Feeling tightness in your chest under normal conditions is already stressful—six months ago, your immediate reaction might have been to suspect a heart attack. But during a global pandemic, an onset of chest tightness will probably make you wonder if you've contracted the new coronavirus.
This is unfortunately a reasonable concern: According to the Centers for Disease Control (CDC), one of the more alarming symptoms of COVID-19 is pressure in your chest. In fact, if you're experiencing persistent pain and pressure in your chest, the CDC classifies that as an emergency warning sign, and advises that you seek medical attention immediately. Something else the CDC says, whether you have tightness in your chest or not: If you think you may have been exposed to COVID-19 and have developed any symptoms, like a cough, fever, or shortness or breath, you should contact a health care provider for medical advice right away.
With all that said, while COVID-19 is likely top of mind for you right now, there are numerous other health conditions that can make you feel that tightness in your chest. Some of them are as serious as a heart attack, while others are nowhere near that dire. That said, you should always seek medical attention when you're experiencing tightness in your chest.
“I always tell people that, no matter what, if you are having chest tightness, you need to see your doctor. It’s never really normal,” Dr. Haythe tells SELF. But there’s a big difference in urgency when it comes to acid-reflux-induced chest tightness because you ate a bunch of spicy nachos, and tightness that’s due to something like a heart issue, COVID-19, or pulmonary embolism. A lot of how you handle when to see a doctor depends on what you already know about your health, Dr. Haythe says. You can read me about that at the bottom of this post.
Meanwhile, in order to know when chest tightness is an emergency, you have to understand a little bit about the conditions most likely to bring on this symptom. Here are some of health issues that often cause chest tightness to alert you that something’s up, plus information about when to reach out to doctor down below.
Since the new coronavirus is undoubtedly is on everyone's minds right now, let's just talk about it one more time to make sure you know all the basics about symptoms and what to do if you think you might have it.
According to the CDC, the most typical symptoms of COVID-19 are fever, cough, and shortness of breath. These typically present between 2 and 14 days after you've been exposed to the virus. For many people, one or several of these symptoms will be the extent of their experience with this new virus; if you have only fever and a cough without other symptoms, you can typically just manage that at home (and consider yourself lucky). But for a subset of other people, the symptoms can be much, much worse—potentially leading to hospitalization, ventilation (having to be put on a respirator to help your lungs function), or death.
As we mentioned above, if you're experiencing symptoms of COVID-19 and think you've been exposed, you should reach out to your health care provider for instructions about what to do—many doctors are advising that people try to take care of themselves at home if their symptoms are mild, instead of rushing to the hospital for testing, which can overload your local health care system and potentially expose more people to the virus. Either way, call your doctor to find out whether you fall into that category. We've published some additional resources that might help: What to Do If You Think You May Have Coronavirus, as well as How to Know If You Need to Go to the E.R. With Coronavirus, in case they are helpful.
Now, about chest tightness and coronavirus. Feeling tightness in your chest is a warning sign that your symptoms are becoming more severe—like by possibly developing into a pneumonia—and that you need medical attention immediately. That also goes for some other red flag symptoms, including trouble breathing, confusion or inability to rouse, and bluish lips or face, according to the CDC. See the CDC's page on coronavirus symptoms for more information.
Experiencing anxiety at some point in life is part of being human. Right now, though, in the middle of a global pandemic, it's likely something that almost everyone around you is dealing with to some degree, yourself included. Various anxiety issues can manifest with physical symptoms, such as a racing heartbeat. But you should know that panic attacks in particular can lead to feelings of chest tightness and pain. Great. Certainly doesn't make this whole situation any easier, does it?
Panic attacks are bouts of acute fear that usually come on suddenly and can be completely debilitating. They can cause a range of symptoms like terror over the loss of control, sweating, trembling, and trouble breathing, according to the National Institute of Mental Health. The chest tightness is linked to that last one.
The rapid breathing that typically comes along with panic attacks can escalate to the point that you’re hyperventilating, or breathing too quickly and deeply, according to the U.S. National Library of Medicine. If you’re not expelling as much air from your lungs as usual, you may feel a sense of tightness and discomfort in your chest, Raymond Casciari, M.D., a pulmonologist at St. Joseph Hospital in Orange, California, tells SELF. This can be so intense that it might make you think you’re having a heart attack. Or, if you're particularly concerned about the new coronavirus, it might make you wonder if you're dealing with that.
If you can't tell if it's anxiety or coronavirus, see the CDC's website about symptoms of coronavirus. If you're still not sure, seek medical attention by reaching out to your doctor, who can help you figure out what's going on. Meanwhile, if it turns out that you're actually dealing with pandemic-induced anxiety, you might find this helpful: What to Do If Your Anxiety About Coronavirus Feels Overwhelming.
Asthma screws with the passages that transport air into your lungs to supply your body with oxygen. If you have asthma, encountering certain triggers can cause these airways to misbehave more than the most rambunctious of toddlers, and may cause you to feel a tightness in your chest.
Exposure to a trigger like pet dander, pollen, mold, cold air, or even exercise can cause your airways to swell, making the muscles around them tighten, according to the National Heart, Lung, and Blood Institute. At the same time, your panicky airways pump out more mucus to try to help the situation. (Fun fact: Mucus is supposed to ensnare any dangerous substances you’ve inhaled so they’re easier to cough out.)
This cascading series of events can lead to chest tightness because when your airways constrict, you can’t get as much air in and out as usual, Dr. Casciari says. This difficulty inhaling and exhaling can make your chest feel tight from built-up pressure, he explains.
Beyond that shortness of breath, if you have asthma-induced chest tightness, you may also experience wheezing (a high-pitched noise when you breathe), coughing, and trouble sleeping, according to the Mayo Clinic.
This condition, also known as gastroesophageal reflux (GER), happens when bitter acid from your stomach basically trespasses and goes into your esophagus, where it doesn’t belong, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). If you get mild acid reflux at least twice a week or more severe instances of it at least once a week, you might have gastroesophageal reflux disease (GERD), the more intense form of this condition.
No matter the severity of your case, when your stomach acid bubbles up into your esophagus, the irritation can cause the tight, burning, painful sensation in your chest that you may know as heartburn. You may also be able to taste food or stomach acid way back in your mouth and experience additional symptoms like bad breath, nausea and vomiting, a hard time swallowing, respiratory problems, and the erosion of your teeth over time due to all that acid, according to the NIDDK.
There’s a fancy name for this—pneumothorax—and it happens when air seeps into the space between your lung and chest wall, according to the Mayo Clinic. This air then applies pressure to the outside of your lung, forcing it to collapse.
Among other causes, your lung can collapse because of something like a chest injury or a lung disease such as pneumonia or chronic obstructive pulmonary disease (COPD, this is a long-term lung disease that most often happens because of smoking), the Mayo Clinic explains.
Whatever the reason, the main symptoms of a collapsed lung are sudden chest pain and shortness of breath. The pain tends to be pretty sharp and located in the area where the lung has collapsed, and in some cases, people register it as chest tightness instead, Dr. Casciari says.
A pulmonary embolism happens when something blocks one of the arteries in your lungs that transports blood, the Mayo Clinic explains. That something is usually a blood clot that, after forming in your legs (this is called deep vein thrombosis), broke off and traveled to your lungs.
Symptoms of a pulmonary embolism can change depending on the size of the clot and how much of your lung it’s affecting. Chest pain and tightness that won’t go away even when you take it easy are one common sign, according to the Mayo Clinic. A pulmonary embolism might actually kill parts of your lungs, making it harder than usual to breathe, Jennifer Haythe, M.D., codirector of the Women's Center for Cardiovascular Health at Columbia University Irving Medical Center and cardiologist at NewYork-Presbyterian/Columbia, tells SELF. This can lead to a tight-feeling, painful chest.
Other symptoms generally include out-of-the-blue shortness of breath that intensifies when you push yourself physically and a cough that may be bloody. You should also keep an eye out for issues like fever, heavy sweating, dizziness, and leg pain or swelling.
Okay, sure, having chest tightness could signal that you’re having a heart attack or angina, which is chest pain caused by reduced blood flow to your heart (and a possible warning of a future heart attack), per the Mayo Clinic. But if you’re an otherwise healthy person, it’s more likely that your chest tightness is due to something less serious like acid reflux, Dr. Haythe says. Still, let’s go over the basics.
Symptoms of angina and a heart attack are pretty similar. They usually include pain, squeezing, pressure, or tightness in your chest, pain in your arms, neck, jaw, shoulder, or back, nausea, fatigue, shortness of breath, sweating, and dizziness. The chest tightness comes from the fact that your heart isn’t getting enough blood, Dr. Haythe explains, so it’s setting off alarm bells to alert you to the emergency.
Again, if you’re healthy and young, it’s unlikely that your chest discomfort is due to a serious heart problem. That doesn’t mean you can just put off persistent chest tightness, though.
For example, if you know you have asthma and your chest tightness gets better when you use your prescribed medication, you can consider checking in with your doctor in a few days, Dr. Casciari says. Having well-controlled asthma means you shouldn’t need to use your short-acting rescue medications often. Even if your symptoms respond to the drugs, this could be a sign that your asthma action plan needs tweaking. But if your chest tightness and other asthma symptoms aren’t getting better in response to your medications, you may need to go to the emergency room.
Another possibility is that you’re aware that you have panic attacks, but you don’t know how to stop them. Totally normal—this is not something many people can overcome on their own. Treatment methods like cognitive behavioral therapy may help, and many drugs, like selective serotonin reuptake inhibitor antidepressants, are meant to relieve panic attack symptoms, according to the Mayo Clinic.
When you’re less sure about what exactly is going on, you can glean clues from when your chest tightness happens and any symptoms that occur with it. If you get burning chest tightness like clockwork after you eat certain foods and it’s especially prone to striking at night, you probably don’t need to rush to the doctor super concerned. But for comfort’s sake, see your doctor soon and ask if you may have acid reflux that’s causing heartburn. If you do, treatment methods like antacids to neutralize your stomach acid may help.
Other symptoms are more worrisome, Dr. Haythe says. If you’re suddenly having chest tightness that sticks around whether you’re exerting yourself or resting, shortness of breath, or pain happening in parts of your body like your jaw and shoulder, get to the emergency room immediately. We can’t diagnose you through the screen, especially since so many things can cause this combination of symptoms, but that could point to an issue like a collapsed lung, pulmonary embolism, or heart problem. Or if you've been experiencing other symptoms of coronavirus, like fever and a cough, and then you also develop persistent chest pain or tightness in your chest, that's a sign you need to seek help immediately.
Of course, these are loose guidelines. No matter when your chest tightness happens or how intense it feels, seek medical help if you’re concerned. A few of your most important organs are packed in there, so it’s okay to play it safe.
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