Why Does the Chest Feel Tight When Heart Tests Are Normal? 'Fire' Is the Cause

Modern medicine explains the Donguibogam concept of 'heart fire' through autonomic nervous system imbalance, excessive stress hormone secretion, and dysfunction along the gut-brain axis. The symptom where the chest feels tight and heart palpitations occur despite normal heart test results is termed non-cardiac chest pain, which is closely linked to psychological factors such as anxiety, panic disorder, and chronic stress. When we experience stress, the hypothalamic-pituitary-adrenal axis activates in the brain, triggering the secretion of stress hormones like cortisol and adrenaline. These hormones increase heartbeat, elevate blood pressure, and constrict blood vessels. They also stimulate the sympathetic nerve to place the body in a fight-or-flight state, causing the heart to pound or the chest muscles to tense, which leads to sensations of tightness or chest pain. This resembles remaining tense while holding one's breath. Stress also influences the gut-brain axis, through which the brain and digestive tract communicate. When stress alters intestinal motility or sensory thresholds, digestive system symptoms such as esophageal spasm or acid reflux can occur, resulting in chest pain. For this reason, esophageal dysfunction or gastroesophageal reflux disease is frequently identified in non-cardiac chest pain patients. Additionally, stress lowers the pain threshold, making the body more sensitive to minor stimuli, or it triggers a chronic inflammatory response that causes discomfort across the body. Ultimately, the concept of 'fire' in Donguibogam reflects the widespread bodily effects of the stress response and autonomic nervous system imbalance recognized in modern medicine, showing how closely mental state links to physical health.