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Why do I have chest tightness, especially in the morning?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am 30 years old. I love caffeine, smoke weed every day, and exercise a couple of times a week. I am not on any specific diet. There is tightness in my chest, mainly in the morning. It feels like my heart is swollen. Nothing really makes it better, and it does seem to fade as the day goes on. Exercise (rising heart rate) does not make it worse or better. I was affected with COVID-19 for four months, and also I have taken the COVID-19 vaccine. Can you please help?

Kindly advise.

Hello,

Welcome to icliniq.com.

I understand your concern.

Based on your description, chest tightness can be due to many causes, such as asthma, smoking, musculoskeletal pain, gastric upset, and heart issues. Heart issues at a young age are uncommon. Do you have asthma, wheezing, chest or muscular pain, or any other disease?

I would suggest the following investigation:

  • An ECG (electrocardiograph).
  • Complete blood count.
  • ESR (erythrocyte sedimentation rate).

Preventive measures include quitting smoking, exercising regularly, and maintaining a healthy body weight.

Kindly get back to us with details.

I hope this helps you.

Thank you.

Patient's Query

Hello doctor,

Thank you for the reply.

I have no other diseases. When I was 12 years, I was diagnosed with athletic asthma but never used an inhaler and played college baseball without any issue. No specific muscle pains that are any different from my normal. I do drink three to four cups of coffee a day and at least one soda.

Kindly advise.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Please do follow these instructions. Stop smoking weed. Get the chest auscultated by a physician to listen for wheeze. Sometimes, there is only wheeze in asthma with no symptoms except chest tightness in the early morning. Do exercise, have a Mediterranean diet, and lose weight. Get an ECG (electrocardiography) done when you have chest discomfort.

This is to be on the safe side; otherwise, the chance of cardiac issues is improbable. You have exercise-induced asthma. This is asymptomatic at rest, and symptoms of difficulty in breathing, wheezing, and chest tightness occur only during exercise or exertion, especially in cold weather. Nebulization with saline or with Salbutamol (or in inhaler form) relieves symptoms.

I hope this helps you.

Thank you.

Medically reviewed byDr. K. Shobana

Published At May 16, 2021
Reviewed AtJune 5, 2026

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