Prolonged pain in the heart. What to do if your heart hurts

The word is given to the resuscitator of the specialized team, the chief specialist in cardiology of the A. S. Puchkov Emergency Medical Station of Moscow, Alexei Sokolov.

When pain occurs in the heart, it is important to act in a collected and clear manner. After all, this symptom can be a signal of serious problems, up to acute coronary syndrome, which is a combination of pathological reactions of the body that occur during the development of myocardial infarction. In order to prevent a cardiac catastrophe and correctly orient the ambulance dispatcher, it is necessary to pay attention to the following nuances:

Where does it hurt?

With problems with the heart, pain behind the sternum (that is, in the center of the chest) is most characteristic. The interweaving of nerve endings located in this zone creates the most sensitive zones that subtly respond to cardiac problems.

How does it hurt? A heart attack is characterized by squeezing, pressing, burning, sometimes tearing pain. “The pain arose in the right shoulder ... Then she crawled to her chest and got stuck somewhere under the left nipple. Then, as if someone's callused hand penetrated into the chest and began to squeeze out the heart, like a bunch of grapes. Squeezed slowly, diligently - one-two, two-three, three-four ... Finally, when there was not a drop of blood left in the squeezed out heart, the same hand indifferently threw it away ... ”- this is how he described a heart attack writer Nodar Dumbadze.

How long does it hurt? With a developing heart attack, an attack of heart pain lasts much longer (from 15 minutes or more) than with angina pectoris, often provoked by exercise or stress, but can also occur at rest, for no apparent reason.

Where does it give? Most of all, cardiologists are alarmed by complaints of pain behind the sternum, which radiates to one or two shoulders and especially to ... the jaw. Some mistake such pain for a toothache and even go to the dentist at the end of the attack, unaware that they were halfway to a heart attack. The fact is that in the projection of the cervicothoracic spine, nerves pass through which the innervation of the heart, and the chin region, and the region of the shoulder joints goes. Therefore, the pain impulse from the heart muscle is often transmitted to the neighboring node. If, at the same time, the person’s left hand also goes numb (from the shoulder to the elbow or to the little finger), and the body is covered with cold sweat, there can be no two opinions: you need to urgently dial “03”.

Does pain depend on movement? Having answered this question, we can assume what the resulting pain syndrome is connected with - with a cardiovascular problem or intercostal neuralgia, diseases of the spine (osteochondrosis). If a person's pain changes or intensifies when inhaling, exhaling, when moving a hand, then it is most likely not of a cardiac nature. If the pain appeared during an ordinary walk around the apartment or at rest, this is a sure sign of acute coronary syndrome and a reason to call an ambulance.

Is there shortness of breath? Shortness of breath that requires serious attention is characterized by a sudden, acute onset. Especially if the feeling of lack of air arose for the first time, at rest or during the usual physical activity for a person (cleaning the apartment, walking, on the way to work), and decreases when the person sat down or lay down. Sometimes coronary heart disease (CHD), pulmonary hypertension, acute coronary insufficiency, a painless form of myocardial infarction, and pulmonary embolism can occur according to this type.

However, shortness of breath can also be of neurotic origin, after emotional stress, when stress hormones are released into the bloodstream, increasing the number of respiratory movements. So this symptom is best considered in combination with others.

Important

If you notice most of the problems described above, feel free to call an ambulance. Before the doctors arrive, you need to sit or lie down on a bed with a high headboard, provide yourself or the victim with fresh air, stop any physical activity, try to count the pulse and measure blood pressure.

With pain in the heart, one- or two-time intake of nitrospray is not forbidden (preferably in a sitting or lying position, this prevents a sharp decrease in blood pressure and the appearance of fainting). By the way, the use of nitrospray can be regarded as a kind of test. If the nitropreparation does not relieve pain or relieves it slightly, this may be the first evidence that you are halfway to a heart attack, or, conversely, this pain syndrome is not associated with the heart. However, it is important to remember that nitroglycerin speeds up the work of the heart and against the background of tachycardia in combination with an increase in blood pressure, its use is undesirable.

Update: October 2018

A healthy heart is a prerequisite for a long and fulfilling life. Pain in the heart area, at least, require careful attention to yourself. If they arise, then there is always alertness and anxiety. “Heart, heart, what happened that confused your life?” Do cardiac pains always indicate problems with the heart and how to distinguish them from other pains - in this article.

The region of the heart - where is it?

The projection of the heart on the anterior chest occupies the area from the upper edge of the cartilage of 3 ribs to the lower edge of the body of the sternum. The apex is projected into the 5th intercostal space 2 cm medially from the line crossing the middle of the clavicle. The right border goes from the cartilage of the 3rd rib to the 5th intercostal space on the right.

Usually, any discomfort in the left half of the chest is taken for heart pain, regardless of its nature and intensity. But the typical location of heart pain is the area behind the sternum and to the left of it to the middle of the armpit.

Features of the spread of heart pains are the appearance of reflected pains (on the left in the shoulder blade and under it, in the arm). Sometimes reflection is isolated, for example, 4-5 fingers of the left hand, left jaw. Rarely, pain radiates to the right arm or left shoulder.

The nature of the pain in the heart

The description of suffering by the patient himself is very important at the first stage of diagnosis. It is a detailed description of pain that allows the doctor to navigate in the direction of the search and minimize additional examination methods to the necessary minimum.

When questioning a patient, take into account:

conditions for the occurrence of pain (during exercise or after, at rest, connection with food, at night or daytime)
the nature of sensations (pricks, compresses, aching, cuts, presses, constantly or periodically)
pain duration
after which they stop.

Causes of pain in the heart

Heart disease:	Diseases of the stomach and esophagus:	Toxic effects:
ischemic disease (angina pectoris, arrhythmias, myocardial infarction, post-infarction) endocarditis pericarditis myocardiopathy myocardial dystrophy secondary lesions on the background of diabetes mellitus, uremia, hyperthyroidism heart injury tumors	esophagitis foreign bodies of the esophagus stomach ulcer tumors stenosis of the esophagus mallory-weiss syndrome chemical burns of the esophagus and stomach gastric bleeding, ulcer perforation.	drugs alcohol heart poisons nicotine drugs
Heart overload:	Pulmonary pathologies:	Pathologies of large vessels:
with arterial hypertension volume in thyrotoxicosis pressure with portal hypertension (for example, with)	pneumonia pleurisy tuberculosis silicosis lung or large bronchial tumors	aortic aneurysm, including its dissection aortic coarctation pulmonary embolism
Diseases of the mediastinum:	Nerve damage:	Bone lesions:
mediastinitis neoplasms	intercostal neuralgia herpes zoster	fractures and fractures of the ribs pain in blood tumors
Muscle damage:	Skin lesions:	Pathologies of the mammary glands:
sprains rhabdomyoma	boils carbuncles	mastopathy (gynecomastia in men) benign tumors

Constricting pain

This is a typical cardiac pain, informing about the oxygen deficiency of the heart muscle. It is characteristic of almost all forms of coronary heart disease. With angina pectoris, compressive pain in the chest in the region of the heart or behind the sternum gives typical reflections under the scapula and left arm. It occurs during exercise and passes independently at rest or from taking nitroglycerin, which dilates blood vessels and redistributes blood between the layers of the myocardium.

Patients with various types of arrhythmia are also concerned about such pain:

it is most typical of atrial fibrillation or ventricular fibrillation
frequent extrasystoles
paroxysmal tachycardia
intracardiac blockades
often the pain is accompanied by a fear of death and necessarily uneven pulse
the equivalent of pain in some cases is shortness of breath, indicating circulatory failure.

Atypical constrictive pain under the left shoulder blade, in the region of the heart, may occur at rest, in the early morning hours against the background of spasm of the coronary arteries (Prinzmetal's angina).

Sharp pain

This variant of pain always signals the need for emergency care, and therefore does not allow you to switch to anything else. The condition can also be described as acute pain, as it occurs suddenly.

angina pectoris

A protracted angina pectoris attack with a typical location and reflection of severe compressive pain is the result of incipient thrombosis, embolism, or a sharp stenosis of the coronary vessels. At this stage, nitroglycerin does not help well, but timely medical assistance can prevent the death of the heart muscle. If, after taking nitroglycerin twice with a break of five minutes, the pain has not gone away. It is necessary to call an ambulance.

myocardial infarction

This is actually necrosis of the heart wall. Here, only treatment in a specialized hospital can save the patient's life and preserve its future quality. With myocardial infarction, the pain is very pronounced, protracted, intractable by nitropreparations, accompanied by fear of death, a feeling of lack of air. sweating, hand tremors. It can also be atypical, for example, give into the stomach or mimic intestinal colic, accompanied by nausea and vomiting, heart rhythm disturbances, convulsions, involuntary urination. Some heart attacks pass with a mild pain syndrome, which does not lose its sharpness, but the pain is more tolerable. With pain, it is stopped only by neuroleptoanalgesia using powerful painkillers.

Diseases of the esophagus and stomach

The second variant of a dangerous sharp pain in the region of the heart is a catastrophe with the esophagus and the cardial part of the stomach. Perforation of a cardiac ulcer will give a dagger pain, which will entail vegetative disorders in the form of lightheadedness. flashing flies before the eyes, dizziness or loss of consciousness.

For the esophagus, bleeding is more typical against the background of frequent vomiting (Mallory-Weiss syndrome) or from dilated esophageal veins with portal hypertension against cirrhosis of the liver. The rate of loss of consciousness and the severity of circulatory disorders will depend on the volume of blood loss. In any case, ulcer perforation or bleeding is a reason for surgical care.

Thromboembolism of the pulmonary artery

This is a thrombus that has sailed from the pelvic system or into the arteries of the lung. The more branches of the pulmonary artery thrombosed and the larger they are, the more pronounced and intense the pain. In addition to it, coughing up blood, shortness of breath, palpitations, swelling of the jugular veins are observed. With thrombosis of large trunks, collapse and loss of consciousness develop. It is also an emergency condition requiring emergency care and hospitalization.

Aortic aneurysm dissection

It occurs more often in older men against the background of long-term unregulated arterial hypertension, atherosclerosis, or coarctation of the aorta. A provoking factor may be heart or aortic surgery. Most often, the ascending part of the vessel is stratified. In this case, a longitudinal rupture of the inner membrane leads to the accumulation of blood between the layers of the aorta. Suddenly there is a sharp tearing pain behind the sternum or in the region of the heart, extending under the shoulder blade. At the same time, the pressure first rises. and then drops sharply. There is asymmetry of the pulse on the limbs, the skin turns blue. Sweating appears, fainting may develop. Neurological manifestations are violations of motor activity. Hematoma can lead to oxygen starvation of the heart, shortness of breath, hoarseness. Often patients fall into a coma.

rib fracture

Sharp pains are also characteristic of. Subsequently, the nature of the pain changes to aching or gnawing.

Pressing pain

In cases of overload of the heart, pressure on it or dull pain may be felt.

This variant of pain can also occur in healthy people, for example, with excessive physical exertion, playing wind instruments that increase pressure in the pulmonary circulation.
With arterial hypertension, the heart has to pump blood against a pressure gradient, which impairs its blood supply and increases the workload.
Thyrotoxicosis leads to increased heart rate and overloads the heart with volume.
Cardiac tamponade is a consequence of injuries and compression of the heart with blood. Also, the heart can compress the effusion with pericarditis of various origins (tuberculous, tumor).
With myocarditis of an infectious or allergic nature, non-intense pressing pains are accompanied by shortness of breath, rhythm disturbances, and heart failure.
Myocardiopathy, myocardial dystrophy, neoplasms of the heart also give pressing sensations without a clear connection with the load, prolonged or episodic.
Pressing pain behind the sternum mimics foreign bodies in the esophagus or esophagitis.
Intoxications of various nature (medicinal, narcotic, alcoholic), as well as poisoning with organophosphorus substances, ether, chloroform, neurotoxic plant poisons give severity to pressure on the heart, are combined with arrhythmias and heart failure, are fraught with.
Purulent pathologies of soft tissues, mastopathy. also give excess pressure in the projection of the heart.
High levels also lead to a situation where pressing pains mimic cardiac pathologies.

In order not to get into the situation of Tom Sawyer, who was not strong in anatomy and hid the donated flower closer either to the heart or to the stomach, you can use a comparative table to distinguish stomach pain from heart pain.

stabbing pain

If the heart stabs occasionally, the pain is not accompanied by blood flow disorders (no fainting, dizziness, memory or speech disorders), as a rule, is not dangerous.

Most often, stabbing pains in the heart are given by neurocirculatory dystonia, in which the vessels do not have time to adequately narrow or expand when the load changes.
Rarely, stabbing pains are accompanied by infrequent extrasystole,),.

Strong pain

Unbearable pain can be with a heart attack, pulmonary embolism, dissection of an aortic aneurysm. Often it is 10 out of 10 points. Patients are excited, rush about. Have an intense fear of dying.
10-9 points on the intensity scale gives mediastinitis - inflammation of the mediastinum. When a purulent process develops due to complications of surgical treatment, injuries of the esophagus, decay of tumors, the pain causes patients to take a forced position with their chin pressed to the chest. It is aggravated by swallowing and tilting the head. There is also fever, sweating, agitation or confusion, swelling of the upper half of the body.
Angina gives pain from 6 to 8 points.
Myocarditis and pericarditis 5 to 2.

Aching pain in the region of the heart

The more intense the rhythm of modern life becomes, the more patients complain of pain in the heart in the cardioneurosis program. There are absolutely no organic changes in the organ or the vessels feeding it in such patients or they are insignificant.

there is only a high degree of neuroticism
depression
anxiety disorder
often cardioneurosis develops as part of somatized depression.

Dissatisfaction with oneself and the world around, which does not come out in behavioral features, breaks through in the form of pain in the heart. At the same time, patients are haunted by many unpleasant sensations: pressure on the heart, its fading when inhaling, aching pains and anxiety for one's health.

Often fixation on a non-existent cardiac pathology makes a person repeatedly examined, change specialists and clinics, significantly poisoning his life. At the same time, an experienced psychotherapist or group correction could solve the problem in a short time.

Pain in the heart: what to do

If you suspect a heart problem, it is better to reassess the risks and immediately contact a general practitioner or cardiologist. After questioning and examination, the doctor will prescribe:

urine and blood tests
fluorography of the chest organs
if necessary, bicycle ergometry, treadmill and ECHO-cardioscopy.

Such a tactic will allow you to react in time to a real heart disease or to make sure that it is absent in a short time and save extra nerve cells. In addition, other serious and not so serious diseases are often disguised as cardiac pathologies, which are also desirable to be diagnosed and treated in a timely manner.

Pain in the chest, in the place where the heart is located, can be a sign of various pathologies and not necessarily cardiac. As a rule, such a symptom causes anxiety in most people and encourages them to quickly go to the clinic, which, of course, is correct. However, it will not be superfluous to learn about what the causes of pain in the heart area may be, and learn how to identify a really dangerous condition.

What are there?

Patients describe pain in the region of the heart in a very diverse way. They are stabbing, aching, burning, pressing, squeezing, piercing, pulling. Sometimes they pass immediately, and sometimes they do not let go for several hours or days. They can occur both at rest and during strong excitement or physical work. Some of them appear only with sudden movements, tilts, turns, deep breathing. In addition, they can be accompanied by shortness of breath, a feeling of suffocation, coughing, palpitations, numbness of the hands, temperature, and also give to the shoulder blade, arms, neck, jaw.

Possible reasons

The causes of chest pain are different, and, as already mentioned, they are far from always associated with a cardiac disease. They appear with diseases of the digestive, nervous, respiratory systems, problems with the spine, with injuries (fractures or bruises of the ribs).

heart pain

Angina. In this case, pain attacks occur due to insufficient blood supply to the heart muscle, which occurs as a result of the deposition of cholesterol plaques on the walls of the arteries that impede blood flow. With angina pectoris, patients complain of squeezing or squeezing pains in the chest, which usually appear during physical exertion or strong excitement and stop at rest.
Myocardial infarction. Pressing or burning pains in the chest area occur when a blood clot clogs a vessel, as a result of which part of the heart muscle is not supplied with blood, and hence oxygen. In addition, there is shortness of breath, nausea, cold sweat. Pain usually increases in waves, lasts quite a long time, often radiates to the arms, neck, shoulders, shoulder blades, lower jaw, and numbness of the hands occurs.
Pericarditis. This acute infectious disease is an inflammation of the lining of the heart, accompanied by general malaise and fever. Patients usually complain of stabbing pains in the depths of the chest, which may be permanent or disappear from time to time. They increase in the supine position and subside when leaning forward.
. With this pathology, the pain is bursting and not too strong. In addition, there are headaches, fatigue, pressure surges.
. In this case, severe sharp pains appear as a result of exfoliation of the inner layer of this vessel under blood pressure. The causes of the disease are a complication of arterial hypertension or chest trauma.

Non-cardiac pains

The causes of chest pain in the region of the heart are very diverse. All of them are a reason to visit the doctor, because otherwise it is impossible to determine how dangerous they are. A threat to life occurs in the case of myocardial infarction and rupture of an aortic aneurysm. Emergency care is needed for acute chest pain with shortness of breath, rapid breathing, a feeling of suffocation, darkening of the eyes, loss of consciousness.

Many people experience chest pain without necessarily having a heart condition. Often this is due to another ailment. If the heart hurts, it can be caused by diseases of the musculoskeletal system, respiratory, digestive and other diseases. However, only a doctor can make an accurate diagnosis by examining the patient.

But any person who has observed such signs should understand if the heart hurts what to do and how to recognize that this is really a heart disease. You need to know this in order to contact a specialist in a timely manner for some serious pathologies. Symptoms of the disease may differ, be sure to learn to recognize them. The most basic thing is to distinguish between cardiac and non-cardiac pain. For this purpose, you need to know what is the duration, intensity of the attack. In addition, it is desirable to have information about other diseases, the symptoms of which are similar to those of the heart.

The first symptoms of a heart attack

Discomfort in the chest can appear for various reasons. To understand what hurts the heart, it is advisable to know a few characteristic symptoms. Not always attacks are accompanied by unpleasant sensations. At the same time, people with other ailments complain that it is difficult for them to breathe, it hurts in the left side of the chest. But all this is not a consequence of cardiological diseases.

The earliest signs that indicate that the work of the motor of the human body is broken, most often appear for several months, or even years before the first attack. Therefore, everyone should know how and where the heart hurts. Early signs of the disease that should alert are as follows:

Pain behind the ribs. They give in the back, arm, neck, teeth. The left side is most often affected. At the same time, there is shortness of breath, nausea, and increased sweating.
Discomfort after physical activity, stress, which disappears after rest or nitroglycerin tablets.
Shortness of breath appears even with moderate exertion, simple work, while eating and even in a supine position. Before the onset of the attack, the patient may be sitting up to sleep or suffer from insomnia.
Severe fatigue from the usual activities can begin long before the first attack.
The representatives of the stronger sex sometimes develop erectile dysfunction several years before the diagnosis of coronary artery disease.
Puffiness. This symptom is considered the most basic evidence of cardiac dysfunction. At first, swelling is almost imperceptible, over time they become larger. This is noticeable when a person removes shoes or rings from their fingers. If swelling is observed, you should contact a specialist and undergo an examination.
Respiratory arrest during nocturnal sleep, as well as snoring. These signs indicate a predisposition to an attack of heart disease.

Signs of coronary disease

1. Myocardial infarction

Heart attacks can proceed in different ways and then, how my heart hurts, symptoms in women and men in different situations can be different. In the case of a myocardial infarction, everything happens something like this:

There is a feeling of heaviness, pain in the central part of the chest, arm.
Discomfort extends to the left arm, neck, throat, lower jaw.
The head is spinning, sweating appears, the skin is paler, nauseous.
There is a feeling of heaviness in the abdomen, it burns in the chest.
Anxiety, weakness.
Rapid pulse.

The course of a heart attack may be different. Signs are sometimes completely absent. Sometimes the patient says that he experiences discomfort in the chest, sometimes there are no such symptoms and the process can proceed painlessly. Signs of a massive heart attack: shortness of breath, blue lips, etc. very similar to the symptoms of acute heart failure.

The duration of such an attack is approximately thirty minutes. Nitroglycerin doesn't help at all.

The main manifestation of IHD is angina attacks. In this case, pain in the heart occurs, the symptoms in women and men are the same. Among them:

cardiopalmus;
dyspnea;
violations of the heart;
unstable pulse;
dizzy, nauseous;
weakness, sweating.

With coronary disease, patients say that they burn, press in the chest. There is a feeling of fullness. Often, discomfort is transmitted to the arm, neck, throat. Most often observed during physical activity, stress and stop when a person is left alone.

With rest angina, pain in the heart, the causes of which are different, appears at any time, even at night. This form is considered unfavorable.

Inflammatory heart disease

1. Pericarditis

Pericarditis is an inflammation of the outer lining of the heart, the main symptom of which is dull pain in the region of the heart. It usually hurts in the center of the chest, in some cases it radiates to the arm, back, neck. When swallowing, coughing, etc. discomfort intensifies. It gets worse when lying down, better when sitting. Although the nature of the pain is usually dull and aching, in some cases it is sharp. Pericarditis is also characterized by a rapid heartbeat.

2. Myocarditis

Inflammation of the myocardium is one of the reasons why the heart hurts, about 90 percent of people complain about it. Its form can be different, it appears regardless of physical exertion, but after a while after that it can become stronger. Nitroglycerin doesn't help.

Valve disease

If valvular disease is present, its severity cannot be judged by the symptoms. The patient may not complain about anything and at the same time be in a serious condition. Main symptoms:

Shortness of breath, which is observed not only with a high load, but even during the most familiar activities and in a supine position;
Discomfort in the chest during exercise, breathing in cold air;
Weakness, dizziness;
Violation of the heart rhythm. These are, in particular, an uneven pulse, frequent heartbeat, disturbances in the work of the heart.

Such a pathology often leads to heart failure. Then the following symptoms appear: the legs swell, the abdomen swells, body weight increases.

cardiomyopathy

Almost all people who have such a pathology complain of pain. With the development of the disease, how my heart hurts the symptoms change. At first, the pain is prolonged, does not depend on physical activity, nitroglycerin does not help. It is felt in various places. Further, it is spontaneous or paroxysmal in nature after exercise and most often disappears after taking a nitroglycerin tablet. Its character is different, its localization is accurate, but sometimes it spreads over a large area. Nitroglycerin does not always help.

Arrhythmia

There are several types of arrhythmias. They are characterized by changes in heart rate. There are several varieties of ailments in which there are heart pains that radiate to the left hand.

Heart defects

These diseases can be acquired or inherited. They may not talk about themselves for a long time. Sometimes the heart hurts, what to do, the doctor should tell. This pain is usually aching, cutting or stabbing. Accompanied by high blood pressure.

Mitral valve prolapse

Aching or pressing pain that appears on the left is not caused by physical activity. They do not stop after taking nitroglycerin. In addition, dizziness, palpitations, and headaches may occur in the morning and evening. Possible shortness of breath, fainting.

aortic stenosis

With such a disease, there is a pressing sensation in the chest. There is a strong heartbeat, weakness, fatigue, shortness of breath during physical activity. Over time, shortness of breath is added during a night's sleep, dizziness. If you suddenly change the position of the body, fainting may occur. Asthma attacks and angina pectoris are possible.

Thromboembolism of the artery of the lung

This is a very serious condition that requires emergency care. The first sign of the disease is a stabbing pain in the region of the heart, which becomes stronger when inhaling and does not radiate to other places. The patient's skin turns blue, blood pressure decreases, shortness of breath, palpitations appear. Nitroglycerin doesn't work.

Pathologies of the aorta

Sudden, very strong pain, bursting sensations in the chest are the result of aortic dissection. They are sometimes so painful that a person can lose consciousness. The patient needs urgent medical attention.

If there is an aortic aneurysm, there is aching or throbbing pain in the heart, what should be done by a specialist. If an aneurysm ruptures, the pain becomes unbearable. If no action is taken, death can occur.

Non-cardiac diseases

1). Intercostal neuralgia. Many people who feel such pain in the region of the heart mistake it for the heart. However, in reality they are different. With neuralgia, pain is acute, stabbing in nature. They are aggravated by coughing, deep breathing, sharp body turns, etc. This can pass quite soon, sometimes the pain lasts for several hours. The patient can accurately determine the place of discomfort, it is located between the right ribs. In the case of angina pectoris, a person experiences a burning, aching feeling that does not go away with a change in the position of the torso. It is impossible to determine the exact location.

2). Osteochondrosis. This disease is quite simple to mistake for angina pectoris. The person is sure that his heart hurts, the symptoms are as follows: numbness of the left hand occurs, it becomes more painful when moving. All this is especially similar to angina pectoris, when an attack occurs during a night's sleep. The main difference is that nitroglycerin does not work.

3). Diseases of the central nervous system. In such a situation, patients often complain. However, the symptoms are different. It can be regular, short-term, sharp or aching pain in the heart area. Neuroses, as a rule, are characterized by a variety of autonomic disorders. A person may experience anxiety, insomnia or, conversely, increased drowsiness. Your hands get cold or cold, your head starts to hurt, and much more. Often neurotic patients complain about numerous symptoms that they do not actually experience. And the “cores” are very reserved in sharing their feelings. Sometimes it is difficult to understand that the patient has coronary artery disease or cardioneurosis, since the cardiogram shows no changes.

4). Violations of the functioning of the gastrointestinal tract. However, in this case, pain in the heart, the symptoms are somewhat different. They last longer, while the person feels sick, vomits, he develops heartburn. The intensity is due to the intake of food. Often the symptoms of acute pancreatitis are similar to myocardial infarction. Sometimes exacerbations of diseases of the gallbladder are given to the left half of the chest and it seems that the pain is in the heart. To understand what the problem is, you should take antispasmodics. If there is relief, then the patient has diseases of the gastrointestinal tract.

5). Pulmonary diseases. Pain, similar to the heart, sometimes appear with inflammation of the lungs. This can happen with pleurisy. But in this case, the pain is acute, aggravated by breathing and coughing.

What to do?

Every person who feels pain in the chest thinks what to do next. If there are suggestions that the heart hurts, urgent measures must be taken. After all, the cause can be serious, in particular a myocardial infarction or an angina attack. Therefore, you need to do the following:

You should calm down and sit down. Stress will only make things worse.
We must try to take a different position. If relief occurs after this, there is a possibility that the reason is different. If the pain increases, pressing pain appears in the region of the heart, there is a risk that this is angina pectoris.
It is recommended to allow access to fresh air and open a window.
So that breathing is not constrained, you need to make clothes looser, unbutton the collar
If you suspect angina pectoris, you need to take a nitroglycerin tablet and put it under the tongue. If relief does not come within a quarter of an hour, you need to take another pill. You should call and call for emergency help. With a heart attack, the medicine does not work.

Finally

Even if the pain in the heart area, the causes of which the specialist should establish, has passed, you need to go to the hospital in the near future and be examined. Self-medication is unacceptable.

In Nizhny Novgorod, you can undergo a preventive examination at the Road Clinical Hospital, where professionals in their field work.

Pain in the heart area is a common reason for visiting a doctor. They have a different character, duration, a certain irradiation. In addition, discomfort in the chest has a different etiology and their appearance is not always associated with heart pathology. This article describes the most characteristic signs of heart pain, indicates the pathologies that can mimic it, and also talks about how to distinguish true cardialgia from a pain syndrome of another etiology.

Causes of pain in the heart

The etiology of this unpleasant symptom is very diverse. Heart pain occurs, as a rule, in the presence of coronary disease, in which the coronary vessels are affected. Also, the cause of true cardialgia is inflammatory heart disease, congenital malformations, VVD. In addition, there is a wide range of pathologies that are accompanied by pain in the chest, which mimics heart damage. Some of them are described below.

Cardialgia with osteochondrosis

Clinical manifestations of thoracic osteochondrosis are very similar to pathologies of the respiratory or cardiovascular system. Patients complain of pain in the chest, which is aggravated by bending over, changing the position of the body, as well as after dynamic or static loads. The pain often appears in the area of the shoulder blades and spreads to the region of the heart, left arm and sternum. It can disturb when lying on the side or back, which forces patients to take a forced position, which reduces pain. Unpleasant sensations have different intensity, occur at different times of the day.

Shortness of breath is also a common symptom. Patients note that they do not have enough air, since normal breathing is difficult. Sometimes during meals, patients also note the sensation of a foreign body in the throat and along the esophagus.

Pain in the heart with neuralgia

Cardialgia in this pathology occurs in only 10% of clinical cases, but is characterized by high intensity. A sudden pain syndrome develops. Patients cannot raise their left arm or turn their head. If the pain spreads from the nerves that are infringed during intercostal neuralgia, palpation of the intercostal spaces leads to increased pain. An increase in the intensity of pain is also observed when inhaling, coughing or laughing. The nature of the pain is usually girdle, stabbing, cutting, dull, constant or paroxysmal. There may be a sharp pain that does not allow you to make a single movement.

Cardialgia in neurosis

Why does the heart hurt during psycho-emotional overstrain? The main reason is the development of cardiac neurosis. At the same time, cardialgia has certain features. So, in most cases, it occurs among people who are characterized by negativism, isolation, emotional lability. Favorable factors in this case can be called bad habits, chronic lack of sleep, concomitant mental disorders. With neurosis of the heart, compression and discomfort in the chest, dizziness and increased sweating, headache and nausea are noted. Patients may lose consciousness. Also characterized by an accelerated pulse, changes in blood pressure, a feeling of lack of air, tremors, panic attacks and stabbing pain in the heart.

Heart pain during exercise

As a rule, this complication develops after excessive training. During intense physical activity, the heart requires more oxygen. An inadequate reaction of the body is manifested in the narrowing of the coronary vessels, which worsens the blood supply to the myocardium, and leads to the appearance of pain. As a rule, athletes can feel heart pain, which disappears after rest. If the aching pain in the region of the heart persists for a longer time, the training regimen should be reviewed and the load should be reduced, as this can be dangerous. In addition, it should be remembered that in cases where, after training, there is a significant tachycardia, excessive sweating and shortness of breath even after the cessation of physical activity or the left arm goes numb, you should immediately consult a doctor.

Cardialgia with vegetative-vascular dystonia

For the cardiological syndrome in this pathology, the following symptoms are mainly characteristic: pain in the heart of an acute and stabbing nature, which appear both after exercise and at rest, heart rhythm disturbance in the form of tachycardia or bradycardia, changes in blood pressure. Pain may be moderate.

As a rule, there is a paroxysmal or dull pain in the heart, but it is accompanied by excessive fear or even hysterical seizures, in which a person cannot adequately assess his condition and overestimate the complexity of the existing manifestations. In addition, with vegetative-vascular dystonia, temperature changes, general weakness and sweating, tinnitus and excessive drowsiness, headaches, mood swings are recorded, which is especially pronounced in adolescents.

Heart pain in chronic alcoholism

With the constant abuse of alcoholic beverages, myocardial dystrophy is formed. At the initial stages of its development, patients complain of palpitations, lack of air, headaches and poor sleep. It is also characterized by pressing pain in the heart, increased irritability and sweating. First, cardialgia occurs in the form of seizures at night, accompanied by tachycardia, extrasystole or paroxysmal atrial fibrillation, which later becomes permanent. In addition, after alcohol, which is consumed in large quantities, the heart enlarges, its tones become deaf, acrocyanosis appears, the liver thickens, edema of the extremities and signs of heart failure develop.

Pain in the heart during pregnancy

During this period, serious changes occur in the woman's body and the usual work of many organs and systems, including the heart, is disrupted. As a rule, the cause of cardialgia during pregnancy is an increase in the volume of circulating blood, a constant increase in body weight, an uncomfortable position, iron deficiency in the body, fluid retention and an increase in blood pressure. Do not forget about the significant hormonal changes during this period, which makes women weaker to the action of stressful situations or to sudden atmospheric changes.

Cardialgia in lung diseases

With damage to the respiratory system, chest pain has the following features:

characterized by an acute, but short-term character;
as a rule, irradiation of pain sensations is not observed;
pain worsens with deep inspiration;
the presence of such pulmonary symptoms as cough, sputum production, the appearance of shortness of breath;
dry or wet rales, percussion data indicating lung damage.

It is worth noting that the most common pain in the heart during inspiration is observed with the development of pleurisy. With this pathology, it can have a different distribution. With inflammation of the parietal pleura, pain is localized in the lower parts of the chest. In the area of the shoulder blades, pain appears if the parietal pleura of the upper lobe of the lung is affected. If apical pleurisy is diagnosed, then due to irritation of the brachial plexus, concomitant pain in the arm may be observed, and with diaphragmatic pleurisy, pain sensations spread to the abdomen and are accompanied by vomiting.

That is why for a correct diagnosis it is important to clearly determine where it hurts. This helps to distinguish true cardiac pain from the clinical manifestations of lung involvement. It is important to remember that cardialgia in the pathology of the respiratory system cannot be considered the leading clinical syndrome. More specific manifestations (cyanosis, fever, signs of intoxication, cough, shortness of breath, sputum production) are taken into account.

How to understand that it is the heart that hurts?

If you experience any discomfort in the heart area, you should immediately consult a doctor for a thorough examination. To confirm heart damage, a blood test, ECG, myocardial scintigraphy, angiography, echocardiography, and cardiac MRI are done.

How does the heart hurt?

Of course, according to the complaints of patients, one or another pathology can be suspected, but for a correct diagnosis, clinical manifestations are not always decisive, since, as can be seen from the information presented above, pain in the heart region can appear with many other diseases not associated with direct damage to the heart.

If we talk about the main characteristic manifestations of heart pain, we can name the following:

if the cause is angina pectoris, the pain occurs behind the sternum, has a compressive, cutting, dull or sharp character. It, as a rule, gives to the left hand, shoulder blade, sometimes it may not have a clear localization, it lasts from several seconds to 20 minutes. During an attack, shortness of breath, a feeling of lack of air and a fear of death appear. Pain sensations do not depend on the position of the body or breathing, they are quickly removed with nitroglycerin;
in case of myocardial infarction, intense anginal pain occurs, which radiates to the shoulder blade, arm, abdomen, left half of the neck, lasts longer than 15 minutes and is not affected by nitrates, is accompanied by profuse sweat and fear of death, as well as shortness of breath and unproductive cough. In some cases, myocardial infarction occurs without pain.

What to do with cardialgia?

When an attack of heart pain occurs, you should stop any physical activity, sit comfortably or, if possible, take a horizontal position, unbutton your clothes and provide fresh air. The patient should be given one tablet of nitroglycerin under the tongue. If there is no effect, the drug can be repeated at intervals of three minutes. If the pain syndrome lasts more than 20 minutes and does not decrease after taking nitroglycerin three times, you should call an ambulance. By her arrival, the patient can be given an aspirin tablet to chew. With tachycardia more than 110 beats / min. it is advisable to take anaprilin (if there are no contraindications).

It is important that first aid is provided as soon as possible after the onset of pain. This helps to avoid serious complications, including myocardial infarction or sudden cardiac arrest. In addition, it should be remembered that even in the case when it was possible to eliminate the pain syndrome on your own, you should definitely consult a doctor to find out its etiology and prevent a recurrent attack.