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Chest Pain: Causes & Treatment


What should you do if you have chest pain?

Call 911 or have someone take you to the closest emergency room right away if you have chest pain that lasts longer than five minutes and does not go away when you rest or take medication. Cardiac chest pain can be life-threatening.

Chest pain can be a sign of a heart attack. Other signs of a heart attack include:

  • Sweating.
  • Nausea or vomiting.
  • Shortness of breath.
  • Light-headedness or fainting.
  • A rapid or irregular heartbeat.
  • Pain in your back, jaw, neck, upper abdomen, arm or shoulder.

What is chest pain?

Chest pain is pain in any area of your chest. You may feel the pain in your back, lungs, ribs, muscles or center of your chest. Chest pain can be sharp or dull. You may feel tightness, achiness, or you may feel like your chest is being crushed or squeezed. Chest pain is often intermittent (lasting for seconds, minutes to hours), but it can also be chronic, which means it lasts six months or longer.

What is angina?

Angina is a type of chest pain that happens when your heart is not getting enough oxygen-rich blood. Angina is a symptom of a heart problem.

Angina can feel like pressure or squeezing in your chest. It can also cause discomfort in your shoulders, arms, neck, jaw and back. Angina sometimes feels like indigestion.

Possible Causes

What causes chest pain?

Although most people think of chest pain as a sign of a heart problem/heart attack, it can be caused by many things. Chest pain can be a symptom of:

  • Heart and vascular problems, such as a heart attack, coronary artery disease (blockages in the blood vessels that carry blood to your heart), pericarditis (inflammation of the lining around your heart), aortic dissection (a tear in the wall of your aorta) or aortic aneurysm (a bulging section of your aorta).
  • Digestive problems such as gastroesophageal reflux disease (GERD), an ulcer, gallstones, spasms in your esophagus, esophagitis, hiatal hernia or gastritis.
  • Lung problems such as a pulmonary embolism (a blood clot in an artery inside your lung), chronic obstructive pulmonary disease (COPD), pneumonia, pleurisy or pleuritis (inflammation of the membrane around your lungs) or a pneumothorax (collapsed lung).
  • Musculoskeletal problems, such as a broken rib or sprained chest muscle.
  • Cancer involving or effecting different structures in the chest.
  • Stress, anxiety or panic attacks.

Care and Treatment

What should I do if I have chest pain?

Do not ignore any type of chest pain or avoid getting treatment.

If your chest pain is new, comes on suddenly, or lasts longer than five minutes after you rest or take medication, call 911 or have someone take you to the closest emergency room.

If your chest pain goes away or comes and goes, see your healthcare provider as soon as possible to find out what is causing the pain, even if it is not severe.

What treatments are available for people with chest pain?

Treatment for chest pain depends on the cause of the pain. If your chest pain is caused by a heart attack, you will get emergency treatment as soon as you seek help. This can include medication and a procedure or surgery to restore blood flow to your heart. If your chest pain is caused by a non-cardiac condition, your healthcare provider will talk to you about treatment options.

How can I prevent chest pain?

You can reduce your risk of heart, vascular and other diseases by following a healthy lifestyle. This includes:

  • A healthy diet. Your healthcare provider or registered dietitian can help you create an eating plan that is right for you.
  • Managing health conditions you have, such as high blood pressure, high cholesterol and diabetes.
  • Exercising most days of the week.
  • Reaching and maintaining a healthy weight.
  • Limiting the amount of alcohol you drink.
  • Not smoking or using tobacco/nicotine products.

When to Call the Doctor

When should I call my healthcare provider about chest pain?

Call 911 or have someone take you to the closest emergency room right away if you have chest pain that lasts longer than five minutes and does not go away when you rest or take medication. Cardiac chest pain can be life-threatening.

Symptoms, Causes, Treatment & When It’s an Emergency

Chest pain includes any type of pain or discomfort that occurs between your upper belly area and your lower neck. Chest pain can occur in any age group or population. People may describe chest pain symptoms as chest tightness, chest pressure, or a feeling of burning or fullness in the chest. Chest pain may also be sharp, dull, throbbing, crushing, tearing, cramping or achy.

Chest pain can be a serious, life-threatening symptom and is the classic symptom of a heart attack. People often associate chest pain with cardiovascular disease. But chest pain causes include a wide variety of other diseases, disorders and conditions. For example, relatively mild to moderate conditions can cause chest pain, such as indigestion, hyperventilation, or an anxiety attack.

Chest pain can also be a symptom of more serious conditions. This includes problems in the digestive tract, such as GERD (gastroesophageal reflux disease). Respiratory conditions can also cause chest pain. These include pneumothorax (collapsed lung), acute bronchitis, bronchiolitis, asthma, COPD (chronic obstructive pulmonary disease), PE (pulmonary embolism), pulmonary edema, and lung cancer. In children, chest pain may occur with a congenital heart condition, pneumonia, pleuritis, or birth defect.

Depending on the cause, chest pain can last briefly and disappear quickly, such as during hyperventilation or when breathing in very cold air. Sharp chest pain that occurs in a sudden, severe episode may be due to a heart attack or PE. Chronic and ongoing chest pain may be due to COPD or lung cancer.

It is not possible to accurately identify the precise cause at home.

Seek immediate emergency care (call 911) if you have unexplained chest pain or a crushing feeling in your chest, if the pain is radiating to your shoulder blades, jaw, or left arm, or if you have shortness of breath, sweating, or chest pain at rest. In addition, sudden chest pain and shortness of breath after a long period of inactivity, such as prolonged bed rest, may be a sign of a PE and is a life-threatening emergency.

​What causes chest pain and when to consult a heart doctor

Is the chest pain you’re experiencing just indigestion from a spicy meal, or could your body be alerting you to a more serious issue requiring medical attention?

Chest pain – also known as angina – is a key indicator of coronary heart disease, the most common type of heart disease that kills 365,000 people each year.

Here’s what you need to know about chest pain, its causes, treatments, and when it indicates a serious coronary artery problem.

Why do people experience chest pain?

Chest pain may be caused by any body structure in the chest – or even abdomen – including superficial structures such as the skin, connective tissue and surface nerves or deep structures and organs such as the heart, lungs and stomach. Other non-cardiac conditions causing chest pain could include shingles, inflammation of the chest wall nerves or cartilage of the ribcage, peptic ulcers or GERD, spasm of the esophagus and, rarely, inflammation of the pancreas or gallbladder. Chest pain may be due to an injury to the chest, a pulled muscle, a lung problem, or acid reflux.

The causes that concern us the most are due to either a blockage in the artery of the heart or a problem with one of the valves of the heart. High blood pressure can also cause chest pain and is a cause for concern. If any of these causes are suspected, patients should see their doctor. Sometimes it’s hard to differentiate, but your doctor can help.

Is there a way to know if chest pain is due to a heart condition?

Chest pain arising from heart conditions is generally slow to start and slow to resolve, lasting minutes, not seconds. It is often associated with other worrisome symptoms such as shortness of breath, passing out or nearly passing out, nausea, vomiting and profuse sweating. Cardiac chest pain can also radiate to the neck, jaw or inner aspect of the left arm; it rarely changes with position but will worsen with exertion or physical activity.

For more information on heart attacks, along with a useful infographic, visit the American College of Cardiology’s CardioSmart patient info page.

When should someone see a doctor for chest pain?

See a doctor anytime you are worried by your chest pain. We are very aware of the “Hollywood heart attack” whereby patients can have chest pain that is tight or heavy that is located in the center of their chest and can go down their left arm. But patients can present with a number of symptoms that they may not normally associate with heart disease such as:

  • Neck pain
  • Jaw pain
  • Back pain
  • Abdominal pain
  • Shortness of breath

Chest pain can be due to a number of causes, but if a patient has developed chest pain, especially while exercising, they should definitely see a doctor.

In general, all chest pains should be evaluated by a physician unless there was a clear and reversible cause for it (mild trauma, cuts, burns, bruises, etc.). It should be noted that early stages of a heart attack are often misinterpreted as gas, indigestion or heartburn and pulmonary embolism (blood clots traveling to the lungs) are often misinterpreted as a variety of lung conditions such as asthma, pneumonia, pleurisy or emphysema.

Chest pain that is persistent or worsening, increasing in intensity or frequency or associated with any of the above symptoms should be urgently evaluated. Chest pain that is unremitting should prompt a call to 9-1-1.

How can being in tune with our bodies prevent chest pain?

Future prevention of chest pain begins with detailed observation of the existing pain:

  • When does it come on?
  • How long does it last?
  • Does it travel to other locations?
  • What improves or worsens it?

Write it all down, and patterns will emerge. Once patients create a “symptom log,” they can present it to healthcare providers who can make specific suggestions for diagnosis and treatment of the symptoms.

Exercise is also a great way to determine whether chest pain could be arising from the heart or not. If somebody experiences chest pain or pressure with a predictable level of physical activity, such as walking up a flight of stairs, and the pain resolves with rest, it is likely to be due to a narrowing in a coronary artery.

How can chest pain be treated?

If the chest pain is due to a blockage in one of the arteries of the heart, it is usually treated in one of three ways: 1) medication, 2) a stent, or 3) artery bypass surgery. Medications, often our first choice, that lower the blood pressure, lower cholesterol, and relieve the pain from the stenosis can be the mainstay of therapy.

However, if the blockages are severe or if the pain is not relieved with medications, a patient may benefit from a stent, which is a tiny tube of metal mesh that helps ensure adequate blood flow through the artery. In cases where the blockages are quite severe or in locations that cannot be treated with stents, then we are led to the third option, which is coronary artery bypass surgery. In this case, a surgeon will use the patient’s own arteries or veins to bypass the blockage.

At the University of Chicago Medicine, we can treat chest pain that is due to narrowed or blocked coronary arteries – and insert coronary stents – with a minimally invasive procedure called a coronary angiogram or a cardiac catheterization. A small catheter, about the size of a spaghetti noodle, is threaded through a large artery in the wrist or groin, and the coronary arteries are seen under X-ray after a small amount of dye is injected.

What technologies are available to patients at UChicago Medicine?

UChicago Medicine specialists offer some of the broadest array of advanced cardiovascular diagnostic tests and treatments available anywhere in the region, ranging from simple medical therapies to the most advanced multi-disciplinary treatments delivered by groups of cardiovascular specialists and surgeons who work using an integrated heart team approach.

We are fully equipped to handle even the most complex cases. This includes opening completely obstructed blood vessels (chronic total occlusions), using tools to remove calcium and plaque from severely diseased vessels (coronary atherectomy), and advanced intracoronary imaging techniques to achieve optimal results for stenting procedures. Our program also uses robotic-assisted surgery to help treat patients in a minimally invasive way.

Chest Pain, Chronic – familydoctor.org

  • See Chest Pain in Infants and Children
  • Diagnosis


    Self Care

    Go to the closest emergency room or call an ambulance right away.

  • Diagnosis

    Your chest discomfort and shortness of breath may be caused by ASTHMA.

    Self Care

    See your doctor right away. Asthma is very treatable, but it can be a serious condition. Make sure that you get your annual influenza vaccination.

    If you feel that you can’t catch your breath or can’t stop coughing, then have someone drive you to the closest emergency room or call an ambulance.

  • Diagnosis

    You may have COSTOCHONDRITIS, an inflammation of the joints in your chest along the ribs or where the ribs meet your breastbone and sternum.

    Self Care

    COSTOCHONDRITIS usually goes away on its own. Try an anti-inflammatory medicine to relieve the pain. Heat may also help. See your doctor if the pain doesn’t get better with these treatments.

  • Diagnosis

    Your pain may be from a heart problem called ANGINA. If it occurs under predictable circumstances (e.g., after 10 minutes of hard exercise) then it is considered STABLE ANGINA. If it occurs at different times or seems to be occurring with less exertion or while you are at rest, then it may be UNSTABLE ANGINA.

    Self Care

    See your doctor. ANGINA is a sign that a person has a higher risk of serious heart problems, such as a HEART ATTACK. If you are concerned about UNSTABLE ANGINA, and it is actively occurring, have someone drive you to the nearest emergency room or call an ambulance.

  • Diagnosis

    The pain you have may be from a GALLBLADDER problem.

    Self Care

    See your doctor. Also, avoid fatty foods.

  • Diagnosis

    You may have an ULCER, IRRITATION OF THE ESOPHAGUS, or SPASM of the muscles of the esophagus.

    If the discomfort is in your upper stomach and gets worse when you lean forward or lie down, you may have a HIATAL HERNIA. This is a common problem in which the top of the stomach is pushed into the lower chest after eating.

    Self Care

    Limit your alcohol intake, eat smaller meals, and avoid fatty foods. Try an antacid to help relieve your discomfort. Sleeping on a foam wedge, or raising the head of your bed with textbooks, bricks, boards under the headboard or front feet of your bed may also help.

    If these steps don’t relieve your symptoms, see your doctor.

  • Diagnosis

    Your pain may be caused by POSTHERPETIC NEURALGIA, a condition where chronic pain remains at the site of the previous  SHINGLES infection.

    Self Care

    See your doctor. In many cases, POSTHERPETIC NEURALGIA can be treated with over-the-counter pain medicines and capsaicin cream.

  • Diagnosis

    These symptoms may be caused by CHRONIC BRONCHITIS, which is a type of CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), a common condition if you smoke or previously smoked.

    Self Care

    See your doctor. If you smoke, stop smoking. Also, avoid breathing in anything that can irritate your lungs. Make sure that you get your annual influenza vaccination.

  • Diagnosis

    EMPHYSEMA, which is a type of CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), may be the cause of your problem.

    Self Care

    See your doctor. If you smoke, stop smoking. Also, avoid breathing in anything that can irritate your lungs. Make sure that you get your annual influenza vaccination.

  • Diagnosis

    You may have an infectious illness, such as TUBERCULOSIS, FUNGAL INFECTION, or PNEUMONIA. A more serious problem, such as LUNG CANCER, could also be the cause.

    Self Care

    See your doctor right away. They may recommend a chest X-ray and/or blood testing. You can take acetaminophen or ibuprofen to help with fever.

  • Self Care

    For more information, please talk to your doctor. If you think your problem is serious, call your doctor right away.

  • Why You Shouldn’t Ignore That Sudden Chest Pain

    Chest pain often signals an underlying heart problem. Find out what the different types of chest pains could mean from the Department of Cardiology at National Heart Centre Singapore (NHCS).

    Don’t ignore the chest pain that suddenly hits you while at rest or during walking or exercising.

    The sensation of squeezing, crushing or pressure on the chest could indicate many things – from “harmless” stress and indigestion to something as serious as an impending heart attack or angina. Angina is recurring chest pain that usually signals coronary artery disease.

    “Please seek emergency assistance if the chest pain lasts more than 15-20 minutes at rest or if it is accompanied by nausea, sweating, shortness of breath or loss of consciousness”, says
    Adj Assoc Prof Aaron Wong, Head and Senior Consultant,
    Department of Cardiology, and the Director of
    Interventional Cardiology at
    National Heart Centre Singapore (NHCS), a member of the
    SingHealth group.

    It is sometimes difficult to determine the cause of the chest pain, but in some higher risk patients, unexplained, sudden chest pains often indicate underlying heart problems, Adj Assoc Prof Wong adds.

    Related article: When Chest Pain Gets Serious

    Identifying different types of chest pain


    Angina pain

    Angina is chest pain that arises from beneath the sternum and is caused by reduced blood flow to the heart due to blockages in the main coronary arteries. Angina pain is usually a warning sign of coronary artery disease.

    Symptoms of angina

    • Chest pain – feelings of heaviness, tightness or crushing pressure beneath the sternum
    • Two to 15 minutes in duration
    • Triggers include emotional stress, strenuous exercise and heavy lifting

    Angina varies in severity, depending on the type of angina pain.

    The most common angina pain –

    stable angina
    – lasts only a few minutes and occurs predictably during physical exertion such as climbing the stairs, or during mental or emotional stress. Symptoms disappear immediately with rest or medication. It does not indicate an impending heart attack.

    Unstable angina
    is more serious than stable angina and it can occur even at rest. The chest pain could last as long as 30 minutes and does not go away with rest or medication. It may progress to a heart attack when complete blockage of the coronary artery occurs.

    New onset stable angina or increasing frequency of stable angina, especially with lesser exertion, is also classified as unstable angina. Unstable angina signifies sudden progression of blockage of the artery due to breakage at the narrowing (rupture plaque) leading to clot formation (thrombosis).

    Variant angina
    is caused by sudden spasms in the coronary arteries which restrict blood flow to the heart. Chest pains are severe and happen at rest. It is usually resolved spontaneously but if the spasms are not controlled, it could lead to a heart attack. Medication can bring immediate relief.

    2. Heart attack chest pain

    Chest pains associated with an impending heart attack are more intense than angina pain and last longer than 15 minutes. Rest cannot bring relief.

    Other associated symptoms and signs are:

    • Sweating
    • Breathlessness
    • Vomiting
    • Nausea
    • Dizziness
    • Fast or irregular heartbeat
    • Radiating chest pain to the neck, arms, and shoulders

    Related article: 
    Heart Attack vs Cardiac Arrest – What’s the Difference? 

    3. Chest wall pain

    Chest wall pain is generally harmless and felt as sharp pain or tenderness in the bones, cartilage or muscles that make up the chest wall.

    Possible causes include: Injury, prolonged coughing, strained chest muscles, cartilage inflammation of the rib cage (costochondritis) and pain caused by the gastrointestinal tract (e.g. gastroesophageal reflux or peptic ulcer disease).

    4. Pulmonary embolism

    A blood clot in a lung artery – a condition called pulmonary embolism – could also cause sudden, sharp chest pains. This is associated with immobilisation of the legs for a long time, e.g. long distance travel in a coach or plane. Clots form in the veins of the leg and are dislodged into the arteries of the lungs. This condition reduces blood flow to the lungs and therefore oxygenation of the blood. The chest pains are often accompanied by breathlessness and a fast heartbeat. The pain worsens when you cough or take deep breaths. Pulmonary embolism is a medical emergency.

    5. Aortic dissection

    This is due to splitting of the layer of the wall (dissection) of the aorta, the main artery in the body and is usually related to very high blood pressure. The pain is usually described as a tearing pain in the chest, radiating to the back. The dissection may extend into the origin of the aorta and block off one or more of the coronary arteries, leading to a heart attack. Aortic dissection is also a medical emergency.

    “Chest pains have many underlying causes. Treat any sudden, severe and recurring chest pains not relieved by rest as a medical emergency,” Adj Assoc Prof Wong advises.

    Ref: T12

    Other articles you may be interested in:

    Heart Palpitations: When Are They Serious?

    How a Viral Infection Can Affect the Heart

    How to Survive a Heart Attack When Alone

    Chest pain in teens: When to worry

    Few things can cause a parent’s heart to stand still like having a teenage child complain of chest pain. Unfortunately, it’s a common complaint. According to national data from 2016, people aged 15 to 24 years comprise 14.2% of all emergency room visits and chest pain is one of the top diagnoses.

    Many people have experienced chest pain, and a variety of words are used to describe it, ranging from dull to squeezing. There are equally as many causes, the most serious of which usually involve the heart or lungs. Luckily, in teenagers, the most serious are not the most likely.

    Frequently, the cause of chest pain in teens is chest wall pain. The chest wall includes the skin, fat, muscles, and bones that form a protective structure around the heart, major blood vessels, lungs, and esophagus. The bones in the chest wall include the ribs, sternum (breastbone), and spine. No wonder there are so many ways to have chest wall pain.

    A leading cause of chest wall pain in teens is costochondritis –­­­ inflammation of the cartilage that connects a rib to the sternum, causing sharp chest pain which worsens with a deep breath. Costochondritis usually has no apparent cause and can last for several weeks or longer. Chest wall pain can also result from rib trauma or sore muscles due to chronic pain syndromes like fibromyalgia.

    Deeper in the chest is the esophagus, no stranger to chest pain. Teens can have gastroesophageal reflux disease (GERD), which occurs when stomach acid flows backwards and irritates the lining of the esophagus. Symptoms often occur after eating or when lying down at night.

    And let’s not forget the mind-body connection; stress, anxiety, and panic attacks can all cause chest pain. Panic attacks are dreadful and include rapid heartbeat, shortness of breath, sweating, nausea, dizziness, and a fear of dying.

    Less often, chest pain in teenagers can be related to the lungs, heart, or blood vessels. For example, a pneumothorax is the sudden collapse of a lung without any apparent cause. Symptoms are sudden onset of chest pain and shortness of breath. Pericarditis is inflammation of the membrane surrounding the heart. It causes sharp pain that gets worse with breathing deeply and lying down. Usually a virus is to blame.

    When it comes to chest pain, genetics count. Inherited conditions such as the factor V Leiden mutation can lead to a pulmonary embolism – a blood clot that travels from a leg and lodges in a lung. Symptoms include chest pain that worsens with breathing deeply, shortness of breath, and cough.

    Hypertrophic cardiomyopathy (HCM) is a usually inherited disease in which the heart muscle becomes abnormally thick. A small number of people with HCM experience chest pain, shortness of breath, or an irregular heartbeat (arrhythmia). Due to the arrhythmia, HCM is the most common cause of heart-related sudden death in athletes and in people under age 30. Any teenager with a family member who has HCM should be screened for it by a cardiologist.

    Certain inherited syndromes including Marfan, Ehlers-Danlos, and Turner can lead to aortic root dissection, another life-threatening condition that causes chest pain. In aortic root dissection, the inner layers of the main artery of the body separate. The aorta then ruptures causing sudden severe chest pain with a tearing or shearing sensation.

    My advice: Even though chest pain in teenagers is usually not serious, it’s important to take it seriously. If it’s severe and sudden, please call 911 or go to the nearest emergency room. Otherwise, make an appointment for your teen’s primary care provider (PCP) to do a complete history and physical examination. The PCP might order tests such as an EKG or chest x-ray and/or refer your teenager to a cardiologist.

    Rima Himelstein is a pediatrician and adolescent medicine specialist at Nemours/Alfred I. duPont Hospital for Children.

    Have you experienced precordial catch syndrome?

    Precordial Catch Syndrome is characterised by a sharp, stabbing pain that is painful to breathe through.

    Have you ever felt a sharp pain in your ribs, that hurt when you breathed in, then quickly disappeared? While you might have panicked for a second thinking it was a heart attack, it’s possible you were actually experiencing precordial catch syndrome, a mysterious condition that can cause sharp and sudden pains in the ribs.

    What is Precordial Catch Syndrome?

    Precordial catch syndrome (PCS), or as it’s sometimes known, “Texidor’s Twinge”, is a condition that causes a sharp pain in the ribs that comes on and disappears quickly. PCS is often experienced by otherwise healthy children and adolescents.

    The syndrome is characterised by a sharp, stabbing pain that is painful to breathe through, often on the upper left-hand side of the ribs. The good news is that the pain will usually go away by itself within a few minutes and doesn’t cause any health problems.

    Doctors don’t quite know what causes PCS, though it’s thought it might have something to do with irritation of the nerves that line the chest wall. Some also think that PCS is more common during growth spurts. It seems to happen most when a child is at rest, sitting or lying down, and isn’t accompanied by other symptoms. The syndrome becomes much less common after the age of 20.

    What to do if my child has chest pains?

    It’s always wise to treat chest pain seriously. If there are any other symptoms accompanying your child’s pain, like nausea, vomiting, headache, dizziness or shortness of breath, or the pain doesn’t go away quickly, you should seek immediate medical help.

    Unexplained chest pain might cause you or your child some understandable anxiety. Even if your child’s chest pain is brief and doesn’t seem to be connected to other health concerns, raise it with your GP. If it’s PCS, have them explain what’s happening to you and your child, so the condition doesn’t keep causing you unnecessary worry.

    You can always call 13 HEALTH (13 43 25 84) 7 days a week, 24 hours a day, with any questions about your health or your child’s health. If you think the situation is an emergency, call Triple Zero (000) for an ambulance straight away.

    90,000 Cause of chest pain

    09 November 2016

    Cause of chest pain: neuralgia or heart? For the time being, the prospect of heart disease seems distant and hazy to most people. But sooner or later, almost every adult is faced with extremely unpleasant sensations: sudden chest pain. It is unlikely that one will be able to console oneself at this time with the thought that it is too early for a heart attack: if a person is impressionable, he, as a rule, experiences panic and fear of imminent death.Meanwhile, pains of a neuralgic nature can very often be confused with heart pains. Today we will talk about how to distinguish one type of pain from another, why neuralgia and chest pain occur, and how to maintain your health. Symptoms of chest pain: similarities and differences People who do not like to see a doctor (especially men) often prefer to endure a pain attack, stopping it with an anesthetic drug. But the cost of a mistake in chest pain can be prohibitively high: if you do not seek help in time for a heart attack, a person can die.On the other hand, many first of all sin on the heart – after all, it is it that is located in the chest, and intercostal neuralgia, in theory, should be located on the side, between the ribs? In fact, the localization of pain can be different, in addition, pain can be felt both in the arm and in the back. The main difference between a heart attack and neuralgia is the duration: attacks of intercostal neuralgia can be quite long, up to several days. Heart pain is short – for example, an attack of angina pectoris lasts about 5-10 minutes.Neuralgic pains are acute, and angina pectoris pain is dull, burning, with a lack of air. In the old days, angina pectoris was called “angina pectoris” precisely because of the feeling that a heavy and cold toad was sitting on the chest. Pain with angina pectoris extends to the entire chest area, and a person finds it difficult to point out exactly where he hurts. With neuralgia, however, it is usually possible to accurately localize the main site of pain. Another very characteristic sign of neuralgia is a decrease or increase in the intensity of pain depending on the position of the body, inhalation and exhalation.Heart pain does not depend on the position of the body, with one exception – with myocardial infarction, the pain during movement just intensifies. A nitroglycerin tablet can stop an attack of heart pain, but it cannot stop the development of a heart attack. Therefore, if the pain continues after taking nitroglycerin, you must immediately call an ambulance. Why do chest pains occur? The logical question is – if a person’s health was in relative order, why do attacks occur immediately with great intensity? In fact, few people are regularly examined by a cardiologist.Most cases of angina pectoris are so-called exertional angina, which occurs after physical or emotional stress. If the attack occurred after sleep, then this is angina at rest. Actually, angina pectoris is a violation of the blood supply in the human heart muscle. Such constant oxygen starvation leads to the development of coronary heart disease and heart attack. The main risk factors here are: arterial hypertension; violation of fat metabolism and atherosclerosis; violation of carbohydrate metabolism and increased blood sugar levels; congenital or acquired heart defects.Intercostal neuralgia is pain passing along the trunk and branches of any of the intercostal nerves (there are 11 pairs of them, and 12 pairs are subcostal nerves). It occurs due to compression, irritation or inflammation of the nerve. There are a lot of reasons for the appearance of neuralgia – these are problems with the spine (osteochondrosis, displacement and herniated intervertebral discs), infections (including influenza), sciatica, neuritis, trauma, hypothermia, excessive muscle tone and others. Which doctors to seek help If you are seeking emergency help, doctors will help you navigate this issue, excluding or confirming heart problems. If you have had an attack of angina pectoris, then you cannot do without examination by a cardiologist. However, even if the attack turned out to be neuralgia, the cardiologist is worth a visit. With neuralgia, things are a little more complicated – first of all, you will need to visit a neurologist, take an X-ray or undergo a tomography. After the reason is found out, the doctor will be able to give recommendations for treatment or refer you to consultations with other specialists – for example, an osteopath. Chest pain: what to do The first step is to stop any physical activity and sit or lie down.Often it is not possible to lie flat – in this case, you need to take a reclining position, placing pillows under your back. Provide fresh air in the room, open the collar of a shirt or blouse. If the cause of the pain is not clear, you should immediately take 1-2 tablets of nitroglycerin. If it was not there – at least validol, valocordin or their analogs. In order to calm down, you need to additionally take valerian or corvalol. It should be borne in mind that nitroglycerin can dramatically lower blood pressure. If the pain persists within 10-15 minutes, call an ambulance.If the pain is acute, not changing with a change in body position, an ambulance should be called immediately. With an attack of neuralgia, you can take painkillers, wrap your chest with a warm scarf, use ointments with a warming and analgesic effect. In the future, the doctor may prescribe physiotherapy sessions, novocaine nerve blocks, acupuncture. If the cause of repeated attacks of neuralgia is osteochondrosis, then you should seek help from a chiropractor, attend massage therapy and gymnastics.During an exacerbation of neuralgia, you cannot sleep on a soft surface: the mattress must be hard. Try to remain calm during an attack of chest pain, but in no case neglect a doctor’s examination, even if it seems to you that the attack has passed without a trace.

    Heart pain? Chest pain?

    One of the most alarming symptoms for humans is chest pain. It is not only painful, but also often signals dangerous diseases of the lungs or heart.Faced with pain syndromes in the chest, you must immediately consult a doctor in order to identify its cause.

    In our cardiology center, we carry out emergency complex diagnostics of the chest. It allows you to quickly and accurately determine the cause of the pain syndrome and begin to relieve pain and comprehensive treatment of the disease.

    How is the complex diagnostics carried out?

    Our cardiology center has a full range of modern devices required for a comprehensive examination.First of all, an electrocardiogram is taken for the patient, then ultrasound examinations of the heart and lungs are performed. If necessary, a chest x-ray is taken to assess the condition of the heart and lungs. During the research, only the most modern equipment (made in Germany and Japan) and disposable consumables are used.

    Also in our cardiology center we use an innovative diagnostic method – NLS-graphy of the chest and heart. This unique study allows you to assess the health of a patient down to the cellular level.It provides the doctor with invaluable information about a person’s health, including about his genetic predisposition.

    If necessary, patients are assigned tests. We have our own and modern medical laboratory and can guarantee the speed and accuracy of analyzes. The whole complex of diagnostics is selected individually for each patient, according to symptoms and complaints.

    How is the treatment going?

    Based on the information received during the diagnosis, our cardiologists quickly relieve pain and begin complex treatment of the disease that caused it.Our clinic employs only experienced cardiologists with many years of experience, including candidates and doctors of science. If necessary, a medical consultation is convened.

    In the event that chest pains are caused by pulmonary problems, a pulmonologist is involved in the work. If the pain is neurological, the patient is referred to the neurology department.

    Thus, you can be sure that you will always be working with experienced narrow-profile specialists who will find the best way to solve your problems.

    The main causes of chest pain
    • Cardiovascular disease
    • Low physical activity
    • Severe physical stress
    • Frequent stress
    • Meteorological dependence
    • Smoking and drug addiction
    • Overweight
    • )
    • Ischemic heart disease (angina pectoris)
    • High blood pressure
    • Inflammation of the heart muscle
    • Damage to the organs of the heart and lungs by viruses and microorganisms
    • Insufficient oxygen supply
    • Functional diseases of the nervous system
    • Violations of the normal rhythm of the heart
    • Stomach problems and esophagus
    • Heart pain with pneumonia
    • General intoxication with influenza and acute respiratory infections
    • Inflammation of the pleura 9003 2
    • Degenerative diseases of the spine
    • Intercostal neuralgia
    • Psychogenic pain associated with neurosis, increased anxiety, mental illness

    Do not delay or tolerate the pain, it can be very dangerous.
    Contact us at the first symptoms. We really help!

    Chest pain

    Chest pain can occur with various diseases, it is sometimes difficult to understand it right away even for a doctor, therefore, patients with such complaints are usually subjected to additional examination. Diseases of the heart, respiratory system, gastrointestinal tract, spine, mediastinum, central nervous system can manifest themselves with chest pains.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, the nerve trunk branches out to individual organs. That is why sometimes stomach pains can be felt like pain in the heart – they are simply transmitted to the common trunk, and from it to another organ. Moreover, the roots of the spinal nerves contain sensory nerves that innervate the musculoskeletal system. The fibers of these nerves are intertwined with the fibers of the nerves of the autonomic nervous system, and therefore a perfectly healthy heart can react with pain in various diseases of the spine.

    Finally, chest pains can depend on the state of the central nervous system: with constant stress and high neuropsychic stress, a malfunction occurs in its work – neurosis, which can also manifest itself as pain in the chest.

    Some chest pains are unpleasant, but not life-threatening, but there are chest pains that need to be relieved immediately – a person’s life depends on it. In order to figure out how dangerous chest pain is, you need to see a doctor.Perhaps it will save your life or calm you down if no serious health problems are found.

    Causes of chest pain

    • Heartburn. Acidic stomach acid from the stomach into the esophagus (the tube that connects the mouth to the stomach) can cause heartburn, an excruciating burning sensation in the chest. It is often combined with a sour taste and belching. Chest pain with heartburn is usually food-related and can last for hours.This symptom most often occurs when bending over or lying down. Eases heartburn by taking antacids.

    • Panic attacks. If you are experiencing bouts of unreasonable fear, combined with chest pain, rapid heartbeat, hyperventilation (rapid breathing) and profuse sweating, you may suffer from “panic attacks” – a kind of dysfunction of the autonomic nervous system.

    • Pleurisy.Acute, limited chest pain that worsens with inhalation or coughing may be a sign of pleurisy. The pain is caused by inflammation of the membrane that lines the inside of the chest cavity and covers the lungs. Pleurisy can occur with various diseases, but most often – with pneumonia.

    • Tietze’s syndrome. Under certain conditions, the cartilaginous parts of the ribs, especially the cartilage that attach to the sternum, can become inflamed. The pain in this disease can occur suddenly and be quite intense, mimicking an attack of angina pectoris.However, the location of pain may vary. In Tietze syndrome, pain may worsen when pressing on the sternum or ribs near the sternum. Pain in angina pectoris and myocardial infarction does not depend on this.

    Osteochondrosis of the cervical and thoracic spine leads to the so-called vertebral cardialgia, which resembles angina pectoris. In this condition, there is intense and prolonged pain behind the sternum, in the left half of the chest. Irradiation to the hands, interscapular region may be noted.The pain increases or decreases with changes in body position, head turns, arm movements. The diagnosis can be confirmed with an MRI scan of the spine. Magnetic resonance imaging of the spine will help determine the cause of chest pain if it is caused by pinching of the nerve roots or the presence of herniated intervertebral discs.

    • Pulmonary embolism. This type of embolism develops when a blood clot enters the pulmonary artery, blocking blood flow to the heart.Symptoms of this life-threatening condition may include sudden, sharp chest pain that occurs or worsens with deep breathing or coughing. Other symptoms are shortness of breath, palpitations, anxiety, loss of consciousness.
    • Other lung diseases. Pneumothorax (collapsed lung), high pressure in the vessels supplying the lungs (pulmonary hypertension), and severe bronchial asthma can also present with chest pain.
    • Muscle diseases. Pain caused by muscle diseases, as a rule, begins to bother when turning the body or raising the arms.Chronic pain syndrome such as fibromyalgia. May cause persistent chest pain.
    • Rib injury and nerve entrapment. Bruises and fractures of the ribs, as well as entrapment of the nerve roots, can cause pain, sometimes very severe. With intercostal neuralgia, pain is localized along the intercostal spaces and increases with palpation.
    • Diseases of the esophagus. Some diseases of the esophagus can cause swallowing problems and therefore chest discomfort.Esophageal spasm can cause chest pain. In patients with this disorder, the muscles that normally propel food through the esophagus do not work in a coordinated manner. Because esophageal spasm can resolve after taking nitroglycerin – just like angina – diagnostic errors are common. Another swallowing disorder known as achalasia can also cause chest pain. In this case, the valve in the lower third of the esophagus does not open properly and does not allow food to enter the stomach. It stays in the esophagus, causing discomfort, pain, and heartburn.
    • Shingles. This infection, caused by the herpes virus and affecting the nerve endings, can cause severe chest pain. Pain can be localized in the left side of the chest or be shingles in nature. This disease can leave behind a complication – postherpetic neuralgia – the cause of prolonged pain and increased skin sensitivity.
    • Diseases of the gallbladder and pancreas. Gallstones or inflammation of the gallbladder (cholecystitis) and pancreas (pancreatitis) can cause pain in the upper abdomen that radiates to the heart.
    • Myocardial infarction – a blood clot that blocks the movement of blood in the arteries of the heart can cause pressing, constricting chest pains lasting more than a few minutes. The pain can radiate (radiate) to the back, neck, lower jaw, shoulders and arms (especially to the left). Other symptoms may include shortness of breath, cold sweats, and nausea.
    • Angina pectoris. Over the years, fatty plaques can form in the arteries of your heart, restricting the flow of blood to your heart muscle, especially during exercise.It is the restriction of blood flow through the arteries of the heart that is the cause of attacks of chest pain – angina pectoris. Angina is often described by people as a feeling of tightness or tightness in the chest. It usually occurs during exercise or stress. The pain usually lasts about a minute and stops at rest.
    • Other causes that may present with chest pain include inflammation of the heart shirt (pericarditis), most often due to a viral infection. Pericarditis pain is most often acute, stabbing.Fever and malaise may also occur. Less commonly, the cause of pain may be a dissection of the aorta, the main artery in your body. The inner layer of this artery can be separated by blood pressure and the result is sharp, sudden and severe chest pain. Aortic dissection can result from chest trauma or a complication of uncontrolled hypertension.

    Since chest pain can result from many different causes, do not self-diagnose or self-medicate or ignore severe and prolonged pain.The cause of your pain may not be so serious – but in order to establish it, you need to contact a specialist.

    Chest pain due to changes in the central nervous system

    Chest pain can also appear 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 of the central nervous system.Neuroses are the body’s response to various mental shocks (intense short-term or less intense, but long-term).

    Pain with cardioneurosis can be of a different nature, but most often they are constant, aching and are felt in 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, pain attacks are accompanied by reactions from the autonomic nervous system in the form of facial flushing, moderate heartbeat, and a slight increase in blood pressure.With cardioneurosis, other signs of neuroses are almost always present – increased anxiety, irritable weakness, etc. It helps with cardioneurosis, the elimination of traumatic circumstances, the correct daily regimen, sedatives, with sleep disorders – sleeping pills.

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

    A similar picture can cause changes in the heart during menopause. These disorders are caused by changes in hormonal levels, resulting in neurosis and metabolic disorders in the heart muscle (climacteric myocardiopathy). At the same time, pain in the heart is combined with the characteristic manifestations of menopause: rush of blood to the face, bouts of sweating, chills and various sensory disturbances in the form of “goose bumps”, insensitivity of certain areas of the skin, etc.e. Just as with cardioneurosis, pain in the heart is not relieved by nitroglycerin, sedatives and hormone replacement therapy help.

    Chest pain in diseases of the spine and ribs

    Chest pains, very reminiscent of heart pains, can occur with various diseases of the spine, for example, with osteochondrosis, herniated intervertebral discs, ankylosing spondylitis, etc.
    Osteochondrosis is dystrophic (metabolic) changes in the spine.As a result of malnutrition or high physical exertion, bone and cartilage tissue is gradually destroyed, as well as special elastic pads between individual vertebrae (intervertebral discs). Such changes cause compression of the spinal nerve roots, which causes pain. If changes occur in the thoracic spine, then the pain can be similar to pain in the heart or pain in the gastrointestinal tract. The pain can be constant or in the form of attacks, but it always intensifies with sudden movements.Such pain cannot be relieved with nitroglycerin or antispasmodics; it can be relieved only by pain relievers or by heat.
    Chest pain can occur when ribs are broken. These pains are associated with trauma and are aggravated by deep breaths and movement.

    Chest pain with lung diseases

    The lungs occupy a significant part of the chest. Pain in the chest can occur against the background of inflammatory diseases of the lungs, pleura, bronchi and trachea, with various injuries of the lungs and pleura, tumors and other diseases.

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

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

    Chest pain: causes, symptoms, treatment, prevention

    Table of contents:


    A feeling of pain or pressure in the chest can be a sign of a minor problem, such as indigestion, or much more serious, such as an angina attack or myocardial infarction. In any case, you should be attentive to the appearance of such pain, especially associated with physical exertion or stressful situations.

    Causes of chest pain

    Myocardial infarction almost always causes pain of varying severity – from moderate to intense. Heart attack pain does not go away quickly. It is impossible to completely relieve pain with rest and medication. Myocardial infarction should also be remembered when severe chest pain occurs during stress and physical exertion, even in fairly young people.

    Attacks of angina pectoris also cause pain similar to myocardial infarction, but this is a different condition.Most angina attacks last about 15 minutes.

    Heartburn can cause burning pain in the chest.

    Exercise, falls, coughing can lead to painful strain on muscles and other tissues of the chest wall. In this case, the pain increases with pressure on the affected area.

    Anxiety, panic may include chest symptoms such as tachycardia (frequent, violent and irregular heartbeats), shallow breathing.Other symptoms of anxiety include anxiety, fear of choking, and fear of death.

    Peptic ulcer and gallbladder diseases also cause pain that can spread to the chest.

    Pulmonary embolism is the presence of a blood clot in an artery from the heart to the lungs. Risk factors for pulmonary embolism include surgical interventions in the past 6 weeks, wearing plaster casts, prolonged sitting on airplanes, cars, conditions that limit mobility.Symptoms of thromboembolism include sudden intermittent breathing, sudden chest pain that gets worse when breathing, and sometimes coughing up blood.


    Immediate medical attention required:

    • chest pain, loss of consciousness or coughing fit after exercise;
    • Burning pain or pressure in the chest that extends to the shoulder, back, neck and lower jaw;
    • 90,031 chest pain lasting more than 15 minutes, which does not relieve after rest;

    • Pain and tightness in the chest with an unstable or fast heart rate, shallow breathing, nausea or vomiting, increased sweating, dizziness, restlessness, or fainting;
    • Sudden severe chest pain and shortness of breath or coughing up blood.

    It is imperative to consult a doctor:

    • Pain that feels like heartburn but is not relieved by over-the-counter heartburn medications
    • chest pain after eating, requiring regular antacids.

    What You Can Do

    If you suspect you or your loved ones have a myocardial infarction, call an ambulance immediately.

    Take a pain reliever such as paracetamol to relieve tension in your chest muscles.Apply hot and relax your muscles. If the pain is associated with eating or, on the contrary, occurs on an empty stomach, try to eat fractionally.

    What a doctor can do

    Asking you about your family history of cardiovascular disease, your current symptoms, and any medications you are taking.

    Perform physical examination to determine if pain is related to heart disease or not.

    Conduct necessary examinations, including ECG, exercise stress test, coronary angiography (a series of X-rays of the heart vessels), stomach studies, etc.

    Prevention of heart attack and angina pectoris

    Exercise regularly, walk. In no case, do not start playing sports or physical education immediately with heavy loads. Before starting classes, visit your doctor and make sure that the program you choose will only benefit you.

    Maintain the optimal weight for you.

    Control risk factors for atherosclerosis such as high blood pressure, cholesterol, diabetes.

    Patients with diabetes should regularly monitor their blood sugar levels.

    Eat regularly.

    Be sure to visit your doctor regularly and do the necessary research. Any health problem is easier to prevent or to deal with early on.

    90,000 reasons, what to do, how to treat

    Chest pain on the left is an alarming and even frightening symptom that is rarely ignored. People take such localization of pain seriously, since they usually associate them with problems of the cardiovascular system.

    Causes of chest pain on the left

    In fact, the chest on the left can hurt for a variety of reasons. In most cases, they are indeed associated with diseases of the cardiovascular system, but problems with other organs can also cause pain. On the left side is not only a part of the heart muscle, but also other important organs: for example, the left lung and bronchus. In addition, pain can radiate to the left side of the sternum from the spine or the digestive system.

    Cardiovascular diseases

    Cardiovascular diseases most often cause characteristic chest pain on the left. These can be conditions that threaten a person’s life or indicate the development of serious diseases.

    Heart attack and ischemia

    Pain in the chest on the left, radiating to the arm, is a typical sign of a heart attack, when the heart muscle becomes inflamed and atrophied. And the precursor of this disease is coronary heart disease, which occurs as a result of impaired blood flow due to atherosclerosis.


    If the chest pain on the left hurts sharply, this may be a sign of pericarditis. Pericarditis is an inflammation of the bursa caused by infections and autoimmune processes. Pericarditis is easy to mistake for a heart attack, but the pain of pericarditis is reduced when the person is standing.


    Angina is an attack of pain in the chest on the left, similar to myocardial infarction. But it arises as a result of strong feelings, emotional upheavals and lasts no more than 5 minutes.Angina occurs due to insufficient blood supply to the heart. If chest pain on the left lasts more than 5-7 minutes, it may be a sign of myocardial infarction.

    Aortic aneurysm

    Sharp tearing pain in the chest on the left is one of the signs of an aortic aneurysm. Aortic aneurysm is a pathological enlargement of an artery that threatens human life. It is accompanied by difficulty breathing, numbness of the limbs, difficulty speaking. Death is possible as a result of rupture of the aorta, so this pathological condition is especially dangerous.

    Respiratory diseases

    The human chest contains not only the heart, but also the bronchi and lungs. Therefore, chest pain on the left can be a sign of diseases of the respiratory system, among which there are also serious pathological conditions.


    Acute chest pain on the left, aggravated by inhalation, is characteristic of pleurisy. The membrane of the lungs – the pleura – becomes inflamed in infectious diseases and secretes a special secret that irritates the nerve endings and causes pain.Pleurisy accompanies pneumonia and other infectious diseases of the lungs.

    Spontaneous pneumothorax

    If the integrity of the pleura is compromised (usually due to injuries), air enters the lungs during inhalation, which causes pain. Pain in the left side of the chest is accompanied by shortness of breath, weakness, and dizziness. The cause of spontaneous pneumothorax may be damage to the pleura as a result of chronic diseases.


    With emphysema, the lungs lose the ability to get rid of excess air, which occurs due to the loss of elasticity in the walls of the bronchi.Pain in the chest to the left or above the chest can occur due to this serious condition, which gives complications in the form of pneumothorax and respiratory failure. This dangerous condition needs immediate treatment.

    Pulmonary embolism

    The lungs are supplied with oxygen through the blood vessels, and a blood clot entering the pulmonary artery is called an embolism. This disease manifests itself as aching pain in the chest on the left and breathing problems.Pulmonary embolism is characterized by increased pain during deep inspiration. It is not associated with cardiovascular disease, but it poses a potential threat to human life.

    Spine problems

    The spine is associated with many organs, so vertebral pain often radiates to the sternum. Often, pressing dull pain on the left in the chest can indicate problems in the thoracic spine.


    Pain in the chest and back on the left with osteochondrosis usually appears at a serious stage of the disease, when complications arise in the form of a vertebral hernia.In the thoracic region, osteochondrosis is the most difficult, since it is often accompanied by difficulty breathing and limited freedom of movement.


    With injuries to the sternum, aching or sharp pain in the chest on the left may appear, sometimes this is a sign of a fractured rib in the left side of the chest. The nature of the pain depends on the severity of the injury. In some cases, with spinal injuries, the pain radiates to the left side of the chest.

    Other causes of chest pain on the left

    In some cases, chest pain on the left can be a sign of gastrointestinal disease.With reflux, this is due to the fact that hydrochloric acid enters the esophagus. Reflux is a consequence of gastrointestinal diseases and other chronic pathological conditions. Also, a sharp sharp pain in the chest on the left is characteristic of a stomach ulcer, if the disease began and develops rapidly. It is with a stomach ulcer that it is most difficult to diagnose the cause of pain.


    Such a complex symptom as aching or sharp pain in the chest on the left needs careful diagnosis.Where exactly to look for its cause, therapist decides, collecting detailed information about the circumstances under which the pain occurs, and the patient’s state of health. If necessary, the patient can be referred to a specialized specialist neurologist . Often, the diagnosis begins with the exclusion of diseases of the cardiovascular system – ECG and a visit to cardiologist , if necessary, the patient is prescribed echocardiogram . In other cases, blood tests, endoscopic, ultrasound and X-ray studies can be prescribed to diagnose diseases that cause chest pain on the left.


    Left chest pain is a potentially serious and unpleasant symptom that will not go away unless the underlying condition is corrected. The success of the treatment is predetermined by the correct diagnosis. With the correct diagnosis, treatment of left chest pain can be carried out in different ways, depending on the type of disease, both conservative and operational. Also, the choice of treatment is dictated by the stage of the identified disease.

    90,000 to be tested in the KDLmed laboratory

    Chest pain – any pain or discomfort in the chest area.It can be caused by various diseases, including pathology of the heart, blood vessels, pericardium, lungs, pleura, trachea, esophagus, muscles, ribs, nerves. In some cases, chest pain is a sign of damage to organs outside the chest, such as the stomach, gallbladder, or pancreas.

    Chest pains are very diverse: sharp, dull, aching, cutting, stabbing, pulling, bursting, burning or pressure. Painful sensations differ in different diseases, but pain is not a specific symptom of a particular disease.Pain characteristics may vary depending on the age, gender of the patient, comorbidities, and psychological characteristics. Determining the immediate cause of chest pain is often challenging and requires a number of diagnostic procedures.

    It is one of the most alarming symptoms, as it can be a manifestation of severe, life-threatening conditions that require emergency medical care, in particular myocardial infarction.

    Russian synonyms

    Thoracalgia, chest pain, chest pain

    English synonyms

    Chest pain, pain in the chest, thoracalgia.


    Chest pain can be of various types. Sometimes it is given to the arm, shoulder, shoulder blade, back, neck. The patient may complain not only of pain, but also of tightness, burning, discomfort in the chest area.

    Unpleasant sensations can be aggravated by coughing, deep breathing, swallowing, pressing on the chest, changing the position of the body (constant or periodic). Pain and discomfort in the chest may be accompanied by a number of additional symptoms, depending on the underlying disease: belching or bitterness in the mouth, nausea, vomiting, difficulty swallowing.

    General information about the disease

    Chest pain is a manifestation of various diseases, each of which requires a specific medical approach.

    • Acute myocardial infarction (heart attack). Acute chest pain in people over 40 is most often associated with this disease. Myocardial infarction occurs when an area of ​​the myocardium is damaged and destroyed as a result of circulatory disorders in the coronary vessels. Most often, it manifests itself as acute pain behind the sternum or to the left of the sternum, which radiates to the back, neck, shoulder, arm and does not decrease when taking nitroglycerin or at rest.Symptoms vary from patient to patient. Elderly women are characterized by atypical symptoms: severe weakness, nausea and vomiting, rapid breathing, abdominal pain.
    • Angina pectoris. A condition in which, as a result of atherosclerosis and narrowing of the coronary vessels, the blood supply to the heart muscle is disrupted. Pain in angina pectoris resembles those in myocardial infarction, however, it occurs during exercise, decreases at rest and is stopped by nitroglycerin.
    • Aortic dissecting aneurysm.The aorta is a large vessel that carries blood from the left ventricle of the heart to organs and tissues. With a dissecting aneurysm, the intima (inner lining) of the aorta ruptures with the penetration of blood into other layers of the aortic wall and subsequent dissection of the wall, which most often leads to a complete rupture of the aorta and massive internal bleeding. In most cases, the disease ends in death within a few hours or days, even with timely diagnosis and timely treatment.

    Aortic dissecting aneurysm is most often a consequence of long-term arterial hypertension, and can also occur in Marfan syndrome, as a result of chest trauma, during pregnancy, or as a late complication of heart surgery.

    Pain with dissecting aortic aneurysm is similar to pain with myocardial infarction and angina pectoris, can last for several hours or days, does not decrease at rest or when taking nitroglycerin.

    • Pulmonary embolism. Blockage by a thrombus of the pulmonary artery or its branches, through which venous blood flows from the right ventricle to the lungs for oxygenation. As a result, gas exchange is disrupted, hypoxia occurs, and the pressure in the pulmonary arteries increases. Chest pain occurs suddenly, increases with a deep breath, is accompanied by rapid breathing and, in some cases, hemoptysis. The risk of thromboembolism increases after surgery, prolonged forced immobility, pregnancy, taking oral contraceptives, especially in combination with smoking, and cancer.
    • Pneumothorax. The accumulation of air or other gas in the pleural space – the slit-like space between the membranes that line the surface of the lungs and the inner surface of the chest. It is accompanied by acute chest pain, rapid breathing, anxiety, loss of consciousness.
    • Pericarditis. Inflammation of the heart sac (pericardium), that is, the serous membrane of the heart. The pain occurs due to the friction of the inflamed pericardial layers. Pericarditis can result from a viral infection, rheumatoid arthritis, systemic lupus erythematosus, and renal failure.Idiopathic pericarditis, that is, pericarditis of unknown etiology, is common. The pain is acute, occurs only in the initial stages of the disease, may be accompanied by rapid breathing, fever, and malaise.
    • Mitral valve prolapse. Pathology of the valve, which is located between the left atrium and the left ventricle of the heart. In some people, the mitral valve flexes into the atrium when the left ventricle contracts, and some of the blood from the left ventricle flows back into the left atrium.For most patients, this does not cause unpleasant sensations, however, some have an increased heart rate and chest pains that do not depend on physical exertion and do not radiate, unlike angina pectoris.
    • Pneumonia. Inflammation of the lung tissue. Chest pain with pneumonia, as a rule, is one-sided, aggravated by coughing, accompanied by fever, malaise, and cough.
    • Esophagitis. Inflammation of the esophagus. It is accompanied by chest pain, swallowing disorder. Symptoms do not improve with antacids.
    • Gastroesophageal reflux disease. A chronic condition in which acidic stomach contents are thrown into the esophagus, causing damage to the lower esophagus. In this case, there may be acute, cutting pain in the chest along the esophagus, heaviness, chest discomfort, belching, bitterness in the mouth, impaired swallowing, dry cough.
    • Pleurisy. Inflammation of the pleura. Friction of the inflamed pleural layers causes pain. Pleurisy can be the result of a viral or bacterial infection, cancer, chemotherapy or radiation therapy, rheumatoid arthritis.
    • Rib fracture. In this case, the pain increases with deep breathing and with movement.
    • Other causes: pancreatitis, gallstone disease, depression.

    Who is at risk?

    • People over 40.
    • Obese.
    • Patients with arterial hypertension.
    • People with high blood cholesterol levels.
    • Recently suffered

    Chest pain. What causes and when is a cardiologist needed?

    Chest pain is a common situation with which people come to a cardiologist.It is believed that “the heart is always to blame for everything.” Fortunately, this is not always the case. In this article I want to tell you: what are the reasons leading to this condition and which doctor should be consulted.

    1. Intercostal neuralgia.

    Perhaps the most common cause of chest pain.

    ⚡ What pain? Of varying intensity, localized along one or more ribs, often on one side. The nature of the pain changes depending on the inclinations, turns of the body, and intensifies at the time of a deep breath.General condition does not suffer

    ❗ What provokes? Usually this is a prolonged uncomfortable position of the body (work on a conveyor belt in a static position, a long journey), general hypothermia of the body is possible (swimming in cool water, strong wind)

    What to do? It is possible to help yourself on your own by smearing the problem area with an anti-inflammatory gel (for example Diclofenac) and consult a neurologist.

    2. Herpes zoster.

    Occurs in people who once had chickenpox

    ⚡ What Pain? Of varying intensity (from minor discomfort to very strong, exhausting.Occurs along one (or several) edges. Can “give” to the spine. Sleep is often disturbed and the general condition suffers – the temperature rises (up to high numbers – 40-41 s), there is a headache, weakness, chills, nausea. After a few days, redness appears in the painful area, and then bubbles with transparent contents.

    ❗ What provokes? Virus of the herpes family. Very often, the disease starts after a viral infection (ARVI), against the background of HIV or cancer, chronic stress, pregnancy.

    What to do? Self-medication for herpes zoster is unacceptable. It is necessary to consult a physician or dermatologist as early as possible.

    3. GER (gastroesophageal reflex). Heartburn

    ⚡ What pain? It occurs behind the breastbone, more often after eating a certain food (alcohol, spicy food, citrus fruits, chocolate, cheese, carbonated drinks). Sometimes it is associated with bending the body forward or taking a horizontal position immediately after eating. May occur at night. May be combined with stomach pain and nausea.

    ❗ What provokes? Errors in food, alcohol. Often, heartburn occurs in pregnant women (after 20 weeks). This is due to the fact that the growing uterus presses on the diaphragm.

    What to do? See a physician or gastroenterologist. In 100% of cases, your doctor will recommend you endoscopy of the esophagus and stomach (EGD). After the results of the examination, the therapy will be selected individually.

    4. Fractures / cracks of ribs

    ⚡ What pain? Usually high intensity, local.Increases sharply when trying to take a deep breath

    ❗ What provokes? Injury to the chest (usually a car accident – a blow with the chest on the steering wheel), falling from a height (including one’s own body). In older patients, it may be falling out of bed. It is important to remember that pain does not always occur at the time of injury, it can increase over the course of several hours or even days.

    What to do? Take an analgesic and urgently go to the emergency room.

    Now consider the situation: When is it still necessary to see a cardiologist?

    1.The pain came on suddenly (sometimes stress, physical activity, smoking tobacco and tobacco-based mixtures, the use of energy drinks (especially in combination with alcohol), drugs can be a provocateur. But most often the pain occurs “from scratch.”

    2. The pain is localized behind the sternum, may radiate to the left arm, left jaw, left half of the neck. May be accompanied by weakness, sweating, fear of death. It is important to remember: vomiting at the height of pain does not exclude its “heart” nature

    3.Duration – a few minutes, but a long one is also possible, during the transition to myocardial infarction

    4. The position of the body does not affect the nature of the pain

    5. Reception of nitroglycerin relieves pain within 2 – 6 minutes. It is important to remember! If this pain occurs for the first time (and you are not registered with a cardiologist), then self-administration of the drug is unacceptable. An urgent need to call an ambulance

    6. Risk factors (may be absent) – age 50+, high blood cholesterol, smoking, chronic stress, physical inactivity, overweight., diabetes.

    Important! Try to always stay in touch with your elderly relatives, teach them to dial the ambulance number from a mobile phone and never lock them alone in the apartment (except for patients with dementia and psychiatric diseases. In this case, the neighbors should have a spare key and your number phone)

    The article was written by V.I. Shendrikova, a cardiologist at the Tsentromed clinic.

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