Alcohol is a useful antidote for a long work week and is enjoyed by anyone from young students to the elderly. When consumed in reasonable quantities, alcohol is a great substance to enjoy but unfortunately, not everyone is able to control their drinking habits and alcohol abuse will surely follow. Studies show that the lifetime risk of becoming alcohol-dependent can be as high as 14 percent of the world population . Not only can this substance interfere with your quality of life, it is the root of numerous health problems that you need to be aware of before you reach for the bottle opener.
Depending on your past history, chest pain after drinking alcohol can be caused from a number of different components. The first group we will focus on is related to your heart and I will present some of the things to consider related to booze and heart disease. Dilated cardiomyopathy is possible in patients who have an extensive history of heavy drinking. Your heart will grow in size and the thickness of the muscles of your heart wall can become smaller in size. Without a doubt, this is a potential cause of chest pain after drinking alcohol. 
Congestive Heart Failure
Another heart-related pathology that can be linked with booze and heart disease would be congestive heart failure. This is similar to the same pathology of dilated cardiomyopathy but it is a much more severe state for your physiology. Studies indicate that moderate drinking is a protective factor and male patients who drink between 8 to 14 alcoholic drinks per week. They have a 57 percent reduction in their chances of developing congestive heart failure compared to those who don't drink . This same phenomenon was not seen in women. The more you drink, however, the worse your congestive heart disease can become and studies show that patients are almost 2 times more likely to have congestive heart failure if they are heavy drinkers. 
Another trend that you need to be aware of is the link between alcohol and levels of arteriosclerosis. Studies show that there may be some protective effects of drinking on the level of fatty plaques that can clog your arteries but as you drink more, the less this helps. As more of your arteries become clogged with plaques, you risk the chance of having ischemic events where blood is not able to flow into oxygen-starved tissue. When your body does not receive enough blood to tissue, it can manifest as excruciating chest pain that will only worsen as long as you continue to drink. 
Another risk of chronic drinking that could lead to severe chest pain. This occurs when the muscles in your lower esophagus are weakened by chronic alcoholism and can present with uncontrollable vomiting and chest pain. Patients most have a long-standing history of alcoholism to be suffering from a condition like this but it can be possible even after a strong night of drinking. Not only is binge drinking worrisome, the use of pain-killers or blood-thinning medications can make this problem even more likely. 
Pain Due to an Underlying Carcinoma
There are a few cases in literature stating that there is a link between chest pain after drinking alcohol and the Hodgkin's lymphoma. In one case study, it was found that a 31 year old male patient with Hodgkin's lymphoma noted severe chest pain after ingesting 2 to 3 sips of alcohol. The mechanism behind why this happens is unknown but researchers believe that when you drink alcohol, the ethanol acts as a vasodilator to "open' your blood vessels. When blood flows into lymph nodes that are already infected with Hodgkin's lymphoma, there is a sudden feeling of pain. 
You may have noticed that some people are able to better tolerate alcohol than others based on gender and race. Asian populations are more likely than others to have a genetic defect in an enzyme called alcohol dehydrogenase which is responsible for the metabolism of alcohol. When you have a defect in this enzyme, patients will notice chest pain after drinking alcohol and facial flushing. It is important to halt your alcohol ingestion if you have an enzyme defect. 
Even if the above topics are possible considerations of chest pain after drinking alcohol, you don't have to worry about the link between booze and heart disease as a reason for your chest pain after one instance in most cases. You could just be having simple muscle cramps due to drinking too much alcohol. Alcohol acts as a diuretic and forces you to urinate more than typical. Your kidneys are not only processing and removing alcohol from your body, it is also removing electrolytes like sodium, potassium and calcium. These are all important in maintaining muscle health and if you have a drop in these enzymes, you will notice that you are more prone to muscle cramps in your legs and chest.