Aching under chest. Chest hurts in the middle: possible causes

Sudden acute chest pain is the most important symptom of acute chest diseases and one of the most common causes patients visiting a doctor. Often in these cases, emergency assistance is required.

It should be emphasized that acute pain in the chest, which appeared in the form of an attack, may be the earliest and before a certain moment the only manifestation of a disease requiring emergency care; such a complaint should always alert the doctor. Such patients should be examined especially carefully. And in most cases, based on the anamnesis, examination data and ECG, the correct diagnosis can be made already at the prehospital stage.

Why can the chest hurt?

The main causes of pain are as follows.

Heart disease - acute myocardial infarction, angina pectoris, pericarditis, myocardial dystrophy.

Vascular diseases - dissecting aortic aneurysm, pulmonary embolism (PE) as causes of chest pain.

Respiratory diseases - pneumonia, pleurisy, spontaneous pneumothorax.

Diseases of the digestive system - esophagitis, hernia esophageal opening diaphragm, peptic ulcer stomach.

Diseases of the musculoskeletal system - thoracic sciatica, chest injuries.

Shingles.

Neurosis as a cause of chest pain.

Why does the chest hurt with lung problems?

Pulmonary embolism often develops in patients who have undergone surgery, suffering from phlebothrombosis of the deep veins of the legs or atrial fibrillation. In this case, there is an acute, intense pain in the center of the sternum, the right or left half of the chest (depending on the localization pathological process), which lasts from 15 minutes to several hours. The pain may be accompanied by severe shortness of breath, a drop in blood pressure, in every tenth patient - fainting (syncope). On the ECG, signs of overload of the right heart can be recorded - a high pointed P wave in leads II, III, and VF, deviation electrical axis of the heart to the right, McGean-White sign (deep S wave in standard lead I, deep Q wave in lead III), incomplete blockade of the right bundle branch block. The pain is relieved with narcotic analgesics.

In lung diseases, chest pain is usually characterized by a clear connection with breathing. Localization of pain in pleuropneumonia, lung infarction depends, as a rule, on the location of the inflammatory focus in the lungs. Respiratory movements, especially deep breathing and coughing, lead to increased pain, which in these diseases is due to irritation of the pleura. In this regard, when breathing, patients usually spare the affected side; breathing becomes shallow, the affected side lags behind. It should be emphasized that with pleuropneumonia and pleurisy in the first hours and days of illness, pain is often the main subjective symptom, against which other manifestations of the disease are less significant for the patient. Critical role for staging correct diagnosis percussion and auscultation of the lungs play, allowing to identify objective signs of pulmonary pathology. The pain associated with irritation of the pleura is well relieved by non-narcotic analgesics.

pneumothorax as a cause pain attack in the chest

With spontaneous pneumothorax, pain is usually prolonged, most pronounced at the time of development of pneumothorax, aggravated by breathing, and then shortness of breath comes to the fore. The pain is accompanied

pallor of the skin,
weakness
cold sweat
cyanosis
tachycardia,
decrease in blood pressure.

Characterized by lagging half of the chest during breathing and tympanitis detected by percussion on the side of the lesion, breathing over these departments is sharply weakened or not audible.

On the ECG, you can see a slight increase in the amplitude of the R wave in the chest leads or a sharp change in the electrical axis of the heart. The appearance in a patient with pneumonia of the sharpest pain in the chest, combined with severe shortness of breath, intoxication, sometimes collapse, is characteristic of a breakthrough of a lung abscess in pleural cavity and development of pyopneumothorax. In such patients, pneumonia from the very beginning may have the character of abscessing, or an abscess develops later.

Heart disease as a source of chest pain

The main task in conducting a differential diagnosis in a patient with acute chest pain is to identify prognostically unfavorable forms of pathology and, first of all, heart diseases.

Why does my chest hurt during a heart attack?

Sharp strong compressive, squeezing, tearing, burning pain behind the sternum or to the left of it - the most important symptom of a heart attack. Pain may appear during exercise or at rest in the form of an attack, or often recurring attacks. The pain is localized behind the sternum, often capturing the entire chest, irradiation is characteristic left shoulder blade or both shoulder blades, back, left arm or both arms, neck. Its duration is from several tens of minutes to several days.

It is very important that pain during a heart attack is the earliest and up to a certain point the only symptom of the disease, and only later do characteristic ECG changes appear (elevation or depression of the ST segment, T wave inversion and the appearance of a pathological Q wave). Often the pain is accompanied

shortness of breath
nausea,
vomiting,
weakness
increased sweating,
heartbeat,
fear of death.

Characteristically, there is no effect with repeated administration of nitroglycerin. To relieve pain or reduce its intensity, it is necessary to repeatedly introduce narcotic analgesics.

Why does the chest hurt with angina pectoris?

Short-term acute compressive pain behind the sternum or to the left of it, appearing in the form of seizures, is the main symptom of angina pectoris. Pain in angina pectoris can radiate to the left arm, left shoulder blade, neck, epigastrium; unlike other diseases, irradiation to the teeth and lower jaw is possible. Pain occurs at height physical tension- when walking, especially when trying to walk faster, climbing stairs or uphill, with heavy bags (angina pectoris), sometimes - as a reaction to a cold wind. The progression of the disease, further deterioration of the coronary circulation lead to the appearance of angina attacks with less and less physical exertion, and then at rest.

With angina pectoris, the pain is less intense than with myocardial infarction, much less prolonged, most often lasts no more than 10-15 minutes (it cannot last for hours) and is usually removed at rest when taking nitroglycerin. Pain behind the sternum, appearing in the form of seizures, long time may be the only symptom of the disease. On the ECG, signs of a previous myocardial infarction may be recorded, at the time of a painful attack, signs of myocardial ischemia (depression or elevation of the ST segment or T wave inversion). It should be noted that ECG changes without an appropriate history cannot be a criterion for angina pectoris (this diagnosis is made only with a thorough questioning of the patient).

On the other hand, a careful examination of the patient, including electrocardiographic, even during a painful attack, may not reveal significant deviations from the norm, although the patient may need emergency care.

In cases where acute, sharp, constricting pain behind the sternum or in the region of the heart with irradiation to left shoulder, the lower jaw develops at rest (usually in a dream or in the morning), lasts 10-15 minutes, is accompanied by a rise in the ST segment at the time of an attack and is quickly stopped by Nitroglycerin or Nifedipine (Corinfar), one can think of variant angina pectoris (Prinzmetal's angina).

Chest pain, indistinguishable in nature from angina pectoris, occurs with stenosis of the aortic orifice. The diagnosis can be made on the basis of a characteristic auscultatory picture, signs of severe left ventricular hypertrophy.

Pain in pericarditis is characterized by a gradual increase, but at the height of the process (when exudate appears), the pain may decrease or disappear; it is related to breathing and depends on the position of the body (usually decreases in a sitting position with a forward bend).

The pain is often cutting or stabbing in nature,
located behind the breastbone
can radiate to the neck, back, shoulders, epigastric region, usually lasts for several days.

A pericardial friction rub detected on auscultation allows for an accurate diagnosis. The ECG may show synchronous (concordant) ST segment elevation in all leads, which often leads to a misdiagnosis of myocardial infarction. Typically, the lack of effect from taking nitroglycerin, pain is best relieved by non-narcotic analgesics.

Aortic aneurysm as a cause of chest pain

Chest pain that is as intense as the pain of myocardial infarction, and sometimes exceeds it, may be a symptom of a relatively rare disease- Dissecting aortic aneurysm. Pain occurs acutely, more often against the background of a hypertensive crisis or during stress (physical or emotional), localized behind the sternum with irradiation along the spine, sometimes spreading along the aorta to the lower abdomen and legs. It has a tearing, bursting, often undulating different character, lasts from several minutes to several days. The pain may be accompanied by an asymmetric pulse on the carotid and radial arteries, rapid fluctuations in blood pressure (BP) from a sharp rise to a sudden drop until the development of collapse. Often there is a significant difference in the level of blood pressure on the left and right hands corresponding to the asymmetry of the pulse.

Due to the deposition of blood under the intima of the aorta, signs of anemia increase. Differential diagnosis with acute myocardial infarction is especially difficult in cases where ECG changes appear - non-specific or in the form of depression, sometimes ST segment elevation (although without the cyclicity of ECG changes characteristic of myocardial infarction during dynamic observation). Repeated administration of narcotic analgesics, including intravenous, often does not stop pain syndrome.

Differential diagnosis of diseases, causing pain in the chest: table 1

Differential diagnosis of non-coronary cardialgia and angina pectoris

Clinical Data	Non-coronary cardialgia
	With emotional stress or for no apparent reason
	Often dull, aching, stabbing, deaf, aggravated by breathing
	The pain is monotonous or slowly increases and slowly stops, the duration of the increase and decrease in pain is not the same
Pain localization	Diffuse in the left half of the chest, sometimes in the region of the apex of the heart or left nipple
Irradiation of pain	More often missing
	Several minutes to several hours
The cycle of pain	Available, corresponds to daily fluctuations in the mood of the day
	psychomotor agitation
Influence of physical activity	Stops an attack
Exercise tolerancePossible ECG changes at the time of an attack	There are no signs of myocardial ischemia, unstable rhythm and conduction disturbances, smoothed or negative T waves are possible
Effect of nitrates	Doesn't stop the pain

Clinical Data	Variant angina
Seizure conditions	At rest
Intensity and nature of pain	Sharp, sharp, squeezing
The rate of development of a pain attack	The periods of increase and decrease in pain are the same
Pain localization
Irradiation of pain
The length of the pain period	Up to 10, sometimes 15 minutes
The cycle of pain	The attack occurs more often during sleep or in the morning
Patient behavior during an attack	lethargy
Influence of physical activity	Causes an attack in some patients
Load tolerance	ST segment elevation
Effect of nitrates

Clinical Data	angina pectoris
Seizure conditions	During physical or emotional stress
Intensity and nature of pain	Sharp, sharp, squeezing
The rate of development of a pain attack	Pain buildup time is longer than pain relief time
Pain localization	Behind the sternum or in the precordial region
Irradiation of pain	In the left shoulder, shoulder blade, neck, lower jaw
The length of the pain period	Usually a few minutes
The cycle of pain	Missing
Patient behavior during an attack	Immobility
Influence of physical activity	Usually provokes an attack
Load tolerance	Usually low
Effect of nitrates	ST segment depression

Gastroenterological causes of chest pain

Acute chest pain caused by diseases of the esophagus (ulcerative esophagitis, damage to the mucous membrane by a foreign body, cancer of the esophagus) is characterized by localization along the esophagus, connection with the act of swallowing, the appearance or sharp increase in pain during the passage of food through the esophagus, a good effect of antispasmodics and local anesthetics. funds. The antispasmodic effect of nitroglycerin determines its effectiveness in pain syndrome due to spasm of the esophagus, which may complicate differential diagnosis with an angina attack.

Prolonged pain in the area lower third sternum at the xiphoid process, often combined with pain in the epigastric region and usually occurring immediately after eating, may be due to a hernia of the esophageal opening of the diaphragm with the release of the cardial part of the stomach into the chest cavity. For these cases, in addition, the appearance of pain in the position of the patient sitting or lying down and its reduction or complete disappearance in vertical position. Usually, when questioning, signs of reflux esophagitis (heartburn, increased salivation) and good exercise tolerance.

Effective for chest pain, antispasmodic and antacids(for example, Maalox, Rennie, etc.); Nitroglycerin in this situation can also stop the pain syndrome. Often, pain caused by diseases of the esophagus or a hernia of the esophageal opening of the diaphragm, in terms of localization, and sometimes in nature, resembles pain in angina pectoris. The difficulty of differential diagnosis is aggravated by the effectiveness of nitrates and possible electrocardiographic changes (negative T waves in the chest leads, which, however, often disappear when ECG is recorded in a standing position). It should also be borne in mind that with these diseases, true angina attacks of a reflex nature are often observed.

Bone, viral and post-traumatic causes of chest pain

Acute prolonged pain in the chest associated with the movement of the trunk (tilts and turns) is the main symptom thoracic sciatica. For pain in sciatica, in addition, the absence of paroxysmal, increased with hand movements, tilting the head to the side, deep inspiration and localization along the nerve plexuses and intercostal nerves are characteristic; in the same place, as well as on palpation of the cervicothoracic spine, severe pain is usually determined. When determining local pain, it should be clarified with the patient whether it is the pain that forced him to seek medical help, or is it another, independent pain. Reception of nitroglycerin, validol almost never reduces the intensity of pain, which often weakens after the use of analgin and mustard plasters.

With a chest injury, diagnostic difficulties may arise in cases where the pain does not appear immediately, but after a few days. However, indications in the anamnesis of an injury, a clear localization of pain under the ribs, its intensification during palpation of the ribs, movement, coughing, deep inspiration, i.e., in situations where there is some displacement of the ribs, facilitate the recognition of the origin of pain. Sometimes there is a discrepancy between the intensity of pain and the nature (strength) of the injury. In such cases, it should be borne in mind that with the slightest injury, hidden pathology may be revealed. bone tissue ribs, for example, with their metastatic lesion, multiple myeloma. Radiography of the ribs, spine, flat bones of the skull, pelvis helps to recognize the nature of bone pathology.

Acute pain along the intercostal nerves in the chest is characteristic of herpes zoster. Often the pain is so strong that it deprives the patient of sleep, is not relieved by repeated intake of analgin, and somewhat decreases only after the injection of narcotic analgesics. Pain occurs earlier than typical shingles pain skin rash which makes diagnosis difficult.

Hormonal, neurological and other causes of chest pain

Pain in the region of the heart of a aching, stabbing character is a frequent complaint of patients with neurosis. Pain in neuroses almost never have a clear paroxysmal, are not associated with physical activity, are located in the region of the apex of the heart. The pains appear gradually, last for hours, sometimes days, while maintaining a monotonous character and not significantly affecting the general condition of the patient. Often attention is drawn to the unusual variety of complaints of the patient, the excessive colorfulness of his description of pain.

Careful questioning reveals no relationship between the onset or worsening of pain and exercise (however, sometimes pain occurs after exercise or during emotional stress). Moreover, often physical labor, sports activities lead to the cessation of pain. Pain in the region of the heart does not prevent patients with neurosis from falling asleep - a situation that is impossible in the event of an attack of angina pectoris.

The effect of nitrates in these patients in most cases is indistinct, sometimes patients note a decrease in pain 20 to 30 minutes after taking nitroglycerin. The attack can be stopped by taking validol and sedatives. Course treatment with beta-blockers and psychotropic drugs usually leads to an improvement in the well-being of patients and the cessation of pain attacks.

With dyshormonal myocardial dystrophy (climacteric cardiopathy), patients describe cardialgia as a feeling of heaviness, tightness, cutting, burning, piercing, piercing pain to the left of the sternum, in the region of the apex of the heart or left nipple with possible irradiation to the left arm, shoulder blade. The pain can be short-term, but more often lasts for hours, days, months, periodically intensifying (especially at night, as well as in spring and autumn), is not associated with physical activity, does not decrease at rest, and is not clearly stopped by nitrates.

Dyshormonal myocardial dystrophy can be suspected in a patient of the appropriate age (45 - 55 years) with a combination of cardialgia with hot flashes (a sudden feeling of heat in upper half trunk, skin of the face and neck, followed by hyperemia and sweating), autonomic crises, often mental disorders (often depression). Characteristic ECG changes, often mistaken for a sign of myocardial ischemia, is a negative T wave in leads V 1 - V 4. Medical therapy includes beta-blockers, if necessary - psychotropic drugs(neuroleptics, antidepressants).

Chest pain due to alcohol abuse

With toxic myocardial dystrophy (alcoholic cardiomyopathy)

pulling, aching, stabbing pain localized in the region of the nipple, apex of the heart,
sometimes captures the entire precordial region;
unrelated to physical activity
appears gradually, gradually;
lasts for hours and days, not stopped by nitroglycerin.
Pain is often combined with a feeling of lack of air (dissatisfaction with inspiration), palpitations, cold extremities.

At the initial stages of the disease, the correct diagnosis is helped by the connection between the occurrence of cardialgia and alcoholic kurtosis, revealed upon careful questioning - pain occurs the next day or a few days after alcohol abuse, at the patient's exit from binge.

characteristic appearance patient with chest pain due to alcoholism

hyperemia of the face,
severe hand tremor.
In the later stages of the disease, an objective examination reveals signs of an increase in the left and right parts of the heart,
rhythm disturbances and symptoms of heart failure.

On the ECG - an overload of the right and left parts of the heart, characteristic changes in the final part of the ventricular complex in the form of depression of the ST segment, the appearance of a pathologically high, two-phase, isoelectric, negative T wave. Rapid - within 5 - 7 days - restoration of a normal ECG pattern in the absence of a characteristic angina clinic allows, as a rule, to exclude coronary heart disease, therefore, for staging accurate diagnosis often require hospitalization and observation in conditions cardiology department. Additional research methods - daily ECG-^T monitoring, bicycle ergometry, echocardiography - may also be required for a differential diagnosis.

A symptom such as pain in the sternum, as a rule, takes a person by surprise, and the first thing that comes to mind is the thought of heart problems and a well-founded fear. Sometimes this is a really alarming sign that requires an ambulance call. Non-urgent cases require self-guided visits to the doctor. In addition, there are a number of diseases that are not related to the heart muscle, but provoke pain in the chest. Knowing these nuances means being able to take care of your health in time.

The main causes of pain in the center of the sternum

Compressive (pressing, burning) - a common symptom coronary disease heart (angina pectoris). Sometimes it spreads to the left half of the chest, left arm (scapula, hypochondrium, back). It usually occurs during physical exertion, stress, less often at rest. The attack lasts up to 10-15 minutes, is removed with nitroglycerin.

Acute, sharp, intense pain in the center of the chest or on the left, accompanied by cold sweat, suffocation, nausea, severe fear of death, is a clinical sign of myocardial infarction. Occurs spontaneously, without reference to stress, even at night in a dream, lasts more than 15 minutes, is not removed by means of angina pectoris. Required for a heart attack urgent hospitalization.

Pain in the sternum is localized in the middle with diseases of the lungs (pneumonia, bronchitis, tracheitis), gastrointestinal tract (gastric ulcer and duodenum, gastritis, diseases of the esophagus), thoracic spine (osteochondrosis), peripheral nervous system (vegetovascular dystonia, intercostal neuralgia), with diaphragmatic abscess or oncological diseases of the organs of the chest region.

Gastroesophageal reflux disease causes constant feeling burning in the middle of the chest and in the throat (heartburn). If pain increases when a person lies down, this indicates possible hernia diaphragm. Pain symptoms in the upper chest are probable diseases of the upper respiratory tract.

What disease can cause pain in the sternum?

With the above diseases, soreness, usually localized in the middle of the chest, sometimes extends to left side body (less often right or in the back). Only a doctor can make a diagnosis, therefore, except in cases of emergency hospitalization, it is unreasonable to postpone a visit to a specialist. It is important to monitor and report to the therapist about accompanying symptoms: shortness of breath, sweating, edema, high fever, cough, nature of pain during exercise / rest, eating, different body positions.

Aching pain behind the sternum on the right

Pericarditis (inflammation of the membrane of the heart), as a rule, is accompanied by a constant moderate (sometimes increasing) aching pain, which worries in the region of the heart and above it, sometimes extends to right half chest, as well as the epigastric region and the left shoulder blade. If a person lies on his back, the pain intensifies.

Other diseases with a characteristic pain symptom on both the right and left side of the sternum can be neurological problems. Inflammation, abscess, tumor right light are accompanied by diverse constant pain (aching, pressing, dull, burning), sometimes with irradiation to the healthy side, abdomen, neck, shoulder, and aggravated by coughing.

Pressing pain on the left

In addition to such typical myocardial diseases as heart attack and angina pectoris, problems with other organs can masquerade as heart disease. So, problems with the pancreas, located on the left side of the abdominal cavity, can cause pressure dull pain in the chest on the left. Another possible cause is a hiatal hernia. Aching, pressing pain on the left side is a symptom vegetative dystonia, inflammation of the left lung or pleura.

What does pain during inhalation and exhalation mean?

Pain in the sternum during exhalation or inhalation is not directly related to the myocardium, but is a sign of the following diseases:

intercostal neuralgia (pain is localized more often on the left, discomfort aggravated when trying to take a deep breath or when coughing);
pneumothorax (when air accumulates between the chest wall and the lung, characterized by pain on the left, which increases when a person breathes deeply);
precordial syndrome (severe pain suddenly occurs during inspiration, repeats several times a day, is not associated with stress, does not require specific treatment).

Chest pain when coughing

If a pain symptom in the chest occurs or intensifies when coughing, this may be a sign of:

diseases of the pleura (the membranes of the internal surfaces chest cavity);
mobility disorders of the thoracic spine and ribs;
intercostal neuralgia;
colds respiratory tract (tracheitis, bronchitis);
renal colic;
pneumothorax;
lung oncology;
chest trauma.

With osteochondrosis

An exacerbation of osteochondrosis of the thoracic spine is sometimes mistaken for a pathology of the cardiovascular system, because. the accompanying pain in the sternum is localized, as a rule, in the region of the heart, sometimes with irradiation to the right half, to the back or side. pain symptom occurs suddenly, paroxysmal or is characterized by a non-intense long-term course. Strengthening of unpleasant sensations occurs when inhaling, exhaling (during an attack it is difficult to breathe), coughing, moving the arms and neck.

The similarity of symptoms with a heart attack and angina leads to the fact that patients unsuccessfully try to alleviate their condition with drugs for these diseases. At improper treatment or its absence, internal organs (pancreas, liver, intestines) are affected, the occurrence of malfunctions of the cardiovascular system is not excluded, so a visit to the doctor should not be postponed.

When driving

In many diseases (angina pectoris, heart attack, myocarditis, pleurisy, osteochondrosis, chest bone injuries, rib fracture), pain in the sternum increases with movement. Sometimes discomfort is disturbing only with certain movements, for example, when bending, making sharp turns, lifting weights, pressing on the sternum. Do not neglect the examination if the pain has passed, or rely on folk methods treatment, because these symptoms may be primary sign serious problem.

Chest pain requiring urgent treatment

If severe pain occurs suddenly and is accompanied by shortness of breath, shortness of breath, clouding of consciousness, nausea, you should immediately seek medical advice. medical assistance.

emergency hospitalization indicated for such diseases that have no timely assistance high mortality rate, such as:

myocardial infarction;
thromboembolism pulmonary artery;
spontaneous rupture of the esophagus;
dissecting aortic aneurysm;
ischemic disease (angina pectoris);
spontaneous pneumothorax.

Myocarditis

This inflammation of the heart muscle is characterized by a variety of (stabbing, aching, pressing) chest pains on the left and in the middle, shortness of breath, weakness, arrhythmia. People with these clinical symptoms should see a doctor immediately, because some types of myocarditis can provoke more serious illness- dilated cardiomyopathy and even lead to death.

rheumatic heart disease

If rheumatic myocardial damage (rheumatic heart disease) is not treated, then 20-25% of cases end in the formation of heart disease. Symptoms depend on the type of disease, severity and are not always pronounced. The following signs may indicate possible development rheumatic heart disease (especially if they appeared 2-3 weeks after an acute nasopharyngeal infection): chest pain (severe or non-intense) in the region of the heart, shortness of breath, tachycardia, swelling of the legs, cough during exercise.

Video: Causes of pain in the middle

Suspect yourself or loved one myocardial infarction or other dangerous cardiovascular disease, it is necessary to call as soon as possible ambulance. What else is important to remember about chest pain, how to prevent such problems and how to help if the disease has already begun, you will learn by watching the presented video with the recommendations of specialists.

Cardiovascular diseases today occupy a leading position among the dangerous and common diseases in the world.

At the heart of such diseases, a genetic predisposition is most often distinguished, as well as an incorrect lifestyle.

There are many cardiovascular diseases and they proceed differently: they can occur as a result of inflammatory processes in the body, intoxication, injuries, birth defects, metabolic disorders, etc.

However, the variety of reasons for the development of these diseases is connected by the fact that their symptoms can be common.

Chest pain as a harbinger of heart disease

A symptom like unpleasant feeling discomfort and pain in the chest area, may portend a violation of the heart and blood vessels.

In case the pains wear burning character, then this condition indicates a spasm coronary vessels leading to malnutrition of the heart. This kind of pain in medicine is called angina pectoris.

There are such pains as a result of:

physical activity,
at low temperature,
often in stressful situations.

Angina pectoris occurs when blood flow stops meeting the needs of the heart. muscle mass in oxygen supply. People call angina pectoris " angina pectoris". The doctor recognizes such a disease literally at the first visit of the patient.

Diagnosing abnormalities in this case is difficult, because to make the correct diagnosis, it is necessary to monitor the development of angina pectoris and additional examinations (for example, daily ECG monitoring). Differentiate between exertional angina and angina pectoris calm state(rest).

rest angina. Usually not associated with physical activity General characteristics with severe angina attacks, may be accompanied by a feeling of lack of air. Often occurs at night.
angina pectoris. Attacks of such angina pectoris occur almost with a certain frequency, which is provoked by the load. When the load decreases, the seizures stop.

However, there are also unstable angina, which is dangerous for the development of myocardial infarction. Patients with an unstable form of angina pectoris are necessarily hospitalized.

Heart disease causing chest pain

According to the patient's description of sensations of pain in the chest area experienced doctor draws conclusions about the nature of the disease. The cardiovisor device in such cases helps to determine whether this deviation is associated with a disease of the cardiovascular system.

Diagnosis of chest pain

Clarification of the duration, localization, intensity and nature of chest pain, as well as reducing and provoking factors is very important.

Previous abnormalities in the work of the heart, the use of potent drugs that can cause spasms of the coronary arteries (for example, cocaine or phosphodiesterase inhibitors), as well as the presence of a pulmonary embolism or a risk factor for coronary heart disease (travel, pregnancy, etc.) are of considerable importance.

A burdened family history increases the possibility development of coronary artery disease However, it makes no sense to specify the causes of acute pain.

Additional research methods

The minimum examination of a patient with chest pain may consist of:

pulse oximetry,
chest x-ray.

For adults, screening for markers of myocardial tissue damage can be done. The effectiveness of such tests with anamnesis data, as well as an objective examination, make it possible to form a preliminary diagnosis.

At initial examination blood tests may not be available. If the indicators of the markers indicate damage to the myocardium, then they cannot ascertain about the damage to the heart.

Diagnostic sublingual nitroglycerin tablets or liquid antacids cannot reliably differentiate between gastritis, GERD, or myocardial ischemia. Each of these medical medicines able to reduce symptoms of disease.

Treating chest pain

Medical and therapeutic treatment pain in the chest is carried out in accordance with the diagnosis.

If the causes of pain in the chest are not fully understood, the patient is taken to the hospital for an in-depth examination, to monitor heart conditions. Of the drugs, only opiates can be prescribed until a correct diagnosis is made.

Prevention of heart disease

To prevent the occurrence of heart ailments, doctors have developed several recommendations:

Walk more, regularly do feasible and simple physical exercises. It is not recommended to start classes exercise with the greatest loads, and before starting such training, it is imperative to consult with doctors so that the selected program will only benefit the body.
Try to maintain optimal weight body.
It is imperative to keep under control possible factors for the development of atherosclerosis, for example, increased arterial pressure, amount of cholesterol, etc.
Nutrition should always be regular and complete, more protein food and vitamins with minerals should be in the diet.
It is recommended to visit a doctor regularly and carry out the necessary laboratory tests.
Remember the golden rule of health: it is always easier to prevent a disease than to treat it later.

Prognosis of symptom of chest pain

Predicting a symptom that subsequently develops into a cardiovascular disease is very difficult. The fact is that it all depends on the provision of first aid to the patient.

Pain is a symptom that signals a person that something is wrong in his body. It can be located anywhere. If pain occurs between the breasts in the armpits, then this symptom should not be ignored. Only doctors can diagnose it and treat the disease, who first establish the cause of the unpleasant symptom.

Pain between the breasts can occur in men and women at any age. The reasons for this could be anything. Some begin to blame the heart. Others think about problems with the lungs. However, only a doctor can find out exactly what is the cause of unpleasant pain in the chest.

Pain in the armpit and between the breasts: causes

It should be understood that the causes of pain in the armpit and between the chest are very diverse. Sometimes they can be localized in the area of \u200b\u200bthe diseased organ, and sometimes irradiate to other places. Thus, to find out the cause of pain, you should seek medical diagnosis. Doctors may identify one of these reasons:

Dysfunction of the musculoskeletal system: costal chondritis, rib fractures.
Gastrointestinal disorders: spasms in the esophagus, gallbladder disease, gastroesophageal reflux, ulcers.
Lung diseases: acute bronchitis, pneumonia, pleuralgia.
Severe diseases of the cardiovascular system: atherosclerosis of the joints, coronary vasospasm, cardiac arrhythmia, ischemic disease, ischemia of cardiac origin, pericarditis, angina pectoris, mitral valve prolapse syndrome.
Anxiety, panic fear or fears, nervous tension, stress.
Neurological diseases.
Causes of uncertain and uncharacteristic origin.

Chest pain can occur at any age. This is due to numerous reasons for their appearance. Often this symptom occurs in people over 65 years of age. In men, pain can occur after 45 years. Children are in last place to experience chest and armpit pain.

Hernia in the diaphragm

Doctors thoroughly examine the patient to find out the causes of pain. Sometimes it consists in a hernia in the diaphragm. The area itself is made up of nerves, making it an innervated organ. The appearance of diaphragmatic hernia can provoke characteristic pain.

The disease can be identified by the following symptoms:

Frequent burps.
Dysphagia.
Chest pain.
Feeling of volume in the epigastrium.

The spread of a hernia in the chest is accompanied by severe pain in this area, as well as discomfort in the interscapular region and the left shoulder. This can cause false suspicions that a person has problems with the heart.

With similar symptoms there are adults after 45-56 years. If it manifested itself in a child or teenager, then you should consult a doctor urgently, since we can talk about something serious.

Often, these symptoms indicate a chest injury. Pain can occur when tilting, turning the body, and also when inhaling. When pressing or feeling the injured area, the pain intensifies and may not go away for a long time. Only at rest does a person stop feeling pain, which gradually disappears.

Problem Diagnosis

Problems arise in the diagnosis of the disease, especially if there are no other obvious symptoms or the diseased organ is not in the chest. Diagnosis is carried out mainly instrumental, until additional laboratory tests are required.

If the pain bothers you for a while, and then goes away on its own, then you can talk about functional reasons her origin. Important are the symptoms that manifest themselves in addition to pain. This helps to draw attention to a specific area of the body.

Doctors sometimes cannot establish an accurate diagnosis. Even if assumptions are put forward, this does not mean that the diagnosis is correct. This makes the patient's condition dangerous, especially if we are talking about a serious illness.

An accurate diagnosis is required from the doctor. The patient himself must be prepared for what may be required. surgical intervention. Depending on the disease, doctors prescribe one or another treatment, which may include surgery. However, sometimes it's just a matter of psychological reasons illness, which requires only the help of a psychotherapist and the use of sedative medications.

We pay attention to the most important thing for pain between the chest and armpit

There is a certain procedure that doctors perform to identify the cause of pain between the chest and armpit. They turn Special attention on the most important indicators that can indicate what triggered the symptom. Consider the main indicators on the site site:

How do pains manifest themselves?
The nature of the flow of sensations is considered.
Are there any ways to reduce the pain? What are they?
How long does the pain last?

Diseases that may be the same in their symptoms - expressed by pain between the chest or armpit, yet differ in duration and strength given symptom. According to such signs, doctors can pay special attention to the organ that is characterized by a similar duration and intensity of pain.

In addition to diagnosing the body, an anamnesis is taken, which can also help in identifying the cause. It will be problematic to examine the entire body, therefore, in order not to waste time, doctors suggest in advance, based on the symptoms and complaints of the patient, what could be the cause of the disease. That is why conversations are conducted with the patient, an external examination is carried out, and the nature of the pains is also observed.

Where and how does it hurt?

What are the pains? The fact that they can be different in duration and strength is already known. How and where can it hurt with a particular disease?

Pain between the breasts and armpit can be sharp or dull in nature, lasting from a few seconds to 2 hours. It could be serious symptom, which indicates pneumothorax, pulmonary embolism, myocardial infarction, or aortic aneurysm. These diseases are life-threatening, so the patient should be urgently hospitalized.
Pain lasting 1 minute may indicate heart disease.
Pain lasting several hours indicates possible problems with the gastrointestinal tract.
Damage to the musculoskeletal system is accompanied by sharp pains that last more than 2 days.
Burning pain after eating indicates problems with the esophagus. In this case, belching and heartburn may appear.
Pain in the intercostal space, which appears on both sides of the chest and has a dull character, often indicates problems with respiratory system and light.

Other types of pain can be squeezing, aching, burning, etc. All of them suggest that the patient should consult a doctor who can identify the disease and prescribe treatment.

Who is at risk?

Almost anyone can experience pain between the chest and armpit. The reasons are so diverse that absolutely everyone can be at risk. Even children can experience similar symptoms, which only indicates a serious illness.

However, often pain in the chest area occurs already in adulthood and old age. This includes people who already had chronic diseases organs located in the chest are negatively affected environment and also have bad habits:

They smoke.
They drink alcohol.
Have high blood pressure.
They have hereditary diseases.
They carry out heavy physical loads on the body.
are going through stressful situations and nervous tension.

People who have diseases associated with chest pain are at risk.

What pains are dangerous for human health?

The reader should be attentive to the sensations that arise in his armpit or mammary gland. There are pains that signal danger to human body. What are they?

Cardiological pain: myocardial infarction, unstable or acute angina pectoris, aortic aneurysm of a dissecting nature.
Pulmonary pain: severe pneumothorax, pulmonary embolism.

Such pains are easy to identify according to the patient's complaints, as well as using medical devices. So, an x-ray or electrocardiographic examination allows you to accurately determine the nature of the pain.

If the patient does not go to the doctor for a long time and does not establish a diagnosis of his condition, then the development of the disease is possible. The condition will worsen, leading to even more severe symptoms.

Pain may indicate rib fractures, which can be detected by probing the chest, or herpes zoster. Treatment comes only after a diagnosis is made, which can only be correct after medical examinations. Medications are prescribed here, the correct daily regimen and nutrition are observed. Only the fulfillment of all medical advice allows you to get rid of the disease and, accordingly, pain between the chest and armpit.

How to treat pain between the breasts?

Treatment of pain between the breasts depends on the condition of the patient. If an attack suddenly occurs, then the person may lose consciousness and fall into pain shock. His face and lips will turn pale, his pulse will quicken, his eyes will be frightened. It is at this moment that you need to call an ambulance and provide emergency:

Lay in bed and raise your legs low.
Release from tight clothing and give a tablet of "Nitroglycerin".
Remove extra people from the room so that they do not irritate the patient.
Give a sniff of ammonia if a person loses consciousness.

You should not do:

Set the bones yourself if there is a chest injury.
Leave the patient alone.
Do warm compresses as different reasons pain, they can both help and hurt.

Medical treatment consists in identifying the cause of pain between the chest and armpit, and then in eliminating the disease:

Pulmonary pathologies are treated with antibiotics, anti-inflammatory and analgesic drugs, immunomodulators. The patient is in bed, consumes a lot of fluids, makes inhalations, refuses smoking and alcohol.
Pathologies of the cardiovascular system are eliminated proper nutrition, in a healthy way life, walks in the fresh air, activities breathing exercises, as well as drugs that thin the blood and dilate the coronary vessels.
Fractures of the chest bones are eliminated by immobilizing the patient and fixing his damaged areas. Ice is applied, massaged with special creams, massages are performed and soft stretches are carried out.

Treatment depends entirely on the causes of pain between the breasts. This is established by the doctor, as he also conducts treatment.

Forecast

The prognosis of pain between the armpit and the chest depends entirely on how quickly the patient seeks medical help, how his disease is correctly diagnosed and the treatment is carried out correctly. This significantly affects life expectancy. How long do people with chest pain live? It all depends on the diseases that provoked them.

There are diseases that are fatal. There are reasons that require emergency care. And there are diseases that are not fatal, but may have complications that threaten lethal outcome. The result is the same - death without treatment.

Pain in the chest can be manifested by diseases of the heart, respiratory organs, gastrointestinal tract, spine, mediastinum, central nervous system. All internal organs of a person are innervated by the autonomic nervous system, the trunks of which extend from the spinal cord. When approaching the chest nerve trunk gives offshoots to individual bodies. That is why sometimes stomach pains can feel like pains in the heart - they are simply transmitted to common trunk, and from it to another organ. Moreover, the spinal nerve roots contain sensory nerves that innervate musculoskeletal system. The fibers of these nerves are intertwined with the fibers of the nerves of the autonomic nervous system, and therefore completely healthy heart can respond with pain in various diseases of the spine.

Finally, chest pain may depend on the state of the central nervous system: constant stress and high neuropsychic stress, a malfunction occurs in her work - neurosis, which can manifest itself, including pain in the chest.

Some chest pains are unpleasant, but not life-threatening, but there are chest pains that need to be removed immediately - a person's life depends on it. In order to understand how dangerous chest pain is, you need to see a doctor.

Chest pain caused by obstruction of the coronary (heart) arteries

The coronary arteries carry blood to the heart muscle (myocardium), which works non-stop throughout life. The myocardium cannot even do without a new portion of oxygen and nutrients delivered with the blood for even a few seconds; its cells immediately begin to suffer from this. If the blood supply is interrupted for several minutes, then myocardial cells begin to die. The larger the coronary artery suddenly becomes obstructed, the larger the area of the myocardium is affected.

Spasms (compression) of the coronary arteries usually occur against the background of coronary heart disease (CHD), the cause of which is partial blockage of blood vessels by atherosclerotic plaques and narrowing of their lumen. Therefore, even a slight spasm can block the access of blood to the myocardium.

A person feels such changes in the form of a sharp penetrating pain behind the sternum, which can radiate to the left shoulder blade and to the left hand, up to the little finger. The pain can be so severe that the patient tries not to breathe - respiratory movements increase the pain. With severe attacks, the patient turns pale, or, conversely, blushes, his blood pressure, as a rule, rises.

Such chest pains can be of short duration and occur only during physical or mental stress(angina pectoris), and can occur on their own, even during sleep (angina at rest). It is difficult to get used to angina attacks, so they are often accompanied by panic and fear of death, which further increases the spasm of the coronary vessels. Therefore, it is so important to clearly know what to do during an attack and have everything you need at hand. The attack ends as suddenly as it began, after which the patient feels a complete loss of strength.

The peculiarity of these pains is that in no case should a person endure them - they must be removed immediately. You can’t do without consulting a doctor here - he will prescribe both the course of the main treatment and the medicine that needs to be taken when pain occurs (the patient should always have it with him). Usually in emergency cases take a nitroglycerin tablet under the tongue, which relieves pain within 1 to 2 minutes. If after 2 minutes the pain has not disappeared, then the pill is taken again, and if this does not help, then you should immediately call an ambulance.

What can happen if you endure chest pain? The cells of the myocardial area, which is supplied by the affected artery, begin to die (myocardial infarction) - the pain intensifies, becomes unbearable, a person often has a pain shock with a sharp decrease in blood pressure and acute heart failure (the heart muscle does not cope with its work). It is possible to help such a patient only in a hospital setting.

A sign of the transition of an angina attack to myocardial infarction is the increase in pain and the lack of effect from the use of nitroglycerin. The pain in this case has a pressing, squeezing, burning character, begins behind the sternum, and then can spread to the entire chest and abdomen. The pain can be continuous or in the form of repeated attacks one after another, increasing in intensity and duration. There are cases when the pain in the chest is not very strong, and then patients often suffer myocardial infarction on their legs, which can cause an instant disruption of the heart and death of the patient.

There are also atypical (atypical) forms of myocardial infarction, when the pain begins, for example, in the region of the anterior or posterior surface of the neck, lower jaw, left arm, left little finger, left shoulder blade, etc. Most often, such forms are found in the elderly and are accompanied by weakness, pallor, cyanosis of the lips and fingertips, disorders heart rate, drop in blood pressure.

Another atypical form myocardial infarction is abdominal form when the patient feels pain not in the region of the heart, but in the abdomen, usually in its upper part or in the region of the right hypochondrium. These pains are often accompanied by nausea, vomiting, liquid stool, bloating. The condition is sometimes very similar to intestinal obstruction.

Chest pain caused by changes in the central nervous system

Chest pain can also occur with other diseases. One of the most common diseases that cause frequent and prolonged pain in the chest is cardioneurosis, which develops against the background of a temporary functional disorder central nervous system. Neuroses are the body's response to various mental shocks (intense short-term or less intense, but long-lasting).

Pain in cardioneurosis can be of a different nature, but most often they are constant, aching and are felt in the region of the apex of the heart (in the lower part of the left half of the chest). Sometimes pain in cardioneurosis can resemble pain in angina pectoris (short-term acute), but they do not decrease from taking nitroglycerin. Often, attacks of pain are accompanied by reactions from the autonomic nervous system in the form of redness of the face, moderate palpitations, and a slight increase in blood pressure. With cardioneurosis, there are almost always other signs of neuroses - increased anxiety, irritable weakness, etc. It helps with cardioneurosis elimination of psycho-traumatic circumstances, the correct regimen of the day, sedatives, and sleeping pills for sleep disorders.

Sometimes cardioneurosis is difficult to distinguish from coronary heart disease (CHD), the diagnosis is usually established on the basis of careful observation of the patient, since there may be no changes on the ECG in either case.

A similar picture can be caused by changes in the heart during menopause. These disturbances are caused by a change hormonal background resulting in neurosis and disturbance metabolic processes in the heart muscle (climacteric myocardiopathy). Pain in the heart is combined with the characteristic manifestations of menopause: flushing of blood to the face, bouts of sweating, chills and various sensitivity disorders in the form of "goosebumps", insensitivity individual sections leather, etc. Just like with cardioneurosis, pain in the heart is not relieved by nitroglycerin, sedatives and hormone replacement therapy help.

Pain in the chest caused by inflammatory processes in the region of the heart

The heart has three layers: outer (pericardium), middle muscular (myocardium) and inner (endocardium). An inflammatory process can occur in any of them, but pain in the heart is characteristic of myocarditis and pericarditis.

Myocarditis ( inflammatory process in the myocardium) can occur as a complication of some inflammatory (for example, purulent tonsillitis) or infectious-allergic (for example, rheumatism) processes, as well as toxic effects(for example, some drugs). Myocarditis usually occurs within a few weeks after past illness. One of the most frequent complaints patients with myocarditis - pain in the region of the heart. In some cases, chest pain may resemble the pain of angina pectoris, but they last longer and do not go away with nitroglycerin. In this case, they may well be confused with pain in myocardial infarction. Pain in the heart may not occur behind the sternum, but more to the left of it, such pain appears and intensifies during physical exertion, but it is also possible at rest. Chest pain may recur many times during the day or be almost continuous. Often chest pain is stabbing or aching in nature and does not radiate to other parts of the body. Often pain in the heart is accompanied by shortness of breath and attacks of suffocation at night. Myocarditis requires thorough examination and long-term care of the patient. Treatment primarily depends on the cause of the disease.

Pericarditis is an inflammation of the outer serous membrane of the heart, which consists of two sheets. Most often, pericarditis is a complication of various infectious and noncommunicable diseases. It can be dry (without accumulation of inflammatory fluid between the sheets of the pericardium) and exudative (inflammatory fluid accumulates between the sheets of the pericardium). Pericarditis is characterized by dull monotonous chest pain, most often the pain is moderate, but sometimes they become very strong and resemble an angina attack. Chest pain depends on respiratory movements and changes in body position, so the patient is tense, breathing shallowly, trying not to make unnecessary movements. Chest pain is usually localized on the left, above the region of the heart, but sometimes spreads to other areas - to the sternum, upper part abdomen, under the shoulder blade. These pains are usually associated with fever, chills, general malaise and inflammatory changes in the general analysis blood (large number of leukocytes, accelerated ESR). Treatment of pericarditis is long, it usually begins in a hospital, then continues on an outpatient basis.

Other chest pain associated with the cardiovascular system

Often the cause of chest pain is diseases of the aorta - a large blood vessel, which departs from the left ventricle of the heart and carries arterial blood throughout the systemic circulation. The most common disease is aortic aneurysm.

Aneurysm thoracic aorta- this is an expansion of the aorta due to a violation of the connective tissue structures of its walls due to atherosclerosis, inflammatory lesions, congenital inferiority, or due to mechanical damage the walls of the aorta, for example, in trauma.

In most cases, aneurysm is of atherosclerotic origin. At the same time, patients may be disturbed by prolonged (up to several days) chest pains, especially in the upper third of the sternum, which, as a rule, do not radiate to the back and left arm. Often the pain is associated with physical activity, does not resemble after taking nitroglycerin.

A terrible consequence of an aortic aneurysm is its breakthrough with fatal bleeding into the respiratory organs, pleural cavity, pericardium, esophagus, large vessels chest cavity, out through the skin with a chest injury. At the same time, it appears sharp pain behind the sternum, drop in blood pressure, shock and collapse.

A dissecting aortic aneurysm is a channel formed in the thickness of the aortic wall due to its dissection with blood. The appearance of a bundle is accompanied by a sharp arching retrosternal pain in the region of the heart, severe general condition often with loss of consciousness. The patient needs emergency medical care. An aortic aneurysm is usually treated with surgery.

An equally serious disease is thromboembolism (blockage by a detached thrombus - embolus) of the pulmonary artery, which extends from the right ventricle and carries venous blood to the lungs. early symptom this serious condition often there is severe pain in the chest, sometimes very similar to the pain of angina pectoris, but usually does not radiate to other areas of the body and is aggravated by inspiration. The pain continues for several hours, despite the introduction of painkillers. The pain is usually accompanied by shortness of breath, cyanosis of the skin, strong heartbeat and a sharp drop in blood pressure. The patient needs an emergency health care in a specialized department. In severe cases, it is surgery– removal of the embolus (embolectomy)

Pain in the chest with diseases of the stomach

Stomach pain can sometimes feel like chest pain and is often mistaken for heart pain. Usually such chest pains are the result of spasms of the muscles of the stomach wall. These pains are more prolonged than those of the heart and are usually accompanied by other characteristic features.

For example, chest pain is most often associated with eating. Pain can occur on an empty stomach and disappear from eating, occur at night, after a certain time after eating, etc. There are also such symptoms of a stomach disease as nausea, vomiting, etc.

Pain in the stomach is not relieved by nitroglycerin, but they can be relieved with the help of antispasmodics (papaverine, no-shpy, etc.) - drugs that relieve spasm of the muscles of the internal organs.

The same pain can occur in some diseases of the esophagus, diaphragmatic hernia. - this is an exit through an enlarged opening in the diaphragm (the muscle that separates the chest cavity from the abdominal cavity) of the stomach and some other parts of the gastrointestinal tract. When the diaphragm contracts, these organs are compressed. Diaphragmatic hernia appears sudden appearance(often this happens at night when the patient is in horizontal position) severe pain, sometimes similar to the pain of angina pectoris. From taking nitroglycerin, such pain does not go away, but it becomes less when the patient moves to a vertical position.

Severe pain in the chest can also occur with spasms of the gallbladder and bile ducts. Despite the fact that the liver is located in the right hypochondrium, pain can occur behind the sternum and radiate to the left side of the chest. Such pain is also relieved by antispasmodics.

It can be confused with heart pain pain in acute pancreatitis. The pain in this case is so severe that it resembles a myocardial infarction. They are accompanied by nausea and vomiting (this is also common in myocardial infarction). These pains are very difficult to remove. Usually this can only be done in a hospital during intensive treatment.

Chest pain in diseases of the spine and ribs

Pain in the chest, very reminiscent of heart pain, can occur with various diseases of the spine, for example, with osteochondrosis, herniated discs, ankylosing spondylitis, etc.

Osteochondrosis is dystrophic (exchange) changes in the spine. As a result of malnutrition or high physical exertion, bone and cartilage tissue, as well as special elastic pads between individual vertebrae (intervertebral discs). Such changes cause compression of the roots of the spinal nerves, which causes pain. If changes occur in thoracic region spine, the pain may be similar to pain in the heart or pain in the gastrointestinal tract. The pain may be constant or in the form of attacks, but it always increases with sudden movements. Such pain cannot be relieved with nitroglycerin or antispasmodics, it can only be reduced by pain medications or heat.

Pain in the chest area can occur when the ribs are fractured. These pains are associated with trauma, aggravated by deep inspiration and movement.

Chest pain in lung disease

The lungs occupy a large part of the chest. Chest pain may be associated with inflammatory diseases lungs, pleura, bronchi and trachea, with various injuries of the lungs and pleura, tumors and other diseases.

Especially often, chest pains occur with a disease of the pleura (a serous sac that covers the lungs and consists of two sheets, between which the pleural cavity is located). With inflammation of the pleura, pain is usually associated with coughing, deep breath and accompanied by an increase in temperature. Sometimes such pains can be confused with heart pains, for example, with pains at a pericarditis. Very severe chest pains appear when lung cancer grows into the pleura.

In some cases, air (pneumothorax) or fluid (hydrothorax) enters the pleural cavity. This can happen with a lung abscess, pulmonary tuberculosis, etc. With spontaneous (spontaneous) pneumothorax, there is a sharp sudden pain, shortness of breath, cyanosis, and blood pressure decreases. The patient has difficulty breathing and moving. The air irritates the pleura, causing severe stabbing pain in the chest (in the side, on the side of the lesion), radiating to the neck, upper limb sometimes in the upper abdomen. The patient's chest volume increases, the intercostal spaces expand. Help for such a patient can only be provided in a hospital.

The pleura may also be affected periodic illness – genetic disease manifested by intermittent inflammation serous membranes covering internal cavities. One of the variants of the course of periodic illness is thoracic, with damage to the pleura. This disease manifests itself in the same way as pleurisy, occurring in one or the other half of the chest, rarely in both, causing the same complaints in patients. Like pleurisy. All signs of an exacerbation of the disease usually disappear spontaneously after 3 to 7 days.

Chest pain associated with the mediastinum

Pain in the chest can also be caused by air entering the mediastinum - a part of the chest cavity, bounded in front by the sternum, behind - by the spine, from the sides - by the pleura of the right and left lungs and from below - by the diaphragm. This condition is called mediastinal emphysema and occurs when air enters from the outside with injuries or from the respiratory tract, the esophagus in various diseases (spontaneous mediastinal emphysema). In this case, there is a feeling of pressure or pain in the chest, hoarseness, shortness of breath. The condition can be severe and requires emergency care.

What to do for chest pain

Chest pain can be of different origin, but very similar to each other. Such pains, similar in sensation, sometimes require absolutely different treatment. Therefore, when pain occurs in the chest, it is necessary to consult a doctor who will prescribe an examination in order to identify the cause of the disease. Only after that it will be possible to prescribe the correct adequate treatment.