Chest Tightness Causes – A List

Experiencing chest tightness can rightly be a source of concern or alarm, being as it is a symptom of heart attack – one of the biggest killers in the Western world. This high level of concern can lead to may individuals mistakenly calling out the emergency services for minor complaints such as indigestion and thereby using up resources and man power. Of course this is highly preferable however to the alternative and many individuals also put off calling, unaware that they could be suffering a fatal heart attack. The best situation then, is to be able to identify chest tightness causes, and there are many, many other conditions that may be causing such a sensation. By knowing the cause of the tightness you will be able to treat the symptoms, and to seek medical attention if necessary.

Sleep Paralysis

Sleep paralysis is an unusual phenomena which sees sufferers waking from their sleep unable to move, which is often accompanied by a sense of fear, the feeling of a presence in the room and a sensation of chest tightness akin to having something sit on your chest (a sensation that leads often to dreams involving a demon or old lady sitting on the dreamer’s chest, which also inspired the famous painting ‘The Nightmare’ by Henry Fuseli). This can be quite scary for those experiencing it for the first time, particularly the tightness around the chest area. The phenomenon is harmless however and is simply caused by the system that paralyses the body during dreaming to prevent sleepwalking.


Asthma is an inflammatory disease which causes the airways to narrow following exertion and stress. This can cause wheezing, general difficulty in breathing and eventually complete cessation of breathing. Though it is the airways that narrow, the chest will also feel as though it is tightening as the body fights for oxygen. Asthma attacks can be fatal and medical attention should be sought immediately.


Allergies are unfavourable and unusual reactions to foreign objects or substances and are a part of our make up. Most people have an allergy to something, and the trigger can be almost anything. Common allergens however are pollen, hair (such as that from an animal), bee stings or nuts; and the most common reactions are the inability to breath or swelling. Again this can cause the chest to feel tight as the heart and lungs begin to struggle. As some allergies can be lethal, medical attention should be sought in cases where the individual’s precise reaction is unknown. Allergies can develop or disappear at any point during an individual’s life.


Angina describes any chest pain that is caused by a lack of oxygen or blood in the heart. This is most often caused by problems with the human circulatory system, particularly in the veins which channel blood to the heart. One common was for this to happen is by the veins becoming ‘clogged’ with ‘arterial plaque’, made up of ‘LDL’ (low density lipoprotein – the ‘bad’ type of cholesterol) and fatty deposits which can build up on the cell walls making them inflexible and causes blockages. This in turn means that the blood struggles to get through to and from the heart which can lead to chronic chest pain. Angina is often a prelude to other more serious conditions such as heart disease, heart attack or stroke which can occur if the arterial plaque eventually forms a blood clot. For this reason it should not be taken lightly. Eat a diet low in fat and high in fibre supplemented with lots of exercise to bring down cholesterol.


In between the ribs in the chest are muscles called the ‘intercostals’ which serve to protect the heart and lungs and help to move the chest wall. Laid over the top of these are two larger sheets of muscle known as the pectoral muscles. Often we experience ‘shooting pains’ in our chest and these are usually caused by twitches or trapped nerves in these muscles. In the case of cramp however it’s possible to feel extreme discomfort and tightness around the chest area that’s hard to alleviate and easy to mistake for heart attack, in this scenario try massaging the chest thoroughly and stretching to relieve the symptoms.


Similarly damaging either your intercostals or pecs can have a similar effect, as can any localised injury in that area. A bruised pec, or damaged lung can make breathing painful and create a sensation of ‘tightness’. It’s even possible in fact to bruise the heart itself, which is a common problem for boxers, and it can take several days for the bruise to ‘come out’ after the accident. Try to think back to any potentially accidents that could have affected your chest and they treat with a dose of rest and relaxation. If your heart itself is bruised it can be wise to take anti-inflammatory medicine such as ibuprofen or arnica.


Indigestion is the number one culprit for being mistaken for heart attack, and causes a similar feeling of tightness as well as a pain that moves around the upper back and even the arms. Unlike a heart attack however, indigestion will often feel as though there is something ‘stuck’ in your chest and result in belching, gas or bile. At the same time you will not feel the shortness of breath associated with heart attack. Cases of indigestion can be treated with medication such as Gaviscon.

Sleep Apnea

Sleep apnea is another sleep disorder much like sleep paralysis. Here the symptoms are rather different however, and the condition is characterised as long periods during sleep where the patient takes no breaths. This can be a minor irritation, causing damaged sleep, but can eventually lead to death if the individual does not wake up. Often the sufferer has no idea that they are suffering sleep apnea and instead will simply notice that they feel tired and lethargic during the day. If they do awaken however they will feel short of breath and tight around the chest area.

There are two forms of sleep apnea, ‘central’ and ‘obstructive’ while some cases are ‘mixed’. The majority of cases of sleep apnea are ‘obstructive’ meaning that the problem is caused by a blockage in the trachea or nasal passage. This can be caused by misshapen bone or from being overweight (where the weight of the neck closes off the trachea). In these cases the problem can often be solved by sleeping more upright. In more difficult cases ‘continuous positive airway pressure’ can be used, utilising a stream of high pressure air which forces open the airways during sleep.

For those with central apnea however the problem is one deep routed in the brain itself, and is caused by an inability of the brain to recognise a lack of oxygen. Here the brain simply fails to send the signal to breath, and with the patient asleep it is not possible to do so consciously. Cases of central apnea are treated with medication though no cure has yet been found.

Panic Attack

Panic attacks are a psychosomatic condition that sees the sufferer experience bouts of extreme stress response – increasing their heart rate and causing shaking, hyperventilation, perspiration, terror and dread, restlessness and a tightness in the chest. Roughly a quarter of adults experience panic attacks at some point in their lives and they are often caused by periods of extreme stress. The problem with panic attacks is that they can often feel as though you are suffering from a heart attack and many who experience claim that they felt as though they were ‘going to die’. This obviously only serves to cause further panic resulting in the secretion of further adrenaline. Once you know you’re suffering a panic attack you should be able to put these thoughts into perspective and try to calm yourself down as best as possible.

Heart Attack

Finally the most dangerous of the potential causes for your chest tightness. A heart attack will feel as though someone is sitting on your chest or like a dull ache. While many people expect this pain to be on the left side of their chest, this is actually a myth. In fact the heart is situated in the centre of the chest and only appears to be located to the left as that is the larger side. Furthermore the nerve that’s connected to the heart (and which sends signals of pain) is located in the centre.

As well as a dull pain and squeezing sensation in the centre of the chest, a heart attack will be accompanied by a several other possible symptoms. These include a tiredness or ‘heaviness’, hyperventilation, perspiration and pain travelling around the shoulders and neck and especially the arms and jaw. If there’s any chance that you or someone you know may be suffering from a heart attack you should seek medical attention immediately. While calling out the emergency services shouldn’t be taken lightly, it’s still better to waste their time than to waste your life.


  1. I am only 13 and it feels like someone is sitting on my chest. My chest is heavy and I feel tired and sluggish during the day.

    1. I have a similar problem but without sluggishness, and I am 13 as well.

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Adam Sinicki

Adam Sinicki is a full time writer who spends most of his time in the coffee shops of London. Adam has a BSc in psychology and is an amateur bodybuilder with a couple of competition wins to his name. His other interests are self improvement, general health, transhumanism and brain training. As well as writing for websites and magazines, he also runs his own sites and has published several books and apps on these topics.

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