What are the main causes of chest pain in heart failure. How can you distinguish between heart-related chest pain and other types. What are the latest guidelines for managing heart failure symptoms. How do medications and devices help treat heart failure. Why is cardiac rehabilitation important for heart failure patients. How can patients effectively engage in self-care to manage their condition.

Understanding Chest Pain in Heart Failure

Chest pain is a common and potentially serious symptom experienced by many heart failure patients. It’s crucial to understand the nature of this pain and its implications for your overall health.

Characteristics of Heart-Related Chest Pain

Heart-related chest pain typically manifests as:

• Discomfort or pressure in the chest area
• A burning or aching sensation
• Pain that may radiate to the arms, shoulders, throat, or upper abdomen
• A feeling of fullness or gas-like pressure in the chest

It’s important to note that chest pain can vary in intensity and duration. Some patients describe it as a mild discomfort, while others experience severe, crushing pain.

When to Seek Emergency Help

If you experience chest pain that lasts for more than 15 minutes or is not relieved by rest or prescribed medication (such as glyceryl trinitrate), it’s crucial to seek emergency medical attention immediately. This could indicate a worsening of your heart failure condition or potentially a heart attack.

Types of Heart Failure: Understanding the Differences

Heart failure is not a one-size-fits-all condition. There are several types of heart failure, each with its own characteristics and treatment approaches.

Left-Sided Heart Failure

Left-sided heart failure occurs when the left ventricle, responsible for pumping oxygenated blood to the body, becomes weakened or stiff. This can lead to symptoms such as shortness of breath, fatigue, and fluid buildup in the lungs.

Right-Sided Heart Failure

Right-sided heart failure affects the right ventricle, which pumps blood to the lungs. This type of heart failure can cause fluid retention in the legs, ankles, and abdomen, as well as fatigue and weakness.

Systolic vs. Diastolic Heart Failure

Systolic heart failure occurs when the heart’s ability to contract and pump blood is impaired. Diastolic heart failure, on the other hand, happens when the heart muscle becomes stiff and cannot relax properly between beats. Both types can cause similar symptoms but may require different treatment approaches.

Medications Used in Heart Failure Treatment

A variety of medications are used to manage heart failure symptoms and improve heart function. Understanding these medications can help patients better participate in their treatment plans.

ACE Inhibitors and ARBs

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) help relax blood vessels, making it easier for the heart to pump blood. They can also help reduce blood pressure and protect the heart from further damage.

Beta-Blockers

Beta-blockers slow heart rate and reduce the heart’s workload. They have been shown to improve symptoms and reduce mortality in heart failure patients.

Diuretics

Often called “water pills,” diuretics help remove excess fluid from the body, reducing swelling and easing the burden on the heart.

Aldosterone Antagonists

These medications help the body get rid of excess sodium and water while retaining potassium. They can improve heart function and reduce hospitalizations in certain heart failure patients.

Innovative Devices for Heart Failure Management

Advancements in medical technology have led to the development of several devices that can significantly improve the quality of life for heart failure patients.

Implantable Cardioverter-Defibrillators (ICDs)

ICDs are small devices implanted under the skin that monitor heart rhythm and can deliver an electric shock to restore normal rhythm if a dangerous arrhythmia is detected. These devices can be lifesaving for patients at risk of sudden cardiac death.

Cardiac Resynchronization Therapy (CRT)

CRT devices help coordinate the contractions of the heart’s ventricles, improving the heart’s pumping efficiency. This therapy can significantly reduce symptoms and improve quality of life for some heart failure patients.

Left Ventricular Assist Devices (LVADs)

LVADs are mechanical pumps that help the left ventricle pump blood to the rest of the body. They can be used as a bridge to transplant or as a long-term solution for patients who are not candidates for heart transplantation.

The Importance of Cardiac Rehabilitation in Heart Failure

Cardiac rehabilitation plays a crucial role in the management of heart failure, offering numerous benefits to patients.

Components of Cardiac Rehabilitation

A comprehensive cardiac rehabilitation program typically includes:

• Supervised exercise training
• Nutritional counseling
• Stress management techniques
• Education about heart failure and its management
• Psychosocial support

Benefits of Cardiac Rehabilitation

Participation in cardiac rehabilitation can lead to:

• Improved cardiovascular fitness
• Better control of risk factors such as high blood pressure and high cholesterol
• Enhanced quality of life
• Reduced risk of hospitalization and mortality
• Improved emotional well-being and reduced anxiety and depression

Multidisciplinary Team Approach to Heart Failure Management

Effective management of heart failure often requires the expertise of various healthcare professionals working together as a team.

Key Team Members

A multidisciplinary heart failure team typically includes:

• Cardiologists specializing in heart failure
• Nurses with expertise in heart failure management
• Pharmacists to help manage complex medication regimens
• Dietitians to provide nutritional guidance
• Exercise physiologists to oversee cardiac rehabilitation
• Social workers to address psychosocial needs
• Primary care physicians to coordinate overall care

Benefits of a Team-Based Approach

A multidisciplinary approach to heart failure management can lead to:

• More comprehensive and coordinated care
• Improved patient outcomes
• Reduced hospitalizations
• Better quality of life for patients
• Enhanced patient education and self-management skills

Self-Care Strategies for Heart Failure Patients

Self-care is a critical component of heart failure management. Patients who actively participate in their care often experience better outcomes and improved quality of life.

Key Self-Care Practices

Essential self-care strategies for heart failure patients include:

• Monitoring daily weight and reporting significant changes
• Following a low-sodium diet
• Taking medications as prescribed
• Engaging in regular physical activity as recommended by healthcare providers
• Quitting smoking and limiting alcohol consumption
• Managing stress through relaxation techniques or counseling
• Keeping all medical appointments and follow-ups

The Role of Technology in Self-Care

Modern technology can aid in heart failure self-care through:

• Smartphone apps for medication reminders and symptom tracking
• Wearable devices to monitor heart rate and activity levels
• Telemedicine platforms for remote consultations with healthcare providers
• Online support groups and educational resources

Understanding Heart Failure Through Animations

Visual aids can greatly enhance patients’ understanding of heart failure and its treatments. The European Society of Cardiology has developed a series of nine animations that provide clear, accessible explanations of various aspects of heart failure.

Key Topics Covered in the Animations

The animation series covers essential topics such as:

• How a normal heart functions
• What goes wrong in heart failure
• How the body compensates for heart failure
• The mechanism of fluid accumulation in heart failure
• How a heart attack can lead to heart failure
• The role of heart valves in heart failure

These animations serve as valuable educational tools, helping patients and their families better understand the complexities of heart failure and its management.

Latest Guidelines for Heart Failure Management

The European Society of Cardiology regularly updates its guidelines for heart failure management, incorporating the latest research and clinical evidence. These guidelines provide valuable information for both healthcare providers and patients.

Key Points from the Latest Guidelines

Some important aspects covered in the recent guidelines include:

• Updated classification of heart failure types
• New recommendations for pharmacological treatments
• Guidance on the use of implantable devices
• Emphasis on patient-centered care and shared decision-making
• Recommendations for lifestyle modifications and self-care

Importance of Guideline-Directed Medical Therapy

Adhering to guideline-directed medical therapy has been shown to:

• Improve symptoms and quality of life
• Reduce hospitalizations
• Extend life expectancy for heart failure patients
• Optimize the use of available treatments

Patients are encouraged to discuss these guidelines with their healthcare providers to ensure they are receiving the most up-to-date and evidence-based care for their heart failure.

Navigating Daily Life with Heart Failure

Living with heart failure requires adjustments to daily routines and lifestyle habits. Understanding how to navigate everyday activities can significantly improve quality of life for heart failure patients.

Managing Physical Activity

Regular physical activity is crucial for heart failure patients, but it’s important to approach exercise safely:

• Start slowly and gradually increase activity levels
• Choose low-impact activities like walking, swimming, or cycling
• Pay attention to your body and stop if you experience chest pain or severe shortness of breath
• Consult with your healthcare provider about an appropriate exercise plan

Dietary Considerations

A heart-healthy diet is essential for managing heart failure:

• Limit sodium intake to reduce fluid retention
• Choose lean proteins and incorporate more plant-based meals
• Opt for whole grains over refined carbohydrates
• Include plenty of fruits and vegetables in your diet
• Monitor fluid intake as recommended by your healthcare provider

Emotional Well-being

Living with heart failure can be emotionally challenging. It’s important to:

• Seek support from family, friends, or support groups
• Consider counseling or therapy if you’re struggling with anxiety or depression
• Practice stress-reduction techniques like meditation or deep breathing exercises
• Engage in activities you enjoy to maintain a positive outlook

Emerging Treatments and Research in Heart Failure

The field of heart failure treatment is continuously evolving, with new therapies and approaches being developed and studied.

Gene Therapy

Researchers are exploring gene therapy as a potential treatment for heart failure. This approach aims to modify or replace genes to improve heart function and slow disease progression.

Stem Cell Therapy

Stem cell therapy is being investigated as a way to regenerate damaged heart tissue. While still in experimental stages, this approach shows promise for certain types of heart failure.

Novel Pharmacological Approaches

New classes of medications are being developed and tested, including:

• SGLT2 inhibitors, originally developed for diabetes but showing benefits in heart failure
• Myosin activators, designed to improve heart muscle contraction
• Anti-inflammatory agents targeting specific pathways involved in heart failure progression

Artificial Intelligence in Heart Failure Management

AI technologies are being developed to:

• Predict heart failure exacerbations before they occur
• Optimize medication regimens for individual patients
• Analyze large datasets to identify new treatment targets

While these emerging treatments offer hope for the future, it’s important for patients to continue following their current treatment plans and consult with their healthcare providers about any new therapies that become available.

Dealing with Chest Pain and Heart Failure

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ESC Guidelines for Heart Failure – what patients need to know


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Pain due to heart problems is usually felt in the chest, although it can be located anywhere between the upper abdomen (upper trunk) and throat, including the arms and shoulders. It can be experienced as discomfort, pressure, gas, or a burning or aching feeling.

Chest pain should ALWAYS be treated as serious as it could indicate a worsening of your heart failure, angina or a heart attack. You should sit or lie down immediately and rest.

If you experience chest discomfort or pain that lasts for more than 15 minutes or is not relieved by rest or glyceryl trinitrate (GTN/nitroglycerin) (if you have been prescribed this by your doctor), then you should call for emergency help immediately.

ESC Guidelines for Heart Failure

What patients need to know

This guide for patients from the European Society of Cardiology aims to provide an overview of the latest evidence-based recommendations for the diagnosis and treatment of heart failure.

In particular, it should help patients to understand the:

• main types of heart failure
• medicines used to treat heart failure
• devices that may be appropriate
• importance of rehabilitation
• management by a multidisciplinary team
• importance of self-care in managing your own condition

Learn more

Download the Guidelines

AN ANIMATED JOURNEY THROUGH HEART FAILURE

A series of 9 simple, captivating animations explaining heart failure and its treatment.

These narrated animations explain how a healthy heart works, what happens to it in heart failure and how various treatments work to improve your health.

How the normal heart works

What goes wrong in heart failure

How the heart and body compensate in heart failure

How heart failure causes fluid accumulation

How a heart attack can cause heart failure

How abnormal heart valves can cause heart failure

How vasodilators work in heart failure

How diuretics work in heart failure

How medical devices work in heart failure

PATIENT AND CAREGIVERS VIDEOS

In this section you can watch, listen or read interviews with other people with heart failure and their caregivers.

Patient in exercise training

Patient with an ICD

An LVAD as a bridge to transplantation

Adjusting lifestyle and staying optimistic

Living with heart failure devices

Challenges in making the diagnosis

Living with an LVAD

VISIT OUR FACEBOOK PAGE

and share your own views and experiences with other patients, families and caregivers.

https://www.facebook.com/heartfailurematters

heartfailurematters.org is a European Society of Cardiology website

The heartfailurematters.org website was developed under the direction of the Heart Failure Association of the European Society of Cardiology (ESC). The ESC is a world leader in the discovery and dissemination of best practices in cardiovascular medicine. Our members and decision-makers are healthcare professionals who volunteer their time and expertise to represent professionals in the field of cardiology in Europe and beyond.

Do patients with chronic heart failure have chest pain?

. 2013 Jul 15;167(1):185-9.

doi: 10.1016/j.ijcard.2011.12.042.

Epub 2012 Jan 12.

Andrew L Clark 
¹
, Kevin M Goode

Affiliations

Affiliation

• ¹ Department of Academic Cardiology, Castle Hill Hospital, Castle Road, Cottingham, Hull HU16 5JQ UK. [email protected]

• PMID:

  22243939

• DOI:

  10.1016/j.ijcard.2011.12.042

Andrew L Clark et al.

Int J Cardiol.

2013.

. 2013 Jul 15;167(1):185-9.

doi: 10.1016/j.ijcard.2011.12.042.

Epub 2012 Jan 12.

Authors

Andrew L Clark 
¹
, Kevin M Goode

Affiliation

• ¹ Department of Academic Cardiology, Castle Hill Hospital, Castle Road, Cottingham, Hull HU16 5JQ UK. a.l.clark@hull. ac.uk

• PMID:

  22243939

• DOI:

  10.1016/j.ijcard.2011.12.042

Abstract

Objective:

In questionnaire surveys, patients with chronic heart failure frequently report “pain” as a symptom. We investigated the prevalence of chest pain as a possible cause for pain, particularly in patients with prior myocardial infarction.

Design:

Questionnaire survey.

Setting:

Community heart failure clinic.

Patients:

1 786 patients with heart failure due to left ventricular systolic dysfunction (mean ± SD age 70. 1 ± 11.0 years; 73% male; left ventricular ejection fraction (LVEF) 35.3 ± 9.9%; 65.6 with underlying ischaemic heart disease (IHD)).

Intervention:

Patients with chronic heart failure completed a questionnaire.

Main outcome measures:

Answers to the questions: (1) “In the last week, how many days did you get angina chest pain?”; and “In the last month, how much did the following affect you:” (2) “chest pains at rest”; (3) “chest pains during normal activity”.

Results:

73% of those with IHD, and 84% of those without had had no angina in the previous week; 79% and 82%, respectively, had at most “little” chest pain at rest; 67% and 76%, respectively, had at most “little” chest pain during exertion. Angina increased with NYHA class, but there was no relation between angina and sex of patient, age or LVEF. There was a weak relation between chest pain and an adverse outcome in the patients with ischaemic heart disease.

Conclusions:

Although pain is commonly reported in patients with chronic heart failure, it seems unlikely that the pain is due to angina, even in patients with underlying coronary heart disease.

Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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MeSH terms

Chest pain – causes, diagnosis and treatment of chest pain

Chest pain can have a different character and vary in intensity. The condition is called thoracalgia and signals chronic and acute pathologies. Among the causes of pain syndrome: damage to the organs of the gastrointestinal tract, respiratory system, pathology of the musculoskeletal system, neoplasms. Unpleasant sensations are the reason for going to the doctor in order to establish a diagnosis.

Anatomy of the thorax

The thorax is part of the body and protects the vital organs from traumatic impact. It contains the lungs, heart, large vessels. It has the shape of a compressed cone with two holes, called the aperture. The anteroposterior size of the cone is significantly inferior to the transverse one.

The cell is formed by the sternum, a semi-rigid structure of bone tissue and cartilage. It is also represented by ribs, a part of the spine and a muscular frame. Inside is the chest cavity, the central sections of which are occupied by the mediastinum, and the lateral lungs. Below are the curved diaphragm and the upper part of the abdominal cavity.

What to do at home if your chest hurts

Pain may indicate the onset or exacerbation of diseases. Some pathologies are associated with an increased risk of complications or a threat to life. The best solution when a symptom is detected is to contact a medical institution to identify the cause.

How to help yourself

Before starting treatment, you can stop the manifestations as follows:

1. Take a horizontal position. It is necessary to lie on the bed with a pillow or cushion under your head. It is advisable to avoid sudden movements and try not to be nervous.
2. Ensure air supply. You need to open the window, get rid of tight clothes, unfasten the buttons on the collar.
3. Take medicine. The choice of the drug is carried out by doctors, but you can take a nitroglycerin tablet or a non-steroidal anti-inflammatory drug on your own. The first drug is effective for pain associated with damage to the heart muscle, and the second group helps to relieve pain against the background of neuralgia, joint damage.

What not to do

If there is discomfort in the sternum, it is strictly forbidden:

1. Continue physical activity. It is important to stop any activity immediately to reduce the risk of complications.
2. Treat with warm or cool compresses. Until the cause is established, it is impossible to heat or cool the affected part of the chest area.
3. Carries out treatment without medical advice. The patient is not always able to differentiate the cause of the pain syndrome, so the drugs may be ineffective or harm the body.

When to see a doctor urgently

Chest pain in itself is a good reason to see a doctor. For some diseases, you need to call an ambulance without delay. Signs-markers:

1. Sensations arose abruptly, and the appearance was accompanied by darkening in the eyes. Also, the patient may complain of general weakness, shortness of breath, sweating, pre-syncope.
2. Pain is acute, burning, without a clear localization. Such manifestations indicate heart disease.
3. The syndrome is not relieved by nitroglycerin or non-steroidal agents. If relief does not occur within 15-20 minutes, you should call an ambulance.
4. The patient is unconscious. This is an extremely alarming sign that requires medical attention.

Various causes of chest pain

Chest discomfort is one of the most common reasons for seeking medical help. However, the symptoms do not always indicate a dangerous disease or an existing threat to life.

After COVID-19, influenza or SARS

Infections can cause complications that affect the functioning of organs and systems. The most common discomfort after a coronovirus infection, flu or SARS is caused by:

1. Postcovid asthenia. This is a respiratory dysfunction, manifested by shortness of breath, sleep disturbance, deterioration in performance. Asthenia is caused by the pathogenic effect of the virus on nerve cells, leading to hypoxia, decreased endothelial function, and microthrombosis.
2. Neuropathy. The condition is characterized by damage to nerve fibers by a viral infection. The patient complains of numbness of the extremities, discomfort in the thoracic region a, convulsions, impaired motor functions. Neuropathy can persist from several weeks to six months.
3. Myalgia. The accumulation of lactate in muscle fibers causes acute manifestations in the muscles. Due to the localization of the inflammatory reaction, discomfort is most often found in the sternum.
4. Myocarditis. Covid-19and influenza can cause inflammation of the myocardium. Shortness of breath appears, the rhythm of the heart changes, weakness is detected. Body temperature may remain normal or rise to subfebrile values.

Pain in the center of the chest

Localization of pain in the central part of the chest refers to manifestations of the following conditions:

1. Ischemic heart disease. It is characterized by sharp, spreading pain. Accompanied by swelling of the extremities, respiratory failure and general deterioration.
2. Myocardial infarction. Against the background of a heart attack, the skin turns pale, cold sweat appears, and arrhythmia occurs. In some cases, the patient loses consciousness due to a sharp decrease in the blood supply to the heart. There is a pronounced decrease in blood pressure.
3. Pathologies of the respiratory organs. Discomfort in the central part is characteristic of bronchitis, bronchial asthma, pneumonia. A similar manifestation may indicate pleurisy.
4. Neuralgia. With intercostal neuralgia, the pain syndrome is acute, aggravated by movement, coughing and sneezing. Osteochondrosis of the spine has similar manifestations, but the source is the spine. The patient feels numbness of the skin or “goosebumps” in the affected area.

Left or right

The heart and great vessels are located on the left side of the chest. Diagnostic measures include ECG and other methods to rule out life-threatening conditions, including:

• coronary syndrome;
• pinching of nerve roots and nerve tissue;
• endocarditis and myocarditis;
• deficiency of blood transport to the heart;
• aneurysm dissection;
• spinal injury.

Localization on the left indicates the development of the tumor process, diseases of the esophagus, gastrointestinal tract, the formation of a diaphragmatic hernia. Pain manifestations on the right usually signal a lesion of the respiratory system. Probable causes include acute and chronic bronchitis, pneumonia, pneumothorax. This is how pancreatitis, gastritis, cholecystitis, and liver disease manifest themselves.

When inhaling or coughing

Pain in the chest area, aggravated by coughing or taking a deep breath, usually indicates diseases of the musculoskeletal system and nervous system. However, other causes affecting the respiratory system or having an infectious nature are also likely. Condition linked to:

1. Development of pneumonia. With the disease, the temperature rises, a cough appears with sputum, sometimes with an admixture of blood. Probably difficulty breathing. Pain and cough may increase with changes in body position.
2. Neuralgia. The diagnosis is often established against the background of osteochondrosis of the thoracic spine. The appearance is associated with a pinched nerve. May be accompanied by numbness and decreased sensitivity of the skin. Worse after exercise or wearing tight clothing.
3. Pleurisy. Inflammatory process localized on the pleural sheets. Has an infectious or non-infectious nature. It is expressed by a painful reflex cough, a change in breathing. May be complicated by the formation of a purulent focus.

Pain in the chest and shoulder

Occurs against the background of spinal osteochondrosis and neuralgia. It happens as a result of humeroscapular periarthritis – a degenerative-inflammatory lesion of the tissue of the shoulder joint. Among the possible diagnoses is respiratory neurosis, associated with lack of air, compression, and a lump in the chest. The manifestation occurs due to myocardial infarction, against the background of angina pectoris or other heart diseases.

Radiating to the arm

The appearance of pain is often associated with irradiation to the arm. Why is this possible:

1. Cardiological diseases are present. Pain radiates to the left arm with angina pectoris. It increases with physical exertion and psycho-emotional stress. Discomfort extends into the shoulder and under the shoulder blade. An angina pectoris attack stops within 10 minutes after taking nitroglycerin. The cause of the deterioration of the condition may be a heart attack. It is characterized by increased intensity of symptoms and lack of response to nitroglycerin.
2. There are spinal lesions. Usually irradiation to the left or right hand is a typical complaint for patients with osteochondrosis. It is important to exclude autoimmune conditions – Bechterew’s disease, rheumatoid arthritis. They also negatively affect the spinal column and cause pain to radiate to the arm.
3. The patient has myalgia. The condition occurs with other diseases or due to traumatic effects. Myalgia accompanies cardiovascular disorders, infectious myositis, endocrine pathological processes. It is a consequence of toxic damage or pharmacological treatment.

Pain in the chest and back

It is also a typical sign of osteochondrosis. Among other causes of chest pain:

1. Scoliosis. Deformation of the spine in three planes, debuting in childhood or adolescence. Scoliosis also occurs after an injury or for idiopathic reasons. Expressed forms are clearly visible on visual inspection. The patient has asymmetry of the shoulder blades.
2. Oncological diseases and benign tumors. Neoplasms are capable of squeezing nerve endings. The combination of chest pain with a burning sensation in the back in women is considered an indirect symptom of breast cancer. Similar manifestations are characteristic of formations in the esophagus and stomach.
3. Experienced trauma. A fall or a traffic accident can negatively affect the musculoskeletal frame. Pain in the chest region occurs with sprains, cell bruises, torn ligaments, and is also observed from several weeks to months after healing.

Radiating to the shoulder blade

The condition is most often associated with pinched nerve roots in the chest and neck. Symptoms are typical for:

• diseases of the pulmonary system;
• cardiac disorders – diagnosis of myocardial infarction, angina pectoris, cardiomyopathy, congenital and acquired defects of the heart muscle is required;
• diagnoses of the musculoskeletal system – this is how osteochondrosis manifests itself;
• recent back injuries with sternum;
• blood diseases.

Aching (pulling), pressing, sharp (sharp)

Acute pain usually occurs against the background of tissue damage. It is typical for pinched nerve roots of the spine, diseases of the heart muscle, inflammatory processes localized in the respiratory system. Sensations are observed with erosive gastritis, pancreatitis, cholelithiasis. Aching and pressing pain accompanies chronic conditions, and is also a consequence of trauma. Pain can talk about osteochondrosis of the spine or neoplasms.

Breast pain in women

Breast pain can be unilateral or bilateral. A common cause is the size of the mammary glands. In this situation, the woman complains of pain localized in the upper back and in the chest area. Pain syndrome is detected after intense physical exertion due to the accumulation of lactic acid. Pain is accompanied by ovulation and the period of menstrual bleeding, as well as pregnancy and lactation. The listed reasons, as a rule, are not associated with manifestations of diseases and do not require a visit to a doctor.

The symptom may indicate a pathology of the spine, heart. Some pains occur against the background of discharge from the chest, are associated with a feeling of heaviness, a local increase in temperature. They require immediate diagnostic measures aimed at identifying:

• mastitis;
• eczema of the nipples;
• breast cancer.

After training

Chest pain after training is associated with overexertion or muscle tissue injury. Usually the situation is solved by the correct selection of a system of exercises for a particular athlete. Pain occurs due to hypoxia during intense training or in the absence of a warm-up before starting classes. If the manifestations are regularly repeated, have an acute form and significantly affect the well-being, then you should contact a medical institution. Pain is observed against the background of hemodynamic disturbances caused by atherosclerotic changes in the coronary vessels. Possible heart disease, pinched nerve roots of the thoracic region, damage to the musculoskeletal system, oncology.

The best solution in case of pain is to immediately contact an experienced specialist.

Make an appointment for a diagnosis

Diseases that cause chest pain

Chest pain is considered a non-specific symptom. It is extremely difficult to differentiate the cause on your own. A comprehensive assessment of manifestations with the participation of narrow specialists is required. The following are the most common diseases that cause pain.

Ischemic heart disease and myocardial infarction

Myocardial injury is provoked by partial or complete blockage of the coronary arteries. Against the background of a decrease in the amount of blood, the nutrition of the tissues of the heart muscle is reduced, which causes the destruction of cardiocyte cells. In severe cases, the condition leads to the death of the patient. The patient complains of dizziness, darkening of the eyes, respiratory and cardiac arrhythmias. The pains in the chest are sharp, squeezing, burning. They can spread to the neck, lower jaw, left arm, and be felt behind the sternum. Symptoms are atypical: slight dizziness, severe fatigue, loss of coordination.

Angina pectoris

With angina, the pain comes on suddenly. The provoking factors are stress, previous physical activity, and a heavy meal. Signs of angina pectoris are squeezing, difficulty breathing, discomfort in the interscapular and epigastric regions. Often an attack is accompanied by an increase in blood pressure. Pain in angina quickly relieves nitroglycerin.

Intercostal neuralgia

Chest pain does not lead to pressure changes or arrhythmias. Risk factors for developing intercostal neuralgia:

• injury to nerves located near the spine and upper back;
• chest pain occurs after surgery followed by a long period of immobilization;
• poisoning with chemicals and drugs;
• inflammatory processes in the lungs;
• congenital developmental features;
• systemic infectious diseases;
• pathology of the spine in acute or prolonged form;
• autoimmune conditions;
• diabetes.

Osteochondrosis of the thoracic spine

Pain in the chest appears when the cartilaginous tissues between the vertebrae of the cervical-thoracic region are damaged. The danger of disease of the thoracic region of the spinal column is associated with potential risks for the spinal cord. Without proper therapy, the destruction of the vertebrae extends to the nervous tissue and the endings of the spinal cord. Symptoms debut brightly, with shootings in the epigastric region and neuralgia. In severe cases, the disease captures all 12 thoracic vertebrae.

Pneumonia or tuberculosis

Pneumonia causes pleural pain in the chest. Diagnosis is based on an intense cough, increased bronchophony, the appearance of dry and wet rales. Atypical forms are expressed in muscle pain, dry cough, subfebrile temperature. Pleurisy appears after an injury to the pleura in the thoracic region, due to an infection or a tumor process. Tuberculosis is also expressed by pain. The clinical picture includes sweating, aggravated at night, fever up to 37-38 degrees, weight loss.

Spondylosis, scoliosis, arthrosis

The appearance of pain is caused by a violation of the musculoskeletal system, including:

• spondylosis – wear of the tissues of the spine with degeneration of the tissues of the fibrous ring;
• scoliosis – congenital or acquired curvature of the spine affecting posture;
• arthrosis is one of the connective and bone tissue diseases that provokes dystrophic changes.

Pathologies of the esophagus

Chest pain in diseases of the gastrointestinal tract is associated with dyspeptic disorders. The latter include heartburn, impaired stool, belching, flatulence. The patient may also complain of epigastric pain, aggravated after eating or prolonged fasting. Discomfort behind the sternum speaks of an ulcer, gastroesophageal reflux, pancreatitis.

Oncological diseases

Oncological formations manifest as pain in the chest. This is a typical symptom of cancer of the stomach, esophagus, intestines. Malignant cells can be localized in the mammary gland or lungs. Additionally, the patient finds pulling pains in the back, under the shoulder blades and in the neck. Similarly, cancer of the thyroid gland and trachea is signaled.

If the symptoms do not go away for a long time, it is necessary to urgently visit an osteopath.

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Diagnostics and research

The choice of activities is made by the therapist. Tactics depends on the general condition of the patient and the proposed diagnosis. In most cases, the diagnosis includes laboratory samples:

• general analysis of urine and blood;
• venous blood biochemical sample;
• tests for tumor markers.

Recommended MRI or CT of the spine, tomography of the respiratory and gastrointestinal tract. An ECG is prescribed to exclude heart muscle diseases. Women with discomfort in the thoracic region are shown ultrasound examinations (ultrasound) and mammography.

Consultation of our specialists will help to make the correct diagnosis.

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Treatment of chest pain

Treatment is selected individually after receiving the results of the diagnosis. It includes pharmacological therapy, physiotherapy, physiotherapy exercises. Sometimes the only solution for the patient is surgery.

Conservative treatment

Treatment involves medication. The drugs of choice may be non-steroidal anti-inflammatory drugs, analgesics, cardiac drugs for angina pectoris or other conditions. For pain, physiotherapy is recommended: electrophoresis, magnetotherapy, electric shock. A good result is given by physical therapy classes according to individual programs.

Surgical treatment

Medical institutions perform excision of benign and malignant tumors, removal of destroyed vertebrae, relief of deformities of the musculoskeletal system. After surgery, conservative therapy will be required.

Methods of treatment in our clinic

The main direction of our clinic is osteopathy. This is a modern trend based on the relationship of organs with areas of the musculoskeletal system. Osteopathic treatment relieves pain, starts the natural processes of cell healing, strengthens the body and restores efficiency.

An osteopath will diagnose all body systems, make the necessary adjustments and draw up a treatment plan. Also, if necessary, he will refer you for examinations or to other specialists. The specialists of our center never impose treatment that the patient does not need.

Our specialists will conduct an examination and prescribe the optimal treatment.

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Answers to frequently asked questions

First, the patient needs to contact a general practitioner for primary diagnosis. After an examination and basic research, the doctor, if necessary, will redirect to narrow specialists: a neurologist, oncologist, rheumatologist.

The duration of the course is determined by the complexity of the case. To achieve lasting results, sometimes you need to visit a doctor only a few times. Some patients feel significantly better after the first visit to a specialist.

methods of treatment, diagnosis and causes of chest pain

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Chest pain – an ambiguous symptom. It can accompany stress or simple overwork, or it can serve as a signal for the development of a serious pathology of the lungs, esophagus, heart or blood vessels. It is impossible to start such symptoms, because the risk of complications is significant and can threaten the patient’s life. Diagnosis is carried out by complex methods and makes it possible to accurately determine the cause of pain in the chest region.

Causes of chest pain

The most mild case is chest pain due to emotional surges, indigestion, overwork or increased stress. Usually a short rest is enough to eliminate such symptoms.

Chest pain caused by injury or damage requires a visit to a traumatologist and an examination.

In addition, the following common causes of pain are noted:

• taking medications: antidepressants, estrogen-containing contraceptives;
• inflammation of the lungs, in which the chest compresses the nerve fibers, as well as the internal organs;
• intercostal neuralgia, discomfort due to pinching of nerve endings by the extremities of the bones of the ribs;
• thoracic osteochondrosis, a serious deformity of adjacent nerve endings, accompanied by chest pain. neck, back;
• thoracic or vertebral scoliosis, a curvature in which the compression of the internal organs is increased;
• intervertebral hernia or protrusion, pinching of the nerve roots by a deformed intervertebral disc;
• angina pectoris, pain symptom of the region of the heart, constriction or burning, radiates to the neck, arm, jaw;
• tachycardia, heart rhythm disturbance due to increased excitability of the nervous system;
• myocardial infarction, an attack due to blockage of a blood artery supplying the heart, gives an attack of pain of both high and moderate intensity;
• pulmonary embolism, occlusion of the lumen by a thrombus, a consequence of a sedentary lifestyle.

Women’s chest pain

More than half of women have experienced chest pain at least once. This is due to the peculiarity of female anatomy and physiology. Chest pain accompanies the menstrual cycle, pregnancy, breastfeeding. The appearance of painful symptoms should not be ignored, since it can signal the development of pathological processes in the tissues of the organ.

A woman should see a specialist if she experiences the following symptoms of pain:

• not linked to menstruation;
• accompanied by burning or pressure;
• increases over time;
• is felt only on one side or in a certain place;
• area of ​​increased pain has a fever;
• seal hurts;
• is accompanied by a change in the size or shape of the breast, color or quality of the skin;
• is accompanied by the release of fluid or blood from the nipple, the appearance of a depression on the areola;
• occurs at the site of a surgical site scar;
• lasts over a week;
• limits the mobility of the arm, body;
• reduces the quality of life, interferes with sleep, work.

Localization of chest pain and possible causes of its occurrence

Localization	Description	Diagnostics	Possible causes
Central chest pain	Accompanied by shortness of breath, fluctuations in pulse and pressure, lung murmurs, wheezing. Character of sensations: sharp, dull, aching, burning, squeezing pain	Short-term discomfort may be associated with permanent stress or overwork. Prolonged pain is a sign of serious illness. Based on the patient’s complaints, the doctor prescribes a series of examinations, tests, x-rays and others	development of oncological neoplasms; deformities of blood vessels or cardiac arteries; ischemic heart disease; myocardial infarction; lesions of the nervous system; digestive problems.
Right chest pain	The pain is severe, drawing, prolonged. Most often it is the result of pathologies of internal organs or injuries	Accurate diagnosis possible after ECG or thoracic ultrasound	infection or inflammation of the gallbladder; diseases of the genitourinary or reproductive systems; renal failure, hepatitis, pancreatitis; spinal injuries, disc displacement.
Left chest pain	Severe pain, occurs during physical exertion, movement, may be accompanied by cough, radiate to other organs	Blood test, x-ray, ultrasound	pathology of the spleen, possible rupture; pleurisy, tuberculosis, pneumothorax; arrhythmia, angina pectoris, ischemic disease; thoracic sciatica, osteochondrosis; spondylosis, scoliosis, arthrosis.

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Diagnostic tests

Diagnosis of pain is important for making a correct diagnosis and developing ways for optimal patient treatment. Comprehensive diagnostics of chest pains includes the following procedures:

• conducting clinical laboratory tests, urine and blood tests of the patient;
• radiography, a widely available study that allows you to quickly and reliably establish the pathology of the respiratory and digestive systems;
• computed tomography, obtaining a detailed three-dimensional image of the area under study, revealing problems in tissues and organs;
• electrocardiography, information about the functionality of the heart muscle, heart rate;
• echocardiography, an ultrasound method for diagnosing the heart, reveals valve problems;
• spirometry, pulmonological examination of the patient’s lungs;
• blood lipidogram, a study aimed at calculating the fat content that affects the activity of the heart and blood vessels.

With initial complaints, it is recommended to make an appointment with a general practitioner, a general practitioner. If specific symptoms are identified, the patient will be referred to a specialized specialist.

Treatment of chest pain

Based on the diagnosis, the exact cause of chest pain is determined. The diagnosis is decisive in the development of a therapy strategy by the attending physician. If violations of the activity of the cardiac system are detected, then the cardiologist will deal with the patient’s further treatment, the pulmonologist will deal with respiratory topics, and the problems of the digestive tract will be the field of activity of the gastroenterologist.

Complex therapy will consist of:

• taking medications according to the disease profile;
• hardware physiotherapy;
• physiotherapy exercises; according to the indications – surgical intervention.

It is possible to place a patient in a hospital, to improve the quality of procedures or surgery.

Prevention of chest pain

To avoid painful discomfort in the chest area, it is recommended to follow the following advice from specialists:

• Increase your daily physical activity, exercise, walk more, take up a sport as advised by your doctor;
• Maintain normal body weight, fight obesity, eat in moderation, eliminate fatty, fried or high-calorie foods from the diet;
• Monitor important indicators of the body: cholesterol, blood pressure, blood sugar;
• Avoid stress, overexertion, high fatigue;
• Take care of a balanced daily menu or include foods rich in useful microelements and vitamins in your diet;
• Give up destructive bad habits: smoking, alcohol;
• Attend preventive medical examinations, undergo an annual medical examination.

People with experience of chest pains, serious chronic or hereditary diseases should be especially attentive to their health.

Chest pain: modern treatment in Moscow

The experienced specialists of our clinic in Moscow have been providing effective treatment for chest pain of various origins for many years, restoring health to the most severe patients who were denied help by other specialists or medical institutions. A guaranteed positive result is a logical result of an innovative approach that combines classical methods of therapy proven by practice, as well as innovative achievements of modern medicine in the field of chest pain treatment. The professional arsenal of doctors of the clinic is rich and varied. It contains a huge number of rehabilitation and recovery programs, and is also systematically updated with the most effective and progressive methods. Our doctors are constantly adopting the best practices of leading experts in this field, leaving for training, seminars, conferences in leading clinics in Israel, the USA, Germany.

Patients of our clinic are given the opportunity to visit a doctor’s consultation free of charge, conduct a comprehensive diagnosis, and draw up a preliminary treatment plan. High efficiency and positive impact are noted from the first sessions of therapy. Patients state a decrease, as well as the complete disappearance of painful discomfort.

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Frequently Asked Questions

Who is more likely to experience chest pain?

At risk are people of retirement age who are overweight, have recently undergone surgery, have arterial hypertension, arrhythmias or chronic lung diseases, smokers, pregnant women, alcoholics, cancer patients, and also take certain medications.

When is chest pain a deadly symptom?

The most dangerous signs are:

• severe pain sensation lasting more than five minutes;
• burning pain behind sternum extending to shoulders, neck or back;
• chest pain with tightness or pressure;
• concomitant palpitations, shortness of breath, shortness of breath;
• pain resulting in increased weakness, dizziness, sweating, nausea or vomiting.

In this case, it is recommended to call an ambulance immediately.

Which medical conditions can cause chest pain in women?

In addition to pregnancy, menopause or a number of other physiological causes, chest pain in women may be associated with dangerous diseases that require urgent contact with specialized specialists:

• Mastopathy. The formation of seals in organ tissues. It is treated medically or surgically;
• Cystosis. The appearance of neoplasms. The risk of rupture is dangerous, planned treatment is indicated;
• Benign tumor. Risk of malignant transformation. Constant pulling pain and discomfort;
• Mastitis. Inflammatory disease caused by hormonal disruptions or violations of the course of breastfeeding of an infant;
• Breast cancer. An oncological disease that poses a serious threat to life.

Material checked by an expert

Marshenin Konstantin Vladimirovich

Chief physician. Neurologist, chiropractor, vertebrologist, psychoneurologist, doctor of the highest qualification category

Work experience – 22 years

Video reviews of patients

Joint block in the neck

Hernias in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months, my lower vertebrae completely disappeared and crunches in the neck disappeared …

Hernia of the lumbosacral region

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot.”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Osteochondrosis of the cervical spine

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder-to-shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Osteoarthritis of the knee joint, 2nd degree

Came in with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort. ”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Back pain

“At the beginning of the path of therapy, my back hurt very badly. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine.”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I came to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, sit at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months. I’m fine, my back doesn’t hurt.”

Hernia and protrusion

“I came to the clinic with L4-L5 hernia and L5-S1 protrusion. Today the course of treatment has ended. Lower back hurt, it was difficult to bend down. After completing the course and receiving instructions in the form of physical exercises, it became much easier. After a month of treatment, I do not feel any stiffness of movements. ”

Pain in the lower back and hip joint

“I have been suffering from back pain since I was young. When they became unbearable, I went to Dr. Length’s clinic. Already after the first procedure, the pain in the hip joint was gone. After the third procedure, the shooting pains in the lower back stopped.

Applying today will help

avoid surgery tomorrow!

Relieve pain and inflammation

After 2-3 treatments, exhausting pain disappears and you feel better.

Eliminate the cause of the disease

Comprehensive joint rehabilitation improves well-being: you feel a surge of strength and energy.

Let’s start the regeneration process

The process of repairing damaged tissues begins.