Chest Tightness

Reviewed by: HU Medical Review Board | Last updated: April 2023

Chest tightness is a common symptom of chronic obstructive pulmonary disease (COPD). The sensation of a tight chest may feel different for different people. Chest tightness may feel like:1

  • It is hard to take a deep breath.
  • It is painful to breathe.
  • Something is wrapped around or sitting on the chest.

Chest tightness is often accompanied by wheezing or feeling out of breath. Wheezing is a high-pitched whistling sound that happens when a person breathes in or breathes out.2

What can cause chest tightness for people with COPD?

Chest tightness can be caused by many things in people with COPD. Causes of chest tightness may include:1,2

  • Blockage in the airways
  • Air sac damage
  • Bronchospasms
  • Respiratory infection

COPD causes lung damage called airway obstruction. In airway obstruction, the airways become blocked. In turn, air cannot travel through the passages and lungs as well as it should. This can be caused by chronic bronchitis, emphysema, or a combination of both.1,2

Chronic bronchitis causes airway obstruction in 2 ways. First, the airways of people with chronic bronchitis are constantly irritated and inflamed. Second, their lungs produce excess amounts of mucus that must be cleared through the airways. The swelling, combined with the extra mucus, causes the airways to become too narrow. This can cause a feeling of chest tightness.1,2

Emphysema causes damage to the millions of tiny air sacs in the lungs where oxygen is absorbed into the body. This can lead to a feeling of chest tightness. The damage to the air sacs can cause air to get trapped in the lungs. This makes it harder to fully breathe all the air out. This can cause a tight feeling in the chest, especially during physical activity or exercise.1,2

People with COPD can also have bronchospasms. A bronchospasm happens when the muscles surrounding the airways suddenly get very tight. When the muscles tighten up, it makes the airways too narrow for enough air to pass through. This can also cause chest tightness.1,2

People with COPD are more likely to get respiratory infections. These infections can also cause chest tightness. Infections that may cause chest pain or tightness include pneumonia, the flu, or acute bronchitis.1,2

Flare-ups and COPD chest tightness

Changes in feelings of chest tightness may be a sign of a COPD exacerbation, or flare-up. Respiratory infections are the most common cause of COPD flare-ups. These infections can also cause chest tightness. If you have signs of a flare-up, contact your doctor about the best way to treat the attack.1,3

Chest tightness can also be a sign of serious heart problems such as a heart attack. If your chest tightness feels different than normal, comes on suddenly, or if you are experiencing other symptoms, call your doctor right away. Other symptoms that can be related to a heart problem include:4

  • Pain that radiates down your left arm or to your back, neck, jaw, or shoulders
  • Cold sweats
  • Nausea or vomiting
  • Dizziness

How can chest tightness be treated or managed?

Treatment for chest tightness related to COPD depends on the cause of the symptom and how severe the symptom is. If an infection is causing the tightness, treating the infection with steroids and antibiotics is helpful. Because COPD is a lung condition, treatment for non-cardiac chest tightness in COPD includes bronchodilators to open the airways.1

Other things that can help prevent or treat chest tightness include:1

  • Avoiding irritants like smoke or pollution
  • Staying up-to-date on flu and pneumonia vaccines
  • Breathing techniques
  • Staying active as much as is safe and possible

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