Tightness in Chest: Heart Attack vs. Other Types of Chest Pain

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Tightness in Chest: Heart Attack vs. Other Types of Chest Pain
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Chest tightness or pain can have a large number of causes, but only some of them are heart related. It’s important to tell if the feeling of tightness in chest is a sign of a serious problem like a heart attack or another condition. Even though it can have less-serious causes, you should never ignore any chest pain or discomfort between the upper abdomen and the neck.

Even doctors sometimes have difficulty telling apart chest pain that is a heart attack related from other types of ribcage pain. For example, tightness in the chest and throat can be caused by anxiety, pneumonia, gallstones, or angina. However, there are some other potentially serious reasons for tightness and sharp pains in the chest that aren’t related to the heart but to the lungs.

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One of the challenges of knowing if the chest pains are serious is that heart attacks feel different for everyone. Many experience the classic heart attack symptom of extreme tightness and heaviness in the chest. However, there may also be chest pain that radiates to the shoulder, arm or jaw. The pain in the chest may feel like a burning sensation along with breathlessness, nausea, and sweating.

In this article, you will find out what tightness in the chest means and how to tell if it is caused by cardiac issues. I will also discuss how to tell the difference between symptoms of a heart attack and other less-serious types of chest pain.

How to Tell If Tightness in Chest is Heart Related

Your heart is located on the left side of your chest and most heart-related chest pains are in the center or left side. According to researchers from Harvard Medical School, some of the many heart attack symptoms can include the following:1

  • An uncomfortable feeling of heaviness in the center of the chest that feels like something is tight, squeezing, or pressing.
  • Tight chest pains that spread to your left arm, jaw, neck, or back.
  • Nausea or vomiting that comes on suddenly.
  • Breathlessness
  • A burning sensation in the chest that feels like heartburn or indigestion.
  • Extreme fatigue and tiredness.
  • Cold sweats

So, tightness in the chest is just one of the possible symptoms of a heart attack. Let’s look in more detail at what a heart attack feels like or if your chest pain is a sign of something else.

What does Heart Attack Feel Like?

Chest pain that is a symptom of an impending heart attack can feel like intense pressure that constricts your chest. Researchers from the National Heart, Lung, and Blood Institute report that men and women describe heart-related pain as squeezing, fullness in the chest, aching chest pain that comes and goes. You can also have a burning sensation which can feel like heartburn or indigestion. The pain may also radiate to the throat, jaw, or even the arms and back. 2

Interestingly, not all heart attack chest pain feels like severe constricting pain. The journal Annals of Emergency Medicine reported that the severity of cardiac-related chest pain isn’t always an indicator of a myocardial infarction (heart attack). Many experience only mild chest pains or discomfort in the center of their ribcage.3

So, a heart attack can feel like mild tightness in the chest that comes and goes and increases in intensity. Or, the heaviness in the chest can be intense and crushing without being felt in one particular place.

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What other Types of Chest Pain Feel Like

Chest pain that isn’t heart-related is usually localized to one place which may be the location of the pain. Researchers from Harvard Medical School say that chest pain that is less likely to be a heart attack feels like sudden stabbing pains that don’t last a long time. You may also find that the pain is made worse by coughing or sneezing and the area may be tender to touch.1

When Heart-Related Chest Tightness Occurs

There is often no way to know exactly when a heart attack can happen. However, there are certain conditions that can trigger a heart attack if you have some kind of existing heart disease or cardiovascular problems.

The American Heart Association reports that heart attacks in some people can be brought on by the following conditions:4

  • Being extremely angry.
  • Engaging in heavy and intense physical activity.
  • Being emotionally upset while exerting oneself physically.

The reason why these conditions can cause chest tightness that leads to a heart attack is that they raise blood pressure, increase the heart rate, and reduce the supply of blood to the heart.

However, you should remember, that regular physical exercise is one of the beneficial habits that can reduce your risk of a heart attack. However, it’s not good to have an intense workout while being very upset.

Another symptom of heart-related chest pain that may lead to a heart attack is if you have coronary heart disease that causes unstable angina. Dr. Walter Tan from the Wake Forest University School of Medicine says that this type of severe chest tightness can happen even without doing any physical exercise.5

Other Types of Chest Pain and When They Occur

You may also feel a burning painful sensation in your chest after eating a large or fatty meal. Doctors from the Mayo Clinic report that heartburn (acid reflux) can feel like a heart attack. However, heartburn pain is usually relieved by drinking baking soda water and may cause a sour taste in your mouth.6

Of course, physical exertion can also cause chest pain if you strain or pull a chest muscle. Researchers from Harvard Medical School say that you can tell the difference between chest pain caused by injury and a heart attack. Usually, sharp pain in the chest that is a result of an injury will be sore to touch.1

How to Tell if Chest Pain is Muscular

Your chest wall muscles can be strained or pulled like any other muscle. Muscular chest pain usually feels localized to the affected muscle and will be quite persistent. The pain will get worse by coughing or sneezing, lifting heavy objects and by walking. Unlike heart attack pain, pressing the affected area will make the pain worse.

Duration of Heart Related Pain

Squeezing pains in your middle or left chest that are heart-related may only last a few minutes. Doctors from the Mayo Clinic say that the duration of chest tightness that is a symptom of a heart attack can be anything among the following:7

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  • Aching or squeezing chest pains that last a few minutes or longer and gradually intensify.
  • Bouts of heaviness in the chest that come and go over a few days or weeks.
  • Pressing chest pains that are associated with physical exercise and get better when resting.

Duration of Other Types of Chest Pain

Compared to cardiac-related aches and pains in the chest, other types of chest pain can last for many hours or days. However, mild to severe chest pain that isn’t heart related or serious usually has no other accompanying symptoms.

Doctors from Harvard Medical say that non-serious chest pains may be sharp and stabbing and only last a few seconds.1

What Relieves Cardiac Chest Tightness

Chest tightness that is cardiac related and a sign of angina usually goes away with rest. If your doctor has diagnosed you with stable angina, then nitroglycerin can help to alleviate the chest discomfort.

However, because constricting, squeezing pains and aches in your chest could indicate an impending heart attack, you should seek medical help immediately.

What Relieves other Types of Chest Pain

Treating other types of chest pain requires diagnosing and treating the underlying condition. For example, if a pulled muscle in chest is to blame for your chest pain, rest and applying a warm compress can get rid of the aching chest pain.

If heartburn causes burning pain in the middle of your chest, changing your diet and drinking baking soda water can help to relieve the discomfort.

You can find out more about how to get relief from left-sided chest pain or get rid of chest pain on the right side.

How to Test for Heart-Related Chest Pain

Unexplained chest pain is a type of pain you should never ignore. You should always arrange for a doctor to diagnose the root cause of squeezing or stabbing chest pains. There are a number of ways that your doctor can find out if the chest pains are something to worry about.

Your doctor may ask the following questions to help find out why you have tightness in your chest:

  • Describe the type of discomfort in your chest – do you have squeezing pains, heaviness or pressure in your chest, or sharp stabbing pains?
  • Do the chest aches and pains get worse at certain times or do they stay constant?
  • Have you had chest discomfort before?
  • Does the constricting pressure in your chest happen after physical activity?

In most cases of chest pain complaints, your doctor will test your heart attack risk using an electrocardiogram (ECG). You may also be asked to give a blood sample.

What to Do if You Have a Heavy Feeling in Chest

What should you do if you have heaviness in your chest that comes in waves and feels like something is pressing on your chest?

You should always see a doctor rather than self-diagnose your chest discomfort. This is especially true if you have other symptoms that can indicate your chest tightness is cardiac-related:

  • Nausea
  • Sweats
  • Shortness of breath
  • Pain in your neck, jaw, or left arm.

Serious Causes of Tightness in Chest or Pain

There are other serious causes of sharp jabbing pains in your chest that can have potentially serious complications. Let’s look briefly at some of these.

Collapsed lung

A chest infection or injury to the chest can cause a collapsed lung which will result in sudden, sharp chest pains. A collapsed lung can interfere with your blood circulation and be potentially fatal if not treated promptly.

Dr. George Schiffman on MedicineNet says that other symptoms of a collapsed lung (pneumothorax) include:8

  • Sharp pains on the affected side of your chest that develops into tightness in the chest
  • Breathlessness
  • Rapid heartbeat
  • Short, rapid breathing
  • A cough
  • Extreme tiredness

Pneumonia

Pneumonia is caused by a viral, bacterial, or fungal infection of the lungs and can result in stabbing chest pains when you breathe deeply. Very often, pneumonia is a complication of an upper respiratory tract infection like the flu or cold.

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Dr. Gregory Thompson on WebMD says that along with chest pain, pneumonia can cause the following symptoms:9

  • Coughing up green or yellow phlegm
  • Fever and chills
  • Shallow breathing
  • Racing heartbeat
  • Nausea and vomiting
  • Gastrointestinal upset

Pleurisy

Pleurisy occurs when the protective lining of your lungs becomes inflamed and usually causes sharp chest pain on your left side or right side. Doctors from the National Health Service say that pleurisy can be a result of pneumonia, injury, or rheumatoid arthritis.10

Pleurisy can also cause some of the following symptoms:

Pulmonary hypertension

Another potentially serious lung condition that causes extreme chest pressure and pain is pulmonary hypertension. Pulmonary hypertension describes a condition where high blood pressure affects your lungs. Doctors from the Mayo Clinic say that pulmonary hypertension usually causes right-sided chest pain. If the condition progresses, it can sometimes be fatal.11

Other signs and symptoms of pulmonary hypertension include:

  • Right-sided chest pressure
  • Fatigue
  • Shortness of breath while exercising
  • Swollen ankles and legs
  • Racing heartbeat and/or palpitations

Less Serious Causes of Tightness in Chest

Thankfully, most cases of aches and pains in the middle of your chest or on either side are nothing to worry about. In many cases, you can find effective home remedies for these types of chest pains.

Acid reflux

Acid reflux, or heartburn, causes a burning, painful sensation in the middle of your chest. The chest tightness is caused by stomach acid that escapes back up the esophagus and irritates it. Poor diet, medications, eating large meals, or a hiatal hernia can all cause acid reflux.

Dr. John Simic on eMedicineHealth says that related symptoms of acid reflux that accompany tightness in the chest include:12

There are many natural treatments for heartburn that get rid of its symptoms of upper abdominal pain. For example, drinking baking soda and water can help to neutralize stomach acid and reduce irritation.

Pulled or tight chest muscles

Pulled muscles in the chest can cause mild to excruciating pain in your chest and cause a feeling of chest tightness.

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You have two large muscles on either side of your chest – the pectoralis major and pectoralis minor, which are sometimes referred to as your “pecs. If you pull any one of them you can feel a sharp severe pain that radiates to your shoulder or arm. Because of this, the symptoms of pulled, strained, or torn muscles in the chest can be similar to a heart attack.

Intercostal muscle strain

The intercostal muscles are found between each of your ribs and provide support to your upper body and assist in breathing. Intercostal muscle strain can cause localized but debilitating pain in and around your chest area. You may also feel that your chest is extremely tight or stiff.

The pain can radiate to other areas of your body such as your shoulder blades and arms. Because the intercostal muscles move with your lungs, breathing could become painful because of the muscle strain.

Peptic ulcer

A peptic ulcer is a sore in your stomach that can cause burning stomach pain as well as symptoms of heartburn. Stomach ulcers are usually caused by a Helicobacter pylori infection. This causes irritation of the stomach lining or small intestine.

Doctors from the Mayo Clinic says that common symptoms of peptic ulcers are:13

  • Nausea after eating
  • Bloating and abdominal discomfort
  • Intolerance to fatty foods
  • Passing bloody stools
  • Unexplained weight loss

Cracked or bruised rib

Trauma or injury to your chest can result in a cracked or bruised rib that will cause varying degrees of chest pain. Depending on the extent of the injury, you may also suffer severe pains in your chest if your lungs, spleen, or internal organs were damaged.

Dr. Colin Tidy on Patient.info reports that most rib injuries heal themselves within a few weeks. Usually, mild to severe pain is the main complication. However, some of the following symptoms could indicate serious complications of a rib fracture:14

  • Sharp stabbing pains in your chest that could indicate a collapsed lung
  • Severe and constant pain in your back or abdomen that may be the result of an injury to an internal organ
  • Trouble breathing that could cause a chest infection

Usually, a warm compress can help reduce inflammation in your ribs because it increases blood flow and makes the pain less intense.

Anxiety disorders

You may experience chest tightness and possibly sharp chest pains if you suffer from any kind of anxiety disorder. A feeling of panic or anxiety can cause the muscles in your chest to tighten which can cause severe aching. In fact, many people who suffer their first panic attack think they have symptoms of a heart attack.

According to the Association of Medicine and Psychiatry, panic disorder can also cause heart-related pain. This is because stress puts your blood pressure up and increases your heart rate. This can result in reduced blood flow to the heart and result in heaviness and squeezing pain in the center or left of your chest.15

If you suffer from stress or depression, you can try some essential oils to lift your mood. Some other ways to get rid of anxiety and stress naturally include regular exercise, meditation, and making sure you have enough vitamins and nutrients.

Costochondritis

Inflammation in the joints between your breastbone and ribs can cause pain and tenderness in the middle of your chest (sternum pain). There are usually very few complications with costochondritis apart from jabbing sharp chest pains.

Dr. William Shiel on eMedicienHealth says that costochondritis is often caused by a viral, bacterial, or fungal infection. The resulting inflammation in your ribcage can cause any of the following symptoms:16

  • Sharp pain in your chest that may radiate to your abdomen or back
  • Signs of inflammation like redness, swelling, or pus if costochondritis is a complication of surgery.

When to See a Doctor for Tightness in Chest

It’s important to see a doctor for any kind of tightness in the chest or a feelings of chest heaviness. Dr. Jennifer Robinson on WebMD says that chest pain accompanied by any of the following symptoms can be a sign of a serious condition:17

  • A sudden feeling of chest tightness, pressure, heaviness, or constriction.
  • Sharp chest pain that intensifies and spreads to your left arm.
  • Sudden jabbing pains in your chest when you haven’t been physically active.
  • Any signs of gastrointestinal upset like diarrhea, nausea, or vomiting.
  • Abnormal heartbeat.
  • Fever or cold sweats.
  • Coughing up yellowish or greenish mucus.
  • Any kind of constant chest pain.

Read these related articles:

Medical Sources

  1. HealthHarvard. Chest pain: A heart attack or something else?
  2. NHLBI. Heart attack.
  3. Ann Emerg Med. 2011 Dec;58(6):501-507.
  4. HeartOrg. Anger, heavy physical exertion may cause heart
  5. Medscape. Unstable angina.
  6. MayoClinic. Heartburn or heart attack: When to worry?
  7. MayoClinic. Chest pain: first aid.
  8. MedicineNet. Pneumothorax.
  9. WebMD. Pneumonia – symptoms.
  10. NHS. Pleurisy.
  11. MayoClinic. Pulmonary hypertension.
  12. eMedicineNet. Acid reflux.
  13. MayoClinic. Peptic ulcer.
  14. PatientInfo. Rib injuries.
  15. Prim Care Companion J Clin Psychiatry. 2002; 4(2): 54–62.
  16. eMedicineHealth. Costochondritis.
  17. WebMD. When you should see a doctor for chest pain.
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