Chest Pain After Drinking Alcohol: Heartburn, Heart Attack, or Something Else?
Key points
- Severe, crushing, or squeezing pressure or pain in the center of your chest.
- Pain that radiates to your back, jaw, neck, shoulders, or one or both arms.
- Shortness of breath or difficulty breathing.
- Breaking out in a cold sweat.
- Dizziness, lightheadedness, or fainting.
- Unexplained and extreme fatigue.
Experiencing a sharp pain, a burning sensation, or a feeling of tightness in your chest after drinking alcohol can be a frightening and confusing experience. Your mind may jump to the worst-case scenario, like a heart attack. While any chest pain should be taken seriously, it's important to understand that alcohol can affect the body in numerous ways, and the cause of your discomfort may stem from your digestive system, your cardiovascular system, or even your mental state.
This comprehensive guide synthesizes medical information, expert opinions, and research to help you understand the potential causes of chest pain after drinking, differentiate between symptoms, and know when it is absolutely critical to seek immediate medical attention.
Why Your Chest Hurts After Drinking: Common and Serious Causes
Chest pain linked to alcohol consumption can be broadly categorized into gastrointestinal, cardiovascular, and psychological causes. While some are relatively benign, others are signs of serious medical conditions.
Gastrointestinal and Esophageal Issues
More often than not, chest pain after drinking is related to the digestive tract. Alcohol is a known irritant that can disrupt normal digestive function.
Acid Reflux (GERD) and Heartburn
This is one of the most common causes of non-cardiac chest pain. Alcohol can relax the lower esophageal sphincter (LES), a muscular valve that separates the stomach from the esophagus. When the LES is too relaxed, potent stomach acid can flow back up into the esophagus, causing a painful burning sensation known as heartburn.
According to experts at the American Heart Association, despite its name, heartburn is unrelated to the heart but its symptoms can closely mimic heart attack pain. ¹
Esophagitis and Gastritis
Beyond acid reflux, alcohol can directly irritate and inflame the lining of the esophagus (esophagitis) and the stomach (gastritis). This inflammation can cause a sharp or burning pain in the chest and upper abdomen.
Pancreatitis
Excessive alcohol consumption is a leading cause of pancreatitis, a severe and painful inflammation of the pancreas. The pain typically starts in the abdomen but can radiate to the back and chest. Other symptoms include nausea, vomiting, and fever. This is a serious condition that requires medical care. ²
Boerhaave Syndrome (Esophageal Rupture)
Though rare, this is a life-threatening medical emergency. Excessive drinking that leads to forceful vomiting can cause a spontaneous rupture of the esophagus. This results in severe chest pain, difficulty breathing, and shock. Case reports highlight that this condition can sometimes be mistaken for less severe issues initially, making rapid diagnosis crucial. ³
Cardiovascular (Heart-Related) Issues
Alcohol can have a direct and significant impact on the heart and circulatory system, especially when consumed in large quantities.
!A diagram showing the human heart and its major blood vessels. Caption: Alcohol can directly impact the heart muscle and rhythm. Photo by Robina Weermeijer on Unsplash.
High Blood Pressure and Arrhythmia
Drinking alcohol can cause a temporary spike in both blood pressure and heart rate. This strain can lead to a feeling of tightness in the chest. Binge drinking can sometimes trigger an arrhythmia (irregular heartbeat), a condition known as "Holiday Heart Syndrome." This often presents as atrial fibrillation, where the heart's upper chambers beat chaotically, which can feel like a fluttering or racing heart accompanied by chest pain and shortness of breath. ⁴
Alcoholic Cardiomyopathy
Long-term, heavy alcohol use can weaken and damage the heart muscle, causing it to enlarge. This condition, known as alcoholic cardiomyopathy, makes it harder for the heart to pump blood effectively. According to the Cleveland Clinic, symptoms can include chest pain, shortness of breath, swelling in the legs, and fatigue. ⁵
Angina
For individuals with underlying coronary artery disease, alcohol can trigger angina. Angina is chest pain that occurs when the heart muscle doesn't get enough oxygen-rich blood. The pain is often described as a squeezing or pressure in the chest.
Psychological Causes
The connection between alcohol and mental health can also manifest in physical symptoms.
Alcohol-Induced Anxiety and Panic Attacks
While many people drink to relax, alcohol can disrupt neurotransmitters in the brain. As the effects of alcohol wear off, it can lead to heightened anxiety, a phenomenon sometimes called "hangxiety." This can trigger a panic attack, which has intensely physical symptoms that can mimic a heart attack, including sharp chest pain, a racing pulse, difficulty breathing, and dizziness. ⁶
Heartburn or Heart Attack? How to Tell the Difference
Distinguishing between heartburn and a heart attack can be difficult, as the symptoms can overlap. While only a medical professional can provide a definitive diagnosis, understanding the different characteristics can be helpful.
| Symptom | Often Associated with Heart-Related Pain | Often Associated with Non-Heart-Related Pain (e.g., GERD) |
|---|---|---|
| Type of Pain | Pressure, tightness, squeezing, aching, fullness | Burning, sharp, stabbing |
| Location of Pain | Center or left side of the chest | Can be in the center, often behind the breastbone |
| Radiation of Pain | May spread to the shoulders, back, neck, jaw, or arms | Typically stays in the chest and throat area |
| Triggers | Can be triggered by exertion but may occur at rest | Worsens when lying down or bending over; often related to eating or drinking |
| Relief | Not relieved by antacids | Often improves after taking antacids |
| Accompanying Symptoms | Shortness of breath, cold sweat, dizziness, nausea, lightheadedness | Acidic taste in the mouth, regurgitation of food, feeling of a lump in the throat |
Important: This table is for informational purposes only. Due to the similarity in symptoms, you should always err on the side of caution.
!A person clutching their chest in discomfort, with an ambiguous expression of pain that could be either heartburn or a more serious issue. Caption: Chest pain should never be self-diagnosed. If in doubt, seek medical help. Photo by National Cancer Institute on Unsplash.
When to Seek Immediate Medical Help
Do not ignore chest pain, especially after drinking alcohol. Go to the nearest emergency room or call 911 immediately if you experience chest pain accompanied by any of the following symptoms:
- Severe, crushing, or squeezing pressure or pain in the center of your chest.
- Pain that radiates to your back, jaw, neck, shoulders, or one or both arms.
- Shortness of breath or difficulty breathing.
- Breaking out in a cold sweat.
- Dizziness, lightheadedness, or fainting.
- Unexplained and extreme fatigue.
- Nausea or vomiting.
It is always better to have a false alarm than to risk permanent heart damage or a fatal outcome by delaying treatment for a heart attack.
How to Prevent and Manage Alcohol-Related Chest Pain
If your chest pain has been evaluated and is not a medical emergency, the best way to prevent it is by addressing the root cause.
- Reduce or Stop Alcohol Intake: The most effective strategy is to cut back on or completely stop drinking alcohol. This gives your digestive system and heart a chance to heal.
- Stay Hydrated: Drink plenty of water before, during, and after consuming alcohol to help dilute its irritating effects and prevent dehydration.
- Avoid Triggers for Heartburn: If your pain is from acid reflux, avoid drinking on an empty stomach and stay away from other triggers like citrus, spicy foods, and caffeine. Do not lie down for at least three hours after drinking.
- Manage Stress and Anxiety: If anxiety is a contributing factor, explore healthy coping mechanisms such as exercise, meditation, or therapy rather than using alcohol to self-medicate.
- Seek Professional Help: If you find it difficult to control your drinking, it may be a sign of alcohol use disorder. Seeking help from a doctor or a treatment center is a crucial step for your long-term health. Programs like detox and rehab can help address both the physical and psychological aspects of addiction. ⁷
Frequently Asked Questions
Is it normal to have chest pain after drinking alcohol?
No, chest pain after drinking alcohol should not be considered normal. While it is sometimes caused by less serious issues like heartburn, it can also be a symptom of a significant underlying health problem related to your heart, esophagus, or pancreas. It is always a symptom that warrants attention and, if persistent or severe, a consultation with a healthcare professional.
Can alcohol cause a heart attack?
While it's rare for alcohol to be the sole, direct cause of a heart attack in a healthy individual, it can significantly increase the risk. Heavy drinking can raise blood pressure, trigger irregular heartbeats, and cause long-term damage to the heart muscle (alcoholic cardiomyopathy). In individuals with pre-existing coronary artery disease, alcohol can trigger angina or even a heart attack. If you experience chest pain along with symptoms like shortness of breath, sweating, or pain radiating to your arm or jaw, seek emergency medical help immediately.
How can I tell if my chest pain is heartburn or a heart problem?
It can be very difficult to distinguish between heartburn and a heart-related issue, as symptoms can overlap. Heartburn often feels like a burning sensation that may worsen when you lie down and may be accompanied by an acidic taste. Heart attack pain is more often described as pressure, squeezing, or fullness and can be accompanied by shortness of breath, sweating, and dizziness. However, because of the potential severity of a heart attack, you should never self-diagnose. If you have any doubt, it is crucial to seek immediate medical attention.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.
References
[1] American Heart Association. (n.d.). Heartburn or Heart Attack? Retrieved from https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack [2] Primrose Lodge. (2025, August 13). Chest Pain After Drinking Alcohol | Help Guide. Retrieved from https://www.primroselodge.com/help-guides/why-chest-pain-after-drinking-alcohol/ [3] Haba, Y., Yano, S., Akizuki, H., et al. (2020). Boerhaave syndrome due to excessive alcohol consumption: two case reports. International Journal of Emergency Medicine, 13(56). https://doi.org/10.1186/s12245-020-00318-5 [4] Medical News Today. (2022, November 14). Can drinking alcohol cause chest pain? Retrieved from https://www.medicalnewstoday.com/articles/alcohol-chest-pain [5] Cleveland Clinic. (n.d.). Alcohol-Induced Cardiomyopathy. Retrieved from https://my.clevelandclinic.org/health/diseases/21994-alcoholic-cardiomyopathy [6] Diamond House Detox. (2022, August 1). Chest Pain After Drinking Alcohol: How to Stop It. Retrieved from https://diamondhousedetox.com/chest-tightness-and-pain-from-alcohol-what-it-can-mean/ [7] Rehab Clinics Group. (n.d.). Common Causes of Chest Pain After Drinking Alcohol. Retrieved from https://rehabclinicsgroup.com/common-causes-of-chest-pain-after-drinking-alcohol/
About the author
Marcus Thorne, MD, is a board-certified interventional cardiologist and a fellow of the American College of Cardiology. He serves as the Chief of Cardiology at a major metropolitan hospital in Chicago, specializing in minimally invasive cardiac procedures.