You’re back home after a night out with friends where you indulged in a few drinks. As you lie down in bed to go to sleep, you notice your chest starts to hurt. Um, what’s going on? Should you be worried?

Chest pain after drinking alcohol may feel alarming, but the reason behind it isn’t likely a serious problem (though you should never ignore it). Here’s a closer look at what might be causing it, plus remedies for alcohol-related chest pain, and red flags to watch out for that may indicate an underlying heart issue.

What causes chest pain after drinking alcohol?

If you’re one of the people that feels alcohol-induced chest discomfort, chances are you have acid reflux or GERD (gastroesophageal reflux disease)—which is just acid reflux that happens on a regular basis, says Olalekan Otulana, MBChB, a general practitioner and addiction specialist at Cassiobury Court, a London-based drug and alcohol rehab center. “This is because alcohol often causes acid reflux, by relaxing the muscles which lead to the stomach,” he says.

When those muscles get relaxed, acid from your stomach can splash up into your throat and cause heartburn. The result can be a painful burning sensation in your chest, especially when you’re lying down. This may also come with a sour taste in your mouth, trouble swallowing, or a feeling like there’s a lump in your throat, according to the Cleveland Clinic. Heartburn after drinking is fairly common, especially if you also ate a heavy meal.

Anxiety might be at play, too, says Dr. Otulana. Alcohol temporarily messes with your brain’s levels of feel-good hormones like serotonin, causing some people to feel on-edge or jittery as the booze leaves their system, per the Cleveland Clinic. At the same time, feeling anxious can cause physical symptoms like heart palpitations or chest tightness, headache, or queasiness—all things that can be made worse by drinking.

And if you drank heavily, your chest pain might stem from an irregular heartbeat. Large amounts of alcohol—like four to five or more drinks on one occasion—can temporarily throw off heart rhythm, increase your heart rate, and make it feel like it’s pounding or fluttering, per the National Library of Medicine.

Underlying conditions that cause chest pain after drinking

Apart from heartburn and anxiety, there are other underlying health problems that can contribute to chest pain while drinking (or make existing chest pain worse after you drink). According to Dr. Otulana, these include the following:

• High blood pressure
• Angina or reduced blood flow to the heart
• Atrial fibrillation
• Heart disease

Can alcohol ever cause a heart attack?

In some instances, it can. “Binge drinking has been linked to an increased risk of heart attacks,” says Benjamin Ravaee, MD, a cardiologist with Delray Medical Center in Palm Beach County, Florida. Drinking in excess over long periods of time can raise your blood pressure, which can increase your risk for heart attack and stroke, according to the British Heart Foundation.

Heavy drinking can also damage your heart muscle over time, per the National Institute on Alcohol Abuse and Alcoholism (NIAAA), making you more “prone to possible heart attack,” says Dr. Ravaee.

This risk is not necessarily as high if you drink alcohol in moderation. In fact, moderate drinking (one to two drinks per day) has been associated with lower risk of dying from heart disease compared to people who drink excessively (four or more drinks per day), according to the American College of Cardiology.

And of course, no matter how much alcohol you drink, your risk of heart attack or stroke from alcohol is higher if you already have a pre-existing heart condition.

How to treat chest pain after drinking

Treating a tight chest after drinking alcohol will largely depend on its cause. If it’s from acid reflux or GERD, cutting back on alcohol should help keep your symptoms at bay.

If you do have an occasional drink, taking an antacid (like Tums) or proton pump inhibitor (like Tagamet or Pepcid AC) should also help neutralize stomach acid and help you feel better, per the Mayo Clinic. Antacids start working in as little as 30 minutes, while proton pump inhibitors take a little longer—about 12 hours–and over long-lasting relief.

If your chest pain is from anxiety, reducing the amount you drink and finding other stress-relieving coping skills, like deep breathing, journaling, or meditation, can help relieve symptoms.

Regardless of the cause, chest pain may be your body’s way of telling you to drink less in general. “If a person has pain or discomfort after drinking, this is a clear sign they should reduce or stop drinking alcohol,” say Dr. Otulana.

“If a person has pain or discomfort after drinking, this is a clear sign they should reduce or stop drinking alcohol.”—Olalekan Otulana, MBChB, addiction specialist

Lifestyle changes to make to reduce alcohol-related chest pain

Again, the simplest and most effective lifestyle change to get rid of alcohol-related chest pain is to cut back your drinking or stop altogether, says Dr. Otulana. Try to aim for no more than one to two drinks per day (the less, the better), per the Centers for Disease Control and Prevention (CDC).

If you suspect GERD is the reason behind your chest pain, you can try other prevention methods like the following, per the Cleveland Clinic:

Getting regular exercise and eating a balanced diet are also great ways to help manage whatever is triggering alcohol-related chest pain—including underlying heart conditions, says Dr. Otulana. Both habits could also help you maintain a healthy weight for your body, which may help curb reflux symptoms, too, per the American Gastroenterological Association.

Staying on top of underlying heart issues—like high blood pressure and heart disease—is also important. This may include taking any medication prescribed by your doctor, and getting regular checkups.

When to see a doctor

While the main causes of chest pain after drinking are usually mild, it’s best to let your doctor know when it happens either way. They can pinpoint and treat the underlying cause—even if it’s something like GERD. Your treatment plan may be as simple as avoiding acid reflux triggers like alcohol, to implementing stress-relief techniques for your anxiety.

You should seek emergency medical attention, though, if your chest pain and tightness is sharp and severe, as this can indicate a heart attack, says Dr. Otulana. This chest pain will likely come with other symptoms like pain that radiates to your shoulder, arm, or jaw (especially on the left side), sudden lightheadedness or dizziness, fatigue, nausea, or shortness of breath, per the Mayo Clinic.

FAQ

What organ does alcohol damage first?

Long-term alcohol abuse can damage many of your organs, but it doesn’t happen in a certain order, says Dr. Otulana. “Key organs negatively affected by alcohol abuse are the liver, heart, brain, kidneys, and pancreas,” he adds. “There are also a number of factors that can affect the extent and speed of organ damage, such as genetics, drinking patterns, and a person’s overall health.”

What are the first signs of kidney damage from alcohol?

Your kidneys’ job is to filter harmful substances from your blood, including alcohol. That means, heavy drinking can harm them over time. “Signs of kidney damage include foamy urine, urinating more or less often than usual, tiredness, weight loss, itchy or dry skin, and achy muscles,” says Dr. Otulana.

Early kidney disease doesn’t always cause symptoms though, “which is why you should drink alcohol sensibly and follow alcohol consumption guidelines,” he adds.

Is it bad to have one drink per day?

While many experts used to say moderate drinking might have some health benefits, the latest thinking is there’s no “safe level” of alcohol consumption, because it’s linked to an increased risk for at least seven types of cancer including colon and breast cancer, according to the World Health Organization.

If you choose to drink, do so in moderation. That’s defined as no more than one to two drinks per day, per the CDC. “Drinking more alcohol on a routine basis is associated with an increased risk of multiple cardiac issues and other medical issues,” says Dr. Ravaee.