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Costochondritis (for Parents) – Nemours Kidshealth

What Is Costochondritis?

Costochondritis (kos-tuh-kon-DRY-tis) is a painful swelling of the cartilage that attaches the ribs to the breastbone (sternum). It’s one of the most common causes of chest pain in kids and teens, and happens more often in girls than boys.

Costochondritis — also called chest wall pain or costosternal syndrome — can cause a sharp, stabbing pain. Usually, it’s harmless and goes away on its own after 2 or 3 days.

What Causes Costochondritis?

Doctors often can’t pinpoint the exact cause of costochondritis. But sometimes it’s linked to:

  • an injury to the ribs or breastbone
  • physical strain due to heavy lifting or strenuous exercise
  • repeated coughing (as can happen with some infections)

What Are the Signs & Symptoms of Costochondritis?

The main symptoms of costochondritis are pain and soreness in the chest. A sharp pain is usually felt on the left side of the breastbone, but can be on both sides.

The pain can get worse when a child:

  • takes deep breaths
  • coughs
  • moves the upper body
  • presses on the affected area

Pain may ease a little when the child stops moving or takes shallower breaths.

A heart attack is rarely the cause of chest pain in young people. Still, it helps to know how costochondritis pain differs from heart attack pain:

  • Heart attack pain is usually more widespread and felt in other body parts, like the arms and neck. It also feels as if it’s coming from under the breastbone.
  • Costochondritis pain usually is felt only in a small area of the chest and feels as if it’s coming directly from where the breastbone meets the ribs.

How Is Costochondritis Diagnosed?

To diagnose costochondritis, the doctor will:

  • ask about the symptoms
  • feel for tenderness along the area where the breastbone meets the ribs

The breastbone and ribs are connected by rubbery

cartilageat points called costosternal joints. It’s in one or more of these joints that the pain is felt.

Costochondritis can’t be seen on a chest X-ray, but the doctor may order one to rule out other possible causes of chest pain, such as pneumonia.

How Is Costochondritis Treated?

Costochondritis usually goes away on its own without any treatment within a few days. Sometimes, it lasts longer — from several weeks to months. If you’re concerned about pain that’s not going away, talk to your doctor.

In the meantime, the doctor will probably recommend giving your child over-the-counter pain medicines like ibuprofen or naproxen to help ease symptoms. Applying a warm compress or a heating pad (set on low) to the sore area also may give some relief.

Until feeling better, your child should get plenty of rest and avoid activities that make the pain worse.

Can Costochondritis Be Prevented?

It’s not always clear what causes costochondritis, so you can’t completely prevent it. But many cases are caused by heavy lifting, like carrying an overstuffed backpack — especially on one shoulder, which many kids do. So if your child has to carry lots of books, buy a supportive backpack that spreads weight evenly over both shoulders and make sure it’s worn over both shoulders.

When Should I Call the Doctor?

If your child has chest pain that doesn’t go away, call your doctor or go to a hospital emergency room. Chest pain rarely is serious in kids. But sometimes it can be the sign of an emergency that needs medical care right away.

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 | Causes, Symptoms and Treatment

It is important to take chest pain seriously because it can sometimes indicate a serious underlying problem. Any new, severe, or persisting chest pain should be discussed with your doctor. This is particularly important if you are an adult and have a history of heart or lung disease. If the chest pain is particularly severe, especially if it is radiating to your arms or jaw, you feel sick, feel sweaty or become breathless, you should call 999/112/911 for an emergency ambulance. These can be symptoms of a heart attack.

Causes of chest pain

Dr Sarah Jarvis MBE

There are many possible causes of chest pain. Below is a brief overview of some of the more common causes.


Angina is a pain that comes from the heart. It is usually caused by narrowing of the coronary arteries, which supply blood to the heart muscle.

In the early stages, blood supply may be adequate when you are resting. However, when you exercise, your heart muscle needs more blood and oxygen, and if the blood cannot get past the narrowed coronary arteries, your heart responds with pain.

The chest pain caused by angina may feel like an ache, discomfort or tightness across the front of your chest.

Angina pain can also occur with coronary artery spasm or cardiac syndrome X.

Heart attack

During a heart attack (myocardial infarction), a coronary artery or one of its smaller branches is suddenly blocked. This cuts off the blood supply to part of the heart muscle completely.

The most common symptom of a heart attack is severe chest pain at rest. Unless the blockage is quickly removed, this part of the heart muscle is at risk of dying. To find out more about the symptoms and treatments for a heart attack, see the separate leaflet called Heart Attack (Myocardial Infarction).

Gastro-oesophageal reflux disease

This is a general term which describes a range of situations including acid reflux and oesophagitis (inflammation of the lining of the oesophagus, or gullet).

Heartburn – usually a burning in the lower chest and upper abdomen – is the main symptom of gastro-oesophageal reflux disease. Severe chest pain can develop in some cases and can be mistaken for a heart attack. To find out more about the symptoms and treatments, see the separate leaflet called Acid Reflux and Oesophagitis (Heartburn).


The rib cage is a bony structure that protects the lungs. Softer, more flexible cartilage attaches the ribs to the breastbone (sternum) and the sternum to the collar bones (clavicles) at joints. In costochondritis, there is inflammation in one or more of these joints.

Costochondritis causes chest pain, felt at the front of the chest. This is typically a sharp, stabbing chest pain and is worse with movement, exertion and deep breathing.

Strained chest wall muscle

There are various muscles that run around and between the ribs to help the rib cage to move during breathing. These muscles can sometimes be strained and can lead to chest pain in that area. If a muscle is strained, there has been stretching or tearing of muscle fibres, often because the muscle has been stretched beyond its limits. For example, a strained chest wall muscle may sometimes develop after heavy lifting, stretching, sudden movement or lengthy (prolonged) coughing. The chest pain is usually worse on movement and on breathing in.


Anxiety is quite a common cause of chest pain. In some people, the chest pain can be so severe that it is mistaken for angina. Chest pain due to anxiety is known as Da Costa’s syndrome. Da Costa’s syndrome may be more common in people who have recently had relatives or friends diagnosed with heart problems, or in people who themselves have recently had a heart attack. Investigations show that the coronary arteries are normal with no narrowing.

Less common causes of chest pain

Some of the less common causes of chest pain include the following.


Pleurisy is due to inflammation of the pleura, a thin membrane with two layers – one which lines the inside of the muscle and ribs of the chest wall, the other which surrounds the lungs. It can cause a ‘pleuritic’ chest pain. This is a sharp, stabbing chest pain, typically made worse by breathing in or by coughing.

Less common but more serious causes of pleuritic pain include pneumonia, or a blood clot in the lung (pulmonary embolism – see below) or a collapsed lung (pneumothorax – see below).

Pulmonary embolism (PE)

A PE occurs when there is a blockage in one of the artery blood vessels in the lungs – usually due to a blood clot (thrombus) which formed in another part of the circulation. A PE usually causes sharp chest pain felt when breathing in (pleuritic chest pain). Other symptoms include coughing up blood (haemoptysis), mild fever and rapid heart rate.

See the separate leaflet called Pulmonary Embolism for more details on this medical emergency.


A pneumothorax is air that is trapped between a lung and the chest wall. The air gets there either from the lungs or, following chest wall injury, from outside the body.

A pneumothorax typically causes sudden, sharp, stabbing chest pain on one side. The pain is usually made worse by breathing in and you can become breathless. Usually, the larger the pneumothorax, the more breathless you become.

Peptic ulcer

A peptic ulcer is an ulcer on the inside lining of the upper gut caused by stomach acid.

A common symptom of a peptic ulcer is pain in the upper tummy (abdomen) just below the breastbone (sternum). Complications of peptic ulcers, which can be serious, include bleeding from the ulcer, and perforation, where the the ulcer goes right through (perforates) the wall of the gut.

There are separate leaflets called Stomach Ulcer (Gastric Ulcer) and Duodenal Ulcer.


Shingles is an infection of a nerve and the area of skin supplied by the nerve. It is caused by the same virus that causes chickenpox. Anyone who has had chickenpox in the past may develop shingles.

The usual symptoms are pain and a rash over the strip of skin supplied by one nerve, sometimes on the chest wall. The pain often starts before the rash appears.

Is my chest pain serious?

Seek medical help immediately if you have chest pain that is in the middle of your chest, is crushing or squeezing and comes with any of the following symptoms:

  • Pain that spreads to the neck, jaw, or one or both shoulders or arms.
  • Sweating.
  • Shortness of breath.
  • Feeling sick (nausea) or being sick (vomiting).
  • Dizziness or light-headedness.
  • Fast or irregular pulse.

You should call 999/112/911 for an emergency ambulance.

There are many different causes of chest pain. Some are more serious than others. Any new, severe, or persisting chest pain should be discussed with your doctor. This is particularly important if you are an adult and have a history of heart or lung disease.

What investigations may be advised?

Your doctor will usually ask you some questions to try to determine the cause of your chest pain. He or she may also examine you. Based on what they find, he or she may advise you to have some investigations, depending on what cause for your chest pain they suspect. Investigations for chest pain can include:

A ‘heart tracing’

There are usually typical changes to the normal pattern of the ‘heart tracing’ (electrocardiogram, or ECG) in a heart attack.

Blood tests

A blood test that measures a chemical called troponin is the usual test that confirms a heart attack. Damage to heart muscle cells releases troponin into the bloodstream. Another blood test that may be suggested is a D-dimer test. This detects fragments of breakdown products of a blood clot. A positive D-dimer test may raise the suspicion of a deep vein thrombosis (DVT) or a PE.

Chest X-ray

A chest X-ray can look for pneumonia, collapsed lung (pneumothorax) and other chest conditions.

Other scans and imaging

  • Myocardial perfusion scan – often done to confirm the diagnosis of heart chest pain (angina).
  • Cardiac magnetic resonance imaging – also to confirm heart chest pain, this is a type of magnetic resonance imaging (MRI) scan.
  • CT coronary angiogram – a quicker alternative to an MRI scan, in which a CT scan is used to to look in detail at your coronary arteries.
  • Coronary angiography – this test uses specialist X-ray equipment and dye injected into the coronary arteries to show the location and severity of any narrowing of the arteries.
  • Isotope scan and CTPA scan look at the circulation in the lung. CTPA stands for ‘computerised tomography pulmonary angiogram’. They can show quite accurately whether or not a PE is present.
  • Endoscopy – which uses a thin, flexible telescope passed down your gullet (oesophagus) to examine your stomach lining. This may be recommended if your team thinks your chest pain could be caused by gastro-oesophageal reflux disease or a peptic ulcer.

What may be advised to help manage the problem?

This will depend on the cause that is found for your chest pain. Follow the links above to the separate leaflets for more information about the treatment for the different causes.

If the problem is not an emergency, your doctor may refer you to a consultant for further specialist investigations, as described above.

Upper and Middle Back Pain


Is this topic for you?

This topic provides an overview of upper and middle back pain. If you have low back pain or neck pain, see the topic Low Back Pain or Neck Pain.

What is upper and middle back pain?

Upper and middle back pain can occur anywhere from the base of your neck to the bottom of your rib cage.

Your ribs attach to a long, flat bone in the centre of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

The upper and middle back (called the thoracic spine) has:

  • 12 vertebrae. These bones attach to your rib cage. They make up the longest part of your back.
  • Discs that separate each vertebra and absorb shock as you move.
  • Muscles and ligaments that hold the spine together.

See a picture of the spine.

Upper and middle back pain is not as common as low back pain or neck pain, because the bones in this area of the back don’t flex or move as much as the bones in your lower back or neck. Instead, they work with the ribs to keep the back stable and help protect vital organs, such as the heart and lungs.

What causes upper and middle back pain?

Upper and middle back pain may be caused by:

  • Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
  • Poor posture.
  • Pressure on thespinal nerves from certain problems, such as a herniated disc.
  • A fracture of one of the vertebrae.
  • Osteoarthritis caused by the breakdown of cartilage that cushions the small facet joints in the spine.
  • Myofascial pain that affects the connective tissue of a muscle or group of muscles.

In rare cases, pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.

What are the symptoms?

Common symptoms of upper and middle back pain are:

  • A dull, burning, or sharp pain.
  • Muscle tightness or stiffness.

More serious symptoms that need to be treated right away include:

  • Weakness in your arms or legs.
  • Numbness or tingling in your arms, legs, chest, or belly.
  • Loss of bowel or bladder control.

How is upper and middle back pain diagnosed?

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical examination. Your doctor may also order an imaging test, such as an X-ray or an MRI, to find out if something such as a broken bone or a herniated disc is causing your pain.

You may need more tests to check for other possible causes for your pain.

How is it treated?

In most cases, people with mild to moderate back pain can manage their symptoms with:

  • Over-the-counterpain medicines, such as acetaminophen (for example, Tylenol) and non-steroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin).
  • Over-the-counter muscle relaxants, such as methocarbamol (for example, Methoxisal, Robaxin).
  • Heat or ice.
  • Exercise.
  • Manual therapy, such as massage, mobilization, or spinal manipulation.

But if your pain gets worse and you’re having a hard time doing your daily activities, you may need to take a prescription pain medicine. Surgery is seldom used to treat upper and middle back pain.

How can you care for yourself at home?

There are several things you can do at home to help reduce your pain. For example:

    • Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly.
    • Use over-the-counter pain medicines, such as acetaminophen (for example, Tylenol) and non-steroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
    • Use over-the-counter muscle relaxants, such as methocarbamol (for example, Methoxisal, Robaxin). These can relax muscles and may reduce pain, but they may cause drowsiness, dizziness, or lightheadedness.
    • Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling.
    • Exercise. Exercises that stretch and strengthen the muscles in your back, shoulders, and stomach can help improve your posture, decrease your chance of injury, and reduce pain.
    • Practice good posture. Be sure to stand or sit tall. Don’t slump or slouch.
    • Learn ways to reduce stress. You might try deep breathing and relaxation exercises or meditation.


In most cases, upper and middle back pain is caused by:

  • Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine.
  • Poor posture.
  • Myofascial pain that affects the connective tissue of a muscle or group of muscles.

For example, some people hurt their backs when they:

  • Slump or slouch when they sit or stand.
  • Play sports or do yard work.
  • Get jolted in a car crash.
  • Get hit hard in the back.
  • Lift something too heavy.

Conditions that put pressure on the spinal nerves also can cause pain. These include:

  • Osteoarthritis. This occurs when the cartilage that cushions the small facet joints in the spine breaks down. When this happens, the back bones rub together and cause damage and pain. Osteoarthritis is caused by the normal wear and tear of the cartilage as you age.
  • A fracture of the vertebrae, which can occur when a lot of force is put on the spine. This force can be from a car crash or bike crash or a direct blow to the spine. A compression fracture occurs when an injury to the bones in the spine causes them to break and collapse (compress) on each other, such as from a fall. In people who have osteoporosis, which makes the bones brittle and weak, a spinal bone can also break and collapse from only a minor injury or simply moving the wrong way.
  • An odd-shaped spine, such as with scoliosis or kyphosis. This can make your back hurt. When you look at a normal spine from the back, it is usually straight. But when a person has scoliosis, the spine curves from side to side, often in an S or C shape. It may also be twisted. When a person has kyphosis, the upper spine is rounded and looks like a hump. In bad cases of scoliosis or kyphosis, a person may have a hard time breathing.
  • A herniated disc. This occurs when one of the small, spongy discs that cushion your spine bulges or breaks open and presses on the nerves in the spine. A herniated disc may be caused by normal wear and tear of the disc as you age. Or it may be brought on by activities that you do over and over again that cause a lot of vibration or motion (such as using a jackhammer) or by a sudden heavy strain or increased force to your back. In most cases, a herniated disc occurs in the lower back or neck. It can occur in the upper or middle back, but this is rare. See a picture of a herniated disc.
  • Spinal stenosis. The spinal cord runs through an opening in the bones called the spinal canal. Spinal stenosis occurs when that opening narrows. In some cases, bone, ligament, and disc tissue grows into the spinal canal and presses on the nerves that branch out from the spinal cord. The tissue can also squeeze and irritate or injure the spinal cord itself. In most cases, spinal stenosis occurs in the lower back and neck. It can occur in your upper or middle back, but this is rare.
  • Degenerative disc disease. This is not really a disease but a term used to describe the normal changes that occur in your spinal discs as you age. Over time, the discs in your spine break down, or degenerate. A loss of fluid in the discs or tiny tears or cracks in the outer layer of the discs can occur over time. The breakdown of the discs can cause back or neck pain, arthritis, spinal stenosis, or a herniated disc. A sudden injury to your back, such as from a fall or a car crash, may also start this process. This problem can occur anywhere on your spine. But in most cases, it occurs in the discs in the lower back and neck.

In rare cases, upper and middle back pain may be caused by other problems, such as gallbladder disease, cancer, or an infection.


In general, symptoms of upper and middle back pain may:

  • Feel like a dull, burning, or sharp pain.
  • Be felt at a single point or over a broad area.
  • Start suddenly or slowly get worse.
  • Be constant or come and go.
  • Occur with muscle tightness or stiffness.
  • Get worse when you do certain activities or move and sit in a certain way.

More serious symptoms that need to be treated right away include:

  • Weakness in your arms or legs.
  • Numbness or tingling in your arms, legs, chest, or belly.
  • Loss of bowel or bladder control.

When to Call a Doctor

In most cases, back pain gets better with home treatment. So unless you have signs of a severe illness, injury, or heart attack, you can give your back pain some time to work itself out before you call your doctor.

Call 911 or other emergency services immediately if:

  • Back pain occurs with chest pain or other symptoms of a heart attack. Symptoms of a heart attack include:
    • Chest pain or pressure, or a strange feeling in your chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in your back, neck, jaw, upper belly, or one or both shoulders or arms. See a picture of areas where symptoms may be felt.
    • Feeling dizzy or light-headed.
    • A fast or uneven heartbeat.
  • A person has signs of damage to the spine after an injury (such as a car crash, fall, or direct blow to the spine). Signs may include:
    • Being unable to move part of the body.
    • Severe back or neck pain.
    • Weakness, tingling, or numbness in the arms, legs, chest, or belly.

Call your doctor now if:

  • You have a new loss of bowel or bladder control.
  • You have new numbness in your legs or numbness in your legs that is getting worse.
  • You have new weakness in your legs or weakness in your legs that is getting worse. (This could make it hard to stand up.)
  • You have new or increased back pain with fever, painful urination, or other signs of a urinary tract infection.

Watchful waiting

Watchful waiting is a wait-and-see approach. If you get better on your own, you won’t need treatment. If you get worse, you and your doctor will decide what to do next. If your back pain is mild to moderate, it probably will get better on its own. You can try home treatment to relieve your symptoms. If you don’t feel better in 1 to 2 weeks, call your doctor.

Be sure to call your doctor right away if you start to have other symptoms or you have:

  • Numbness.
  • Weakness.
  • Fever.
  • Urinary symptoms, such as pain when you urinate.
  • Pain that is getting worse.
  • Pain that you can’t manage at home.

Who to see

Health professionals who can evaluate and treat neck pain include:

If your neck pain is severe or long-lasting, health professionals who can treat you include:

You can also get care from:

Examinations and Tests

Your doctor will first ask you about your past health, your symptoms, and your work and physical activities. Then he or she will do a physical examination. Your doctor may also order an imaging test to find out if something such as a broken bone or a herniated disc is causing your pain.

The type of imaging test you have depends on what kind of problem your doctor suspects. You may have one or more tests, such as:

  • An X-ray to look for injuries or diseases that affect the discs and joints of the spine.
  • An MRI to look for injuries and diseases that affect the discs and nerves of the spine, such as a herniated disc, a pinched nerve, or a tumour. It can also show whether any part of the spinal canal has narrowed.
  • A CT scan to look for a tumour, a fracture, a herniated disc, narrowing of the spinal canal, or an infection. It can also show whether osteoporosis is the cause of a compression fracture.
  • A bone scan to look for damage to the bones, a tumour, or infection, or to find the cause of unexplained back pain.
  • An electromyogram and nerve conduction study to check how well the spinal cord, nerve roots, and nerves and muscles that control your arms and legs are working. It can help find out what is causing pain, numbness, or weakness in the arms or legs.

More tests may be done to check for other possible causes for your pain.

Treatment Overview

There are many treatments for upper and middle back pain. What works for someone else may not help you. Work with your doctor to find what is best for you.

Treatment for upper and middle back pain is based on:

  • How bad your symptoms are.
  • How much your symptoms prevent you from doing your daily tasks.
  • How well other treatments have worked.

Treatment for mild to moderate pain

In most cases, people with mild to moderate upper and middle back pain can manage their symptoms with:

    • Over-the-counterpain medicines, such as acetaminophen (for example, Tylenol) and non-steroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin), to reduce pain. But if these don’t get rid of your pain, you may need a prescription pain medicine that is stronger.
    • Over-the-counter muscle relaxants, such as methocarbamol (for example, Methoxisal, Robaxin). These can relax muscles and may reduce pain.
    • Heat or ice to reduce pain and stiffness.
    • Exercise to stretch and strengthen the muscles of your back, shoulders, and stomach.
    • Physiotherapy to help increase your flexibility, strength, and balance. Your physiotherapist may teach you an exercise program so you can do it at home.
    • Massage to help reduce muscle tension and pain for a short time and to improve blood flow.
    • Spinal manipulation to help relieve pain and improve function. It can range from massage and slow pressing to a quick thrust.
    • Acupuncture. It involves putting tiny needles into your skin at certain points on the body to promote healing and pain relief.
    • Capsaicin cream may help relieve pain.footnote 1 Capsaicin is a substance contained in cayenne peppers. Capsaicin cream is applied directly to the skin over the painful area. Do not apply topical products that contain capsaicin to areas of broken skin.

Treatment if back pain gets worse

If your back pain doesn’t get better or it gets worse, your doctor may recommend:

  • Prescription medicines, such as opioids, to help reduce pain.
  • Prescription muscle relaxants to help reduce pain and muscle tension and improve mobility. These can help with severe muscle spasms that happen when the back pain starts (acute phase).
  • Antidepressants, such as amitriptyline and duloxetine, to help treat long-lasting (chronic) back pain.
  • Steroid shots to help reduce swelling and relieve pressure on nerves and nerve roots. But there is little evidence showing that these shots can help control back pain.

In some cases, a back brace may be used to support the bones in the spine after a fracture.

Surgery is seldom used to treat upper and middle back pain. If your doctor recommends surgery, the type will depend on the problem you have. Surgery choices may include:

  • Kyphoplasty or vertebroplasty. Bone cement is injected through a needle into the broken vertebrae to try to stabilize the bone. These surgeries are not done very often, because most fractures heal on their own. And there is no evidence that kyphoplasty or vertebroplasty are better than non-surgical treatment.footnote 2
  • Herniated disc removal. It removes the portion of the disc that is herniated and pushing into the spinal canal. In most cases, herniated discs that occur in the upper and middle back are small and don’t need surgery. But you may need surgery for a large herniated disc that presses on the spinal cord.
  • Spinal decompression for stenosis. It widens the spinal canal that has narrowed, and it relieves pressure on the spinal cord or nerves. This procedure is not done very often, because spinal stenosis in the upper and middle back is rare.

Home Treatment

There are several things you can do at home to help reduce your pain. For example:

  • Rest. If your back hurts a lot, take a break. But try not to let too much time pass before you get moving again. Instead, return to your activities slowly, and avoid things that make your pain worse. Studies show that bedrest doesn’t relieve back pain better than staying active. And bedrest of more than a couple of days can make your back pain worse and lead to other problems, such as stiff joints and muscle weakness.
  • Useover-the-counterpain medicine, such as acetaminophen (for example, Tylenol) and non-steroidal anti-inflammatory drugs (for example, Advil, Aleve, aspirin, and Motrin). These can reduce pain and swelling. Be safe with medicines. Read and follow all instructions on the label.
  • Use over-the-counter muscle relaxants, such as methocarbamol (for example, Methoxisal, Robaxin). These can relax muscles and may reduce pain.
  • Use a heating pad or ice pack. Heat can reduce pain and stiffness. Ice can help reduce pain and swelling. You might want to switch back and forth between heat and cold until you find what helps you the most.
  • Exercise. Ask your doctor or a physiotherapist about what kinds of exercises you can do to stretch and strengthen the muscles in your back, shoulders, and stomach. These muscles help support your spine. Strong muscles can help improve your posture, keep your body in better balance, decrease your chance of injury, and reduce pain.
  • Practice good posture. Poor posture puts stress on your back. Be sure to stand or sit tall, with your shoulders and your stomach pulled in to support your back. Don’t slump or slouch.

Here are some other things you can do to feel better:

  • See a counsellor.Cognitive-behavioural therapy can show you how to change certain thoughts and behaviours to control your pain. For more information, see the topic Positive Thinking With Cognitive-Behavioural Therapy.
  • Learn ways to reducestress. Stress can make your pain feel worse. You might try deep breathing and relaxation exercises or meditation.
  • Eat nutritious foods. Getting plenty of calcium and vitamin D may help prevent osteoporosis, which can lead to compression fractures and back pain. For more information, see the topic Healthy Eating.
  • Don’t smoke. Smoking decreases blood flow and slows healing. If you need help quitting, see the topic Quitting Smoking.
  • Take extra care when you lift. When you must lift, bend your knees and keep your back straight. Avoid twisting. Keep the load close to your body.
  • Use a pain diary. Write down how your moods, thoughts, sleep patterns, activities, and medicines affect your pain. Having a record of your pain can help you and your doctor find the best ways to treat your pain.



  1. Gadomski AM, Brower M (2010). Bronchodilators for bronchiolitis. Cochrane Database of Systematic Reviews (12).
  2. Esses SI, et al. (2011). The treatment of symptomatic osteoporotic spinal compression fractures. Journal of the American Academy of Orthopaedic Surgeons, 19(3): 176–182. Also available online: http://www.aaos.org/research/guidelines/guide.asp.


Adaptation Date: 7/22/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Adaptation Date: 7/22/2020

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

3 Reasons You Might Have Rib Cage Pain

Learn the symptoms of each condition and what treatment to expect.

Pain in your chest can be scary — you may even be worried you’re having a heart attack. But the pain you’re experiencing might not actually be coming from one of your organs. The ribs themselves, and the area surrounding them, can also cause discomfort. Here are three conditions that can cause rib cage pain, and the telltale symptoms doctors use to tell them apart.

1. Bruised or fractured rib

Your rib cage provides a crucial function: to protect your heart, lungs and other vital organs. But this may also mean they take the brunt of the damage in the case of trauma, such as a car accident, steep fall, physical assault or even intense coughing. A bruised rib means the bone is not actually cracked, but it still may have sustained damage. Symptoms for bruised and broken ribs are much the same: pain, particularly when breathing or coughing.

Telltale sign: Injured ribs cause pain when breathing, coughing, twisting or bending.

Your doctor may order a chest X-ray to determine if you’ve fractured your rib. If you have, a CT scan will help determine whether your lungs have been injured.

Ribs obviously can’t be put in a cast or immobilized, like other broken bones. Plus, they need to keep moving when you breathe. Even if it hurts, it’s important to breathe deeply, so you can keep your lungs clear. Failing to do so may result in pneumonia. Respiratory complications like pneumonia occur in nearly a third of patients with rib fractures. Your doctor may give you a device to breathe into to help improve your lung function, and pain medications to make breathing easier until your broken or bruised rib heals.

2. Costochondritis

You may not have heard of this condition, but it’s actually a common cause of rib cage pain. All but two of your ribs are attached to your sternum, or breastbone, by cartilage.

“This area where the ribs meet the breastbone, called costosternal joints, can become inflamed,” says Rose Taroyan, MD, a family medicine physician at Keck Medicine of USC and assistant professor of clinical medicine at the Keck School of Medicine of USC.

Taroyan explains that costochondritis causes pain (it can be either sharp or dull) and tenderness in your chest. It may result from a blow to the chest, heavy lifting or hard exercise, or sustained coughing and sneezing.

Telltale sign: When the area where the rib meets the breastbone is pressed, you’ll feel pain.

Your doctor may order an electrocardiogram to rule out any cardiac issues. Depending on whether you have any other symptoms, your doctor may also order additional tests. If you’re diagnosed with costochondritis, though, it usually goes away on its own in a few days to a few weeks.

“You can do stretching exercises, put a heating pad on the painful area a few times a day, and take pain relievers, such as acetaminophen or ibuprofen,” Taroyan says. “And any activity you do that causes or reliably exacerbates the pain should be reduced and/or stopped, at least temporarily.”

3. Pleurisy

Lining the inside of your chest cavity and the outside of your lungs are two layers of tissue called pleura; the area between these layers is called the pleural space. The layers generally glide against each other smoothly as you inhale and exhale.

With pleurisy, the layers become inflamed due to a viral infection, pneumonia or other medical condition, and rub together roughly, causing pain every time you breathe or cough. Fluid may also collect in the pleural space, causing shortness of breath.

Telltale sign: Doctors can actually hear the membranes rubbing together, called a friction rub, when they listen to your chest with a stethoscope.

Based on your symptoms, your doctor may order imaging or blood tests to help determine the underlying cause of the pleurisy and to see if fluid has built up. If it has, the fluid may need to be drained. If the fluid is a result of a bacterial infection, you’ll be given antibiotics. If it’s from a virus, it may have to run its course, but over-the-counter pain relievers may help to reduce your symptoms.

With any rib cage pain, if you can’t breathe, your skin turns blue or you have severe chest pain, call 911 or go to the emergency room right away.

by Tina Donvito

Are you concerned about rib cage pain? Our expert family medicine physicians can help. If you’re in Southern California, request an appointment or call (800) USC-CARE (800-872-2273).

Should You Worry About Your Child’s Chest Pain? – Cleveland Clinic

can get chest pain too — even sudden, sharp pain that takes their breath away.

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

While it may be scary, brief episodes of chest pain usually aren’t caused by the heart or lungs, says pediatric cardiologist Kenneth Zahka, MD.

“Of course, heart problems are the first thing many parents think of, but chest pain in children is most often not due to a serious condition,” he says.

Common causes of chest pain in children

So what does frequently cause chest pain in kids and teens? It could be due to:

  • Muscle or joint strain. “Kids might have chest pain from doing different or more-strenuous-than-normal activities,” Dr. Zahka says. “Usually, they can trigger the pain with a certain movement or by pressing on a certain area.”
  • Inflammation. “If the ribs are tender adjacent to the breastbone, it may be costochondritis, a type of joint inflammation,” he says.

conditions go away in a few days. The best treatment is taking pain relievers
and staying away from activities that aggravate the pain.

Another common cause: Texidor’s twinge

Texidor’s twinge (also called precordial catch syndrome) is also a common cause of childhood chest pain. (It’s named for one of the physicians who first identified it in 1955.) Fortunately, the most harm it does is cause worry.

Zahka describes it as:

  • Sudden, sharp and intense pain.
  • Usually on the left side of the chest.
  • Lasting only seconds or minutes.
  • Occurring several times a day or only one time.
  • Affecting children and adolescents who are otherwise healthy.
  • Not triggered by physical activity.
  • Often occurring when at rest.
  • Worsened by inhaling, exhaling or moving.

pain can be stunning. But it typically leaves as quickly as it comes — with
no explanation.

causes Texidor’s twinge isn’t known for sure, but it most likely has nothing to
do with the heart. Some doctors think it’s a muscle cramp or caused by a
compressed nerve.

So what should you do about Texidor’s twinge? Like other common childhood chest pain, there’s no treatment for it, but it should go away quickly on its own. If the pain recurs, try anti-inflammatory medicine, like ibuprofen.

twinge isn’t dangerous or life-threatening and usually resolves by adulthood,”
says Dr. Zahka.

When chest pain is serious

chest pain feels different than Texidor’s twinge, according to Dr. Zahka.
Usually, serious pain is:

  • Very intense.
  • Long-lasting.
  • Triggered by physical activity.
  • Accompanied by fever or other symptoms such as dizziness, shortness of breath or fainting.

Pain related to the heart also typically radiates out from the chest. If your child has these symptoms, call your doctor immediately.

It’s never wrong to consult a healthcare professional if you are worried about your child’s chest pain symptoms. A pediatrician or pediatric cardiologist can help get to the bottom of it.

Chest pain | healthdirect

Key facts

  • Chest pain is any sort of pain felt from your jaw down to the bottom of your ribs.
  • Chest pain can be a symptom of a heart attack and should be considered heart-related until proven otherwise.
  • All chest pain should be checked out by a doctor as soon as possible.

On this page

What is chest pain?

Chest pain is any sort of pain felt in your upper body, from your jaw down to the bottom of your ribs. Because it can be a symptom of a heart attack or another cardiac condition, it’s safest to consider chest pain as heart-related, until proven otherwise.

When should I call an ambulance?

If you have any of the symptoms below, call triple zero (000) immediately and ask for an ambulance. If calling triple zero (000) does not work on your mobile phone, try calling 112.

You should call triple zero (000) immediately and ask for an ambulance if:

  • your chest pain is severe, or worsening, or has lasted longer than 10 minutes
  • your chest pain feels heavy, crushing or tight
  • you have other symptoms, such as breathlessness, nausea, dizziness or a cold sweat
  • you also feel the pain in your jaw or down your left arm

While waiting for the ambulance

Stop any activity and rest while waiting for an ambulance. Don’t try to drive yourself to hospital. Loosen any tight clothing, such as collar buttons or ties. Avoid breathing in cigarette smoke. Don’t have anything to eat or drink.

If you have been prescribed angina medicine, sit or lie down and take a dose of this under your tongue. If this doesn’t relieve your symptoms in 5 minutes, try taking 2 more doses at 5-minute intervals.

Chew 300mg aspirin straight away, unless you’re allergic or your doctor has told you not to. Do not give aspirin to anyone under 12 years.

What are the warning signs of a heart attack?

There are several different warning signs of a heart attack, and they are not always sudden or severe. Whether or not your chest pain symptoms include mild to severe pain, they should be considered heart-related until proven otherwise.

People having a heart attack may have just one of these symptoms, or a combination of several. They can come on suddenly or develop over a few minutes and get progressively worse. Symptoms usually last for at least 10 minutes.

Warning signs could include:

  • discomfort or pain in the centre of your chest — a heaviness, tightness or pressure, like something heavy sitting on your chest, or a belt tightening around your chest, or a bad case of indigestion
  • discomfort in your arms, shoulder, neck, jaw or back
  • other problems such as:
    • a choking feeling in your throat
    • your arms feeling heavy or useless
    • feeling short of breath
    • feeling nauseous
    • having a cold sweat
    • feeling dizzy or light-headed

The common symptoms of a heart attack.

Heart attacks are more common in older people than in younger people, but they can occur in people of any age.

The pain you have may not sound like that described above, but it’s still important to see a doctor. Remember, all chest pain should be checked out by a doctor as soon as possible.

CHECK YOUR SYMPTOMS — Use our chest and back pain Symptom Checker and find out if you need to seek medical help.

What are the causes of chest pain?

Chest pain can be a symptom of many different conditions, some of which are more serious than others. It’s best to seek medical attention for any chest pain in case it is heart-related.

Common causes of chest pain include:

  • indigestion or reflux (heartburn) — when stomach acid rises up the food pipe, and causes a burning pain in the chest
  • muscle strains
  • inflammation where the ribs join the breast bone (known as costochondritis)
  • chest infections such as bronchitis and pneumonia
  • pleurisy (inflammation of the tissue lining the lungs)
  • angina — pain caused by poor blood flow to the heart muscle, which usually occurs when the heart needs to work harder than usual. This might be due to exercise, anxiety or emotion, cold weather, or following a large meal. The pain is usually short lived and eases with rest.
  • heart attack — when the blood flow to a part of the heart muscle is blocked. Chest pain caused by a heart attack usually does not go away with rest, and urgent medical attention is necessary.
  • anxiety or panic attack — these may also cause dizziness, heart palpitations, sweating and breathlessness and can last for up to 20 minutes.

Less common causes of chest pain include:

  • shingles (herpes zoster) — an infection that typically causes pain before a skin rash appears
  • mastitis — usually caused by a breast infection related to breastfeeding
  • inflammation of the gallbladder
  • a pulmonary embolism — a blockage in the blood vessel that carries blood from the heart to the lungs. You may have sharp, stabbing chest pain that is worse when you breathe in.
  • pericarditis (inflammation of the sac surrounding your heart)

Other questions you might have

How do I know if my chest pain is serious?

Whether your chest pain symptoms are mild or severe, they are considered to be heart-related — and therefore serious — until proven otherwise.

When should I call triple zero for chest pain?

You should call triple zero (000) and ask for an ambulance immediately if:

  • your chest pain is severe, or worsening, or lasts longer than 10 minutes
  • your chest pain feels heavy, crushing or tight
  • you have other symptoms, such as breathlessness, nausea, dizziness or a cold sweat
  • you also feel pain in your jaw or down your left arm

What are some common non-cardiac causes of chest pain?

Common non-cardiac causes of chest pain include:

  • indigestion or reflux (heartburn) — when stomach acid rises up the food pipe, and causes a burning pain in the chest
  • muscle strains
  • inflammation where the ribs join the breast bone (known as costochondritis)
  • chest infections such as bronchitis and pneumonia

Resources and support

Visit the Heart Foundation website for more information about heart attack symptoms.

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Apps and tools

You might find this app helpful:

Call healthdirect

Call 1800 022 222 to speak with a registered nurse, 24 hours, 7 days a week (known as NURSE-ON-CALL in Victoria).

90,000 Cardiologist: chest pain is not always associated with heart disease

Often people with chest pains think that their heart hurts. But this can be a sign of completely different diseases.

Cardiologist Dina Sulimanova told the viewers how to learn to distinguish precisely heart pain.

“We need to pay attention to the localization of pain,” advises Dina Rushanovna. – Heart pain occurs just behind the sternum or in the left side of the chest.It appears with excessive physical exertion. For example, when a person climbs stairs faster, speeds up a step, or carries something heavy.

According to the description, heart pain – pressing, constricting, burning. It can be given to the lower jaw, left arm, or under the left shoulder blade.

Such pain will pass if a person calms down, stops, breathes. Or if a patient who has had a heart attack before takes a nitroglycerin tablet. ”

The cardiologist received a lot of questions from the viewers and the presenter.

For example:

“It hurts in the left side of the chest, closer to the heart. When inhaling, the pain increases. Maybe it hurts your heart? ”

Doctor: “This pain is characteristic of osteochondrosis of the thoracic spine. It increases with inhalation, exhalation, change in body position. You need to go to a neurologist for appointments and recommendations. ”

“Often people come to see you with pain in the chest, which turns out to be not cardiac?”

“Yes, of course, because chest pain is a fairly significant symptom, and people most often come to a cardiologist to rule out the pathology of the cardiovascular system.With a clear collection of anamnesis, complaints, we understand whether it is cardiac pain, or is it still osteochondrosis, diseases of the stomach or lungs. Further, we already recommend contacting the specialist who will help to cope with this pain. ”

“Disturbed by anxiety and chest pain. I did an ultrasound of the heart. In conclusion, the doctor wrote “aortic sclerosis”, and in words said that everything was normal. Tell me what is aortic sclerosis? Is it worth worrying about this? ”

“Don’t worry.Aortic sclerosis indicates a hardening of the walls of the aorta. It occurs most often with a prolonged increase in pressure during hypertension. It is recommended to do an ultrasound of the heart once a year. You need to see a local physician. ”

“I was picking up a gas stove with a friend. It was light, carried away at a time. An hour later, when I came home, I felt pain in my chest. I have a heart defect, could this somehow affect? Or just pulled a muscle? Acute pain: when bending, turning, or when moving the arm … “

“This pain is also associated with osteochondrosis.If the pain is related to movement, it is not heart pain. When a person’s heart hurts, he can lie down, sit, but the pain will not change the intensity, it will also be squeezing, squeezing, burning. Muscle pain or osteochondrosis will be during body movements, turns. If you are worried about this, you need to see a therapist and a neurologist and take an X-ray of the thoracic spine. ”

“Recently, while climbing the stairs at the entrance, I had pain and heaviness in the left chest area.The left hand was numb and burning. I came home, took nitroglycerin and lay down. Did I do the right thing? ”

“You did the right thing, but in addition to taking glycerin, you had to call an ambulance. Your pain is very similar to cardiac pain. The ambulance doctors would have taken a cardiogram. If the blood flow is disturbed, changes appear on the ECG that indicate a pre-infarction state and then you would be hospitalized. You need to see a cardiologist. ”

“Recently, I have a sharp constricting pain in the center of the chest.The pain lasts for about two seconds. Everything goes without medication. Could this be a heart problem? ”

“Most likely, the pain is associated with osteochondrosis, but to clarify the diagnosis, it is worth contacting a neurologist and a cardiologist to clarify the diagnosis.”

More important and useful information, interesting questions and answers – in the program “Tell me, doctor” NT, led by Svetlana Sterligova.

← Escherichia coli found in “Doctor’s” sausage of “Velikonovgorodsky meat yard”
90,000 Chest pain: causes, symptoms, diagnosis, treatment

Feelings of pain in the chest in terms of frequency of occurrence are not inferior to headaches and abdominal pain.It has been found that up to 40% of people have ever experienced chest pain during their lifetime. Vital organs are located in the chest, chest pains are often the main symptom of a number of life-threatening diseases, which necessitates the differential diagnosis of dangerous and non-dangerous conditions and their adequate correction. As doctors have noticed in the past, if an attack of pain occurs for no apparent reason and stops on its own, most likely it is of a functional nature.According to modern concepts, when examining patients with pain in the chest area, it is advisable for a doctor to assess possible options for the causes of pain, as well as determine the need for intervention and choose the most optimal among a large array of medical and diagnostic methods. Diagnosis of such conditions is further complicated by the fact that chest pain can be an integral part of pathological, psychological and psychosocial factors.

Treatment of spinal diseases at the Meddiagnostika Center is carried out

Gongalsky Vladimir Vladimirovich

Doctor of Medical Sciences, orthopedist-traumatologist, neurologist, vertebral neurologist

Kopyl Evgeny Gennadievich

Orthopedist-traumatologist, vertebrologist

Maximov Grigory Alexandrovich

Assistant Director

The most common causes of chest pain are:

  1. Diseases of the musculoskeletal sphere (osteochondrosis, costal chondritis, rib fractures).
  2. Diseases of the cardiovascular system (ischemic heart disease, angina pectoris, mitral valve prolapse, arrhythmias, pericarditis).
  3. Problems with the digestive system (gastroesophageal reflux, achalasia of the cardia, stomach and duodenal ulcer).
  4. Panic disorder, anxiety, stress.
  5. Pathology of the bronchi and lungs (bronchitis, pleurodynia, pneumonia).
  6. Atypical chest pain.

Correlation of chest pain by gender and age:


  • 18-24 years old – gastroesophageal reflux, muscle pain in the chest wall;
  • 25-44 years old – gastroesophageal reflux, muscle pain in the chest wall, costal chondritis;
  • 45-64 years old – angina pectoris, myocardial infarction, muscle pain in the chest wall, atypical pain;
  • over 65 years of age – muscle pain in the chest wall, atypical pain, diseases of the heart and blood vessels;


  • 18-24 years old – costal chondritis, anxiety or stress;
  • 25-44 years – muscle pain, rib chondritis, atypical pain, gastroesophageal reflux:
  • 45-64 years old – angina pectoris, myocardial infarction, atypical pain, muscle pain in the chest wall;
  • over 65 years old – angina pectoris, unstable angina pectoris, myocardial infarction, muscle pain in the chest wall, atypical pain, costal chondritis.

The classification of chest pain includes:

  1. Anginal (coronary, non-coronary) and non-anginal (cardialgia) pain, as well as pain in a number of vascular diseases (aorta, pulmonary artery).
  2. Pain associated with the pathology of the respiratory system (with pneumonia, lung abscess, neoplasms of the bronchi and lungs, pleurisy).
  3. Pain in the cervical and thoracic spine, in the muscles of the shoulder-scapular region, in the anterior chest wall.
  4. Pain due to psychovegetative disorders.
  5. Pain in diseases of organs located in the mediastinum (esophageal spasm, reflux esophagitis, diverticula, tumors, mediastinitis).
  6. Pain in diseases of the gastrointestinal tract (stomach and duodenal ulcer, chronic cholecystitis, etc.) and diaphragm (hernia, diaphragmatic pleurisy).

Life-threatening coronary pain; pain accompanying pulmonary embolism, aortic aneurysm, pneumothorax. Life-threatening pains are accompanied by a serious condition of the patient, severe disorders of cardiac function and respiration, which makes it possible to fairly quickly judge the nature of the pathology.According to modern concepts, overdiagnosis is preferable to underdiagnostics. Thus, in the United States, 6-8% of patients with chest pain who have not been hospitalized after going to the hospital are released by mistake. Differential diagnosis of this type of pain provides for the definition: localization, irradiation, nature, intensity of pain, conditions for its onset and cessation, duration, frequency of attacks. A significant number of adverse outcomes for chest pain are associated with an incorrect assessment by patients of their condition as not serious enough to seek medical help.

Tactics of the doctor when treating a patient with chest pain:

  • collection of anamnesis; physical examination;
  • electrocardiogram;
  • stress tests;
  • if necessary – nitroglycerin test, test with anaprilin;
  • blood tests;
  • fluorography of the lungs;
  • X-ray of the spine for suspected spondylogenic (spinal) pain
  • other studies: echocardiography, radiography, examination of the gastrointestinal tract, fibrogastroduodenoscopy, consultation with a psychologist.

Algorithm for diagnosing chest pain (according to G.I. Lysenko and V.I. Tkachenko, 2007)

After carrying out the necessary research and establishing the causes of chest pain, appropriate treatment of the revealed pathology is carried out.

The diseases listed below may be the cause of your complaints

Treatment can only be effective if the diagnosis is correct. Diagnosis and treatment of chest pain is carried out at the Meddiagnostika Center.

Cost of services

To make an appointment
How can I get to

90,000 COVID 19 “State Budgetary Institution of Health

The procedure for vaccination of the adult population against COVID-19

Recommendations for the prevention of new coronavirus infection (COVID-19) among employees

Questions regarding payments to workers caring for patients with COVID-19 can be asked from 9-00 to 18-00 on weekdays by phone:


Vaccination against COVID -19

Children and coronavirus

Kebabs for May holidays are canceled

The Federal Service for Supervision of Consumer Rights Protection and Human Welfare has developed “Recommendations for the population on the prevention of a new coronavirus infection ( COVID -19) during the May holidays”

Alcohol and coronavir.infection

Smoking and coronavirus infection

Food for self-isolation WHO for the population

Why viral pneumonia is dangerous for the population


COVID-19. Should you seek medical attention?

Coronavirus infection has no specific symptoms, therefore, it is difficult for a person without medical education to distinguish it from influenza and traditional SARS, especially at the onset of the disease.Often, a sick person, hoping for “maybe”, does not go to doctors and self-medicates. Late seeking medical help leads to the development of serious complications that are difficult to treat, and even the death of the patient. In addition, a sick person serves as a source of infection for their relatives and friends.

Unfortunately, residents of the Penza region are no exception. Patients with already advanced forms of the disease that require urgent resuscitation are admitted to hospitals.And in this case, unfortunately, doctors cannot guarantee a favorable outcome.

Fever, dry cough, weakness, malaise are the most common symptoms of COVID-19. Some people have headaches, body aches, nasal congestion, runny nose, sore throat, or diarrhea (diarrhea). Most often, these symptoms develop gradually, and by the 5-6th day, coughing may worsen, chest pain appears when breathing, shortness of breath. Such symptoms can be signs of the development of pneumonia and respiratory failure, which develop when the lower respiratory tract is attacked by the coronavirus.It is these conditions that cause death in patients.

Therefore, if you experience respiratory symptoms, you should immediately seek medical help by calling a doctor at home. In each case, an individual patient management tactics will be chosen. If there are indications that threaten life and health, the patient will be hospitalized. In other situations, the patient will be left at home under dynamic supervision with regular monitoring of the main indicators (temperature, blood oxygen saturation, respiratory rate, etc.)). In the future, if the condition worsens, treatment in a hospital may be required. But only a doctor can correctly assess the state of health and determine the tactics of treating a patient.

Remember that only correct and timely correction of the disease can save your life! Do not self-medicate, seek help in a timely manner, without risking your health!

Chief freelance specialist in medical prevention of the Ministry of Health of the Penza region I.V.Puzrakova

Overweight people need to be especially careful during a pandemic!

To date, more than 2.5 million people have been infected with a new coronavirus infection in the world. In all countries, doctors note a large number of obese patients admitted to intensive care units, and many of them are quite young. As noted by experts familiar with the situation, overweight people are more likely to become infected and get sick more severely.The doctors also noticed that the severity of the disease depends on the degree of obesity: the more it is, the more severe the person gets sick, and this also applies to middle-aged and young patients.

High susceptibility to a new strain of coronavirus in overweight is associated with a weakened immune system due to chronic inflammatory processes characteristic of this category of patients and their lifestyle.

It is also known that obese people are inactive, tend to eat a lot of fast food and few vegetables and fruits, which does not contribute to the maintenance of a healthy immune system . In addition, scientists have found that excess weight contributes to the production of a large amount of protein, with the help of which the virus is introduced into healthy cells.

Also, the situation of overweight patients is aggravated by impaired respiratory function, decreased breathing depth and lung volume. The extent of these disorders depends on the severity of the obesity. It is difficult for such patients to deal with pneumonia, since fatty deposits in the chest area limit the amount of air entering the lungs during inhalation.

It should be noted that obese people often suffer from type 2 diabetes mellitus, heart and vascular diseases. These factors themselves increase the risk of severe COVID-19 infection.

For these reasons, obese people in a pandemic should be very careful.

If there is excess weight, a person is at risk for coronavirus infection, regardless of age.

Controlling your weight is not easy, but now it is extremely important, especially in conditions of self-isolation.You need to adhere to the principles of a healthy diet. The diet should contain easily digestible foods rich in vitamins. You should limit the size of portions, refuse heavy foods, sugary drinks, confectionery.

It is important to organize physical activity, do gymnastics and breathing exercises.

Preventive measures should be carefully followed and the self-isolation regime should not be violated unless absolutely necessary. If you need to leave the house, you must wear a medical mask and gloves; in public places, be sure to maintain a social distance of 1.5–2 meters.

Overweight people should avoid any contact with sick people, and in case of symptoms of a respiratory illness, seek immediate medical attention.

Only attention to your own health and the implementation of simple rules will avoid serious consequences.

Doctor for medical prevention GBUZ “Penza
Regional Center for Medical Prevention A. Filyushkin.

90,000 Chest cancer – symptoms and signs

Article content:

Features of breast cancer

The chest is made up of many organs, including bones and soft tissues, as well as the lungs and pleura, heart and mediastinal organs (esophagus, trachea, thymus, thoracic lymphatic duct, pericardium), vessels, nerves, lymph nodes.All of them can be affected by malignant tumors. The most common type of malignant lesion of the chest cavity is lung cancer. Other types of tumors are less common and can be primary (occur directly in the chest cavity) or secondary (occur when tumors metastasize). In addition to the organs of the chest cavity, cancerous lesions can occur in the area of ​​the pleura, diaphragm or sternum, which limit the chest cavity Source:
V.M. Karpov, A.F. Lazarev
Prevalence of multiple primary malignant neoplasms with lesions of the chest organs //
Russian Journal of Oncology, 2015, No. 5, p.53-56.

The severity, growth rate and prognosis for treatment depend on the specific type of cancer and organ affected.

Types of oncological diseases of the chest cavity

Malignant neoplasms of the chest cavity are divided into groups:

  • Lung cancer . There are several types of malignant lung lesions – non-small cell, accounting for up to 80% of all types of cancer, small cell carcinomas, adenocarcinoma, large cell carcinoma.
  • Respiratory tract cancer . It includes carcinoid tumors of the respiratory tract and cystadenoid, mucoepithelioid carcinomas of the bronchi.
  • Neoplasms in the mediastinal region . These include malignant lesions of the intrathoracic, extrathoracic lymph nodes, esophageal cancer and thymic tumors.
  • Disorders of the heart and blood vessels . Primary and metastatic cancers are possible.
  • Pleural neoplasms .Especially dangerous is pleural mesothelioma and malignant fibrous tumor.
  • Formations of the chest wall with damage to bones, mesenchymal tissues and cartilage . The most common malignant tumors are multiple myeloma and chondrosarcoma.

Causes of breast cancer

The exact cause of the development of various types of breast cancer has not yet been determined. There are a number of factors that increase the risk of tumor lesions of the chest.These include:

  • Genetic predisposition. In families where cancer of various localization is common, the likelihood of tumors of the chest cavity is higher. This is due to the inheritance of defective genes that control cell division.
  • Smoking is especially relevant for lung cancer, although it can also be found in non-smokers. Alcohol intake plays a role, especially for esophageal cancer. The joint intake of alcohol and smoking increases the risk several times.
  • Poor diet and deficiency of vitamin A, zinc, molybdenum increases the risk of certain types of cancer.Being overweight and esophageal reflux increases your risk of developing esophageal cancer.
  • Chronic inflammation increases the risk of developing tumors of the chest cavity, including cancer of the heart and blood vessels, lymph nodes, lungs and esophagus.

First signs, symptoms of tumors of the chest cavity

For a long time, cancers of the chest cavity have no symptoms. As tumors grow in size, three groups of signs may appear:

  • symptoms of compression of organs adjacent to the affected organs, signs of cancer growth into tissues and adjacent organs;
  • common symptoms of chest cancer;
  • Specific signs typical of a particular neoplasm.

For example, lesions in the mediastinum can produce pain similar to angina pectoris. Pain may radiate to the shoulder, arm or neck, possibly impaired swallowing and breathing Source:
Saynak M, Veeramachaneni NK, Hubbs JL, Okumuş D, Marks LB
Solitary Fibrous Tumors of Chest: Look with the Oncologic Another Perspective // ​​
Balkan Med J. 2017 May 5; 34 (3): 188-199. doi: 10.4274 / balkanmedj.2017.0350. Epub 2017 Apr 6.

Common symptoms can be identified among the key features of chest tumors:

  • development of shortness of breath on exertion or at rest;
  • the appearance of a cough with phlegm, which can be stained with blood;
  • pain during deep inhalation or exhalation;
  • 90,079 noises, wheezing when breathing;

  • frequent bronchitis, pneumonia;
  • violation of the general condition – weight loss, lack of appetite, severe weakness, nausea.

Certain types of cancer are characterized by special symptoms – dysphagia (impaired swallowing), pruritus, decreased blood glucose levels.

Diagnosis of chest cavity cancer

It is possible to detect breast cancer from the earliest stages. The medical center “CM-Clinic” is equipped with everything necessary for the fastest and most accurate diagnosis, including histological and biochemical studies in its own laboratory. Used in the diagnostic process:

  • Radiography for the detection of large tumors, bone and lung lesions.The method helps to determine the area of ​​the lesion for more targeted research.
  • MRI or CT diagnostics allows you to determine the exact size of the tumor, the involvement of adjacent structures, vessels, bones, cartilage.
  • Diagnostic thoracoscopy is indicated for pleural lesions or suspected metastases, complications of lung cancer.
  • Bronchoscopy is indicated for examining the bronchial tree, clarifying the localization of the tumor, taking material for histological examination.
  • Various options for sputum examination in order to exclude concomitant pathologies, to identify tumor cells.
  • Pleurocentesis and sampling of pleural fluid for examination (sometimes for therapeutic purposes).
  • Biopsy of tumor sites, affected lymph nodes with determination of the type of cancer and its histochemical characteristics Source:
    M.I. Davydov, D.G. Zaridze
    Screening of malignant tumors //
    Bulletin of theN.N. Blokhin “, 2014, vol. 25, No. 3-4, p. 5-16.

Chest cancer treatment

Based on the diagnostic data, the final diagnosis, stage of cancer, its type and specific localization are established. Patient management tactics are developed individually, taking into account age and diagnosis, comorbidities and general condition Source:
Semenova EA, Nagel R, Berns A
Origins, genetic landscape, and emerging therapies of small cell lung cancer //
Genes Dev. 2015 Jul 15; 29 (14): 1447-62.doi: 10.1101 / gad.263145.115.

If possible, surgical removal of the tumor with pre- or postoperative use of conservative techniques is used. These include:

  • Chemotherapy . Before surgery, it helps to shrink the tumor to make it easier to remove. After – to suppress the remaining cancer cells.
  • Targeted therapy is aimed at combating a specific type of cancer, for example, small cell lung carcinoma.
  • Radiation therapy is indicated to suppress the growth of malignant cells in inoperable forms or to prepare for surgery.

Symptomatic treatment, plastic surgery is also carried out, in case of advanced processes, palliative therapy is indicated.

The treatment protocol for each patient is drawn up on the basis of international and domestic clinical guidelines, modern drugs and methods of surgical intervention are used that reduce the risk of side effects, which have proven efficacy with the lowest possible effects on the patient’s body.

Predictions for chest cancer

With early detection of lung cancer, about 80% of patients live for more than 5 years, with other breast tumors, prognosis depends on the form of cancer and the stage of its detection. The smaller the tumor and the damage to the surrounding tissues, the higher the chances of favorable outcomes Source:
V.V. Starinsky, L.M. Alexandrova,
O.P. Gretsova
Lung cancer: epidemiology, prevention //
Medicine in Kuzbass, 2014, pp. 30-31.

The risk of recurrence for tumors of the thoracic cavity is low; to prevent recurrent episodes of cancer, doctors conduct long-term follow-up with follow-up examinations.


  • V.M. Karpov, A.F. Lazarev. The prevalence of multiple primary malignant neoplasms with lesions of the chest organs // Russian Journal of Oncology, 2015, No. 5, pp. 53-56.
  • M.I. Davydov, D.G. Zaridze. Screening of malignant tumors // Bulletin of the Federal State Budgetary Scientific Institution “Russian Oncology Center N.N. Blokhin “, 2014, vol. 25, No. 3-4, p. 5-16.
  • V.V. Starinsky, L.M. Alexandrova, O. P. Gretsova. Lung cancer: epidemiology, prevention // Medicine in Kuzbass, 2014, p.30-31.
  • Saynak M, Veeramachaneni NK, Hubbs JL, Okumuş D, Marks LB. Solitary Fibrous Tumors of Chest: Another Look with the Oncologic Perspective // ​​Balkan Med J. 2017 May 5; 34 (3): 188-199. doi: 10.4274 / balkanmedj.2017.0350. Epub 2017 Apr 6.
  • Semenova EA, Nagel R, Berns A. Origins, genetic landscape, and emerging therapies of small cell lung cancer // Genes Dev. 2015 Jul 15; 29 (14): 1447-62. doi: 10.1101 / gad.263145.115.

The information in this article is provided for reference purposes and does not replace the advice of a qualified professional.Do not self-medicate! At the first signs of the disease, you should consult a doctor.

ABC Medicine

Angina (angina pectoris) is a sharp pain or discomfort in the chest area. The reason for this is a lack of blood supply in certain parts 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 blood vessels of the heart. All patients experience approximately the same sensations – pressing or constricting pain behind the chest, which often radiates to the arm, shoulder, jaw or neck.The pain usually does not last more than 5 minutes and disappears after taking certain medications or relieving tension. However, the duration of the attack is purely individual, some patients experienced pain from 30 seconds to 30 minutes.


When angina pectoris occurs, the pain is usually intense and is stopped by taking nitroglycerin, coupled with the cessation of physical activity. These pain sensations have characteristic signs: a pronounced time of onset and termination (the nature of the attack), the occurrence in certain circumstances.

Among the most common conditions for the appearance 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 symptoms of angina pectoris. To determine the pain arising from physical exertion, it is enough to stop the tension. And the discomfort will subside within 5 minutes. The complete elimination of the symptoms of angina pectoris is facilitated by the intake of 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 physical exertion, a favorable reaction to nitroglycerin and the nature of the attack.


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

So, among the reasons for the lack of oxygen supply to the heart, a local disturbance of blood flow is often singled out.It can be triggered by chronic narrowing of the lumen of the artery supplying the heart, due to atherosclerotic plaque. Also, angina pectoris occurs due to a sharp and prolonged spasm of the blood vessels of the heart. 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 attacks of angina pectoris are the result of exhausting and hard work or stress.


Compared with myocardial infarction, when the circulatory disturbance in the heart muscle is irreversible and catastrophic, angina pectoris is a less pronounced circulatory disorder that quickly recovers after the cause of the attack is eliminated. Therefore, there is no extensive damage to the heart tissue. It should be borne in mind that exceeding the survival threshold of the heart muscle threatens that an attack of angina pectoris will develop into a heart attack.


Not all pain in the chest or heart can be called angina pectoris. If it lasts less than 30-40 seconds and is eliminated through a deep breath or a change in body position, do not worry about angina pectoris. To make such a diagnosis, the doctor must analyze your complaints, find out the symptoms and the circumstances of their manifestation. In order to exclude concomitant diseases in the diagnosis of angina pectoris, a number of medical examinations are carried out, including an electrocardiogram (ECG) in two states (rest and stress), stress test, pressure measurement and X-ray of the coronary arteries.

Thanks to the ECG, the doctor can determine the electrical impulses of the heart, and with them the symptoms of angina pectoris. They show the absence or presence of ischemia (insufficient 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 whether to treat angina pectoris.

The complex stress test enables the diagnosis of angina pectoris and the assessment of 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. 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. A catheter is placed in an artery in your groin or forearm, and then it travels down the bloodstream to one of your heart arteries.Next, a radiopaque liquid is injected, which makes it possible to observe the changes in the arteries under study, diagnosing angina pectoris.


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

Currently, mononitrates, dinitrates and trinitrates are used to relieve symptoms of angina pectoris. Their mechanism of action is the expansion of the vessels of the heart, which makes it possible 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 pectoris, headache, lowering blood pressure, facial flushing, dizziness and the appearance of insensitivity to certain doses of the drug can be distinguished. Also used are beta blockers, which reduce the strength and frequency of the heartbeat, and calcium channel blockers, which prevent vasospasm.

In the case when the symptoms of angina pectoris are severe and medications are not able to help, surgical intervention (in the form of coronary bypass grafting) and balloon angioplasty are prescribed. Coronary artery bypass grafting is the implantation of a blood vessel into a blocked section of a coronary artery. Thus, blood flow in this part of the heart is restored using a bypass path. 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 the narrowing of the coronary vessel. Here it quickly inflates or stretches, eliminating the spasm.

The treatment of unstable angina pectoris, which can occur even in the absence of tension, needs especially close attention. Such chest pain does not have predictable boundaries of onset, unlike stable angina pectoris, and does not need a reason to appear.


Basic methods of prevention and treatment of angina pectoris:

  • absolute cessation of smoking and alcohol;
  • long walks in a relaxed mode, physical activity within reasonable limits in accordance with the doctor’s prescription;
  • blood pressure control;
  • should follow the diet prescribed by the doctor, limit the consumption 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 unnecessary emotional stress.

If you are worried about regular pain in the chest area during physical exertion, it is possible that these are manifestations of stable or unstable angina pectoris, which are treated by the specialists of our polyclinics. You should see your doctor, as every attack of angina pectoris inevitably worsens the condition of the heart muscle. You can get professional help in one of our clinics in Moscow. Make an appointment with us by phone +7 (495) 223-38-83 .

when you need to urgently call an ambulance

19 September 2019

Pain is the body’s way of notifying us that things are going wrong. If it causes significant discomfort, the usual painkillers have no effect, or they help badly, the pain grows, or suddenly pierces like a blow with a dagger, there are feelings of anxiety, panic, you must definitely listen to your body and take action.If painful sensations appear and disappear for a long time, but in the same place, it is imperative to inform the attending physician about it.

What can cause chest discomfort and when should an ambulance be called immediately?

What diseases can cause chest pain?
• – angina pectoris
• – heart attack
• – heartburn
• – chest contusion
• – fracture of ribs
• – increased anxiety or panic disorder
• – asthma, bronchitis, pneumonia
• – mitral valve prolapse
• – pericarditis
• – peptic ulcer
• – spasm of the coronary arteries
• – aortic dissection
When is chest pain a reason to urgently call an ambulance?
There is little or no relationship between the strength and duration of chest pain and the risk of illness it can accompany.Even a slight discomfort behind the breastbone can be a symptom of heart vascular disease: for example, according to statistics, up to 30 percent of heart attacks that have occurred were not accompanied by any symptoms noticeable to a person.
Therefore, the most correct decision is to urgently consult a doctor for any alarming sensations in the chest. And the symptoms listed below will help you make the right decision when helping another person. So, the emergency medical phone number must be dialed if:
• – A person over 40 years of age and has one or more risk factors for heart disease: a family history of heart attacks and strokes, smoking, obesity, a sedentary lifestyle, high cholesterol, diabetes.
• – A person of any age has already been diagnosed with cardiovascular disease.
• – The pain is in the nature of strong compression, heaviness in the chest, making it difficult to breathe, or very sharp.
• – The pain is accompanied by nausea, weakness, shortness of breath, sweating, pallor, dizziness, or fainting.
• – Chest pain radiates (radiates) to the shoulder, arm or jaw.
• – Painful sensations are much more acute than those that have ever been experienced in this part of the body.
• – Pain causes increased anxiety, fear, a sense of doom.
• – The pain does not subside after 15–20 minutes.
• – The pain is constantly increasing.

If you find at least one of the above signs in yourself or another person, you must immediately call an ambulance.
If the ambulance team suspects you have heart disease, do not refuse hospitalization and do not ask for treatment at home.

Remember that the speed of diagnosis of a heart attack and the immediate start of its treatment can save lives and protect a person from disability.A timely diagnosis of angina pectoris allows rapid and aggressive treatment to begin and to avoid further damage to the heart muscle.

The main symptoms of lung disease | Euromed. Private clinic in Omsk. The largest medical center in Omsk

The main symptoms of lung diseases

Chest pain . The pain can be varied. It can be constant or intensify with inspiration. The pain can radiate to the neck, shoulder, shoulder blade.Chest pain cannot be ignored, since it can be a manifestation of not only “the notorious osteochondrosis”, or “intercostal neuralgia”, but much more serious and dangerous diseases. In addition, chest pain may have a real cause and not in the chest at all, but, for example, in the abdomen or retroperitoneal space. Chest pain is a reason for going to a doctor, and not for self-medication in the form of thoughtless and uncontrolled use of pills and warming ointments.

Cough and phlegm. Cough is dry (when sputum is not coughing up) and moist (with sputum discharge). Cough is one of the most persistent symptoms of pulmonary disease, although not strictly necessary. Cough can be accompanied not only by lung diseases, but also by heart disease, taking certain medications, diseases of the peripheral nerves, stomach and esophagus, etc. The sputum that the patient coughs up has characteristics that can be helpful in diagnosis. For example, the color of the sputum is important.Mucous sputum is white and / or transparent, purulent sputum is light yellow to green in color. If there is blood in the sputum, it can be scarlet to rusty or brown. The smell of phlegm is also important. Fetid putrid odor – indicates destructive processes in the lungs. Unfortunately, patients often neglect to see a doctor, believing that a daily cough is a common phenomenon “I smoke, it means I cough”, “Yes, I cough, I will have to go.” Unfortunately, it is often difficult to help a patient if he is not treated in a timely manner, and sometimes it is impossible.

Shortness of breath and suffocation . Perhaps this is the only complaint that does not allow postponing a visit to the doctor. Shortness of breath can be during exertion, it can disturb the patient at rest and even during sleep. It happens that shortness of breath increases or occurs when in contact with strong odors or pets. Some patients “attribute” shortness of breath to age, body weight, smoking, fatigue. There are many reasons for shortness of breath. These can be: lung diseases (asthma, COPD, bronchitis, tuberculosis, cancer, etc.)etc.), heart disease (myocarditis, arrhythmia, coronary artery disease, heart failure, heart defects), blood diseases (anemia, erythremia), vascular disease (pulmonary embolism, pulmonary vasculitis, pulmonary arterial hypertension), kidney disease (glomerulonephritis, pyelonephritis, polycystic kidney disease), metabolic diseases (obesity) and much, much more. In order to identify the cause of shortness of breath, it is necessary to undergo an in-depth examination, which will make it possible to make the correct diagnosis and begin treatment. Shortness of breath is ALWAYS a DREAMING SYMPTOM that requires immediate help.

Snoring. Unfortunately, in our country, snoring is paid attention solely as an inconvenience to others, and not as a symptom of the disease. In fact, every fifth inhabitant of the earth after 30 years – snoring is a symptom of a serious illness – obstructive sleep apnea syndrome or OSAS for short. This disease increases the risk of death from a heart attack or stroke tenfold, and is the cause of a feeling of chronic fatigue and weakness. In order to determine whether snoring threatens you and your health, you need to see a doctor and get tested.

As can be seen from the variety of diseases and symptoms, it is difficult to diagnose respiratory diseases on your own (using the Internet, reference books, friends).