Causes of Chest Tightness and Cough

Chest tightness refers to a sensation of chest compression or stiffness, or difficulty taking a deep breath. The combination of chest tightness and cough usually signals a lung ailment, which may be short term or ongoing. An infection or another inflammatory condition commonly leads to lung irritation that frequently triggers both chest tightness and a cough.

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Lung Infections

Your lungs contain a branching network of airways that narrow at each division point, just like the branches of a tree. These airways, collectively called the bronchial tree, terminate in tiny air sacs called aveoli. Lung infections top the list of short-term causes of chest tightness and cough.

Acute Bronchitis

Acute bronchitis refers to an infection of the bronchial tree, usually caused by a virus. While the infection spares the air sacs, it inflames the airways provoking a hacking cough that is typically dry or produces only a small amount of phlegm. Chest tightness also commonly occurs. A low-grade fever might accompany the illness but is often absent. Head cold symptoms frequently precede the lung symptoms as many of the same viruses cause both illnesses. Acute bronchitis typicallly clears without treatment in 2 to 3 weeks, although the cough might persist longer in some people.


Unlike with acute bronchitis, pneumonia involves infection of the air sacs. This leads to an accumulation of pus, fluid and cellular debris in the air sacs that obstructs gas exchange. Bacteria account for most cases but viruses, such as influenza and others, can also cause pneumonia. Due to fluid in the air sacs, a wet cough and shortness of breath are characteristic symptoms of pneumonia. Chest tightness and/or pain also frequently occurs as do fever and a generalized feeling of being unwell. Antibiotics are the cornerstone of treatment for bacterial pneumonia.


Asthma leads the list of chronic conditions that cause chest tightness and cough. Ongoing airway inflammation leads to swelling, narrowing and excessive mucus production that cause intermittent chest tightness, cough, wheezing and shortness of breath. Symptoms generally occur episodically with flareups known as asthma attacks. Treatment involves avoidance of symptom triggers, use of medications to prevent or reduce the frequency of attacks, and use of quick-relief medicines for symptom flareups.

Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) describes gradual damage to the small airways and air sacs of the lungs. Over time, airway narrowing occurs along with increased mucus production and destruction of supporting tisue that diminishes lung elasticity and leads to loss of functioning air sacs. These abnormalities obstruct airflow, particularly during expiration, which leads to trapping of so-called dead air and overinflation of the lungs. Tobacco smoking and exposure to secondhand smoke accounts for most cases of COPD. Common symptoms include a chronic wet cough, shortness of breath, wheezing and chest tightness. Although not curable, medications and lifestyle changes can control COPD symptoms and slow disease progression.

Other Causes

The conditions mentioned represent the most common ailments associated with chest tightness and cough. There are, however, other more uncommon causes. A few examples include:

  • Idiopathic pulmonary fibrosis -- a condition characterized by progressive, unexplained scarring of the lungs
  • Sarcoidosis -- a condition resulting in accumulation of immune cells, known as granulomatous tissue, in the lungs and other body sites
  • Drug-induced pulmonary disease -- lung damage triggered by exposure to medications, such as cancer drugs, anti-inflammatories and biological agents, among others

Warnings and Precautions

Contact your doctor right away if you experience chest tightness and a cough, especially if you have a preexisting lung condition, are a senior or have a weakened immune system. Seek immediate medical care if you experience any warning signs or symptoms, including:

  • Shortness of breath or difficulty breathing
  • Chest pain
  • Fever, chills or cold sweats
  • Confusion or other mental changes
  • Dizziness, lightheadedness or fainting

Reviewed and revised by: Tina M. St. John, M.D.

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