Alcohol and Chest Pain: Causes, Symptoms, How to Help

man clutches chest; alcohol chest pain, Castle Craig rehab

Have you ever had an ache in your chest after a night of heavy drinking, perhaps over the holidays? Or maybe you even felt it a few hours after a binge-drinking session. If this sounds familiar, you may have a serious problem. While getting chest pain after alcohol consumption is not something that everyone experiences, it is more common than you think. Although not a defined condition, some doctors have labelled having an irregular heart beat, breathlessness, or chest pain after alcohol as “holiday heart syndrome”.

There are many reasons for alcohol-related chest pain, some of which are directly tied to alcohol while others aren’t. In either case, there is a definite correlation between alcohol and heart disease, and many other conditions. And it is especially true among people who engage in heavy consumption.

Of course, there may be occasions when the pain is found to have a relatively minor cause, such as indigestion, but the symptoms should never be ignored.

How Alcohol Affects the Heart

Alcohol and its metabolites have various negative effects on the heart, all of which can directly and indirectly lead to heart disease. While these effects aren’t lethal on their own, they may trigger or lead to other conditions ranging from reversible cardiovascular damage to a heart attack or stroke.

Alcohol, even in healthy individuals, usually increases blood pressure and causes an irregular heart beat (atrial fibrillation), and episodes of these are often noticeable during hangovers and withdrawals. Chronic drinking can also raise levels of fatty acids in the blood, which can lead to blockage of arteries and increase the risk of cardiovascular problems.

Heavy drinking over a long time causes the heart muscle to expand which weakens it and causes it to work less efficiently.

Repeated binges force your body to rapidly go from sedation to overstimulation, which can stress the heart over time. Alcohol can also imbalance electrolytes, alter hormonal levels, and increase adrenaline, all of which put extra pressure on the heart.

Isn’t Alcohol Good for the Heart?

While there are studies that have shown there are health benefits from low consumption of alcohol, none are 100% conclusive. It is believed that moderate drinking lowers blood pressure, balances cholesterol levels, thins the blood, and reduces the risk of heart disease.

However, all alcohol-related health benefits apply only if the person drinks in moderation. If they drink heavily, the opposite becomes true. Most of the time, if someone experiences heart problems from drinking, they are drinking significantly more than recommended.

Why You May Have Chest Pain After Alcohol

Alcohol-related chest pain can be caused by a number of reasons. If it’s heart-related, it may be angina (reduced blood flow to the heart) or, as a worst-case scenario, a heart attack. It may also signify the presence of a pre-existing condition, which was triggered by alcohol consumption. There are many conditions that are caused or aggravated by alcohol. However, they may also be unrelated to one’s alcohol intake.

Alcohol Cardiomyopathy

The expansion and weakening of the heart puts extra pressure on surrounding blood vessels which results in alcohol cardiomyopathy (disease of the heart muscle) and often presents itself as chest pain. People who have a long history of heavy drinking tend to develop this condition. Repeated hangovers can make this worse. If it is not treated in the beginning, the damage may be irreversible, and ultimately lead to heart failure.

Cardiomyopathy has various causes, and alcohol is only one of them. However, alcohol may worsen any cardiomyopathy that is present due to other reasons.

Allergic Reaction

An allergic reaction can present itself in multiple ways, two of which, breathlessness and chest pain, resemble a heart attack. If a person has chest pain specifically after drinking, they may have an allergic reaction to alcohol itself or one of the ingredients present in the drink.

Acid Reflux

Some alcohol can be good for digestion, but large amounts can have the opposite effect and trigger acid reflux. The symptoms of acid reflux include discomfort or pain in the upper body and can even be mistaken for a heart attack. This is even more likely if a person eats a large meal at the same time, which isn’t rare after one has a lot to drink.


Along with a bad diet and genetic predisposition, pancreatitis can be caused by long-term alcohol abuse. An acute pancreatitis attack is extremely painful and can radiate to the upper chest, although it is usually felt in the abdominal area or lower back.

Stress and Anxiety

Excessive drinking can worsen anxiety levels, and can cause “hangxiety” (hangover anxiety), which is essentially stress. And stress is not healthy for any part of the body, let alone the heart. Some people even have panic attacks after a night of heavy drinking, which can resemble a heart attack if severe.

Of course, angina and chest pain may be caused by just stress alone, which may be due to an extreme emotional response, overeating, or even by being in a too cold or too hot environment.

Muscle Strain

You may get muscle aches from just working out or a heavy night of partying, but they become more noticeable after drinking. This is due to dehydration and electrolyte imbalance from alcohol.


It is not exactly known why, but chest pain after alcohol may signify the presence of cancer. Specifically, lymphoma. It is theorised that alcohol increases blood flow to lymph nodes causing pain which radiates to the chest.

Additional Substances

If someone is taking other medications or drugs, the interaction can result in chest pain as well. If alcohol is mixed with cocaine, it puts a lot of strain on the cardiovascular system. Metronidazole, an antibiotic, can worsen high blood pressure when taken with alcohol.

Smoking alone can irritate the lungs, which may cause chest pain, but combined with alcohol can also increase blood pressure. In addition, smoking tends to worsen symptoms of acid reflux.

What to Do If You Experience Alcohol Chest Pain

Any chest pain shouldn’t be ignored. When you feel unwell after drinking, there are some things you should do. Try to relax, drink water, and take an anti-inflammatory medication, such as aspirin or ibuprofen.

If you experience chest pain accompanied by hangovers, it may signify a bigger problem, so it is best to consult a doctor as soon as possible to rule out any serious conditions. If it doesn’t get better or stop after some time, it may be wise to call the A&E.

Know the Symptoms of a Heart Attack

Because alcohol can trigger a heart attack, it is important to know the signs. Some people tend to dismiss chest pain, which can be dangerous. In addition, the symptoms may not always be present or as extreme, especially in women. However, if any of the following major symptoms last for more than 15 minutes, it is better to go to a hospital.

Major symptoms:

  • Severe chest pain (crushing, tight, or heavy pressure)
  • Radiating pain to other parts of the body (shoulders, arms, back)
  • Difficulty breathing

Other symptoms:

  • Sweating
  • Anxiety
  • Dizziness
  • Nausea

How to Prevent Alcohol Chest Pain

A healthy diet and regular exercise can help prevent heart disease and any strain on the heart in general. It also helps not to overeat, even if you don’t have digestion issues, and to lower your stress levels.

If you notice that you get regular chest pain after drinking, you should moderate your intake or stop altogether. Because it may signify the presence of a different problem, it is important to talk to a doctor.  And if you feel that you can’t limit yourself or stop, you might have a different problem – alcohol dependency.

Addiction to alcohol and heart disease is very serious. If you realise you can’t control your drinking, you should check for symptoms of alcohol addiction. Addiction is a progressive disease but a treatable one. Should you notice any signs of alcohol dependency in yourself or anyone you know, it is best to attend an AA meeting, consult your GP, or look into rehab.

Castle Craig specialises in all types of addiction, and has treated thousands of people addicted to alcohol and drugs. If you think you have a problem, don’t hesitate to give us a call. Our consultants will can give you advice and guidance without any obligation.


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