You may experience occasional chest tightness if you have asthma. These episodes are usually accompanied by wheezing, shortness of breath, and a chronic cough. Chest tightness can be anxiety-provoking, and it is often a sign of worsening asthma control and/or an impending asthma attack.
If you haven’t experienced it before, it’s especially important that you seek medical care right away for chest tightness or chest discomfort—even if you have already been diagnosed with asthma.
Chest Tightness in Asthma Symptoms
When you have chest tightness due to your asthma, you may feel like you can’t easily push air in and out of your chest. With asthma, mild chest tightness can be present all or most of the time, but it may worsen in response to asthma triggers and in the hours or minutes before an asthma exacerbation.
Not all people who have asthma experience chest tightness. But there is a type of asthma described as chest tightness variant asthma (CTVA) in which this symptom is especially frequent.
Symptoms of chest tightness include:
- A feeling that your chest is constricted, as if there’s a band around it
- A sense that you’re trying to push against your chest from the inside as you breathe
- A struggle to fully exhale (breathe out)
- Difficulty inhaling (breathing in)
When the feeling of chest tightness triggers anxiety, your sense of not being able to move air through your lungs can worsen.
When to See a Healthcare Provider
Whether you have been diagnosed with asthma or not, it is important that you get medical help for your chest tightness.
Consider going to an emergency room if:
- The discomfort is severe.
- You have associated chest pain, tachypnea (rapid breathing), nausea, sweating, dizziness, or fainting.
- The sensation is localized to a specific area of your chest.
- Your chest tightness is associated with physical activity or progressively worsens.
- You have a feeling of impending doom or that something is horribly wrong.
Call your healthcare provider’s office for an appointment if:
- You experience mild chest tightness at the same time every day or when your asthma medicine is wearing off.
- You only experience chest tightness along with your other asthma symptoms.
- You started having occasional chest tightness when you had a change in your asthma medication.
- Your chest tightness improves when you use your asthma rescue treatment, but is recurrent.
Asthma Doctor Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Chest tightness is one of the manifestations of asthma. The sensation occurs as a result of several asthma-induced physical changes.
Asthma is an obstructive lung disease, which means that difficulty exhaling is the main problem. As you try to exhale, your narrowed bronchi (airways) trap air inside your lungs. Even though it is an obstructive disease, you struggle to inhale when you have asthma as well.
When asthma acts up, your bronchi constrict (narrow), and your lungs become inflamed and produce excess mucus. This results in airway limitation that makes it hard for air to pass through, even as you put all your effort into breathing.
All of these effects of asthma can lead to the sensation of chest tightness.
A number of triggers can lead to worsened chest tightness when you have asthma:
- A respiratory infection
- Cigarette smoke or other airborne fumes
- Exercise if you have exercise-induced asthma
- Foods that trigger your asthma
- Fragrances that you are sensitive to
- Not using your medication as needed/directed
- Pets and other animals
A Warning Sign
When chest tightness is one of your most noticeable symptoms, it may take your medical team longer to determine whether your asthma is to blame. (The same goes for those who have not yet been diagnosed with asthma.) This is because chest tightness is an especially concerning sign of life-threatening issues, including heart disease or pulmonary embolism (PE).
If you seem to be in distress, your medical team will rapidly assess you to determine if you are experiencing a medical emergency, such as a heart attack or a lung emergency (like a PE or a pneumothorax). Often, people who have chest tightness due to these and other emergencies are visibly short of breath.
Your medical team will check your pulse, respiratory rate, and blood pressure. Depending on your symptoms, you may have an electrocardiogram (EKG) to check your heart rhythm and pulse oximetry to check your oxygen saturation as well.
If your chest tightness is not a sign of an emergency, your healthcare provider may order further tests to help determine whether asthma or another lung disease is the cause.
The list of chronic conditions that can cause chest tightness along with other symptoms similar to those of asthma is long and includes chronic obstructive pulmonary disease (COPD), lung cancer, and pulmonary sarcoidosis.
Tests you may need include:
- Pulmonary function tests (PFTs) to measure your respiratory function and lung capacity
- Complete blood count (CBC) to check for signs of chronic inflammation or anemia
- Chest X-ray or computerized tomography (CT) scan
- Echocardiogram to check your heart function
- Stress test to identify coronary artery disease that can lead to angina (chest pain)
If you have an established diagnosis of asthma with chest tightness, it’s important that you promptly use your rescue asthma treatment when you develop this symptom. Ideally, you would also regularly use controller asthma treatment to avoid having episodes of chest tightness in the first place.
For standard asthma treatment, rescue medication includes short-acting bronchodilator inhalers like albuterol. Maintenance therapies include inhaled corticosteroids like Pulmicort (budesonide), long-acting bronchodilators like Spiriva (tiotropium bromide), and immunomodulators like Dupixent (dupilumab).
Sometimes chest tightness in asthma is relived with bronchodilators, but some people with asthma experience improvement of chest tightness only with other asthma treatments.
Chest tightness is a sign of severe asthma that may be less responsive or refractory to standard asthma treatment.
Asthma with chest tightness relieved with the use of asthma drugs except bronchodilators (CTRAEB) might differ from asthma with chest tightness relieved with bronchodilator use (CTRB). The latter is associated with inflammation and bronchoconstriction, while the former is only associated with inflammation.
Lifestyle management is especially important, because chest tightness is so often associated with anxiety. Using these strategies can help you gain a sense of control that may alleviate some of the feeling of panic that further exacerbates chest tightness:
- Avoid asthma triggers: These are personal for everyone, but may include cigarette smoke, mold, pets, pollens, and so on.
- Pulmonary rehabilitation: This approach includes exercise, endurance training, breathing retraining, respiratory exercises, weight management, and education—the guidance for which is provided by a pulmonary therapist
A Word From Get Meds Info
Chest tightness is an especially distressing symptom in asthma, but it can also be a sign of serious heart and lung problems. As such, your medical evaluation for this problem will be carried out with urgency.
If you tend to experience recurrent chest tightness as part of your asthma, it’s important that you learn to recognize the need for rescue treatment and that you seek medical attention if anything about your chest tightness changes.