Causes of Chest Pain & Tightness

Chest pain is the alarming sensation of squeezing, tightening, pressing, and crushing in and around the chest area. Often, chest pain associated with intense pain, directs poor blood flow or blockage to the coronary arteries, resulting in a heart attack. Apart from heart ailments, chest pain is accompanied with breathing issues, sweating, and other symptoms reflect underlying health issues including heartburn, gastroesophageal reflux disease (GERD), chest infection, lung disease, anxiety, or serious allergic reactions. 

Therefore, medical examination and investigations are extremely important to diagnose the exact cause of chest pain. Cardiologists at AMRI Hospitals point out that unexplained pressure and tightening of the chest shouldn’t be ignored. It is essential for everyone to seek medical advice to make sure it’s nothing serious. In a heart attack, every minute counts; immediate medical attention could prevent severe damage to the heart and save a life. 

  1. Angina

Angina is a short-lived chest pain, caused by narrowing of the coronary arteries due to the accumulation of plaque (fatty deposits) in the artery walls, restricting blood flow to the heart, especially during exertion. Usually, the pain eases with a resting position and certain medications. The symptoms of angina include ache, discomfort, sudden tightness across the chest wall, and pain radiating to shoulders, back, neck, arms, or jaw. 

  1. Heart Attack 

Chest pain is the first sign of a heart attack. Blockage in one or more arteries supplying blood to the heart muscle gradually weakens the organ. The first one hour is considered crucial in a heart attack as deprivation of oxygen-rich blood damages the heart muscles, causing sharp stabbing pain, associated with tightness or pressure in the chest. Some heart attacks can be fatal, while some are mistaken for gastric issues. “If a person is experiencing chest pain that lasts more than 10 to 15 minutes, it is best to call medical emergency services immediately,” say doctors at AMRI Hospitals. 

  1. Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease is a digestive disorder where the stomach acid flows back into the esophagus. It causes inflammation and severe heartburn to the patient. In some cases, the symptoms include pain and tightness in the chest that can be mistaken for a heart attack. In such a situation, some people also experience difficulty in swallowing and unpleasant sensations in the throat.

  1. Costochondritis

Costochondritis is a prominent inflammation of the rib cage cartilage, causing sharp chest pain in the front of the chest. The pain may get worse with certain postures and movements, physical activity, and deep breathing. Due to this, many people panic and mistake it for a heart attack. While costochondritis is a self-limiting and benign condition, it is ideal to go for a physical examination to rule out other, more serious causes of chest pain. 

  1. Anxiety

One of the most common causes of chest pain is anxiety, which has the same signs and symptoms of heart attack or angina. Typically, anxiety is detected during medical investigation by ruling out the usual symptoms of heart disease, such as narrowing coronary arteries or blockages. With anxiety attacks, people experience needle-like sensations, stabbing pain in the middle of the chest, and sometimes face breathing issues with sweating. An anxiety attack can often happen if someone gets triggered by upcoming events or past traumas.

  1. COVID-19

In 2020, the world witnessed the new viral infection of SARS- CoV-2 or COVID-19, which has numerous symptoms and affects a number of organs differently in different patients. People have experienced persistent tightness in the chest with symptoms such weakness, fatigue, drowsiness, and trouble breathing in rare cases. More common signs of COVID-19 include fever, dry cough, irritation in the eyes, and shortness of breath.


Chest pain doesn’t necessarily mean heart attack; there are several underlying causes for chest pain that deserve a thorough investigation and medical attention. Accompanying symptoms often provide helpful diagnostic cues. Yet, the challenge of identifying the cause of chest pain can be complex and you should seek immediate medical help.