Why am I feeling pressure in the middle of my chest?

September 25, 2025 •

4 min read

According to the CDC, chest pain is one of the most common reasons for emergency department visits in the U.S., but non-cardiac causes are frequent. If you are wondering, “why am I feeling pressure in the middle of my chest?”, a range of issues from mild to serious may be the cause, and proper evaluation is crucial.

Quick Summary

Pressure in the middle of the chest can stem from numerous conditions affecting the heart, lungs, digestive system, muscles, or from psychological factors like anxiety. This symptom requires careful consideration, as it can mimic a heart attack, emphasizing the need for medical evaluation, especially if it is new, severe, or accompanied by other serious symptoms.

Key Points

Not always a heart attack: While serious cardiac conditions are a possibility, chest pressure can also result from digestive, musculoskeletal, pulmonary, and psychological issues.
Recognize emergency signs: Seek immediate medical help if chest pressure is sudden, severe, or accompanied by symptoms like shortness of breath, nausea, sweating, or pain radiating to other areas.
Consider digestive causes: Acid reflux (GERD) and esophageal spasms can feel very similar to cardiac pain, often triggered by food and sometimes relieved by antacids.
Check for musculoskeletal pain: Inflammation of chest wall cartilage (costochondritis) or muscle strain from physical activity can cause localized tenderness and pressure.
Understand anxiety's role: Stress and anxiety can trigger physical symptoms like chest tightness and a racing heart, which can be frightening but are typically not life-threatening.
Evaluation is key: Because many conditions mimic each other, a medical professional is necessary to determine the true cause of chest pressure and provide appropriate treatment.

Understanding the Anatomy of Chest Pressure

Your chest cavity is home to several vital organs and structures, including the heart, lungs, esophagus, and a complex network of muscles, bones, and cartilage. Pain or pressure in this area can originate from any of these systems, making it a challenging symptom to self-diagnose. While a heart attack is a critical concern, many other conditions can produce a similar sensation.

Cardiac Causes of Chest Pressure

Though not always the culprit, heart-related issues are the most critical to rule out and should be considered first, especially if you have risk factors.

Heart Attack (Myocardial Infarction)

A heart attack occurs when a blockage stops blood flow to the heart muscle. Symptoms often include a feeling of uncomfortable pressure, squeezing, or fullness in the chest that may last for more than a few minutes. Other signs can include:

Pain that radiates to the arms, back, neck, or jaw.
Shortness of breath.
A cold sweat.
Nausea or lightheadedness.

Angina

Angina is chest pain or discomfort caused by reduced blood flow to the heart muscle. It is a symptom of coronary artery disease and often feels like a squeezing or pressure in the chest. Angina pain can be triggered by physical exertion or stress and typically subsides with rest.

Pericarditis

This is the inflammation of the pericardium, the thin sac surrounding the heart. Pericarditis can cause sharp, stabbing chest pain that often worsens with deep breathing or lying down and may be relieved by sitting up and leaning forward.

Non-Cardiac Causes: Digestive Issues

Digestive problems are a frequent, non-life-threatening cause of central chest pressure.

Gastroesophageal Reflux Disease (GERD)

GERD, or chronic acid reflux, is when stomach acid flows back into the esophagus, causing a burning sensation known as heartburn that can be felt behind the breastbone. The pain can sometimes mimic a heart attack, especially after eating a large or fatty meal.

Esophageal Spasms

These are abnormal muscle contractions in the esophagus that can cause a feeling of squeezing or intense pressure in the chest. The pain can be so severe it is mistaken for a heart attack.

Hiatal Hernia

This condition occurs when part of the stomach pushes up through the diaphragm. It can lead to acid reflux and chest discomfort.

Non-Cardiac Causes: Musculoskeletal Issues

Pain originating from the chest wall's muscles, bones, or cartilage is often mistaken for heart problems.

Costochondritis

This involves the inflammation of the cartilage connecting your ribs to your breastbone. It can cause sharp, aching, or pressure-like pain that worsens with deep breaths or coughing. The pain is often tender to the touch.

Muscle Strain

Overstraining chest muscles from activities like heavy lifting, exercise, or even persistent coughing can lead to soreness and a feeling of pressure.

Rib Fractures

Rib fractures or bruising from trauma can cause localized pain in the chest that is often exacerbated by movement or deep breathing.

Non-Cardiac Causes: Psychological Factors

Psychological stress can manifest as physical symptoms, including chest pressure, due to the body's 'fight or flight' response.

Anxiety and Panic Attacks

Anxiety can cause a rapid heart rate, muscle tension, and hyperventilation, leading to a feeling of chest tightness or pressure. Panic attacks, in particular, can cause a sudden and overwhelming sense of fear with physical symptoms like chest pain, shaking, and shortness of breath that can be mistaken for a heart attack.

Comparison of Common Chest Pressure Causes


Feature	Heart Attack	GERD/Heartburn	Musculoskeletal Pain	Anxiety/Panic Attack
Sensation	Squeezing, pressure, fullness, or crushing	Burning sensation (heartburn), sour taste	Sharp, aching, localized, tender to touch	Tightness, racing heart, feelings of doom
Onset	Often starts slowly, may intensify	After eating, lying down	After physical activity, coughing, or trauma	Sudden, without clear physical trigger
Location	Center or left of chest, may radiate to arms, jaw, back	Behind breastbone	Localized to chest wall, tender spot	Can be widespread chest tightness
Duration	Lasts minutes or comes and goes over hours	Variable, often resolves with antacids	Improves with rest, worsens with movement	Fleeting, usually resolves in 10–20 minutes
Aggravated by	Physical exertion, emotional stress	Large meals, lying down, spicy/fatty foods	Movement, coughing, deep breathing	Emotional stress, anxiety, hyperventilation

Non-Cardiac Causes: Pulmonary Issues

Conditions affecting the lungs and surrounding structures can also cause chest pressure.

Pulmonary Embolism

This is a serious condition where a blood clot blocks an artery in the lungs. It can cause sudden chest pain, shortness of breath, a rapid heart rate, and lightheadedness.

Pleurisy

This is the inflammation of the lining of the lungs and chest cavity. It causes sharp chest pain that is often made worse by deep breathing, coughing, or sneezing.

Pneumonia

A lung infection can lead to chest pain, especially with deep breathing or coughing, along with fever, chills, and shortness of breath.

When to Seek Medical Attention

While many causes of chest pressure are not emergencies, others are life-threatening. You should call 911 immediately if you experience sudden, severe chest pressure or if it is accompanied by any of these symptoms:

Shortness of breath.
Sweating, nausea, or dizziness.
Pain that radiates to your arm, neck, jaw, or back.
A feeling of impending doom.

For any new, persistent, or worsening chest pressure, it is best to be evaluated by a healthcare professional to rule out serious conditions. A doctor can use tests like electrocardiograms (ECGs) and blood tests to make an accurate diagnosis. Learn more about cardiovascular symptoms and health from the American Heart Association.

Conclusion

Feeling pressure in the middle of your chest is a symptom that should never be ignored. The range of potential causes, from relatively benign issues like acid reflux or muscle strain to critical medical emergencies such as a heart attack or pulmonary embolism, necessitates professional medical evaluation. By understanding the different characteristics of chest pain and being vigilant for accompanying symptoms, you can make an informed decision to seek timely care when needed.

Frequently Asked Questions

Yes, anxiety and panic attacks can cause significant chest pressure. The body's fight-or-flight response leads to muscle tension and changes in breathing, resulting in feelings of tightness or squeezing that can be mistaken for a heart attack.

Heartburn is typically a burning sensation that occurs after eating, while a heart attack is more often described as a squeezing or crushing pressure. A heart attack may also involve pain radiating to other areas and symptoms like sweating and shortness of breath. If uncertain, seek emergency medical care.

Yes, musculoskeletal issues like costochondritis (inflammation of chest cartilage) or a strained chest muscle can cause pain and pressure. This type of pain is often localized and may worsen when you press on the area or move certain ways.

Seek immediate help if chest pressure is severe, doesn't go away, or is accompanied by other symptoms like pain radiating to the jaw or arm, shortness of breath, dizziness, or a cold sweat. These can be signs of a heart attack or other serious condition.

Yes. Conditions like esophageal spasms, which are involuntary muscle contractions in the food pipe, and hiatal hernias, where the stomach pushes through the diaphragm, can also cause chest discomfort that feels like pressure.

You should see a doctor if your chest pressure is new, persistent, or worsening, even if you don't have emergency symptoms. A doctor can perform a proper evaluation to determine the underlying cause and ensure it is not a serious condition.

While conditions like pleurisy or pneumonia can cause chest pain that worsens with breathing, musculoskeletal issues like costochondritis or a muscle strain can also be aggravated by deep breaths or coughing. A doctor can help differentiate the cause.