Chest Pain & Tightness: 9 Causes and What To Do

Most of the times, chest pain or chest tightness, are actually not a sign of a heart attack, as they are more common to happen due to excess gas, anxiety or muscle fatigue.

However, this type of pain continues to be an important sign of a heart attack, especially if it happens in people who have uncontrolled high blood pressure or high cholesterol. In these cases, the pain or tightness, tends to get worse overtime and it usually irradiates through the neck and arms. Other symptoms, such as difficulty breathing, malaise, cold sweats and dizziness may also be present.

Since there are many reasons for a chest pain, it's very important to go to the hospital, or call medical help, whenever pain lasts more than 20 minutes or gets worse overtime, especially when there are other symptoms.

Chest Pain & Tightness: 9 Causes and What To Do

Here's a list of the main causes for chest pain so that it's easier for you to identify each one and know what to do:

1. Excess gas

Excess gas is possibly the most common cause for a sharp pain in the left side of the chest region, particularly in people who suffer from chronic constipation. This happens because the accumulation of gas in the intestines can push up some abdominal organs, causing a type of sharp pain that radiates through the chest.

How to identify: it's usually a sharp pain that then disappears, but that can come back repeatedly, especially every time you bend down, for instance, to get something from the floor.

What to do: a good strategy to relieve this type of pain is to massage the abdominal area, starting from the right side to the left ans then pressing down to the groin region. Another thing you can do is get into a position that helps to release gas, like laying down with your knees bent. Additionally, walking for a few minutes may also help.

2. Stress and anxiety

Anxiety and excess stress can cause an increase in muscle tension around the ribs, as well as increased heart rate. This combination causes a sensation of chest tightness which can happen even if the person does not feel stressed, but had an argument a few minutes before, for example. This type of chest discomfort happens more commonly in people who are frequently stressed or suffer from panic attacks or anxiety.

How to identify: it usually comes with other symptoms such as fast breathing, sweating, fast heart rate, nausea and bowel problems.  

What to do: try to rest in a quiet place, take a calming tea, such as valerian or chamomile, or do a leisurely activity, such as watching a film, playing a game or gardening. If the chest tightness does not get better after 30-60 minutes, or if it gets worse, you should seek medical help.

3. Heart attack

Even though this is the first concern of anyone who has a chest pain, heart attack is actually a rare cause. It's more frequent in people with uncontrolled high blood pressure, very high cholesterol, diabetes, age over 45, and smokers.

How to identify: pain is usually very strong type of pain that does not improve after 15-20 minutes and it can irradiate through the arms or jaw, causing a tingling sensation. Other symptoms include dizziness, difficulty breathing, tingling sensation in the arms, and legs, and general malaise.

What to do: every time you suspect of a heart attack, the best thing to do is to call medical help or ask someone to take you to a hospital, in order to do some tests to diagnose heart problems, such as an electrocardiogram, cardiac enzymes test, and an X ray.

4. Sore muscles

Sore muscles is a very common condition, especially for those who go to the gym often or do some type of sport. But they can also happen after simple activities such as coughing or lifting an heavy object. In addition, muscles may also contract a lot during stressful or scary situations which can result in inflammation and pain.

How to identify: it's a chest pain that usually gets worse when breathing deeply, but it also worsens when you turn your body around to look behind you. It also normally occurs after one of the situations indicated above.  

What to do: a good way of alleviating muscle sores is to rest and apply warm compresses into the region that is hurting. It may also help if you stretch your chest muscles, placing two arms stretched out behind you and holding your hands together.  

5. Acid reflux (GERD)

People who suffer from acid reflux (GERD) and do not have an adequate diet have a higher probability of getting frequent chest pain, as it can be related to the esophageal inflammation that happens when stomach acid reaches the walls of the esophagus.

How to identify: in most cases, it's a pain that starts in the middle of the chest and that comes with a burning sensation and stomach pain. It may also cause a slight tightening sensation, specially on the upper chest region and in the throat, which happens due to the spasms of the esophagus.  

What to do: take a chamomile or ginger tea, as this improves digestion and decreases stomach acidity, reducing inflammation in the esophagus. In addition, you can take an antacid or some fruit salt. When you're not having a crisis, keep to a light diet, avoiding fatty or spicy foods. Learn some dietary changes you can do.

6. Stomach ulcer

Stomach ulcers can cause pain in the chest are due to the inflammation of the walls of the stomach. This type of pain can easily be mistaken as a heart pain, due to the proximity of the two organs.

How to identify: it's a localized pain in the middle of the chest, but that can radiate through all the right side of the chest, depending on the location of the ulcer. In addition, pain is more common after meals, and it can cause bloating, nausea and vomiting.

What to do: if you suspect you have a stomach ulcer it's recommended to visit a gastroenterologist, in order to start adequate treatment, which may include medication, such as Omeprazole, and dietary changes. While you wait for your check-up you can relieve your symptoms by taking potato juice, since it is a great natural remedy to reduce stomach inflammation. See other home remedies to reduce stomach pain.  

7. Gallbladder problems

The gallbladder is a small organ located on the right side of the stomach that can get inflamed due to the presence of stones or excess fat consumption. When that happens, it's normal to feel pain on the right side of the chest, which can radiate to the heart, and seem like a heart attack.

How to identify: it mainly affects the right side of the chest and it gets worse after eating, especially after ingesting fatty foods, such as fried foods and canned foods. In addition, you may also have intense nausea and bloating.

What to do: try avoiding fatty foods and drink a lot of water. If pain still persists, or gets worse over time, it's recommended you visit your GP or go to a hospital.

8. Respiratory problems

Chest pain is more commonly linked to respiratory problems, such as bronchitis, asthma, or an infection, than heart problems. As a part of the lungs is located in the thorax and behind the heart, pain from some respiratory problems can be felt as heart pain, even though it isn't.  

How to identify: you may feel chest pain when coughing or even while breathing, especially when taking a deep breath. You may also feel breathless, wheeze when breathing, or have a persistent cough.

What to do: if you suspect of a respiratory problem, you need to visit you GP, or a pulmonologist, to try and identify the specific cause and start adequate treatment. 

9. Heart conditions

Various heart conditions can cause chest pain, especially angina or arrhythmia. Nevertheless, other symptoms usually appear as well such as fatigue, difficulty breathing or palpitations. 

How to identify: it's a type of pain, or tightness sensation, that does not seem to be caused by any of the reasons mentioned above and that appears with other symptoms such as palpitations, swelling, fatigue, and shallow breathing. 

What to do: you must visit a cardiologist in order to do some tests that will examine your heart function. If there is any cardiac condition that is causing pain, your doctor will recommend adequate treatment.

When to go to the hospital

It's important to seek medical attention when chest pain takes more than 20 minutes to get better or if it gets worse over time. In addition, there are some other symptoms that can indicate that it is important to visit the doctor. These include:

  • Dizziness;
  • Cold sweats; 
  • Vomiting and nausea;
  • Difficulty breathing;
  • Intense headache.

It's also important to look for medical help whenever chest pain brings concern, in order to screen for serious complications. 

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  • DELANEY, Matthew C.; NETH, Matthew; THOMAS, Jared J. Chest pain triage: Current trends in the emergency departments in the United States. Journal of Nuclear Cardiology. 2016
  • RUSHTON, Sharron; CARMAN, Margaret J. Chest Pain: If It Is Not the Heart, What Is It?. Nurs Clin N Am. Vol 53. 3 ed; 421-431, 2018
  • HEART RHYTHM SOCIETY. Heart Diseases & Disorders. Available on: <>. Access in 07 Feb 2020
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