If you feel tightness in your chest, you’re likely concerned about what’s causing the sensation. In fact, chest pain accounts for approximately 5% of all emergency room visits in the U.S.

But there are many reasons why you might have chest tightness, and not all of them are medical emergencies.

Depending on the cause, sensations can be described as dull or sharp, can feel like squeezing or stabbing, or may be considered deep. The location of the pain, which can vary from localized (say, a specific area of the chest) to less pronounced (like the left or right shoulder, jaw or left arm), can also help determine the cause.

What Does Chest Tightness Feel Like?

There are two main types of chest pain that can be described by their sensation and location: visceral and somatic.

Visceral pain can be described as dull or deep and can feel like pressure or squeezing. This type of pain usually isn’t localized, spanning larger surface areas—like into the shoulders, jaw, or left arm—as a result of nerves traveling near the spinal cord. Often, visceral pain is accompanied by other symptoms, such as nausea and vomiting.

Somatic pain is more specific and can be characterized by sensations that are sharp, stabbing, or poking. People who experience this type of pain can usually pinpoint the exact location of the pain. The pain is rarely felt in areas other than the chest.

Depending on the cause, other symptoms that may accompany chest tightness include:

• Shortness of breath

• Nausea and vomiting

• Fever

• Excessive sweating

• Cough

• Upset stomach

• Excessive fluid retention (often in the feet, ankles, and legs)

• Calf pain or swelling

• Recent illness

Should You Be Concerned About Chest Tightness?

Not all chest tightness is a cause for concern. Common causes of chest pain that aren’t life-threatening include gastrointestinal reflux disease, musculoskeletal issues, and anxiety.

So, how do you know if chest pain is heart-related? The most likely indication of a cardiac-related episode is pain or discomfort in the center or side of the chest that continues or worsens over time. This includes pain that subsides and returns.

Chest tightness might also be heart-related if it is accompanied by light-headedness, cold sweats, nausea, or unusual tiredness. These symptoms can indicate a heart attack, in which you should immediately dial 9-1-1.

If you think you are experiencing a medical emergency, call for help right away.

Causes of Chest Tightness

Tightness in the chest can result from multiple issues. The most common occurrences include:

Cardiovascular Disease

Cardiovascular disease is an umbrella term to describe diseases that affect the heart or blood vessels. Among the most common is coronary artery disease (CAD). CAD is the leading cause of death in the U.S., accounting for approximately 610,000 deaths annually, as well as the leading cause of heart attack.

CAD occurs when plaque (fat, cholesterol, calcium, and other substances in the blood) clogs the arteries and forms blood clots. The clots block blood and oxygen from reaching the heart. When there is poor blood flow through the blood vessels of the heart muscle, you can experience chest tightness known as angina.

In addition to tightness, angina might be described as pressure, squeezing, or burning in your chest. That discomfort may radiate to your arms, shoulders, neck, jaw, throat, or back.

With either a chest cold or pneumonia, you can develop pericarditis. Pericarditis is inflammation of the pericardium, which is the sac-like membrane that surrounds the heart. Pericarditis can also cause chest pain. The pain can be sharp and can worsen when breathing or swallowing.

Editor’s Note: Cold weather or physical activity, such as going upstairs or having sex, might bring on angina.

Acid Reflux

Acid reflux occurs when stomach acid repeatedly flows back into the esophagus, the point where the mouth and stomach connect. This sensation is called heartburn. Because of how close the chest and esophagus are, heartburn can mimic the symptoms of angina.

Besides chest tightness, other signs of acid reflux include:

• A burning sensation in the chest, usually after eating or at night

• Pain that worsens when lying down or bending over

• A bitter or acidic taste in the mouth

Musculoskeletal Issues

Chest pain may be due to a musculoskeletal issue, meaning that the pain is due to a problem affecting the muscles, bones, tendons, ligaments, joints, or cartilage. Often described as tenderness, this type of chest discomfort can stem from a wide range of issues, including rheumatic diseases—like fibromyalgia—or rib fractures.

Musculoskeletal chest pain typically comes on gradually and then sticks around for hours to days. The pain may get worse when you take a deep breath, turn, or move your arms.

Asthma

Asthma is a condition that causes your airways to become inflamed. When these tubes that carry air in and out of your lungs narrow, you can experience chest tightness.

Other symptoms of asthma include:

• Coughing, especially at night or in the early morning

• Shortness of breath

• Wheezing

Chest tightness and other asthma symptoms can worsen when you have an asthma attack. Asthma attacks can be brought on by a wide range of triggers, including allergies, smoke, and exercise.

Respiratory Conditions

Some viral infections can cause a chest cold, also known as acute bronchitis. A chest cold is when the lungs’ airways get inflamed and mucus develops in the lungs. One of the major symptoms of the condition is coughing, which can be accompanied by chest soreness.

Viral infections may also cause pneumonia, which is inflammation of your lungs' air sacs (alveoli). The sharp or stabbing chest pain can get worse as you breathe deeply or cough.

Infections

The skin, muscles, bones, and other tissues between the neck and abdomen form a protective barrier known as the chest wall. Its function is to protect the heart, liver, lungs, and other vital organs. When the immune system becomes compromised, the chest wall can become infected.

Infections like pleurisy (swelling of the lung lining), costochondritis (inflammation of the cartilage between the ribs and breastbone), and empyema (the rare development of pus between the lungs and the lung lining) can cause chest pain. This pain can be sharp or dull and typically worsens with breathing.

Mental Health Disorders

Panic disorder and generalized anxiety disorder are the two most common psychiatric disorders associated with chest pain. Unlike a heart attack, chest pain as a result of anxiety is usually brought on by stress and subsides when the panic episode comes to an end.

Other signs that your chest tightness may be due to a mental health issue include:

• Pounding or racing heart

• Sweating

• Chills

• Trembling

• Difficulty breathing

• Weakness or dizziness

• Tingly or numb hands

• Stomach pain or nausea

Treatment Options for Chest Tightness

Treatment for chest tightness can vary depending on the cause. In some cases, the pain can improve on its own or over time with assistance. Before trying any remedies on your own, it’s best to check with a healthcare provider.

Chest pain that is severe, continuous, or worsens over time should receive immediate medical attention. In cases when pain is accompanied by light-headedness, cold sweats, nausea, or unusual tiredness, get emergency help—especially if you or your loved one has a history of cardiovascular disease.

If it’s determined that your chest pain isn’t an immediate cause for concern, there are some things you can do to help reduce discomfort depending on the reason for the tightness. For instance, if your chest pain is from anxiety, you can partake in mental health therapy to learn how to best cope. If your pain is from heartburn, you can take acid-blocking drugs called proton pump inhibitors or H2-blockers to help reduce acid reflux.

A Quick Review

There are many reasons why your chest might feel tight. While the discomfort or pain may be disconcerting, the cause behind the tightness is not always a medical emergency of the heart. Instead, tightness may be due to asthma, acid reflux, anxiety, or muscle strain. When the cause is not heart-related, the discomfort often subsides on its own. Depending on the cause, there might also be steps you can do to prevent or manage the discomfort. Signs that your chest tightness may be a signal of something serious affecting the heart include pain that radiates to your arm, shoulders, or jaw and pain that continues or worsens—especially if the pain follows physical activity or if you have a history of cardiovascular disease. 

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