Chest Pain & Tightness: 11 Causes & What To Do

Updated in March 2024

Most of the time, chest pain or tightness is actually not a sign of a heart attack. It commonly occurs due to excess gas, anxiety or muscle fatigue.

However, this type of pain is still an important sign of a heart attack, especially if you have a history of uncontrolled high blood pressure or high cholesterol. With a heart attack, chest pain or tightness tends to become progressively worse and it usually radiates to the neck or arms. Other symptoms may also appear, such as difficulty breathing, general malaise, cold sweats and dizziness.

You are advised to go to the hospital or call an ambulance if your pain lasts more than 20 minutes or if it worsens overtime, especially when you also have other symptoms.

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Learn more about chest pain that is localized more to the left side of the chest and to the right side.

What causes chest pain?

The main causes of chest pain are as follows: 

1. Gas pain

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 accumulation of gas in the intestines can push up and dislocate some abdominal organs, causing a sharp pain that radiates through the chest.

How to identify: This type of pain is usually intermittent. It is often very sharp and then disappears. This can happen repeatedly, and can be triggered when you bend down to pick-up something from the floor. You may find some relief from this pain after drinking a tea for relieving gas.

What to do: A good strategy to relieve this type of pain is to massage the abdominal area, starting from the right side and moving to the left, and then moving down to the groin region. This will help to distribute any accumulated gas.

Another way to release trapped gas is to lay down on your back, with your knees bent up to your chest. Additionally, engaging in light activity like walking for a few minutes may also help. Check out other home remedies you can try to get rid of gas.

2. Stress and anxiety

Anxiety and excess stress can cause an increase in muscle tension around the ribs, which can result in an increased heart rate. This combination causes a sensation of chest tightness that can happen even if the person does not feel stressed. Chest tightness can also occur following an argument or stressful situation. Chest discomfort related to stress commonly happens in people who suffer from panic attacks or anxiety disorders.

How to identify: It usually occurs with other symptoms such as fast breathing, sweating, fast heart rate, nausea and bowel problems.  Learn more about how to identify an anxiety attack.  

What to do: Try to rest in a quiet place, drink a calming tea (like valerian or chamomile), or engage in a leisurely activity, such as watching a movie, playing a game or gardening. If the chest tightness does not improve after 30-60 minutes, or if it worsens, you should seek medical assistance. Learn how to prepare chamomile tea to help soothe any nerves.

3. Heart attack

Even though this is the first concern of anyone who has chest pain, heart attack is actually the least common cause of it. Chest pain related to a heart attack will be more frequent in those over the age of 45 or those with a history of uncontrolled high blood pressure, elevated cholesterol, diabetes, and smoking.

How to identify: Chest pain caused by a heart attack is usually very strong and does not improve after 15-20 minutes. It typically radiates to the arms or jaw, causing a tingling sensation. Other symptoms include dizziness, difficulty breathing, a tingling sensation in the arms and legs, and general malaise. Learn about the 10 main symptoms of a heart attack. 

What to do: If you suspect you are having a heart attack, proceed to the hospital immediately or dial 911. Your heart function will be assessed through an ECG, bloodwork and an x-ray.

Also recommended: 11 Heart Disease Symptoms (You Shouldn’t Ignore)

4. Gastritis

Gastritis is another possible cause of chest pain. This condition can cause pain in the center of the chest which can radiate to the back.

Gastritis is more common in people who have a poor diet, but it can also happen in people with excessive worry and stress which can change the pH of the stomach, and lead to more inflammation. 

How to identify: Gastritis may cause symptoms like the  feeling of full stomach, lack of appetite, acidity and frequent belching. Read more about gastritis symptoms that may appear.

What to do: one way to reduce stomach inflammation is by relieving symptoms, which can be done by drinking water with a few drops of lemon. Check-out other home remedies for gastritis that you can use to relieve mild symptoms, as well as the gastritis treatment your doctor may recommend.

Also recommended: Gastritis Diet: Meal Plan, Foods Allowed & What To Avoid

5. Sore muscles

Having sore muscles is very common, especially after engaging in sports or working-out at the gym. You can also experience soreness after simple occurrences like heavy coughing or lifting a heavy object. In addition, excess muscle contraction can occur during stressful or frightening situations, and this can result in muscle soreness and inflammation.

How to identify: This type of chest pain usually gets worse when taking deep breaths, but it also worsens with specific movements, like turning your body around to look behind you.

What to do: A good way of alleviating muscle sores is to rest and to apply warm compresses to affected regions. Stretching your chest muscles may also help. You can stretch your chest by placing your arms stretched behind you and holding your hands together. If your chest muscles are sore from coughing, learn about different ways you can relieve your cough.

6. Acid reflux (GERD)

People who suffer from acid reflux (GERD) and do not follow the appropriate, indicated diet have a higher probability of experiencing frequent chest pain. This type of pain is usually a result of esophageal inflammation that happens when stomach acid reaches the walls of the esophagus.

How to identify: In most cases, this chest pain that starts in the middle of the chest. A burning sensation and stomach pain are also often felt. and you may experience a mild tightening sensation, particularly in the upper chest region and in the throat, which happens due to spasms in the esophagus.  

What to do: Drink chamomile or ginger tea, as this improves digestion and decreases stomach acidity, which help to reduce inflammation in the esophagus. In addition, you can take an antacid or reflux medication. When you are not actively experiencing a reflux attack, you should try to maintain light diet, avoiding fatty or spicy foods. Learn about other natural remedies you can try to alleviate your reflux symptoms.

Also recommended: GERD Diet: What to Eat & Avoid for Acid Reflux

7. Stomach ulcers

Chest pain related to stomach ulcers occurs due to inflammation of the stomach lining. This type of pain can easily be mistaken as heart-related pain, due to the proximity of the stomach and the heart.

How to identify: This chest pain is localized to the middle of the chest, but that can radiate to the right side of the chest, depending on the location of the ulcer. In addition, pain will more commonly occur following meals, and can be accompanied by bloating, nausea and vomiting.

What to do: If you suspect you have a stomach ulcer, you are advised to see your doctor or gastroenterologist. If a diagnosis is confirmed, treatment as indicated will be initiated. Treatment may include use of medication (e.g. omeprazole) and dietary changes. While you wait for assessment, you can try relieving your symptoms by drinking potato juice, which is a great natural remedy to reduce stomach inflammation.

8. Gallbladder problems

The gallbladder is a small organ located to the right side of the stomach. It can become inflamed due to the presence of gallstones or excess fat consumption. When the gallbladder becomes swollen, pain is typically felt on the right side of the chest, but it can radiate to the heart, and seem like a heart attack.

How to identify: This pain mainly affects the right side of the chest and it gets worse after eating (especially after consuming fatty foods, such as fried or processed foods). In addition, you may also experience intense nausea and bloating.

What to do: Try avoiding fatty foods and drink plenty of water. If pain still persists, or gets worse over time, you are advised to see your doctor or proceed to the hospital if the pain is very severe.

9. Respiratory problems

Interestingly, chest pain is more commonly related to respiratory problems (link bronchitis, asthma, or an infection) as opposed to heart problems. Because a part of the lungs is located in the thorax and behind the heart, pain from some respiratory problems can feel like heart pain, even when 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 experience shortness of breath, wheezing, or have a persistent cough.

What to do: If you suspect you have a respiratory problem, you should see your family doctor for assessment. He or she will try to identify the cause and will indicate treatment as appropriate.

10. Heart conditions

Various heart conditions can cause chest pain, especially angina or arrhythmia. Heart-related chest pain will often occur with other symptoms like fatigue, difficulty breathing or palpitations. 

How to identify it: Chest pain or tightness that occurs due to a heart problem may also occur with palpitations, swelling, fatigue, and shallow breathing. See what can cause heart pain and how to identify it. 

What to do: You should consult your doctor for assessment. He or she will likely order testing to evaluate your heart function. If a cardiac condition is identified, your doctor will recommend adequate treatment and this should help with resolving your chest pain. 

11. Costochondritis

In some cases, chest pain may be due to inflammation of the cartilage that connects the ribs to the sternum (the bone in the middle of the chest). Pain from costochondritis may be noted to bestronger when pressure is placed on the chest or when lying face down,

How to identify: feeling of sore chest and pain that worsens when applying pressure to the region, coughing and/or breathing. 

What to do: You can apply a warm compress to the sternum to relieve pain, as well as take take anti-inflammatory medications as prescribed by your doctor

Also recommended: Sternum Pain: Symptoms, Causes, Diagnosis & Treatment

When to go to the hospital

It's important to seek medical attention when chest pain occurs for longer than 20 minutes or becomes progressively worse. 

In addition, there are some other symptoms that indicate when you should seek medical attention. These include:

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