Yes, hives can sometimes cause chest tightness, which is usually related to a worsening allergic reaction. You should be vigilant and seek medical attention promptly. If you experience chest tightness, especially if accompanied by difficulty breathing or dizziness, it is recommended to seek medical attention immediately.

Specifically, chest tightness may be related to the following:

1. Severe allergic reactions: When the body has a significant allergic reaction to certain substances (such as food or drugs), in addition to hives and itching on the skin, internal tissues may also swell. If the respiratory tract is affected, chest tightness or difficulty breathing may occur.
2. Accompanying symptoms during acute attacks: During an acute attack of urticaria, some people may feel pressure or tightness in their chest due to physical discomfort, tension or inflammatory response, but this does not necessarily mean that there is a serious breathing problem.
3. Combined with other factors: If you have a history of asthma, allergic rhinitis, or other medical conditions, an urticaria attack may trigger or worsen your existing symptoms, making you more prone to chest tightness.
For your health, please note: If you experience chest tightness, especially if accompanied by wheezing, difficulty swallowing, or bluish lips, please go to the emergency room immediately. Keep a record of known allergens and try to avoid them, maintain emotional stability, and use antihistamines as directed by your doctor. Regular follow-up appointments will help better manage your condition and reduce discomfort.