Chest and Shoulder Pain: Symptoms, Causes, and Diagnosis

Pain from your chest to your shoulder can have many causes. Your heart, lungs, or other internal organs may be involved. If your pain is sudden or severe, it’s very important to get immediate medical care.

The pain may also be referred. This means it’s felt in your chest and shoulder but is actually caused by pain in another part of your body.

In this article, we’ll look at some of the most common causes of chest and shoulder pain and the treatment options for these causes.

Pain in the chest and shoulder can have many causes. Some can be more serious than others. The conditions listed below are some of the most common culprits of this kind of pain.

Angina is the name for chest pain that results from clogged and narrowed arteries around your heart. When this happens, your heart muscle isn’t able to get enough oxygen-rich blood.

It’s not a heart attack. Rather, it’s a sign you have a heart condition. Physical activity often triggers the pain, when you need more oxygen. Emotional stress can trigger it, too.

Angina can be stable. This means it follows a predictable pattern and typically occurs when you’re doing something, or when you’re stressed. With stable angina, symptoms usually go away within a few minutes.

Angina can also be unstable. This type of angina tends to occur suddenly or while you’re at rest. With unstable angina, symptoms can last longer than 20 minutes and may return. The pain may also get worse over time.

An unstable angina attack can be life threatening and requires emergency medical attention.

Symptoms

Chest pain is the main symptom of both stable and unstable angina. Pain usually starts behind the breastbone. Pain may be referred to your left shoulder or arms.

Other common symptoms include:

• fatigue
• shortness of breath
• light-headedness
• nausea or indigestion
• sweating
• weakness

A heart attack happens when a blockage in an artery in your heart stops or reduces the blood flow to your heart muscle. It’s also called a myocardial infarction.

Symptoms can start suddenly or come on slowly. People with gradual symptoms may not seek medical care right away.

If you think you’re having a heart attack, call 911 or get emergency medical help immediately.

Symptoms

Heart attack symptoms can vary in intensity.

Common heart attack symptoms include:

• a feeling of tightness or pressure in your chest
• chest pain that spreads to your neck, shoulders, one or both arms, or back
• faintness or dizziness
• shortness of breath
• cold sweat
• fatigue
• indigestion, stomach pain, or heartburn

While chest pain is the most common symptom for men, women are more likely to have symptoms other than chest pain. Some of the symptoms women often experience that happen less frequently with men include:

• unusual fatigue that lasts for several days or extreme fatigue that comes on suddenly
• sleep disturbances
• anxiety
• indigestion or gas-like pain
• jaw or back pain
• symptoms that come on more gradually

Your gallbladder is a small organ on your right side that sits below your liver. Its purpose is to release bile into the small intestine. Bile helps the digestive process by breaking down the fats in the food you eat.

Gallstones are little masses that form out of hardened digestive fluid in the gallbladder. Gallstones can range in size, from grains of sand to pingpong balls.

Why some people develop gallstones isn’t clear. But risk factors include:

• being female
• being over 40 years old
• having overweight
• being pregnant

Symptoms

Sometimes gallstones don’t cause any symptoms. But gallstones can cause intense pain when they block a bile duct or when you eat fatty foods. Pain can last up to several hours.

Pain may occur on:

• your right side, above the stomach
• in the center of your stomach, below the breastbone
• in your right shoulder
• between your shoulder blades

You may also have fatigue, nausea, or vomiting.

Pericarditis is the inflammation of the pericardium, the thin sac that surrounds your heart. The two-layered pericardium protects your heart and holds it in place. Fluid between the pericardium layers prevents friction when your heart beats.

Pericarditis usually starts suddenly. It can last from a few days to a few weeks. A viral infection is thought to cause most cases.

Symptoms

The main symptom is sharp or dull pain in the center of your chest or on the left side.

Other common symptoms include:

• pain that spreads from your chest to the shoulder blade
• pain that worsens when you lie down or take a deep breath
• pain that decreases when you lean forward
• weakness
• mild fever
• fatigue

Your pancreas is located behind your stomach near the first part of your small intestine. It releases fluids that help break down the food in your intestine. It also controls your body’s blood sugar by regulating the release of insulin.

Pancreatitis is an inflammation of the pancreas. It can be chronic or acute. Acute pancreatitis can come on suddenly and usually gets better with treatment. Chronic pancreatitis gets worse over time.

The most common cause of acute pancreatitis is gallstones.

Symptoms

Symptoms of pancreatitis can vary, depending on the type of pancreatitis. The main symptom of both acute and chronic pancreatitis is pain in your upper abdomen, as well as pain that radiates to your back.

Acute pancreatitis symptoms include:

• mild or severe pain that lasts for several days
• abdominal pain that gets worse after eating
• fever
• nausea and vomiting
• fast pulse
• swollen or tender stomach

Chronic pancreatitis symptoms include:

• pain in your upper abdomen
• nausea or vomiting
• weight loss without trying
• oily stools that smell bad

Pleurisy is an inflammation of the thin layer of tissues, called pleura, that separate your lungs from your chest wall.

The most common cause of pleurisy is a viral infection in the lungs.

Symptoms

The most common symptoms of pleurisy include:

• sharp chest pain that gets worse when you breathe, cough, laugh, or sneeze
• pain in your shoulders or back
• shortness of breath
• muscle or joint pain
• headaches

Some people may also experience a cough or fever.

Chest pain with shoulder pain isn’t always an emergency, but it can be very hard to tell. That’s why it’s important to pay attention to any other symptoms you may have.

Call 911 or go to an emergency room if you have:

• severe chest and shoulder pain
• have an existing heart condition
• think you’re having a heart attack

Other symptoms that can be a sign you need immediate medical attention are:

• escalating chest and shoulder pain
• difficulty breathing
• fainting or dizziness
• extreme weakness

A 2019 review looked at the most common causes of chest pain for people who went to an emergency room. The review found that:

• 31 percent of the causes were due to acute coronary syndrome, which included angina and other heart problems
• 30 percent of chest pain causes were due to acid reflux
• 28 percent of causes were due to a musculoskeletal condition

See your doctor if you have unexplained chest and shoulder pain. Any time you have chest pain, it’s important to get a proper diagnosis and appropriate treatment.

Because there are many possible causes for chest and shoulder pain, diagnosis can be challenging.

Your doctor will take a full medical history to find out about any other health conditions you may have. They’ll also ask if your family members have heart disease or other types of conditions.

Your doctor will ask about your symptoms, when they started, how long they lasted, and if they changed.

Once your doctor knows more about your symptoms and any other health conditions, they’ll do a physical exam and listen to your heart and lungs.

There are many diagnostic tests your doctor may use to determine what’s causing your shoulder and chest pain. Common diagnostic tests include:

• an X-ray of your lungs, heart, gallbladder, or other organs
• an electrocardiogram (EKG) to look at how your heart is beating
• an echocardiogram to look at your heart muscle and how it’s working
• blood tests to look for signs of a heart attack or specific enzyme levels for certain conditions, like pancreatitis
• a stress test to see how your heart functions when you exercise
• a coronary angiography to find out if you have a blockage in a coronary artery
• a heart CT scan, also known as CT angiography, to look at your heart and blood vessels and to check for blood clots or other problems
• an MRI to look at heart movement and blood flow, or to get a more detailed view of your gallbladder or pancreas
• a biopsy of lung tissue if pleurisy is suspected
• a pancreatic function test to see if your pancreas is responding normally to specific hormones

Treatment for shoulder and chest pain depends on what’s causing the pain.

Because there can be so many variables, treatment plans for the same condition may be different from one person to the next. Some factors that may influence your treatment plan include:

• your age
• other health conditions you may have, including overweight
• whether or not you smoke

Heart problems

For heart problems, your doctor may prescribe:

• aspirin
• nitroglycerin
• blood thinners to prevent clots
• clot-busting drugs (thrombolytics)
• antibiotics for pain caused by an infection
• fluid drainage for pericarditis

For life threatening situations, you may need surgery, such as bypass surgery or angioplasty.

Your doctor will likely recommend lifestyle changes, including changes to your diet, physical activity, and stress management.

Gallstone attack

Depending on the frequency of your gallstone attacks, your doctor may recommend surgery to remove your gallbladder. This is usually done laparoscopically.

For a less serious gallstone condition, your doctor may prescribe a drug called ursodiol. This drug may help dissolve the gallstones over time. Your doctor may also put you on a low fat diet to help prevent further gallstone development.

Some people have success with natural remedies for gallstones. Be sure to talk to your doctor before trying any at-home treatments for gallstones.

Pleurisy

Treatment for pleurisy will depend on the cause.

Your doctor may prescribe antibiotics if you have a bacterial infection. Viral infections often clear up without treatment. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve chest pain.

If you have a lot of fluid buildup, known as pleural effusion, your doctor may want to drain it. This is done with local or general anesthetic. It may require a hospital stay.

A hospital stay may also be necessary if you have other health conditions that make your pleurisy more difficult to treat.

Pancreatitis

Your doctor will give you medications to help reduce the pain. You may also have to fast for a couple of days to give your pancreas a rest. You may need intravenous fluids to prevent dehydration.

You may be hospitalized if your pancreatitis is severe.

Other treatment may include surgery to drain your pancreas, or surgery to remove your gallbladder if gallstones caused your pancreatitis.

Longer-term treatments may include:

• diet changes
• limiting alcohol use
• taking pancreatic enzyme supplements to aid digestion

Other chest pain causes

For chest pain conditions that aren’t related to your heart or coronary arteries, you doctor may prescribe:

• acid suppressing drugs to reduce acid reflux
• antidepressants or therapy to help control panic attacks

Pain in your chest and shoulder can have many causes. Some of the most common include angina or other heart conditions, gallstones, pericarditis, pleurisy, or pancreatitis.

Unexplained pain that occurs in both your chest and shoulder should always be checked out by your doctor.

If the pain is severe or lasts longer than a few minutes, immediately go to the emergency room or call 911. For many conditions, the earlier you receive treatment, the better your outcome is likely to be.

Causes and When to Get Medical Help

There are a number of possible causes of chest and neck pain. The discomfort you experience in either your chest or neck may be the result of an underlying condition in one of the two areas or it might be pain that radiates from elsewhere.

Pain in your chest and neck may be caused by any of the following conditions:

• angina
• heartburn
• pericarditis
• chest infections
• esophagus disorders

Read on to learn more about these conditions.

Angina is caused by a reduction in blood flow to your heart, and symptoms include:

• nausea and dizziness
• shortness of breath
• pain extending to your neck, jaw, shoulder, arms, or back

Stable angina can result from overexertion and generally goes away by resting. Unstable angina is an emergency that involves severely decreased blood flow to the heart, often because of a rupture in a blood vessel or because of a blood clot.

If you experience the symptoms of angina, seek medical attention.

Diagnosis and treatment

Angina is often diagnosed through an electrocardiogram (ECG), chest X-ray, or blood tests. If you are diagnosed with angina, your doctor can determine the more specific diagnosis of stable or unstable angina.

Angina is generally treated through lifestyle changes and medication, though there are surgical options. Unstable angina could be a sign of a heart attack and requires medical treatment immediately.

Heartburn occurs when some of the contents of your stomach are forced back into your esophagus. It may result in a burning sensation in your chest, especially after eating or when lying down. Heartburn can often result in a bitter taste in your mouth.

You have an increased risk of worsening heartburn if you:

• smoke
• are overweight
• consume spicy foods

Diagnosis and treatment

Though heartburn is a common condition, experiencing heartburn on multiple occasions throughout the week — or if pain worsens — is a cue to visit your healthcare provider. It may or may not indicate a more serious condition, but, following a diagnosis, your doctor can provide appropriate treatment.

If it the diagnosis suggests heartburn, you healthcare provider will suggest proper heartburn treatment such as lifestyle changes and medications.

The saclike membrane that surrounds your heart is called the pericardium. When it swells or is irritated, it can cause chest pain in your left shoulder and neck, especially when you:

• cough
• breathe deeply
• lie down

Diagnosis and treatment

The symptoms are often difficult to distinguish from other conditions related to the heart and lungs. Your doctor can provide a diagnosis, likely through an ECG, X-ray, or other imaging tests.

Some cases improve without treatment, but there are medications that reduce symptoms. One complication of the condition is called cardiac tamponade. It requires hospitalization to remove the excess buildup of fluid surrounding your heart.

While chest infections are felt primarily in the chest, you may also experience pain in your neck when breathing or swallowing.

Two common chest infections are pneumonia, an inflammation of the air sacs in your lungs, and bronchitis, which occurs when the lining of your bronchial tubes are inflamed.

Diagnosis and treatment

Bronchitis can be diagnosed through:

• chest X-rays
• sputum tests
• pulmonary function test

Acute bronchitis symptoms sometimes improve without treatment.

Bronchitis from a bacterial infection may require medication. Chronic bronchitis is often treated through a pulmonary rehabilitation program including the learning specific breathing techniques.

Pneumonia can be diagnosed through similar tests as bronchitis. Treatment usually focuses on preventing complications. This can involve:

• antibiotics
• cough medicine
• hospitalization (more serious instances)

Two conditions related to your esophagus that could result in chest and neck pain are esophagitis and esophageal spasms.

Esophagitis occurs when the lining of your esophagus is inflamed. This can cause heartburn or pain when swallowing. Esophageal spasms are contractions of your esophagus that cause chest pain. The pain is often described as a squeezing pain or a feeling something is stuck in your throat.

Diagnosis and treatment

Diagnostic techniques for both conditions may involve an endoscopy or X-ray.

For treating esophagitis, your doctor may help you determine which food allergies could trigger inflammation or recommend medications to relieve symptoms, such as:

• Over-the-counter antacids that reduce acid production, such as Mylanta
• Over-the-counter H-2-receptor blockers that block acid production, such as Pepsid
• Prescription strength H-2-receptor blockers

For treating esophageal spasms, your doctor may recommend treating underlying conditions such as GERD or anxiety. To relax swallowing muscles, they may suggest medications such as Viagra or Cardizem.

If conservative approaches do not work, surgery is an option for both conditions.

Experiencing pain in your chest and neck may require immediate medical attention. In fact, many symptoms of the above conditions are similar to those of a heart attack.

It is best to be cautious and seek medical attention for chest pain, especially if symptoms worsen or persist or you are at risk for a heart attack due to related conditions, age, or family history.

Conditions related to either your chest or neck may be a sign of an underlying condition that causes the pain to spread to surrounding areas. Pain in your chest or difficulty breathing or swallowing should always be taken seriously, seek medical attention for a proper diagnosis and treatment.

90,000 cheaters | Articles by doctors of the EMC clinic about diseases, diagnosis and treatment

The body reacts to most disorders and failures with pain and other unpleasant sensations. The first reaction to them is unambiguous – the sore spot indicates the disease itself.

Commentary for Domashniy Ochag magazine was given by Evgeny Avetisov, general practitioner, medical director of the European Medical Center.

“The right shoulder hurt, which means it blew out or turned awkwardly.” Do you know that a diseased liver can give an alarm in this way? And pain in the liver, quite possibly, causes renal colic. By the way, liver diseases are often manifested by the so-called chronic fatigue syndrome, and the liver itself, as an organ devoid of nerve endings, suffers “silently”.

Or, for example, cardiac arrhythmia, as well as depression, indigestion, insomnia, excessive sweating, hair loss, impaired nail growth, skin changes can be caused by a violation of the thyroid gland. With this disease, in general, a very difficult situation, because the thyroid gland affects all metabolic processes, it can affect any organ. This is the reason for such a variety of manifestations in the form of a wide variety of symptoms that can mask or mimic many diseases.

We asked the expert about some symptoms that can mislead us (but not attentive doctors!)

Symptom: Chest pain

At first glance: problems with the heart.

In fact: very often heart problems cause pain not in the chest at all, but, for example, in the left shoulder, in the left elbow, in the left hand, on the left side of the neck, etc. And real chest pains can be the result of intercostal neuralgia. Or lung disease – if a sharp pain in the chest is accompanied by shortness of breath, this may be a sign of pneumothorax, when a sudden rupture of the lung occurs for no apparent reason. A person can live without being aware of the peculiarities of the structure of his lungs, and suddenly – after active sports or a strong attack of coughing – there is a sharp pain in the chest, coughing, shortness of breath – a feeling of lack of air. One lung stops functioning.

Acute pain in the chest can be caused by Tietze’s syndrome – an inflammation of the junction of the ribs with the sternum. Such an indisposition is quite common, it is not dangerous to health, although it is accompanied by painful sensations, in this case, the diagnosis is usually made easily.

Pain in the middle of the sternum sometimes indicates problems with the esophagus – its inflammation, damage to a sharp bone, for example, fish, as well as a hernia of the esophageal opening of the diaphragm.

Symptom: Lower back pain

The most obvious: sciatica (“lumbago”).

In fact: May be a sign of kidney disease, such as pyelonephritis, a gynecological disease in women, most often such pain is caused by problems with the spine or muscle spasms. There is even such a special diagnosis – pain in the lower back.

Symptom: Upper abdominal pain

The most obvious: diseases of the stomach (gastritis), especially if the pain is associated with eating, the symptoms of a duodenal ulcer appear in a similar way.

In fact: such pain can be a sign of a heart attack, if the process develops in certain parts of the heart, the pain is “redirected” to the stomach area. It can also be a sign of gallbladder disease, rarely inflammation of the pancreas (pancreatitis) or intestines. And yet – a manifestation of radiculitis or lower lobe pneumonia. To make a diagnosis, the doctor needs to take into account other additional manifestations.

Symptom: Shoulder pain

The most obvious: a disease of the shoulder itself – damage to the joint, ligaments due to overload or injury.

Actually: shoulder pain is caused by damage to the cervical spine. It can also be a sign of heart or lung disease. By the way, pain in the cervical spine sometimes mimics a heart attack – they can cause severe pain in the heart.

Changes in the cervical region helps to accurately diagnose MRI.

If we talk about the right shoulder, it is rare, but it happens – when the pain indicates a problem with the gallbladder, which irradiates to the right shoulder joint. And the pain in the left shoulder is a possible irradiation of the pain of the stomach or lungs.

Symptom: Headache

The most obvious: increased blood pressure, vascular problems, migraine.

In fact: in 90% of cases, causal relationships are also violated here. Pressure rises with any discomfort – a headache, especially severe, especially if a person is alarmed; it rises because the head hurts, and not vice versa! You need to know that a headache due to high blood pressure occurs only when the numbers are very high. With a pressure of 140/90, there may not be a headache.

Much more often headache occurs due to problems with the upper spine, neuralgia of the occipital nerve is associated with its exit to the first vertebrae. Very often it gives headaches, especially in the back of the head, temples.

Inflammation of the sinuses – sinusitis, frontal sinusitis – are also likely culprits of headache, which is localized in the forehead, eye sockets and cheekbones. Headache can be caused by a viral infectious disease, for example, herpes lesions of the nerves: occipital, trigeminal.

Vision problems also provoke a headache – people with myopia and astigmatism, especially pronounced, often experience severe pain in the forehead and temples when they are forced to read a lot, work at a computer, due to visual overload.

Headache may be associated with anemia (lack of hemoglobin), but this is rare.

As for the increase in intracranial pressure, this diagnosis is made quite often in our country: in order to make it, in fact, you need to insert a probe or do a spinal puncture.

Symptom: Joint pain

The most obvious: inflammation of the joints (arthrosis).

In fact: on the one hand, indeed, pain is often caused by degeneration of the articular cartilage. As well as an inflammatory process that develops right in the joint.

But it can also be a sign of reactive changes when the infection develops elsewhere, such as in the urogenital organs or in the gastrointestinal tract. Due to the work of the immune system, this inflammation does not manifest itself in the intestines (there is no diarrhea or disorders), and the pain is “transferred” to the joints. In this case, it is simply pointless to treat only the joints – this will only help relieve symptoms for a while, and then the process resumes.

Pain in the joints is sometimes caused by chlamydial infection, salmonella, shigella – different pathogens that “dig in” in different places, without even causing the classic symptoms of their disease – shigellosis or salmonellosis.

Therapist’s commentary

Natalia Rivkina, Head of the Psychotherapy Clinic of the European Medical Center:

Heart stone

Feelings of physical discomfort, which, as it seems to a person, are caused by a somatic disease, in fact, can be caused by neurotic conditions or mental stress. The likely cause is depression. One of the symptoms of moderate to severe depression is retrosternal pain, a feeling of heaviness in the region of the heart. Often these symptoms are confused with heart disease, manifestations of angina pectoris. How to explain this connection? With depression, such conditions arise as mental anguish, and it gives this feeling, which in everyday life we ​​call “a stone in the heart.” Often such experiences can be accompanied by a feeling of physical pain in the region of the heart. Pain is a subjective sensation. A person really feels it and experiences suffering.

Often, abdominal pain and discomfort can be caused by neurotic situations, stress, in any case, such symptoms require a complete medical examination. And only when diseases of the gastrointestinal tract are excluded, we can talk about the psycho-emotional causes of such conditions. Somatic discomfort caused by emotional factors requires, first of all, an analysis of the factors that provoke such symptoms, and the selection of an individual, adequate psychotherapeutic treatment.

ABC Medicine

Angina (angina pectoris) is a sharp pain or discomfort in the chest area. The reason for this is the lack of blood supply in certain areas of the heart. Angina pectoris is noted as the leading symptom in coronary heart disease (CHD), which develops due to blockage or narrowing of the heart vessels. All patients experience approximately the same sensations – pressing or squeezing pain behind the chest, which often radiates to the arm, shoulder, jaw or neck. Usually the pain does not last more than 5 minutes and disappears after taking certain medications or relieving stress. However, the duration of the attack is purely individual, some patients experienced pain from 30 seconds to 30 minutes.

Symptoms

When angina occurs, the pain is usually intense and relieved by taking nitroglycerin in conjunction with the cessation of exercise. These pain sensations have characteristic features: a pronounced time of onset and cessation (the nature of the attack), the occurrence in certain circumstances.

Among the most common conditions for the onset of an attack of angina pectoris, active walking can be distinguished (acceleration of movement, climbing uphill, difficulty in the form of a sharp headwind, heavy burden). Also, other physical efforts and significant emotional stress can cause angina symptoms. To determine the pain arising from physical effort, it is enough to stop the tension. And the discomfort will subside within 5 minutes. The complete elimination of symptoms of angina pectoris is facilitated by taking nitroglycerin. As a rule, to make a diagnosis, it is enough to take into account the above symptoms and signs: an increase in pain during exercise, a favorable response to nitroglycerin, and the nature of the attack.

Causes

The main phenomenon that characterizes the symptoms of angina pectoris is an imbalance between the heart’s need for oxygen and its direct supply. Due to lack of nutrition, the muscle can develop its necrosis.

So, among the reasons for the lack of oxygen supply to the heart, local blood flow disorders are often singled out. It can be triggered by chronic narrowing of the lumen of the artery that feeds the heart due to atherosclerotic plaque. Also, angina pectoris occurs due to a sharp and prolonged spasm of the heart vessels. As a result, one part of the heart receives less oxygen than it needs to function properly. During physical activity, this deficiency is felt especially strongly. This is the reason why the vast majority of acute angina attacks are the result of exhausting and hard work or stress.

Consequences

Compared to myocardial infarction, when the circulatory failure in the heart muscle is irreversible and catastrophic, angina pectoris is a less obvious circulatory disorder that quickly recovers after the cause of the attack is removed. Therefore, extensive damage to the tissues of the heart does not occur. It should be borne in mind that exceeding the survival threshold of the heart muscle threatens that an angina attack will develop into a heart attack.

Diagnosis

Not every pain in the chest or heart can be called angina pectoris. If it lasts less than 30-40 seconds and is eliminated by a deep breath or a change in body position, you should not worry about angina. To make such a diagnosis, the doctor must analyze your complaints, find out the symptoms and the circumstances of their manifestation. A number of medical tests are performed to rule out comorbidities in the diagnosis of angina pectoris, including a two-state electrocardiogram (ECG) (rest and exercise), a stress test, blood pressure measurement, and an X-ray of the coronary arteries.

The ECG can help the doctor determine the electrical impulses of the heart and, with them, the symptoms of angina pectoris. They show the absence or presence of ischemia (lack of blood supply), characteristics of changes in heart rate and some other parameters. To get a complete picture of cardiac activity, the specialist compares the ECG readings after exercise and at rest, and then decides on the need to treat angina pectoris.

Comprehensive stress test makes it possible to diagnose angina pectoris and evaluate blood flow in the heart muscle. A small amount of a radioisotope (usually thallium) is used, which is injected into a vein by microinjection during exercise. Using a special device, the doctor monitors the distribution of thallium in the heart. The unequal concentration or absence of this element in one or another part of the muscle reveals areas of insufficient blood supply.

The most accurate way to determine angina pectoris (angina pectoris) is an angiogram, or x-ray of the coronary artery. The catheter is placed in an artery in the groin or in the forearm, and then it moves along the path of blood flow all the way to one of the heart arteries. Next, an injection of a radiopaque fluid is performed, which allows you to observe changes in the studied arteries, diagnosing angina pectoris.

Treatment

Successful treatment of angina is generally associated with a reduction in risk factors that can cause cardiovascular problems. These include: high blood pressure, excess cholesterol, overweight, smoking. The doctor will prescribe you all the necessary medicines to bring your blood pressure back to normal, suggest the right diet and help you create an exercise program for the treatment of angina pectoris.

Mononitrates, dinitrates and trinitrates are currently used to relieve the symptoms of angina pectoris. The mechanism of their action is the expansion of the vessels of the heart, which allows you to increase the flow of oxygen and reduce the tension of the myocardial wall. Among the undesirable effects of nitrates in the treatment of angina are headache, lowering blood pressure, facial flushing, dizziness and the appearance of insensitivity to certain doses of the drug. Also used are beta-blockers, which reduce the strength and frequency of the heartbeat, and calcium channel blockers, which prevent vasospasm.

When the symptoms of angina pectoris are severe and medications are not able to help, surgical intervention (in the form of coronary bypass surgery) and balloon angioplasty are prescribed. Coronary artery bypass surgery is the implantation of a blood vessel into a blocked segment of a coronary artery. Thus, blood flow is restored in this part of the heart using a bypass. Angioplasty is an operation to treat angina pectoris using a catheter that has a small balloon at the end. It is inserted into the axillary or femoral artery, and then advanced to the site of narrowing of the coronary vessel. Here it quickly inflates or stretches, eliminating spasm.

Particular care needs to be taken in the treatment of unstable angina, which can occur even in the absence of exertion. Such chest pain has no predictable onset, unlike stable angina, and does not need a reason to appear.

Prevention

Main methods of prevention and treatment of angina pectoris:

• absolute cessation of smoking and alcohol;
• long walks in a calm mode, physical activity within reasonable limits in accordance with doctor’s prescriptions;
• blood pressure control;
• you should follow the diet prescribed by the doctor, limit the intake of animal fats and salt, increase the use of vegetables, vegetable fats and fruits in the diet;
• detection and appropriate treatment of diabetes mellitus, control of blood glucose levels;
• lack of excessive emotional stress.