Sore throat and tight chest

A viral illness such as a common cold, influenza or COVID-19 can irritate the throat and cause cough or a tight feeling in the chest. Asthma or another airway problem may cause chest tightness with wheeze, breathlessness or coughing. Acid reflux can cause throat burning, a sour taste or discomfort behind the breastbone, often after meals or when lying down. Allergic rhinitis may irritate the throat, while a severe allergic reaction can affect breathing. Strep throat and tonsillitis mainly affect the throat, but a person can have more than one problem at the same time. The description of tightness, its timing and accompanying symptoms are essential.

Stop strenuous activity and sit upright while you assess how you feel. If you have a prescribed reliever inhaler, use it according to your personal plan. Sip fluids for throat discomfort and avoid smoke or other airway irritants. Do not start someone else’s inhaler or antibiotics. Contact a clinician promptly for new chest tightness, especially if you have asthma, heart or lung disease, or symptoms after an allergen exposure. A clinician can check breathing, oxygen level, heart and throat and decide whether tests are needed.

Call emergency services for severe or rapidly worsening breathlessness, chest pressure or pain, blue lips, fainting, confusion, sweating with chest discomfort, or swelling of the lips, tongue or throat. Urgent help is also needed if you cannot speak in full sentences, your inhaler is not relieving symptoms, or tightness began suddenly. Do not drive yourself when breathing or chest symptoms are severe.

Is the chest feeling more like pressure, pain, wheeze or difficulty taking a deep breath? Did it follow an infection, meal, exercise or allergen? Could asthma, reflux or another condition be involved? Do I need an examination, breathing test or other assessment?