What causes chest pain when pressing on the chest? Is it a heart attack or something less serious like costochondritis? Get the answers.

What Causes Chest Pain When Pressing on the Chest?

There are several potential causes of chest pain when pressing on the chest:

Costochondritis: This is a common cause of chest pain when pressing on the chest. Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone. It can cause sharp, achy, pressure-like pain that worsens with deep breathing or upper body movement.

Injury or strain: Physical strain or injury to the chest wall, such as from strenuous exercise or severe coughing, can also cause chest pain when pressing on the area.

Respiratory infection: Chest infections like bronchitis or pneumonia can sometimes lead to chest wall pain that is aggravated by pressing on the chest.

Arthritis: Conditions like rheumatoid arthritis or psoriatic arthritis can cause inflammation in the chest wall and lead to chest pain when pressing on the affected area.

Chest wall infections or tumors: Rare conditions like relapsing polychondritis, chest wall infections, or tumors may also be potential causes of chest pain when pressing on the chest.

How to Tell if Chest Pain is a Heart Attack

So how can you tell if chest pain is a sign of a heart attack or something less serious? Here are some key differences:

Heart attack chest pain:
– Feels like pressure, fullness, burning or tightness in the chest
– Radiates to the back, neck, jaw, shoulders and arms
– Lasts more than a few minutes, gets worse with activity, or comes and goes
– Often accompanied by shortness of breath, cold sweats, dizziness or nausea

Non-heart related chest pain:
– May have a sour taste or trouble swallowing
– Gets better or worse when changing body position
– Worsens with deep breathing or coughing
– Tender when pressing on the chest

If you’re experiencing new or unexplained chest pain, it’s important to seek immediate medical attention to rule out a heart attack or other serious condition. Don’t try to self-diagnose – let a doctor determine the cause.

Diagnosing the Cause of Chest Pain

To diagnose the cause of chest pain, your doctor will:

• Perform a physical exam and press on your chest to check for areas of tenderness
• Assess your range of motion and listen to your breathing
• Order tests like a chest X-ray or EKG, especially if you’re over 35 or at risk for heart disease

These tests can help rule out serious conditions like a heart attack, blood clot, or other underlying problem.

Treating Chest Pain From Costochondritis

If your doctor determines the cause of your chest pain is costochondritis, the main treatment approaches include:

1. Pain relievers like aspirin or ibuprofen
2. Applying heat with a heating pad or hot compress to the affected area
3. Avoiding physical activities that make the pain worse
4. Improving posture and addressing any muscle imbalances
5. Corticosteroid injections if the pain persists

Most cases of costochondritis resolve within a few weeks or months, though about a third of people may experience persistent pain for up to a year.

When to Seek Emergency Medical Care

If you experience new or unexplained chest pain, especially if it feels crushing, burning or radiates to your arms or back, don’t hesitate to call for emergency medical help. Chest pain can be a sign of a serious problem like a heart attack. Get it checked out right away, as time is critical.

Key Takeaways

Chest pain when pressing on the chest is often caused by a condition called costochondritis, which is an inflammation of the cartilage connecting the ribs to the breastbone. Other potential causes include injury, infection, arthritis, or rare conditions.

To tell if chest pain is a sign of a heart attack versus something less serious, look for symptoms like radiating pain, shortness of breath, and changes in pain with activity. Seek immediate medical care for any new or unexplained chest pain.

Your doctor can diagnose the cause through a physical exam and potentially order tests like an EKG or chest X-ray. Treatment for costochondritis typically involves pain relievers, heat, and avoiding activities that aggravate the pain.

Is This Why My Chest Hurts or Am I Having a Heart Attack?

If you have sudden chest pain, always have it checked out by a doctor to make sure your heart is healthy.

Chest pain isn’t always serious. It could be caused by a mostly harmless condition called costochondritis, an inflammation of the cartilage that connects your ribs to your breastbone. If you press on your upper ribs and it feels tender, you may have it. One study found that 30% of those complaining of chest pain had costochondritis. 

While costochondritis is a common cause of chest pain, injury, physical strain, respiratory infection, rheumatoid arthritis or psoriatic arthritis, chest wall infections, tumors, or rare conditions like relapsing polychondritis may also cause chest pain.

Costochondritis affects both children and adults, and it’s more common in women and Hispanics.

Causes

There isn’t one known cause of costochondritis. It’s often triggered by strenuous exercise or strain from severe coughing. It can also be brought on by an infection from chest surgery or intravenous, or IV, drug use.

Symptoms

Chest wall pain is a main symptom. Most people describe the pain as sharp, achy, and pressure-like. It usually gets worse if you breathe deeply or move your upper body.

When you press on your chest, it feels tender and painful.

The pain usually lasts for a few weeks or months, but about a third of those with costochondritis will have it for about a year.

Diagnosis

Your doctor will do a physical exam, pressing on your chest to check for areas of tenderness. They will also take a look at your range of motion and listen to your breathing. If you’re over 35, at risk for coronary artery disease, a blood clot, or you recently had a respiratory infection, your doctor may order additional tests like a chest X-ray and EKG to rule out more serious problems.

How Is It Treated?

Your doctor will focus on pain relief, and will probably recommend one or more of the following:

• Pain relievers like aspirin or ibuprofen
• Hot compresses or a heating pad to the area
• No physical activities that make the pain get worse

Continued

Your doctor may also give you information on how to improve your posture and fix any muscle imbalances.

If the pain won’t go away, your doctor may give you a shot of an anti-inflammatory medicine, or corticosteroid, in the area that hurts.

Chest pain – Symptoms and causes

Overview

Chest pain appears in many forms, ranging from a sharp stab to a dull ache. Sometimes chest pain feels crushing or burning. In certain cases, the pain travels up the neck, into the jaw, and then radiates to the back or down one or both arms.

Many different problems can cause chest pain. The most life-threatening causes involve the heart or lungs. Because chest pain can indicate a serious problem, it’s important to seek immediate medical help.

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Symptoms

Chest pain can cause many different sensations depending on what’s triggering the symptom. Often, the cause has nothing to do with your heart — though there’s no easy way to tell without seeing a doctor.

Heart-related chest pain

Although chest pain is often associated with heart disease, many people with heart disease say they experience a vague discomfort that isn’t necessarily identified as pain. In general, chest discomfort related to a heart attack or another heart problem may be described by or associated with one or more of the following:

• Pressure, fullness, burning or tightness in your chest
• Crushing or searing pain that radiates to your back, neck, jaw, shoulders, and one or both arms
• Pain that lasts more than a few minutes, gets worse with activity, goes away and comes back, or varies in intensity
• Shortness of breath
• Cold sweats
• Dizziness or weakness
• Nausea or vomiting

Other types of chest pain

It can be difficult to distinguish heart-related chest pain from other types of chest pain. However, chest pain that is less likely due to a heart problem is more often associated with:

• A sour taste or a sensation of food re-entering your mouth
• Trouble swallowing
• Pain that gets better or worse when you change your body position
• Pain that intensifies when you breathe deeply or cough
• Tenderness when you push on your chest
• Pain that is persistently present for many hours

The classic symptoms of heartburn — a painful, burning sensation behind your breastbone — can be caused by problems with your heart or your stomach.

When to see a doctor

If you have new or unexplained chest pain or suspect you’re having a heart attack, call for emergency medical help immediately.

Causes

Chest pain has many possible causes, all of which need medical attention.

Heart-related causes

Examples of heart-related causes of chest pain include:

• Heart attack. A heart attack results from blocked blood flow, often from a blood clot, to your heart muscle.
• Angina. Angina is the term for chest pain caused by poor blood flow to the heart. This is often caused by the buildup of thick plaques on the inner walls of the arteries that carry blood to your heart. These plaques narrow the arteries and restrict the heart’s blood supply, particularly during exertion.
• Aortic dissection. This life-threatening condition involves the main artery leading from your heart (aorta). If the inner layers of this blood vessel separate, blood is forced between the layers and can cause the aorta to rupture.
• Pericarditis. This is the inflammation of the sac surrounding your heart. It usually causes sharp pain that gets worse when you breathe in or when you lie down.

Digestive causes

Chest pain can be caused by disorders of the digestive system, including:

• Heartburn. This painful, burning sensation behind your breastbone occurs when stomach acid washes up from your stomach into the tube that connects your throat to your stomach (esophagus).
• Swallowing disorders. Disorders of the esophagus can make swallowing difficult and even painful.
• Gallbladder or pancreas problems. Gallstones or inflammation of your gallbladder or pancreas can cause abdominal pain that radiates to your chest.

Muscle and bone causes

Some types of chest pain are associated with injuries and other problems affecting the structures that make up the chest wall, including:

• Costochondritis. In this condition, the cartilage of your rib cage, particularly the cartilage that joins your ribs to your breastbone, becomes inflamed and painful.
• Sore muscles. Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain.
• Injured ribs. A bruised or broken rib can cause chest pain.

Lung-related causes

Many lung disorders can cause chest pain, including:

• Pulmonary embolism. This occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue.
• Pleurisy. If the membrane that covers your lungs becomes inflamed, it can cause chest pain that worsens when you inhale or cough.
• Collapsed lung. The chest pain associated with a collapsed lung typically begins suddenly and can last for hours, and is generally associated with shortness of breath. A collapsed lung occurs when air leaks into the space between the lung and the ribs.
• Pulmonary hypertension. This condition occurs when you have high blood pressure in the arteries carrying blood to the lungs, which can produce chest pain.

Other causes

Chest pain can also be caused by:

• Panic attack. If you have periods of intense fear accompanied by chest pain, a rapid heartbeat, rapid breathing, profuse sweating, shortness of breath, nausea, dizziness and a fear of dying, you may be experiencing a panic attack.
• Shingles. Caused by a reactivation of the chickenpox virus, shingles can produce pain and a band of blisters from your back around to your chest wall.

Dec. 08, 2017

Chest Wall (Musculoskeletal) Pain and Its Many Causes

Chest pain is always an alarming symptom since it usually makes everyone—both you and your doctor—think of heart disease. And because chest pain may indeed be a sign of angina or of some other heart problem, it is always a good idea to have it checked out. But heart disease is only one of the many types of conditions that can produce chest pain.

One of the more frequent causes of non-cardiac chest pain is chest wall pain, or musculoskeletal chest pain.

​Illustration by Emily Roberts, Verywell

Diagnosis of Chest Wall Pain

Chest wall pain is caused by problems affecting the muscles, bones and/or nerves of the chest wall. Doctors diagnose “chest wall pain” in at least 25% of patients who come to the emergency room for chest pain.

Unfortunately, in many cases, that’s as far as the doctor takes the diagnosis. This is because ER doctors usually are focused on making sure it’s not cardiac pain. So once they have ruled out a serious problem, they often consider their job to be done.

But if you are the person having this “chest wall pain”—as thankful as you may be that you don’t have a heart problem—you still have pain. You’re interested in an actual diagnosis since that might help you to understand what you can do about the pain.

There are several causes of chest wall pain, and fortunately, in the great majority of instances, the underlying cause of chest wall pain is benign and most often is self-limited. However, some types of chest wall pain may indicate a serious problem and may require specific treatment.

Chest wall pain is a category, not a diagnosis. If you are told you have chest wall pain, you need to press your doctor to make a specific diagnosis—”What is causing my chest wall pain?” 

Fortunately, if the doctor focuses on making a specific diagnosis for a few minutes, it is usually pretty straightforward to home in on the underlying cause. Here are the most common causes of chest wall pain.

Chest Trauma

Trauma to the chest wall can cause muscle sprains or strains, bruises, or fractures of the ribs. The trauma may be due to some dramatic event (such as being struck by a baseball or a car).

Or, it may be due to some more subtle trauma (such as lifting a heavy object) that may be more difficult for the victim to recall clearly, especially if the onset of pain is delayed. As a result, when evaluating chest wall pain your doctor should ask you about activities that potentially might have caused chest wall trauma.

Costochondritis

Costochondritis, sometimes called costosternal syndrome or anterior chest wall syndrome, merely indicates pain and tenderness in the costochondral junction, which is the area along the sides of the breastbone where the ribs attach.

The pain of costochondritis is generally localized to one particular spot, most typically on the left side of the breastbone. Whether left-sided costochondritis is actually more common, or whether people with left-sided chest pain are simply more likely to see a doctor because they’re worried about a heart problem, is unknown.

The pain of costochondritis usually can be reproduced by pressing on the affected area.

The causes of costochondritis are very poorly understood. While the suffix “-itis” is generally used in medicine to indicate inflammation, there is actually no evidence of actual inflammation with costochondritis. That is, there is no swelling, redness, or heat in the painful area.

In children and young adults, this syndrome appears sometimes to be related to strain or weakening of the intercostal muscles (muscles between the ribs), following repetitive activities that place extra stress on those muscles, such as carrying a heavy book bag.

In some cases, costochondritis seems to be related to a subtle dislocation of a rib. While chiropractors are well aware of rib dislocation as a cause of costochondritis, physicians have seldom heard of it.

The dislocation may actually originate in the back, where the rib and the spine join. This relatively slight dislocation causes torsion of the rib along its length, and along the breast bone (at the costochondral junction) this torsion produces pain

The rib may “pop” in and out of its proper orientation (usually with some reproducible movement of the trunk or shoulder girdle), in which case the pain will come and go. Chiropractors are generally adept at manipulating a dislocated rib back into its normal position and relieving the pain.

Costochondritis is usually a self-limited condition. Sometimes it is treated with localized heat or stretching exercises, but it is unclear whether such measures help. If the pain of costochondritis persists for more than a week or so, an evaluation looking for other chest wall conditions may be a good idea, and consulting with a chiropractor may also be useful.

Lower Rib Pain Syndrome

Lower rib pain syndrome (also called slipping rib syndrome) affects the lower ribs, and people who have this condition usually complain of pain in the lower part of the chest or in the abdomen.

In this syndrome, one of the lower ribs (eighth, ninth, or tenth rib) becomes loosened from its fibrous connection to the breastbone, usually following some type of trauma. The “moving” rib impinges on nearby nerves, producing the pain.

This condition is usually treated conservatively, with advice to avoid activities that reproduce the pain, in an attempt to allow the ribs to heal, but surgery may be required to stabilize the slipping rib.

Precordial Catch

Precordial catch is a completely benign and very common condition, generally seen in children or young adults, in which sudden, sharp chest pain occurs, usually on the left side of the chest, lasting for a few seconds to a few minutes.

It typically occurs at rest, and during the episode, the pain increases with breathing. After a few seconds or a few minutes, the pain resolves completely. The cause of this condition is unknown, and it has no known medical significance.

Fibromyalgia

Fibromyalgia is a relatively common syndrome consisting of various, diffuse musculoskeletal pains. Pain over the chest is common with this condition.

Fibromyalgia often has many other symptoms in addition to pain, such as fatigue, sleep disorders, and gastrointestinal symptoms, which cause many physicians to characterize this condition as one of the dysautonomias.

Rheumatic Diseases

Chest wall pain associated with inflammation of the spine or rib joints can be seen with several rheumatic conditions, in particular, rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.

While it is uncommon for chest pain to be the only symptom associated with any of these conditions, unexplained chest wall pain, especially if an evaluation suggests it is related to arthritis or any other type of inflammatory disorder, should lead a physician to at least consider a rheumatic disease as a possible cause.

Stress Fractures

Stress fractures of the ribs can be seen in athletes who engage in strenuous, repetitive motions involving the upper body, such as rowers or baseball pitchers. Stress fractures can also be seen in people with osteoporosis or vitamin D deficiency.

Cancer

Advanced stages of cancer invading the chest wall can produce significant pain. Breast cancer and lung cancer are the two most common kinds of cancer that produce this problem. Primary cancer of the ribs is an extremely rare condition that can produce chest wall pain.

Sickle Cell Crisis

It is now believed that the chest wall pain sometimes seen in people with sickle cell crisis may be due to small infarctions in the ribs. The rib pain usually resolves relatively quickly as the sickle cell crisis is brought under control.

A Word From Verywell

Chest wall pain is very common in people seen by doctors for chest pain, and is only rarely caused by a serious medical problem. In the large majority of cases it is relatively easy for an attentive physician to diagnose the cause of chest wall pain, and to recommend appropriate treatment.

Chest pain | NHS inform

Chest pain can be caused by anything from muscle pain to a heart attack and should never be ignored.

When to get help for chest pain

You should call 999 for an ambulance immediately if you develop sudden severe chest pain, particularly if:

• the pain feels heavy, pressing or tight
• the pain lasts longer than 15 minutes
• the pain spreads to other parts of your body, such as your arms, back or jaw
• you also have other symptoms, such as breathlessness, nausea, sweating, or coughing up blood
• you are at risk of coronary heart disease – for example, you smoke, are obese, or have high blood pressure, diabetes or high cholesterol

If the discomfort is only minor or has resolved, it may be more appropriate to either:

• speak to your GP
• call the 111 service

Could it be a heart problem?

Chest pain isn’t always caused by a problem with your heart, but it can sometimes be a symptom of:

• angina – where the blood supply to the muscles of the heart is restricted
• a heart attack – where the blood supply to part of the heart is suddenly blocked

Both of these conditions can cause a dull, heavy or tight pain in the chest that can spread to the arms, neck, jaw or back. They can also cause additional symptoms, such as breathlessness and nausea.

The main differences between these conditions is that chest pain caused by angina tends to be triggered by physical activity or emotional stress, and gets better with rest after a few minutes.

If you have previously been diagnosed with angina, the pain may also be relieved by your angina medication.

Symptoms that last more than 15 minutes, occur at rest, and include sweating and vomiting are more likely to be caused by a heart attack.

Dial 999 immediately to request an ambulance if you think you or someone else is having a heart attack, or if you have the symptoms above and haven’t been diagnosed with a heart condition.

If you have an angina attack and you’ve previously been diagnosed with the condition, take the medication prescribed for you. A second dose can be taken after five minutes if the first dose is ineffective.

If there is no improvement five minutes after the second dose, call 999 and ask for an ambulance.

Common causes of chest pain

Most chest pain is not heart-related and isn’t a sign of a life-threatening problem. Some common causes of chest pain are outlined below.

This information should give you an idea of whether these conditions may be causing your chest pain, but you should always seek medical advice to make sure you get a proper diagnosis.

Gastro-oesophageal reflux disease (GORD)

Gastro-oesophageal reflux disease is a common condition where acid from the stomach comes up into the oesophagus (gullet).

Common symptoms of GORD include:

• burning chest pain (heartburn)
• an unpleasant taste in the mouth caused by stomach acid coming back up into your mouth

These symptoms usually occur soon after you’ve eaten and get worse if you bend over or lie down.

GORD can often be treated by making lifestyle changes and, if necessary, using medication. Read more about treating GORD.

Bone or muscle problems

If your chest is painful and tender to touch, it may be caused by a strained muscle in your chest wall. This can be surprisingly painful, but with rest the pain should ease and the muscle will heal in time.

If you have pain, swelling and tenderness around your ribs, and the pain is made worse by lying down, breathing deeply, coughing or sneezing, you may have a condition called costochondritis.

This is caused by inflammation in the joints between the cartilage that joins the ribs to the breastbone (sternum).  The symptoms often improve after a few weeks and may be relieved by painkillers.

Anxiety and panic attacks

Some episodes of chest pain occur as part of an anxiety or panic attack.

In addition to chest pain and overwhelming feelings of anxiety, these attacks can cause symptoms such as heart palpitations, sweating, breathlessness and dizziness.

Most panic attacks last for 5 to 20 minutes. In the long-term, you may benefit from psychological therapy and medication, or both. 

Lung conditions

If you have sharp chest pain that gets worse when you breathe in and out, and is accompanied by other symptoms such as a cough and breathlessness, it may be caused by a condition affecting the lungs or surrounding tissue, such as:

• pneumonia – inflammation of the lungs, usually caused by an infection
• pleurisy – inflammation of the membrane surrounding the lungs, also usually caused by an infection

Mild cases of pneumonia can usually be treated with antibiotics, rest and fluids. For people with other health conditions, the condition can be severe and they may need to be treated in hospital.

Treatment for pleurisy will depend on the underlying cause. Pleurisy caused by a viral infection will often resolve without needing treatment, whereas pleurisy caused by a bacterial infection will usually need to be treated with antibiotics.

Again, people who are frail or already in poor health may need to be admitted to hospital for treatment.

Other possible causes of chest pain

There are many other potential causes of chest pain, including:

• shingles – a viral infection of a nerve and the area of skin around it, which causes a painful rash that develops into itchy blisters
• mastitis – pain and swelling of the breast, which is usually caused by an infection, most commonly during breastfeeding
• acute cholecystitis – inflammation of the gallbladder, which can cause a sudden sharp pain in the upper right side of your tummy that spreads towards your right shoulder
• stomach ulcers – a break in the lining of the stomach, which can cause a burning or gnawing pain in your tummy
• a pulmonary embolism – a blockage in the blood vessel that carries blood from the heart to the lungs, which can cause sharp, stabbing chest pain that may be worse when you breathe in, as well as breathlessness, a cough and dizziness
• pericarditis – inflammation of the sac surrounding your heart, which can cause a sudden, sharp and stabbing pain in your chest, or more of a dull ache; the pain usually worsens when lying down

Some of these conditions can be very serious. Make sure you seek medical advice so you can be correctly diagnosed and treated.

3 Types of Chest Pain That Won’t Kill You – Health Essentials from Cleveland Clinic

Some types of chest pain should send you to the emergency room immediately.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

If you experience new or unexplained pain, pressure or discomfort in the center of your chest or in your arms, back, jaw, neck or upper stomach — along with shortness of breath, a cold sweat, nausea, fatigue or lightheadedness — for at least five minutes, call 911.

These symptoms may signal a heart attack, or myocardial infarction. Immediate treatment is essential to save heart muscle.

But when chest aches and pains are fleeting, it’s often something different.

Symptoms that suggest another problem

Cardiologist Curtis Rimmerman, MD, notes that the following symptoms are unlikely to signal a heart attack:

1. Momentary chest discomfort, often characterized as a lightning bolt or electrical shock. Heart discomfort or pain is unrelenting, typically for several minutes. Momentary chest discomfort is more likely to result from musculoskeletal injury or inflammation, or nerve pain (e.g., a cracked rib, a pulled muscle in the chest wall or shingles involving the chest.)
2. Pinpoint chest discomfort that worsens with positional changes in breathing. Heart pain is usually diffuse, or radiating. Pinpoint discomfort that worsens with chest expansion (breathing, for instance) is more likely to involve the lungs.
3. Chest discomfort that gets better with exercise. Heart-related pain typically worsens with exercise. Sharp chest pain that improves with movement is more likely to have other causes (e. g., acid reflux.) 

Heart attack symptoms vary widely

Dr. Rimmerman emphasizes that the symptoms of heart attack or angina can vary greatly from person to person. Some people experience no symptoms at all. Others experience crushing chest pain. Still others may feel only arm, throat or jaw discomfort.

But the discomfort is unrelenting, typically lasting five minutes or more (even up to half an hour or, rarely, two hours).

“Regardless of where the pain is, people typically can’t find a position that relieves the pain,” Dr. Rimmerman says. “Nor do they find relief by taking a drink of water, popping antacids or taking deep breaths.”

That’s when it’s important to call 911  to get emergency treatment.

If chest discomfort is fleeting but severe, make an appointment to see your primary care doctor. But when in doubt, Dr. Rimmerman advises, “Err on the side of caution, and visit a doctor or emergency room.”

Chest Wall Pain, Costochondritis

The chest pain that you have had today is caused by costochondritis. This condition is caused by an inflammation of the cartilage joining your ribs to your breastbone. It’s not caused by heart or lung problems. Your healthcare team has made sure that the chest pain you feel is not from a life threatening cause of chest pain such as heart attack, collapsed lung, blood clot in the lung, tear in the aorta, or esophageal rupture. The inflammation may have been brought on by a blow to the chest, lifting heavy objects, intense exercise, or an illness that made you cough and sneeze a lot. It often occurs during times of emotional stress. It can be painful, but it’s not dangerous. It usually goes away in 1 to 2 weeks. But it may happen again. Rarely, a more serious condition may cause symptoms similar to costochondritis. That’s why it’s important to watch for the warning signs listed below.

Home care

Follow these guidelines when caring for yourself at home:

• If you feel that emotional stress is a cause of your condition, try to figure out the sources of that stress. It may not be obvious. Learn ways to deal with the stress in your life. This can include regular exercise, muscle relaxation, meditation, or simply taking time out for yourself.

• You may use acetaminophen, ibuprofen, or naproxen to control pain, unless another pain medicine was prescribed. If you have liver or kidney disease or ever had a stomach ulcer, talk with your healthcare provider before using these medicines.

• You can also help ease pain by using a hot, wet compress or heating pad. Use this with or without a medicated skin cream that helps relieves pain.

• Do stretching exercise as advised by your provider. Typically rest is beneficial for the first few days. Avoid strenuous activity that worsens the pain.

• Take any prescribed medicines as directed.

Follow-up care

Follow up with your healthcare provider, or as advised.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

• A change in the type of pain. Call if it feels different, becomes more serious, lasts longer, or spreads into your shoulder, arm, neck, jaw, or back.

• Shortness of breath or pain gets worse when you breathe

• Weakness, dizziness, or fainting

• Cough with dark-colored sputum (phlegm) or blood

• Abdominal pain

• Dark red or black stools

• Fever of 100.4ºF (38ºC) or higher, or as directed by your healthcare provider

One of the most commonly misdiagnosed and mistreated causes

Chest pain, especially acute (meaning “new onset”) or severe, frequently elicits a workup for heart disease. When no cardiac or lung problems are found, however, the treatment is often to ignore the problem and hope it goes away. If it lasts long enough to become chronic pain — meaning that it is consistently present and lasts for 6 to 12 weeks — the patient is frequently started on pain medications or treatments ranging from the mild, such as ibuprofen or chiropractic, to the more significant, such as narcotic pain relievers, injections, or nerve blocks.

Characteristics of cardiac pain: Usually (though not always) crushing, deep pressure associated with shortness of breath, nausea, and/or profuse sweating. It may radiate up into the neck, to the back, or into either arm. Sometimes it presents with a pain similar to heartburn. Touching or pushing on the chest usually has no significant effect on the intensity or character of the pain. When a person is asked to show where the pain is, they will often open up their hand and place the whole hand over an area, indicating that the pain is diffuse and not particularly well localized.

Characteristics of rib pain: Often sharp. Not usually associated with other symptoms. When indicating where the pain is, the patient will most often do so by pointing to the spot with one finger, indicating that the pain is well localized and not diffuse. The pain is usually in the front of the chest, near the sternum (breast bone) or in the back within one to three inches of the spine. Touching the chest wall often aggravates or relieves the pain. When the patient moves his or her arm(s) or changes position, the pain may be aggravated or relieved. Inhaling deeply or exhaling very completely often aggravates the pain.

Understanding the cause of the pain: Ribs move up and down with inspiration and expiration. Sometimes, due to a slight dislocation of the rib or due to the rib “getting stuck,” the rib stops moving in concert with the rest of the rib cage. In other words, the rib stays down when the rest of the ribs rise during inhalation or the rib stays up when the rest of the ribs fall during exhalation. The pain can be very severe and can cause a person to take only shallow breaths due to the increase in pain with deep breathing or complete exhalation.

Treatment: No medications are necessary and no amount of high tech treatment or physical therapy will necessarily help. The problem can usually be corrected easily, however, by hands-on techniques, such as osteopathic manipulation, directed at the rib and its attachments. Properly employed manipulation techniques tend to help free up the rib’s attachments, allowing the rib to move normally and rejoin the normal inspiratory / expiratory motion of the rib cage as a whole.

Pain resolved.

Note: Chest pain has many more potential causes, some of which can present with symptoms quite similar to rib / chest wall pain, many of which are lethal if not properly diagnosed and treated as quickly as possible. When significant chest pain is present, you should always see a doctor for proper diagnosis and not engage in self-diagnosis or treatment.

Dr. Cohn is employed at the Born Preventive Health Clinic in Grand Rapids, Michigan, where he is focused on treating acute/chronic pain and injury via osteopathic manipulation and prolotherapy. Dr. Cohn regularly blogs on medical issues and other issues of global and personal interest.

Chest pain: symptoms and causes of occurrence

May 10, 2018

Breast pain: symptoms and causes of occurrence

If you have become worried about pain in the mammary glands, the reasons for this can be very different. They can be subjective signals of the onset or progressive development of a pathological condition and various diseases.

A characteristic of this situation is that pain usually extends only to the mammary gland, but not to the entire chest area.Such pain in the mammary gland can be not only in the right or left breast, but also disturb both at once and have an acute or chronic manifestation.

The nature of the manifestation is also very different – from pulsating and acute to mild and rare. Quite often, the occurrence of such pain is associated with certain days during the menstrual cycle. Regardless of the cause, pain in the breast area should not be ignored or neglected. Only a doctor can help you find out the real reasons for your poor health and get rid of it.

What causes pain in the mammary glands: why you shouldn’t panic

Chest pains can occur for a variety of reasons. Moreover, each symptom can indicate a variety of diseases.
It is customary to refer to the main reasons:

• hormonal disruptions during ovulation or during the menstrual cycle, in principle;
• changes occurring during pregnancy in the female body;
• breast disease;
• chest injury; 90 017 90 016 transferred transactions;
• diseases and malfunctions in the digestive system, gastrointestinal tract, etc.

Periodically severe pain in the mammary glands causes uncomfortable and tight underwear to be worn. Don’t forget about infectious and inflammatory diseases.

Aching pain in the mammary gland can signal the development of mastopathy. Then your pain will be localized and cyclical.
Intermittent pain may indicate cysts or even swelling in the glands.

In this case, the unpleasant sensations will be one-sided, pulling and aching.They will be other than breast pain before or after menstruation.

The conditioning of pain can be mechanical due to chest injuries. Then the woman usually feels acute pain both with pressure and at rest. In any case, a professional examination by a mammologist will become mandatory and necessary. Before that, we recommend that you conduct a self-examination at home. The doctor will tell you the rest.

Pain in the mammary glands before menstruation: characteristic signs

This type of pain is considered the most common and cyclical.So there can be pain in the mammary gland after menstruation, before and during. Basically, discomfort begins to bother a woman a few days before the onset of menstruation and completely disappears after it ends.

Pain may worsen in the middle of the cycle, before it begins. But at the end of the cycle, the pain should go away.

If this does not happen, be sure to consult a doctor for advice. When you begin to be bothered by pain in the mammary gland after menstruation, pay attention to the state of your nervous, endocrine and cardiovascular systems, lifestyle and other external factors.

Pain in the mammary glands in nursing

Soreness in this case occurs in connection with lactation and the beginning of preparation for it. During pregnancy, serious hormonal disruptions occur in the female body, as a result of which the cells of the glandular tissues begin to grow, prolactin increases, and therefore the volume of the glands themselves also increases.

Because of this, strong pressure arises on the nerve endings of the tissues, which leads to unpleasant sensations and pain.

Pain in the mammary glands in nursing women usually occurs because there is a large flow of milk to the breast.This can lead to stagnation, so doctors recommend regular pumping procedures. Remember to check nipples and halos – these are considered gateways for infections.

Therefore, pain in the mammary glands in nursing mothers can be caused by such a factor.

Pain in the mammary gland with menopause

Like pregnancy, menopause is accompanied by serious changes in the woman’s body. And quite often they lead to diseases of the mammary glands.At a younger age, menopause causes irregularities in the menstrual cycle. This forces women to go to the doctor and, accordingly, detect the problem in a timely manner.

But in most cases, pain in the mammary gland with menopause (especially expected) may become the only indicator of the development of diseases. Pain in this case can be short-term or periodic, pulling and aching.

Regardless of the type of pain, we recommend not to postpone the visit to a specialist.

“Many-sided pain” in the mammary gland

A woman in our country is a special woman! She thinks and worries about everyone except herself – for her husband with his complaints and problems, for the children with their vaccinations, examinations and schools … At the very last moment, she suddenly remembers herself. And he remembers why? Something is ill! The most common complaint of women of any age and the most compelling reason to see a doctor is pain in the mammary gland. This is what I would like to talk to you about, dear women.

Pain in the mammary gland can be characterized and divided into various manifestations: cyclic – non-cyclic; instantaneous – constant; sharp, dagger, dull, aching, bursting, encircling, local (local), bilateral, unilateral, etc.

The most common of these is cyclical soreness. A few days before the expected menstruation, the mammary glands become rough, become sensitive, painful when pressed. This symptomatology can appear both in 14 and 2-3 days and disappear immediately after menstruation.This is due to ovulation and the preparation of the body for the natural process – pregnancy. In the second phase of the menstrual cycle, the female body is rebuilt. The hormonal background and rheological properties of the blood change. For example, have you ever wondered why it is recommended to come to the mammologist for examination from 6 to 12 days of the cycle? Of course, these are average days for most women, and they can change significantly specifically from your personal menstrual calendar: if the discharge stops already for 2-3 days, and the cycle duration is, say, 35 days, then such a patient can extend the consultation days from 4 to 17th day of the cycle.The principle should be clear: discharge practically stops, and ovulation does not occur. On these (recommended) days, the doctor will objectively assess the situation: the chest is in a calm state; if swelling is observed, then it has nothing to do with physiological processes. In the case when the patient turns to any convenient day for her (not according to the cycle), this threatens with overdiagnosis, sometimes even errors in diagnosis. I’ll give you an example again. Patient N., 45 years old, underwent mammographic examination two years ago.Now there are complaints of soreness of the mammary glands. The patient came for examination on the 25th day of the cycle. A mammogram was performed, on which there was no exact data for a nodular formation, but the glandular tissue, in comparison with a mammogram two years ago, became much larger. This indicates a hormonal surge, since the amount of glandular tissue should decrease over the years, not increase. In this case, you and I knew in advance that the patient did not come according to the cycle, therefore, repeating the study on the right days, we saw that the state of the mammary glands on radiographs was without significant dynamics.

The same error often occurs with diagnostic punctures. First, you need to know that in the second phase of the menstrual cycle, the risk of hematomas at the biopsy site is much more serious. Therefore, surgeons try to carry out any operations for women of reproductive age during the week following menstruation, when bleeding decreases significantly. Secondly, swelling is directly related to the swelling of each cell of the gland. The cytologist at the time of the procedure – taking a puncture – does not take into account the day of the cycle: he sees a cell that is slightly larger than the norm and – the diagnosis is automatically complicated.The edges are very close: norm – hyperplasia – atypia – cancer. Hence, the conclusion follows – neither you nor the doctor need overdiagnosis.

Pain in the mammary gland on both sides is associated with an imbalance of hormones that are not completely eliminated from the body by our liver, which remain on the cells of the glandular tissue of the mammary gland and attract fluid. Such a clinical picture with exacerbations in the autumn-spring period is characteristic of fibrocystic mastopathy. Sometimes there are displacements in a specific direction associated with the asymmetry of the mammary glands themselves or with a different amount of glandular tissue in the breast.

Local pain (local) inside the gland, aggravated by movement, is often characterized by patients as sharp, dagger or, conversely, dull and aching. It occurs with cystic inclusions in the mammary gland. Filling, the fluid formation moves apart the tissues, which leads to the appearance of unpleasant sensations in a specific zone of the gland, and the severity of complaints depends on the degree of filling of the cavity. Cysts are the most benign of all problems, but they are the ones that bring the most discomfort to a woman’s life.
In adolescents, cysts are more often asymptomatic and do not cause any complaints. They are diagnosed by ultrasound, sometimes they can be suspected when examining the gland – the appearance of a bluish color on the skin of the areola of the nipple. During the screening examination of schoolgirls, it was cysts in the mammary gland that were the most frequent pathology, although the girls did not complain of soreness. In adolescence, untreated cysts are often complicated by inflammation.

Inflammation of the mammary gland – mastitis – manifests itself as soreness, accompanied by reddening of the skin over this place and an increase in temperature, both local and general.The clinical picture, as a rule, develops quickly – within 1-2 days. There is a misconception that mastitis occurs only in lactating women. This is a really frequent complication in this group: it occurs, as a rule, in the first 2-3 weeks after childbirth, and in most cases – after the first birth; has two causes – lactostasis and infection (as a result of the penetration of infection through cracks and / or other damage to the nipples).

In our practice, we often have to deal with inflammation of the mammary glands in adolescents or in women outside the lactation period.Change of season or a sharp change in temperature, drafts are the most common causes of mastitis. We observe a surge of such calls in the May period. But this year, at the beginning of autumn (after the unbearable heat), the number of patients with this pathology has increased dramatically. For the timely appointment of treatment, it is important to consult a doctor at the first symptoms, then, most likely, local antibacterial treatment will be sufficient. In advanced cases, surgical opening of the abscess is not excluded.

Significant changes have been outlined in the treatment of mastitis. In specialized centers, fine needle biopsy and conservative treatment are increasingly used, rather than surgery. I would like to note an important point that after healing there are no skin scars and defects.

With constant, girdle pain in the mammary glands, not associated with the menstrual cycle, radicular syndrome and other problems with the spine must be excluded. Osteochondrosis, scoliosis, osteopenia can cause pain in the mammary gland.

The task of the doctor is to understand and find the cause of your complaints.You should always remember that the human body is a single whole, and several organs and systems are involved in its processes.

Pain is a signal from the body that it is worth paying attention to yourself and undergoing a medical examination. Pain – does not allow for a diagnosis, but encourages our patients to come to the doctor. Remember that the absence of pain is not an indicator of health.

Painful sensations in the mammary gland

Painful sensations in the mammary gland (mastodynia) are the most common reason for women to visit an oncologist-mammologist.

According to statistics, 70 to 82% of women have ever experienced this condition.

Pain can have many different causes:

• inflammatory process,

• hormonal imbalance

• taking various medications (especially oral contraceptives),

• intercostal neuralgia.

Despite the fact that the patient often complains to the oncologist-mammologist, most often after examination, ultrasound and / or mammography, she is sent for further examination to a gynecologist.

Why is this happening and why you should not neglect these recommendations?

Let’s start with the fact that pain in the milk can be constant or periodic (non-cyclic, i.e. not associated with the menstrual cycle).

Constant pain is most often stabbing or burning and is usually associated with various manifestations:

• osteochondrosis,

• humeroscapular periarthritis,

• intercostal neuralgia,

less often declare themselves like this:

• adenoma or fibroadenoma of the breast,

• sclerosis or liposclerosis of breast tissue (manifestations of age-related changes in breast tissue),

• extremely rare, breast cancer.

Non-cyclic chest pain is more common in women in late reproductive years and postmenopausal women, i.e. 40+.

It is these patients who must undergo mammography and ultrasound of the mammary glands without fail, and these studies are not mutually exclusive, but complement each other and give the doctor a complete picture of the state of the mammary gland.

It is not surprising that a doctor, after a complete examination, can refer such a patient to a neurologist or rheumatologist, excluding the pathology of the mammary gland.

The situation is more complicated with cyclical chest pain , which can be either a manifestation of various types of mastopathy, or presented as an independent diagnosis.

To understand the causes of pain, I would like to recall the anatomical structure of the mammary gland. If you try to simplify, the mammary gland is like a cross-section of an orange, where the flesh is glandular lobules, interspersed with fatty tissue, separated by Cooper’s ligaments – connective tissue fibers similar to citrus septa.That is, the mammary gland is a multicomponent formation.

Most often, complaints of pain in the mammary gland appear at the end of the menstrual cycle, on the 22-24th day of the cycle. Let me remind you that the menstrual cycle is counted from the first day of the previous menstruation to the first day of the next.

Such mastodynia is associated with the function of the ovaries and should be considered only in conjunction with the general state of the female reproductive system.

The fact is that with the normal functioning of the ovaries in the mestrual cycle, there is an alternation of the secretion of ovarian hormones, i.e.That is, at the beginning of the menstrual cycle, the secretion of estrogens prevails, and in the second phase – progestogens (progesterone).

If enough progesterone is secreted in the second phase, if receptors for it work correctly in the mammary gland, and if all metabolic products of the body in general and hormones in particular are utilized in the liver, then the mammary glands can only slightly coarse on the eve of menstruation, which does not cause discomfort in women.

But, unfortunately, all these “ifs” rarely coincide, which is why most women suffer from one or another manifestation of mastodynia, but rarely seek help.

Today, the generally accepted point of view is that mastodynia is caused by fluid retention, edema, overstretching of the Cooper’s ligaments and subsequent compression of the nerve endings.

Progesterone just contributes to the regulation of water metabolism, and with a deficiency of progesterone in the body, sodium ions are retained, fluid retention, an increase in the volume of the mammary gland and body weight in general.

That is, cyclic chest pain (mastodynia) is not an isolated disease, it is a manifestation of hormonal imbalance, and it occurs in patients with high estrogen levels.

It is also very common to hear about mastodynia from patients taking COCs. Here, the mechanisms of the onset of pain are the same as those described above, only they are part of the normal adaptation period.

When prescribing COCs, the body is rebuilt from synthesizing its own hormones to receiving similar substances from the outside , and therefore the first 3 months of taking COCs are allotted for the body’s “habituation” to the new order of work.If, after 1-3 months, complaints of mastodynia persist, it is better to choose another contraceptive drug.

The format of this article does not allow to tell in detail about all the pros and cons of hormonal contraception, but the most important thing is the following principles of its use:

1. Oral contraceptives are prescribed only by a gynecologist.

2. For optimal selection of COCs, the gynecologist should appoint a woman an examination, which includes hormonal status, biochemical blood test, coagulogram, ultrasound of the pelvic organs and mammary glands, examination of the cervix.

3. Reception of COCs should take place strictly under the supervision of a gynecologist. Usually, control is prescribed 3 months after the start of therapy, then every 6 months.

Thus, it is obvious that a woman with complaints of pain in the mammary gland should first seek help from a gynecologist , for a faster and more accurate search for the causes of this pathology, and only a gynecologist will refer to an oncologist-mammologist …

Chest pain

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, and 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 requiring emergency medical care, in particular myocardial infarction.

Synonyms Russian

Thoracalgia, chest pain, chest pain

English synonyms

Chest pain, pain in the chest, thoracalgia.

Symptoms

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, and 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.
• Dissecting aortic 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 dissection aneurysm is most often a consequence of prolonged 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 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 is usually one-sided, aggravated by coughing, accompanied by fever, malaise, and coughing.
• 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 underwent surgery.
• Suffering from alcoholism.
• Smokers.
• Pregnant.
• Suffering from cardiac arrhythmias.
• People with cancer.
• Taking certain drugs.
• People with chronic lung diseases.

Diagnostics

Chest pain is not a specific symptom and can unambiguously indicate a particular disease.However, when this sign appears, the doctor must first of all exclude a number of life-threatening conditions that require immediate assistance. Sometimes only additional laboratory and instrumental studies can accurately establish the cause of chest pain.

Laboratory research

• Complete blood count. Leukocytosis (with pleurisy, pneumonia), anemia (with dissecting aortic aneurysm), thrombocytosis and erythremia (with pulmonary embolism) can be detected.
• Erythrocyte sedimentation rate (ESR). Non-specific indicator of inflammation. ESR can be increased with pleurisy, pericarditis, pneumonia and other diseases.
• C-reactive protein. Increased in inflammatory diseases, as well as in myocardial infarction. With angina pectoris, the level of C-reactive protein does not change.
• NT-proBNP (sodium uretic brain propeptide). Protein, the bulk of which is found in the cells of the myocardium. It is a precursor of the sodium uretic peptide, which is responsible for the excretion of sodium in the urine.This indicator is used to assess the risk of heart failure, identify the initial stages of heart failure, and evaluate the therapy. It is highly specific. May be elevated in myocardial infarction.
• Troponin I. Troponin is a protein involved in muscle contraction. The cardiac form of troponin is found in the heart muscle and is released when the myocardium is damaged. It can be increased in case of myocardial infarction and other diseases, accompanied by the destruction of cardiomyocytes.
• Myoglobin. A protein similar in structure to hemoglobin and responsible for the storage of oxygen in muscle tissue, including the heart muscle. It increases with damage to muscle tissue, in the first hours after myocardial infarction.
• Alanine aminotransferase (ALT). An enzyme that is found primarily in the liver, as well as in skeletal muscle, kidney and myocardium. An increase in ALT indicates liver damage, but may also indicate a myocardial infarction and is an indicator of the extent of the damage to the heart muscle.
• Aspartate aminotransferase (AST). This enzyme is found mainly in the myocardium, skeletal muscles, liver. An increase in AST levels is a sign of myocardial infarction. The value of AST corresponds to the degree of damage to the heart muscle.
• Total creatine kinase. An enzyme involved in energy metabolism reactions. Its various isoforms are found in different tissues of the human body. An increase in the level of total creatine kinase is observed in myocardial infarction and myopathies.
• Creatine kinase MB. Isoform of creatine kinase, which is found mainly in the myocardium and tissues of the nervous system. Its level corresponds to the extent of myocardial damage.
• Lactate dehydrogenase (LDH) total. An enzyme that is involved in energy metabolism and is found in almost all tissues of the body. Different types of LDH are present in different organs. Total lactate dehydrogenase can be increased in myocardial infarction and liver disease.
• Lactate dehydrogenase 1, 2 (LDH 1, 2 fractions).These are types of lactate dehydrogenase, the increase in which is a more specific indicator of myocardial and renal damage.
• Lipase. Pancreatic enzyme. An increase in lipase levels is specific to pancreatic disease.
• Total cholesterol. This is the main indicator of fat metabolism in the body. It is used to diagnose atherosclerosis and liver diseases.
• D-dimer. Fibrin cleavage product. It is an indicator of the fibrinolytic activity of the blood.The D-dimer level may change with pulmonary embolism, dissecting the aortic aneurysm.
• The main blood electrolytes are potassium, sodium, chlorine, calcium. A change in the level of blood electrolytes may indicate pathology of the kidneys, adrenal glands, endocrine diseases, and malignant neoplasms.
• Urea, serum creatinine. These are the end products of nitrogen metabolism, which are excreted from the body by the kidneys. Their increase may indicate kidney pathology.

Instrumental research methods

• Electrocardiography (ECG). Changes in the ECG are detected with myocardial infarction, angina pectoris, pericarditis. Helps to determine the localization and degree of myocardial damage.
• Radiography, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound examination (ultrasound) of the chest organs. These are imaging methods that allow assessing the state of the chest organs, identifying injuries, neoplasms, signs of internal bleeding and other pathological changes.
• Transesophageal echocardiography. An ultrasound scan in which a probe is inserted into the esophagus. With its help, the condition of the heart, its valves, large vessels is assessed. It is of great diagnostic value in pulmonary embolism, aortic aneurysm.
• Angiography. X-ray examination of blood vessels using a non-toxic contrast agent that is clearly visible on the images. Allows you to assess the condition and patency of blood vessels, including coronary.

Treatment

Treatment depends on the underlying condition, the symptom of which is chest pain. Therapy can consist of both the use of appropriate medications and surgical procedures.

Prevention

There is no specific prophylaxis for most diseases accompanied by chest pain. However, to reduce the risk of their development, it is useful to quit smoking and alcohol, sufficient physical activity, a healthy diet, and timely preventive medical examinations.

Recommended analyzes

90,000 12 reasons why your chest may hurt and when is it time to go to the doctor / HB

Women’s breasts are a very sensitive organ and extremely dependent on hormonal balance. Every woman periodically encounters “natural” soreness of the mammary glands, and with prolonged and acute pains, one can already talk about any disease. Why does a woman’s chest hurt, in what cases is it worthwhile to be wary and which doctor to turn to?

Diseases of the mammary glands are dealt with by a highly specialized doctor – mammologist.But usually they do not immediately turn to a mammologist. The gynecologist most often finds out about the problem first, who, during a routine examination, detects changes in the chest or hears the patient’s complaints. Alas, our women continue to postpone the visit to the doctor, which only aggravates the condition, which just a few months ago could have been completely harmless. But behind the aching pain or changes in the skin of the chest, cancer can be hidden, which takes more women’s lives than any other cancer.So why does the chest hurt and what are the symptoms of serious breast diseases?

1. PMS and ovulation. Constant cyclical fluctuations in hormonal levels are the reality of every woman. Not everyone feels chest discomfort during ovulation or before the start of a new cycle, and, nevertheless, some soreness is considered a normal variant.
2. Hormonal imbalance. Women’s health is regulated by 4 main hormones (estrogen, progesterone, growth hormone and prolactin) and a bunch of additional ones.The slightest imbalance can cause cycle irregularities and chest pain. And to earn this imbalance, you don’t need much: stress, unhealthy diet, lack of sleep, in general, the usual state of a resident of a big city. By the way, in such cases, a gynecologist or endocrinologist is involved in the treatment of a patient with complaints of chest pain.
3. Birth control pills . The hormones in oral contraceptives cause the breast to grow, which causes tension and soreness in the breasts.
4. Pregnancy . This condition is not a disease, but it definitely provokes dramatic changes in the female body. And chest pain can be one of the first symptoms of pregnancy.
5. Lactation. Inflow of milk is a very unusual condition for the breast, therefore, at first, there may be tension and soreness in the mammary gland, a feeling of heaviness. And breastfeeding mothers also have a problem with cracks and nipple bites, which also hurts.
6. Milk stagnation during lactation (lactostasis) .For one reason or another, lactating women may have clogged milk ducts, which causes milk stagnation, inflammation of these very ducts and, of course, pain.
7. Mastitis is an inflammation of the breast of an infectious nature. It can be lactational (while breastfeeding) and non-lactational. It is imperative to treat, otherwise it can be brought to an abscess.
8. Cyst . Cystic formations do not appear very often in the chest and are more characteristic of age-related changes.But in any case, the cyst will expand the breast tissue and cause pain.
9. Fibroadenoma is a benign tumor, which does not make it good at all. It is accompanied by swelling of the diseased breast, changes in the skin (a la lemon peel), changes in the shape and color of the nipple, the appearance of a bloody, purulent or bloody discharge from the nipples.
10. Breast cancer. The most life-threatening condition, accompanied by the same symptoms as fibroadenoma.
11. Injury . It is not surprising that the chest will ache after being hit or pressed. But protect it from injury, as the glandular tissue is easily transformed into fibrous tissue, overgrown with all kinds of nodules and cysts.
12. Uncomfortable underwear. This is the main cause of non-medical chest pain. Bras that are too tight and inappropriate in shape cause blood congestion in the breasts and trauma to the breast.

Total, chest pain, alas, in some cases is the norm, and we live with it.But it is better to consult a mammologist for a diagnosis. And, dear women, do not forget to visit a gynecologist 1-2 times a year, whose breast examination is required. Well, do not hesitate to self-check at home. No one knows your breast better than you, and it is you who, in the first place, can detect the first symptoms of her disease.

Chest pain | Men’s Health – Middle Age | Men’s health | Thematic pages

Chest pain

A feeling of pain or pressure in the chest can be a sign of both non-fatal problems (for example, osteochondrosis, digestive disorders), and much more serious – an attack of angina pectoris or myocardial infarction.

Care should be taken of the appearance of chest pain, especially associated with physical exertion or stressful situations.

Causes of chest pain
Myocardial infarction in most cases is accompanied by pain of varying severity – from moderate to intense. Myocardial infarction is characterized by diffuse pressing or burning pain behind the sternum, radiating to the left or both arms, neck, under the left shoulder blade, lower jaw, upper abdomen. The pain of a heart attack does not go away quickly, increasing in the supine position; rest and drugs do not completely relieve pain.Myocardial infarction should also be remembered when severe chest pains appear during stress and physical exertion, even in fairly young people.

With an attack of angina pectoris, the nature of the pain is the same as with myocardial infarction. The difference in the duration of pain – an attack of angina pectoris lasts about 3-5 minutes, it passes after the cessation of physical activity or taking medications.

With pulmonary embolism, there is sudden chest pain, increasing shortness of breath, there may be coughing up blood.

Pain that aggravates when turning, bending, when pressing on the affected area, and subsiding in the supine position, is characteristic of osteochondrosis.

Diseases of the gastrointestinal tract can also be a source of pain that will spread to the chest. Pain in peptic ulcer disease increases on an empty stomach, decreases after eating. With diseases of the gallbladder, pancreas, pain appears after errors in the diet (intake of fatty foods, alcohol). Heartburn can also cause a burning sensation in the chest bone (hydrochloric acid from the stomach into the esophagus).

Symptoms requiring IMMEDIATE medical attention (call the ambulance team):

• burning or pressing pain in the chest, radiating to the left or both arms, neck, under the left shoulder blade, lower jaw, upper abdomen;
• chest pain lasting more than 15 minutes, which does not relieve after rest;
• chest pain with an unstable or fast heart rate, shallow breathing, nausea or vomiting, sweating, dizziness, restlessness, or fainting;
• Sudden severe chest pain, shortness of breath, or coughing up blood.

Symptoms of compulsory medical attention:

• 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 myocardial infarction, call an ambulance immediately.

Prevention of heart attack and angina pectoris

Control risk factors for atherosclerosis: obesity, high blood cholesterol, smoking, excessive salt intake, excessive alcohol consumption, insufficient physical activity, inability to manage stress.

1. Balance your diet

1. Eat a sufficient amount of omega-3 polyunsaturated fatty acids (omega-3 PUFAs prevent the formation of atherosclerotic plaques and must be taken with food daily), a large amount is found in mackerel, herring, salmon, tuna, trout, flax seeds, walnuts , soy.
2. Eat at least five servings of fruits and vegetables a day, excluding potatoes: 2-3 servings of fruits and 3-5 servings of vegetables (1 serving is an amount of food the size of your fist: 1 apple, banana or orange, a slice of melon, 100 g of berries, 100 g of boiled or canned fruits, 60 g of dried fruits, 175 ml of freshly squeezed juice).Dietary fiber contained in fruits and vegetables absorbs cholesterol and removes it from the body as part of feces.
3. Eat a sufficient amount of foods containing antioxidants (prevent cholesterol deposits in the vessel wall). Vitamin A is found in sea fish, fish oil, egg yolk, tomatoes, citrus fruits, carrots, apricots, parsley and spinach leaves, pumpkin. Vitamin C is found in fresh fruits, vegetables (Brussels sprouts, red and cauliflower, green peas, red peppers), berries (rose hips, black currants, sea buckthorn, mountain ash).Vitamin E is found in vegetable oils, eggs, cereals, legumes, Brussels sprouts, broccoli, rose hips, sunflower seeds, peanuts, and almonds.
4. Limit fatty foods: A low-fat diet promotes weight loss, helps lower blood cholesterol levels and thus reduce the risk of atherosclerosis. Avoid foods that contain a lot of hidden fats: sausages, sausages, pies, poultry with skin, curds, cheeses, cut off visible fat from meat and remove it from ready-made meals.Buy low-fat milk and cheese, and lean meats. Use the oven, steamer, grill when preparing food.
5. Limit salt intake: salt prevents the breakdown of fats, makes the inner surface of blood vessels looser and more susceptible to cholesterol deposition and the formation of atherosclerotic plaque.
6. Eat less simple carbohydrates (sugars): An excess of simple carbohydrates stimulates the production of insulin, which increases appetite and converts sugars into fats.
7. Limit alcohol consumption. It is best not to drink alcoholic beverages at all, or reduce your alcohol intake to two drinks at a time for men and one dose for women. One dose is approximately 10 g (or 12 ml) of pure (100%) alcohol (250 ml of beer, 100 ml of wine, or 30 ml of spirits). Alcohol is absolutely contraindicated in case of high blood triglycerides, arterial hypertension. Remember that there is no safe daily dose of alcohol!

2.Get regular physical activity. 30-45 minutes of moderate to moderate aerobic (dynamic) physical activity at least 5 days a week reduces the risk of heart attack and improves physical fitness. In no case do not start physical culture classes immediately with heavy loads. Before starting classes, visit a doctor and make sure that the program you have chosen will only benefit you

3. Quitting smoking is essential. Smoking greatly increases the risk of atherosclerosis progression, heart attack and stroke.

4. Patients with diabetes should regularly monitor their blood sugar levels.

5. It is necessary to regularly undergo medical examination and preventive medical examinations, know your cholesterol level and follow the doctor’s recommendations in order to correct risk factors and prevent the development of atherosclerosis.

6. If you already have diseases associated with atherosclerosis, then you should:

• regularly visit a doctor,
• carry out the necessary research,
• Take medications prescribed by your doctor regularly.

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90,000 Breast discharge

Sudden discharge from the chest is often troubling, but in fact is rarely a symptom of a serious medical condition.

The breast is a gland, so it sometimes secretes fluids, even without a previous pregnancy. Cancer is rarely the cause of breast discharge; more often, other less serious conditions are causing breast discharge that may require treatment.

What is breast discharge?

Non-dairy discharge exits the nipple through the same openings as milk. There are about ten of these holes on each nipple.

Fluid may leak from one or both breasts, sometimes on its own, sometimes from compression. Discharge from your breasts may resemble milk in appearance, or be yellow, green, brown, or even bloody. Discharge from the breast can be thick or very thin, watery.

The chances of breast discharge increase with age and with the number of pregnancies.

Examination by mammologist

First, the mammologist will ask you a few questions:

What is the color of breast discharge?

Is there a discharge from the second breast

Is fluid coming out of one hole in the areola of the nipple or from many?

Does the discharge appear spontaneously or from expression?

Any other symptoms (fever, redness or chest pain, headaches, blurred vision)?

Have there been any recent chest injuries?

What medications are you taking?
Based on questioning and examination, the mammologist will decide if additional research methods are needed, for example, blood tests, mammography, breast ultrasound, ductogram or breast MRI.Sometimes it is necessary to analyze the fluid secreted from the breast.

Causes of breast discharge

Discharge from the nipples can be normal (physiological), in this case, the discharge stops on its own. Try not to stimulate the nipples, as this can slow down the disappearance of secretions

In addition to the physiological causes of discharge from the chest, there are pathological ones:

Milk duct ectasia . Ectasia of the milk ducts is one of the most common causes of pathological discharge from the chest.Inflammation occurs in one or more of the ducts, and the duct becomes clogged with thick, sticky green or black discharge. Most often, ectasia of the milky ducts occurs in women 40-50 years old. Some improvement can be achieved by using warm compresses and taking aspirin or ibuprofen. In some cases, antibiotics are prescribed if an infection is suspected. If conservative treatment is ineffective, surgery may be required.

Intraductal papilloma . Intraductal papilloma is a small, usually pre-malignant tumor that develops in the milk duct close to the nipple.Intraductal papilloma most often occurs in women 35-55 years old. The cause of its occurrence is unknown, and the risk factors for the appearance of this tumor are also unknown. Discharge from the chest with intraductal papilloma can be bloody, usually they have a thick consistency. Discharge is secreted from one duct when the nipple is stimulated. Usually, the tumor can be palpated inside the areola.

Ultrasound of the areola and surrounding tissues is usually performed for diagnosis. Treatment – surgical removal of the duct and histology of the tumor (to exclude its malignancy).

Galactorrea . With galactorrhea, the discharge from the nipple is usually white or transparent, less often yellow or green. Discharge can be from one or both mammary glands. Galactorrhea is caused by an increase in the level of prolactin in the body. Prolactin is a special hormone produced by the brain to stimulate milk production after a baby is born. The reasons for an increase in prolactin levels can be different: taking contraceptives, decreased thyroid function, pituitary tumor (prolactinoma), chronic stimulation of the nipples, etc.

Injury . Blunt trauma to the breast (such as hitting the steering wheel in an accident) can cause discharge from one or both breasts. The discharge can be clear, yellow, or bloody. The outflow of fluid occurs from several ducts and occurs spontaneously, without stimulation.

Abscess . An abscess is a collection of pus. Most often, breast abscesses occur in lactating women. Cracks in the nipple allow bacteria to enter the breast tissue and cause infection.