Could a seatbelt cause injury to your chest when your in a car accident?

Most certainly: Depending on the speed of the crash and from what direction you were hit, the restrictive mechanism of the seatbelt has the potential to cause damage to the chest wall as well as other structures within the chest. A thorough history and physical examination by your primary care provider or an emergency room physician would be warranted if you are having pain or shortness of breath.