's important that you promptly use your rescue asthma treatment when you develop this symptom. Ideally, you would also regularly use controller asthma treatment to avoid having episodes of chest tightness in the first place.

Medication

For standard asthma treatment, rescue medication includes short-acting bronchodilator inhalers like albuterol. Maintenance therapies include inhaled corticosteroids like budesonide, long-acting bronchodilators like tiotropium bromide, and immunomodulators like dupilumab.

Sometimes chest tightness in asthma is relived with bronchodilators, but some people with asthma experience improvement of chest tightness only with other asthma treatments.

Chest tightness is a sign of severe asthma that may be less responsive or refractory to standard asthma treatment.

Asthma with chest tightness relieved with the use of asthma drugs except bronchodilators (CTAREB) might differ from asthma with chest tightness relieved with bronchodilator use (CTRB). The latter is associated with inflammation and bronchoconstriction, while the former is only associated with inflammation.

Lifestyle Management

Lifestyle management is especially important because chest tightness is so often associated with anxiety. Using these strategies can help you gain a sense of control that may alleviate some of that feeling of panic that further exacerbates chest tightness:

  • Avoid asthma triggers: This is personal to everyone, but may include cigarette smoke, mold, pets, pollens, and so on.
  • Pulmonary rehabilitation: This approach includes exercise, endurance training, breathing retraining, respiratory exercises, weight management, and education—the guidance for which is provided by a pulmonary therapist.

A Word From Verywell

Chest tightness is an especially distressing symptom in asthma, but it can also be a sign of serious heart and lung problems. As such, your medical evaluation for this problem will be carried out with urgency.

If you tend to experience recurrent chest tightness as part of your asthma, it's important that you learn to recognize the need for rescue treatment and that you seek medical attention if anything about your chest tightness changes.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Stubbs MA, Clark VL, McDonald VM. Living well with severe asthmaBreathe (Sheff). 2019;15(2):e40-e49. doi:10.1183/20734735.0165-2019

  2. Irwin RS. Chest tightness variant asthma (CTVA): reconfirmed and not generally appreciated. J Thorac Dis. 2014;6(5):405-6.doi:10.3978/j.issn.2072-1439.2014.02.05

  3. Stubbs MA, Clark VL, McDonald VM. Living well with severe asthmaBreathe (Sheff). 2019;15(2):e40-e49. doi:10.1183/20734735.0165-2019

  4. Gherasim A, Dao A, Bernstein JA. Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy. World Allergy Organ J. 2018;11(1):29.doi:10.1186/s40413-018-0207-2

  5. Taniguchi H, Nakanishi Y, Tsuda T, et al. Chest tightness is relieved with the use of asthma drugs except bronchodilatorsJ Asthma. 2019;56(11):1182-1192. doi:10.1080/02770903.2018.1531999

  6. Zampogna E, Zappa M, Spanevello A, Visca D. Pulmonary Rehabilitation and Asthma. Front Pharmacol. 2020;11:542.doi:10.3389/fphar.2020.00542