Chest tightness around the sternum: what to know

The sternum is the breastbone in the centre of the chest. Pressure or constriction there may occur with exertion, wheezing, coughing, indigestion, chest-wall strain, or a surge of fear. Angina presents with chest pressure when the heart muscle is not receiving enough oxygen; it may spread to an arm, jaw, back, or shoulder. Acid reflux can cause burning or pressure behind the breastbone, sometimes after eating or when lying down. Asthma presents with chest tightness alongside wheeze or cough, while COPD may cause tightness with breathlessness and ongoing cough. Anxiety and panic can also produce a gripping chest sensation, fast breathing, trembling, or a racing heartbeat.

Stop strenuous activity and sit upright. Notice when the tightness began, whether it changes with movement or breathing, and whether food, cold air, or stress affects it. Record breathlessness, sweating, nausea, dizziness, fever, cough, or pain spreading away from the chest. If you have a prescribed reliever inhaler, use it only according to your action plan; learn more about Inhaler Therapy. Arrange medical review for new, recurring, or unexplained symptoms, even when they settle.

Call emergency services for severe or persistent chest pressure, trouble breathing, fainting, blue or grey lips, heavy sweating, confusion, or discomfort spreading to the arm, jaw, back, or shoulder. Seek urgent help if symptoms start during exertion or occur with marked weakness. Do not drive yourself if you feel faint or seriously unwell.

Ask what causes fit the timing and triggers, whether your heart and lungs need checking, and which warning symptoms should change your plan. Bring a list of medicines and describe any previous episodes.