Why Do I Get Chest Pain After Drinking Alcohol?

Chest pain after drinking alcohol can feel alarming. Whether it’s a dull ache, burning sensation or sharp discomfort, it’s a symptom that often causes people to panic – especially if it feels like it’s coming from the heart. If you drink alcohol regularly or heavily, you might be wondering whether alcohol is to blame, and what your symptoms mean. Let’s explore this further. 

In this guide, we’ll explain the common causes of chest pain after drinking, when to seek medical advice, and how cutting down or stopping alcohol can help ease symptoms – especially if you’re beginning to worry about how drinking is affecting your health.

Alcohol’s Direct Effects on the Heart

Alcohol has a huge impact on the cardiovascular system – especially when consumed in large amounts. Heavy alcohol use can cause:

• Heart muscle damage: Alcohol disrupts calcium flow and energy production in heart cells, weakening contractions and affecting rhythm.
• Oxidative stress: Alcohol generates harmful molecules that damage heart tissue and trigger inflammation.
• Poor blood flow regulation: This can lead to chest pain, irregular heartbeat, and reduced exercise tolerance.

In the long term, this damage can develop into alcoholic cardiomyopathy – a condition where the heart becomes enlarged and less effective at pumping blood.

Even binge drinking on occasion can cause short-term chest discomfort and palpitations. If you regularly feel chest pain after drinking – especially with a history of heavy use –it could be a sign that alcohol is directly affecting your heart.

Reflux and Heartburn After Drinking

One of the most common causes of chest discomfort after drinking is acid reflux, also known as heartburn. Alcohol relaxes the valve between your stomach and food pipe (oesophagus), which can allow acid to rise up into the chest.

Symptoms of reflux-related chest pain:

• Burning or tight sensation in the chest
• Sour taste in the mouth
• Worse after eating or when lying down

This type of pain can feel very similar to heart-related pain, but it’s usually linked to digestive issues. Drinking on an empty stomach, consuming large amounts, or choosing acidic mixers can all make it worse.

Irregular Heart Rhythms (“Holiday Heart Syndrome”)

Binge drinking, even in people who don’t drink often, can trigger irregular heart rhythms, especially atrial fibrillation (AFib). 

This is sometimes known as Holiday Heart Syndrome. First described in 1978, this clinical phenomenon typically manifests 24-36 hours after heavy drinking, often during holidays or celebratory periods when alcohol consumption increases.

Symptoms of alcohol-related arrhythmia:

• Pounding or fluttering heartbeat
• Chest discomfort
• Light-headedness or fatigue

While these symptoms often pass on their own, they can be dangerous – especially if they happen repeatedly or if you have underlying health conditions. 

Check out this study on Holiday Heart Syndrome for more information.  

Alcoholic Cardiomyopathy (Heart Muscle Weakening)

Long-term heavy drinking can damage the heart muscle, a condition called alcoholic cardiomyopathy. Over time, the heart becomes less efficient at pumping blood, which can lead to symptoms like chest pain, shortness of breath, and swelling in the legs or feet.

Signs to watch for:

• Persistent chest discomfort
• Feeling breathless during normal activities
• Fatigue and weakness
• Swollen ankles or legs

If you’ve been drinking heavily for years and notice these symptoms, it’s important to get checked – especially if you’re concerned about your heart.

Anxiety and Panic 

Alcohol affects the brain’s chemical balance, which is why it can feel relaxing at first. But once the effects wear off,  can trigger anxiety, restlessness and even panic attacks. These psychological symptoms often come with physical ones, like chest tightness or a racing heart.

How this causes chest pain:

• Withdrawal increases stress hormones like cortisol and adrenaline
• This can lead to shallow breathing and muscle tension
• Panic attacks can mimic heart problems

If you feel chest pain along with breathlessness, dizziness, or a sense of dread – especially the day after drinking – it could be related to anxiety, not your heart.

Other Causes of Chest Pain Linked to Alcohol

There are a number of other ways alcohol can lead to chest pain:

• Oesophageal spasms: These are painful muscle contractions in your food pipe that can be triggered by alcohol.
• Dehydration: Alcohol is a diuretic and can lead to muscle cramps and general discomfort.
• Vomiting: After heavy drinking, frequent vomiting can strain your chest muscles.
• Poor sleep: Alcohol disrupts sleep, which can increase stress and physical tension.

When to Worry About Chest Pain After Drinking

While many cases of chest pain after drinking are caused by reflux or anxiety, you should seek urgent medical attention if:

• The pain is severe, crushing, or spreads to your arm, neck or jaw
• You feel short of breath, light-headed or faint
• You have a known heart condition
• Symptoms don’t improve after resting or stopping alcohol

Don’t try to self-diagnose – especially if it’s the first time you’ve had symptoms like this. Chest pain should always be taken seriously.

How Cutting Down or Stopping Alcohol Can Help

Reducing or quitting alcohol can dramatically improve symptoms like reflux, anxiety and heart palpitations. It also gives your body and heart a chance to recover – epecially if you’ve been drinking heavily over a long period.

Benefits of cutting down:

• Improved digestion and fewer reflux symptoms
• Reduced anxiety and better sleep
• Lower risk of high blood pressure and heart disease
• More stable heart rhythms

If you’ve started to feel chest pain after drinking, it may be your body’s way of telling you something isn’t right. Taking steps to reduce your intake can make a big difference.

Chest Pain During Alcohol Withdrawal

For some people, chest pain doesn’t just happen while drinking – it can also strike during alcohol withdrawal. This isn’t just anxiety or panic. When your body is dependent on alcohol, suddenly stopping can trigger a wave of stress hormones that put serious strain on your heart. 

Learn more about the dangers of cold turkey here. 

Why withdrawal can cause chest symptoms:

• Alcohol withdrawal triggers a “fight or flight” response, increasing heart rate, blood pressure and narrowing of blood vessels.
• This can make your heart work harder and mimic signs of a heart attack – especially if you already have heart disease.
• In some cases, the oxygen supply to the heart muscle can’t meet demand, leading to real ischemic (heart-related) chest pain.

That’s why chest pain during withdrawal should always be taken seriously – not just assumed to be anxiety.

If you’re undergoing detox or thinking about stopping alcohol, proper medical monitoring is essential:

• Heart rhythm monitoring for at least 72 hours after your last drink
  Regular ECGs (heart tracings) to check for abnormal rhythms
• Troponin blood tests if there’s any suspicion of heart strain or damage
• Blood pressure and pulse checks several times a day

In people with very high heart rates, medications like beta-blockers may be used – but only after withdrawal symptoms are controlled with the right dose of sedatives like benzodiazepines. Using them too early can actually make things worse.

In more severe cases, treatment might include:

• Nitroglycerin (if there’s a history of heart disease)
• Clonidine to calm the overactive nervous system
• Specialist medications in hospital or ICU if symptoms are intense or prolonged

One thing doctors watch out for during withdrawal is QT prolongation, a heart rhythm issue that can be dangerous if untreated. If this happens, patients are given magnesium through a drip and electrolytes are carefully managed.

Many people going through withdrawal develop significant heart rhythm problems. That’s why detoxing – especially after long-term heavy drinking – should always be done with medical support.

Thinking About Detoxing?

If you’re considering stopping drinking altogether, especially if you’ve been drinking heavily or for a long time, it’s important to do so safely. Suddenly stopping alcohol can trigger withdrawal symptoms, some of which can be dangerous without medical support.

Common withdrawal symptoms include:

• Sweating, shaking or nausea
• Anxiety and restlessness
• Insomnia
• Chest tightness or palpitations

A home alcohol detox can be a safe and discreet way to stop drinking with the help of medical professionals. It usually involves medication to ease withdrawal symptoms, check-ins with a doctor or nurse, and ongoing support.

You’re Not Alone

Chest pain after drinking can be frightening, but it’s more common than you think. Whether it’s caused by reflux, anxiety, or something more serious, it’s worth paying attention to. And if you’re worried about how alcohol is affecting your health, there is help available.

You don’t have to go through it alone.

Need help cutting down or stopping alcohol? Learn more about our home alcohol detox programmes and speak to a member of our team today.