What causes pain near the breastbone. How to differentiate between heartburn and more serious conditions. When should you seek medical attention for chest pain. What are the treatment options for costochondritis.

Common Causes of Pain Near the Breastbone

Pain near the breastbone, also known as the sternum, can be alarming and uncomfortable. There are several potential causes for this type of discomfort, ranging from minor digestive issues to more serious conditions. Understanding these causes can help you determine when to seek medical attention and how to manage your symptoms effectively.

Heartburn and GERD

One of the most common causes of pain below the sternum is heartburn or gastroesophageal reflux disease (GERD). This condition occurs when stomach acid flows back into the esophagus, causing a burning sensation in the chest. Heartburn symptoms can develop within minutes of eating, particularly after consuming trigger foods such as fried foods, alcohol, chocolate, mint, onion, garlic, caffeine, tomatoes, and fatty foods.

Peptic Ulcers

Another potential cause of pain near the breastbone is peptic ulcers. These are wounds that form in the lining of the digestive system, primarily in the esophagus, stomach, or small intestine. The pain from peptic ulcers may be felt between the navel and the top of the chest and often develops within a few hours after eating.

Costochondritis

Costochondritis is inflammation of the cartilage that connects a rib to the breastbone. This condition causes tenderness and sometimes sharp or aching chest pain. The pain may worsen with deep breathing, movement, or exercise. While the exact cause of costochondritis is not always clear, it can occur after a chest injury, infection, or coughing episode.

Distinguishing Between Heartburn and More Serious Conditions

While heartburn is often a benign condition, it’s crucial to be able to distinguish it from more serious issues, such as heart attacks. Heartburn typically causes a burning sensation in the chest that may extend to the throat. It often worsens when lying down or after eating certain foods.

In contrast, a heart attack may cause pressure, squeezing, or fullness in the chest, often accompanied by pain radiating to the arm, jaw, or back. If you experience shortness of breath, lightheadedness, or pain in your left arm along with chest discomfort, seek immediate medical attention.

Diagnosing the Cause of Chest Pain

Diagnosing the cause of chest pain often involves a combination of physical examination, medical history review, and potentially diagnostic tests. For conditions like costochondritis, there is no specific test, and diagnosis is based on symptoms and physical examination. However, your healthcare provider may order tests to rule out more serious conditions.

Common Diagnostic Procedures

• Physical examination
• Chest X-ray
• CT scan
• ECG (electrocardiogram)
• Blood tests

These tests can help identify or rule out conditions such as heart disease, pneumonia, or other underlying causes of chest pain.

Treatment Options for Pain Near the Breastbone

The treatment for pain near the breastbone depends on the underlying cause. Here are some common treatment approaches for various conditions:

Heartburn and GERD Treatment

• Lifestyle changes (avoiding trigger foods, eating smaller meals)
• Over-the-counter antacids
• Prescription medications (proton pump inhibitors, H2 blockers)
• In severe cases, surgical intervention

Peptic Ulcer Treatment

• Antibiotics (if caused by H. pylori infection)
• Proton pump inhibitors to reduce stomach acid
• Avoiding irritating foods and beverages
• Stress reduction techniques

Costochondritis Treatment

• Over-the-counter pain relievers (NSAIDs like ibuprofen)
• Application of heat to the affected area
• Rest and avoiding activities that exacerbate pain
• In some cases, physical therapy or stretching exercises

Preventing Pain Near the Breastbone

While not all causes of chest pain are preventable, there are steps you can take to reduce your risk of developing conditions that cause pain near the breastbone:

1. Maintain a healthy diet and weight
2. Avoid trigger foods if you’re prone to heartburn
3. Practice good posture to reduce strain on the chest wall
4. Manage stress through relaxation techniques or exercise
5. Quit smoking and limit alcohol consumption
6. Stay hydrated and exercise regularly

When to Seek Medical Attention for Chest Pain

While many cases of chest pain are not life-threatening, it’s important to know when to seek medical attention. You should contact a healthcare provider immediately if you experience:

• Severe chest pain that doesn’t respond to over-the-counter medication
• Chest pain accompanied by shortness of breath, dizziness, or fainting
• Pain that radiates to your jaw, left arm, or back
• Chest pain accompanied by a feeling of pressure or squeezing
• Rapid or irregular heartbeat along with chest pain
• Chest pain that worsens with physical activity or stress

Remember, it’s always better to err on the side of caution when it comes to chest pain. If you’re unsure about the severity of your symptoms, seek medical advice promptly.

Lifestyle Changes to Manage Chronic Chest Pain

For individuals who experience recurring pain near the breastbone, certain lifestyle changes can help manage symptoms and improve overall quality of life:

Dietary Modifications

Adjusting your diet can significantly impact the frequency and severity of chest pain, especially if it’s related to digestive issues like heartburn or GERD. Consider the following changes:

• Eat smaller, more frequent meals throughout the day
• Avoid eating close to bedtime
• Limit or avoid known trigger foods
• Incorporate more fiber-rich foods to promote healthy digestion
• Stay hydrated by drinking plenty of water

Stress Management Techniques

Stress can exacerbate many health conditions, including those that cause chest pain. Implementing stress-reduction strategies can be beneficial:

• Practice mindfulness meditation
• Engage in regular physical exercise
• Try deep breathing exercises
• Consider yoga or tai chi for relaxation
• Seek professional counseling if needed

Sleep Hygiene

Improving your sleep habits can help reduce the occurrence of nighttime heartburn and promote overall health:

• Elevate the head of your bed by 6-8 inches
• Avoid eating at least 3 hours before bedtime
• Establish a consistent sleep schedule
• Create a relaxing bedtime routine
• Limit screen time before bed

Understanding the Long-Term Outlook for Chronic Chest Pain Conditions

The long-term prognosis for conditions causing pain near the breastbone varies depending on the underlying cause. Here’s an overview of what to expect for some common conditions:

GERD and Heartburn

With proper management, most people with GERD can control their symptoms effectively. However, it’s often a chronic condition that requires ongoing treatment and lifestyle modifications. In some cases, long-term GERD can lead to complications such as Barrett’s esophagus, which requires regular monitoring.

Peptic Ulcers

Most peptic ulcers heal with appropriate treatment, which may include antibiotics if caused by H. pylori infection. However, recurrence is possible, especially if risk factors (such as NSAID use or smoking) persist. Regular follow-ups with a healthcare provider may be necessary to monitor healing and prevent complications.

Costochondritis

Costochondritis often resolves on its own within weeks to months. In some cases, mild symptoms may persist for an extended period. Most people respond well to conservative treatments and can manage their symptoms effectively. Recurrence is possible but not common.

Emerging Research and Treatment Options for Chest Pain

Medical research continues to advance our understanding of chest pain and related conditions. Some areas of ongoing research and emerging treatments include:

New Medications for GERD

Researchers are exploring new classes of medications to treat GERD more effectively, including drugs that target different aspects of acid production and esophageal function. These may provide alternatives for patients who don’t respond well to current treatments.

Minimally Invasive Surgical Techniques

Advances in surgical techniques are making procedures for conditions like GERD and hiatal hernias less invasive. These include endoscopic approaches that can potentially offer faster recovery times and fewer complications compared to traditional surgery.

Personalized Medicine Approaches

There’s growing interest in tailoring treatments for chest pain conditions based on individual patient characteristics, including genetic factors. This personalized approach may lead to more effective and targeted therapies in the future.

Alternative Therapies

Some studies are exploring the potential benefits of alternative therapies for managing chest pain, including acupuncture, herbal remedies, and mind-body techniques. While more research is needed, these approaches may offer complementary options for some patients.

As research progresses, it’s important to stay informed about new developments and discuss potential treatment options with your healthcare provider. They can help you understand the latest advancements and determine which approaches may be most suitable for your specific condition.

The Importance of Mental Health in Managing Chronic Pain

Chronic pain, including persistent chest pain, can have a significant impact on mental health. Conversely, mental health issues can exacerbate pain symptoms. Understanding this connection is crucial for comprehensive pain management:

The Pain-Depression Cycle

Chronic pain can lead to depression, anxiety, and stress, which in turn can intensify pain perception. This creates a cycle that can be challenging to break. Recognizing this relationship is the first step in addressing both the physical and emotional aspects of chronic pain.

Psychological Approaches to Pain Management

Several psychological techniques can be effective in managing chronic pain:

• Cognitive Behavioral Therapy (CBT): Helps change negative thought patterns and behaviors related to pain
• Mindfulness-Based Stress Reduction (MBSR): Teaches mindfulness techniques to reduce stress and pain perception
• Biofeedback: Trains individuals to control certain bodily processes to reduce pain
• Relaxation techniques: Including progressive muscle relaxation and guided imagery

Seeking Professional Help

If you’re struggling with the emotional impact of chronic chest pain, don’t hesitate to seek help from a mental health professional. They can provide strategies to cope with pain, manage stress, and improve overall quality of life. Many pain management clinics now offer integrated care that addresses both the physical and psychological aspects of chronic pain.

Remember, addressing mental health is not a substitute for medical treatment of the underlying cause of chest pain, but rather a complementary approach that can enhance overall pain management and improve daily functioning.

By taking a holistic approach to managing pain near the breastbone – addressing both physical symptoms and emotional well-being – individuals can often achieve better outcomes and improved quality of life. Always work closely with your healthcare team to develop a comprehensive treatment plan tailored to your specific needs and circumstances.

Pain Below the Sternum After Eating

Girl on couch gripping her lower stomach in pain

Image Credit: AlexRaths/iStock/Getty Images

Developing pain after you eat may cause anxiety whenever you have a meal. Pain that develops below the sternum may be the result of a few digestive conditions. Talking with your doctor is the most effective way to receive a clinical diagnosis and treatment options for your condition. If you notice that the pain develops immediately and causes a burning sensation, it is most likely from heartburn or gastroesophageal reflux disease — GERD. If the pain develops within a few hours after eating, you may have a peptic ulcer. Certain foods can trigger pain below the sternum after eating with a peptic ulcer.

Heartburn

Heartburn symptoms can occur anywhere in your chest and may develop below the sternum. Heartburn that occurs on occasion doesn’t require any further medical evaluation. If you develop heartburn more than twice a week, make an appointment with a gastroenterologist to determine the cause. This condition may occur within a few minutes of eating. Some foods are more likely to trigger heartburn symptoms, such as fried foods, alcohol, chocolate, mint, onion, garlic, caffeine, tomatoes and fatty foods.

Peptic Ulcer

The pain that develops from a peptic ulcer may be felt between your navel and the top of your chest. A peptic ulcer is a wound that forms in the lining of your digestive system, primarily in your esophagus, stomach or opening of the small intestines. As food digests, leaving the stomach empty, you may develop pain from increased stomach acid interacting with the wound. Some foods, such oranges, pineapple, tomatoes, caffeine and alcoholic beverages can irritate the ulcer, causing pain almost immediately after eating.

Ulcer Causes

Peptic ulcers were at one time thought to be the result of stress and eating too much spicy food. While stress and spicy foods can trigger ulcer pain, they are not the cause of your symptoms. Ulcers are primarily the result of an infection that is treated with antibiotics. Your doctor may determine that your ulcers are the result of the overuse of certain medications, the abuse of alcohol or the use of tobacco. If this is the case, you will be advised to make changes in your lifestyle choices.

Warning

Sometimes heartburn is confused with a minor heart attack. If you become short of breath or feel a painful sensation in your left arm, call you doctor immediately. Call your doctor if you vomit blood or emit vomit that looks like coffee grounds. If you notice that your stools are maroon or black, contact medical personnel.

Costochondritis | Saint Luke’s Health System

Costochondritis is inflammation of a rib or the cartilage that connects a rib to your breastbone (sternum). It causes tenderness, and sometimes chest pain may be sharp or aching, or it may feel like pressure. Pain may get worse with deep breathing, movement, or exercise.  In some cases, the pain is mistaken for a heart attack. Despite this, the condition is not serious. Read on to learn more about the condition and how it can be treated.

What causes costochondritis?

The cause of costochondritis is not completely clear, but it may happen after a chest injury, chest infection, or coughing episode. Some physical activities can sometimes lead to costochondritis. Large-breasted women may be more likely to have the condition. Often, the reason for the inflammation is unknown.

Diagnosing costochondritis

There is no test for costochondritis. The condition is diagnosed by the symptoms you have. Your healthcare provider will perform a physical exam. He or she will ask you about your symptoms and examine your chest for tenderness. In some cases, tests are done to rule out more serious problems. These tests may include imaging tests such as chest X-ray, CT scan, or an ECG.

Treating costochondritis

If an underlying cause is found, treatment for that will likely relieve the problem. Costochondritis often goes away on its own. The course of the condition varies from person to person. It usually lasts from weeks to months. In some cases, mild symptoms continue for months to years. To ease symptoms:

• Take medicine as directed. These relieve pain and swelling. Ibuprofen or other NSAIDs are often recommended. In some cases, you may be given prescription medicine, such as muscle relaxants.

• Avoid activities that put stress on the chest or spine.

• Apply a heating pad (set to warm, not too high, heat) to the breastbone several times a day.

• Perform stretching exercises as directed.

Call the healthcare provider right away if you have any of the following:

• Pain that is not relieved by medicine

• Shortness of breath

• Lightheadedness, dizziness, or fainting

• Feeling of irregular heartbeat or fast pulse

Anyone with chest pain should see a healthcare provider, especially those who are older and may be at risk for heart disease.

IT’S CHEST PAIN — BUT NOT FROM YOUR HEART

Q. My doctor says I have “costochondritis” in my chest. Can you please tell me something about this condition. Is it curable? What causes it? How is it treated?

Since I’ve had a heart attack in the past, this new form of chest pain can be quite alarming. How can I tell the difference between the two?

A. You have a very common form of chest pain that understandably sends many people to their doctors or the emergency room. But unlike pain from your heart, costochondritis stems from pain in your chest wall — the muscles and cartilage of your rib cage. The term costochondritis comes from words meaning rib (costo-), cartilage (-chondro-) and inflammation (-itis).

Doctors don’t know for sure what causes this condition, although it’s sometimes blamed on a strain or a viral infection. It affects the junction of the ribs where they connect to either side of your breastbone in front of your chest. These spots become sore and tender, and many people may initially fear they have something wrong with their heart.

A variation of costochondritis is a condition called Tietze’s syndrome. This ailment is relatively rare compared with costochondritis, but it’s similar. The main difference is that several of the rib-breastbone junctions become noticeably swollen, in addition to being sore and tender.

Another similar condition is something called chest wall syndrome. This is a more general term referring to pain in the rib cage, including the muscles of your chest wall; it’s not limited to pain originating in the rib cartilage.

Costochondritis starts as an aching in the front of your chest. Although the tenderness is usually localized to a few rib cartilage junctions, you may feel the pain spread or radiate across your chest. The pain lasts for hours to days at a time.

As for the difference between this condition and a heart attack, costochondritis typically feels like a dull or sharp soreness in your chest. Heart attack pain typically feels like a crushing weight or pressure on your chest rather than sharp or aching pain.

Another difference between costochondritis and heart attack pain is that with costochondritis you’ll have the typical tender spots along your breastbone. However, there are reports of a few people having a heart attack who also have tenderness in their chest wall — so you can’t always count on using this clue to distinguish between the two conditions.

So, because it can sometimes be difficult to know what’s causing a sudden attack of chest pain, you may have to get emergency care to know for sure.

The pain of costochondritis will eventually clear up by itself, even without treatment. But for relief, your doctor will usually recommend pain pills such as acetaminophen (Tylenol), ibuprofen or prescription pain relievers. Warm compresses or ice packs to the sore spots may also help. Occasionally, your doctor may inject a local anesthetic into any sore spots that are giving you particular trouble.

Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington.

Consultation is a health education column and is not a substitute for medical advice from your physician.

Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered personally.

Chest Wall Pain – Comprehensive Pain Phyicians – Doctors Ajakwe and Tatevossian

What is Chest Wall Pain?

Chest wall pain (Costochondritis) is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

What are the Symptoms?

Chest pain associated with costochondritis is usually occurs after exercise, minor trauma, or an upper respiratory infection.

Specific symptoms include:

• Sharp or dull pain on your front chest wall. It may radiate to your back or abdomen and is more common on your left side.
• Pain with a deep breath or cough.
• Pain in 4^th, 5^th and 6^th ribs that increases as you move your trunk or take deep breaths. Conversely, it decreases as your movement stops or with quiet breathing.
• Reproducible tenderness when pressing on the rib joints (costochondral junctions). Without this tenderness, a diagnosis of costochondritis is unlikely.
• When costochondritis occurs as a result of infection after surgery, you will see redness, swelling, or pus discharge at the site of the surgery.

Comparison to Tietze Syndrome

A related condition, tietze syndrome, typically exhibits swelling at the rib-cartilage junction, whereas ostochondritis has no noticeable swelling. Neither condition involves pus or abscess formation.

Tietze syndrome usually affects the junctions at the second and third ribs, and the swelling may last for several months. The syndrome can develop as a complication of surgery on your sternum months to years after the operation.

What are the Treatments?

The treatments for costochondritis are painkillers and anti-inflammatory medications. Often, just simple painkillers such as paracetamol or codeine are needed.

Ibuprofen is an anti-inflammatory medication (also called a non-steroidal anti-inflammatory drug, or NSAID) that is often effective for costochondritis. Other NSAIDs are available on prescription.

For severe cases of costochondritis not responding to painkillers and anti-inflammatory medication, injections of steroids or local anaesthetic medicines may be used.

In extreme cases, an intercostal nerve block can be performed (usually by a doctor specializing in acute pain and/or anaesthetics). This involves injection of a local anaesthetic medicine around the painful ribs, to block the nearby intercostal nerve. The intercostal nerves transmit the painful sensation in costochondritis. This sort of injection temporarily disrupts nerve impulses to stop the pain. Nerve blocks can last several weeks or months. In repeated, severe cases of costochondritis, a series of these injections can be given to permanently destroy the nerve causing the pain.

Non-medicinal measures can be tried for relief of pain in costochondritis. Examples of such techniques include:

• Heat pads.
• Ice application.
• Transcutaneous electrical nerve stimulation (TENS).
• Acupuncture.
• Gentle stretching exercises.
• Avoidance of sports or activities that worsen the pain.
• Physiotherapy or chiropractic therapy.

Oesophageal cancer symptoms | Cancer Research UK

The most common symptoms of oesophageal cancer include:

• difficulty swallowing (dysphagia)
• indigestion or heartburn that don’t go away
• unexplained weight loss
• pain in your throat or behind your breastbone

There are many other conditions that cause these symptoms. Most of them are much more common than oesophageal cancer.

You should see your doctor if you have difficulty swallowing, or you have symptoms that are unusual for you or that won’t go away. Your symptoms are unlikely to be cancer but it is important to get them checked by a doctor.

Difficulty swallowing (dysphagia)

You may feel pain or a burning sensation when you swallow, or your food may stick in your throat or chest.

This is the most common symptom of oesophageal cancer.

A harmless narrowing of the oesophagus called a stricture can also make it difficult for you to swallow. It is important to get this symptom checked by your doctor.

Indigestion or heartburn that don’t go away

You can get indigestion when acid from your stomach goes back up (refluxes) into the oesophagus. Or when the stomach is inflamed or irritated.

The valve between the stomach and oesophagus normally stops this from happening. The valve is called the cardiac sphincter. A tumour that develops here can stop the valve working, causing indigestion.

Remember that indigestion is common and it’s not usually caused by cancer. It can be very painful, even when there’s nothing seriously wrong.

See your doctor if you’ve had heartburn most days for 3 weeks or more, even if you’re taking medicine and it seems to help. Heartburn is burning chest pain or discomfort that happens after eating.

Weight loss

You may be put off eating if you find it hard to swallow or have pain when you swallow your food. This can make you lose weight.

Rarely, extreme weight loss can be a sign of an advanced cancer.

Pain in your throat or behind your breastbone

You may feel pain in the centre of your chest, or more rarely in your back or between your shoulder blades. This can get worse when you swallow or have indigestion.

Other symptoms

Other symptoms can include:

Food coming back up

You may regurgitate food – this is when food comes back up soon after you swallow it. It usually starts with food like meat and bread. You may start to bring up soft foods such as mashed potato, drinks and saliva if you don’t have treatment.

A cough that won’t go away

A cough that won’t go away or that happens when you try to eat can be caused by oesophageal cancer. 

Hoarseness

Your voice can become raspy or croaky. It’s not a common symptom and can be caused by other harmless conditions.

Coughing up blood

You may cough up blood or have blood in your vomit (or food that you bring back up) if your oesophagus is bleeding. This isn’t common. 

Dark poo

Your poo may be darker – almost black – if cancer is making your oesophagus bleed. This is uncommon. You can get darker poo if you’re taking iron tablets.

Costochondritis – Doctors Australia

What is costochondritis?

Your ribcage is an arrangement of bones and cartilage that protects the inner organs in your chest and helps the lungs to function. The cartilage connects the bones to each other; it is more flexible than bone, and that flexibility allows the ribcage to expand and contract so that you can breathe, cough or sneeze.

Costochondritis is pain caused by inflammation of the joints in the rib cage where the cartilage connects to rib bones or to the breastbone (sternum). It is a common cause of chest pain.

Costochondritis is inflammation of rib joints.  

Causes and risk factors

Costochondritis can be caused by several factors, including muscle over-use, arthritis, or vitamin D deficiency.

Muscle overuse and strain

Repetitive, strenuous exercise or work can lead to muscle over-use and strain the rib joints. Repetitive coughing can also strain these joints.

Arthritis

Arthritis is the inflammation of joints. Rheumatoid arthritis, osteoarthritis and ankylosing spondylitis all increase your risk of costochondritis.

Vitamin D deficiency

Low levels of vitamin D can cause the costochondral junctions in the rib to grow, and this can potentially cause costochondritis.

Signs and symptoms

Symptoms of costochondritis include:

• Sharp chest pain, which feels worse when coughing, sneezing or breathing heavily, and;
• Tenderness or swelling in the joints between the cartilage and rib or breastbone.

Methods for diagnosis

Physical examination

Your doctor may diagnose costochondritis by asking about your symptoms and performing a physical exam. They may gently press on your rib joints to see whether you feel pain or tenderness in that spot.

Tests to rule out other causes

X-ray

An X-ray of the chest may be used if the diagnosis is uncertain.

Electrocardiography

Electrocardiography (ECG) uses electrodes attached to your chest to check your heart rhythm. If you are at risk of heart disease, you may undergo electrocardiography to rule out heart attack as a cause of your chest pain.

Computerised tomography (CT) scan

This scan is usually done when other causes, such as infection or tumours, are suspected as the cause of your chest pain.

Vitamin D test

Vitamin D levels can be checked using a blood test.

Types of treatment

Pain-relief medications

Treatment for costochondritis focuses on pain relief. Non-steroidal anti-inflammatory drugs, such as ibuprofen, are used to reduce inflammation and the pain associated with it. In rare instances, a combined injection of a local anaesthetic and corticosteroid are used to reduce pain and inflammation.

Physical therapy

If the cause of the pain is muscle overuse and strain, physical therapy, heat pads and minimising the intensity and frequency of exercise or work can reduce pain.

Potential complications

Costochondritis is not a disease, but a symptom (chest pain due to inflammation). Different causes, such as rheumatoid arthritis or osteoarthritis, have different complications associated with them.

Prognosis

The pain caused by costochondritis usually goes away in a few days or weeks. Because your chest moves whenever you breathe, cough or sneeze, recovery can be slow, and your condition can sometimes get worse before it gets better.

Prevention

There is no way to prevent costochondritis. It occurs at any age and without warning.

Amir Malik, MD: Costochondritis

The thorax is composed of ribs, the sternum (breast bone), cartilaginous tissue and the vertebral column. At the junction of the ribs with the breast bone is cartilage that can sometimes become inflamed and painful. This condition is known as costochondritis. In this article, we shall briefly review this condition and talk about how it can be managed.

What is Costochondritis?

Costochondritis is a painful condition that is characterized by inflammation of the cartilage that joins the ribs and the breast bone.

The word ‘costo’ means ribs and ‘chondritis’ means ‘inflammation of cartilage.’ Costochondritis can affect any rib and any cartilaginous joint. In costochondritis, there does not appear to be any swelling of the cartilage, which is important to note, as this can be easily confused with another clinical condition known as Tietze’s syndrome.

Causes of Costochondritis

The majority of cases of costochondritis do not have a clear cause. Sometimes, however, in patients who have suffered some form of chest wall injury, pain may occur. This can be due to direct trauma to the chest or from strenuous activities such as lifting heavy weights.

Costochondritis tends to affect younger individuals rather than older individuals. There does not appear to be any predilection toward men or women, but anecdotal reports have suggested that it may be more common in women.

Symptoms of Costochondritis

The characteristic symptom experienced by patients is a sharp chest pain which is felt in the front of the chest where the cartilage is present. The pain can be exaggerated upon movement and when taking a deep breath in. Upon pressing the affected area, patients can replicate the pain. Unlike cardiac pain, the pain from costochondritis is localized to one area and does not radiate anywhere else (like to the jaw or the shoulder).

Due to the pain, some patients may experience a degree of breathlessness, as they are unable take a deep breath in. Clinical examination clearly demonstrates tenderness over the costochondral junctions, that is, the junction where the ribs meet the breast bone.

Diagnosis of Costochondritis

There is no specific diagnostic tool that can be used in confirming costochondritis and clinical examination is often sufficient.

However, given the location of the pain, patients may undergo additional investigation such as an electrocardiogram to rule out a cardiac cause of chest pain. A chest X-ray may also be performed to rule out the presence of any fractures.

Treatment for Costochondritis

The primary modality of treatment for costochondritis is painkillers. Simple over-the-counter painkillers such as paracetamol are often sufficient. Non-steroidal anti-inflammatory drugs such as ibuprofen are excellent in managing the pain. Patients are also advised to avoid any sudden movements or activities that can worsen the pain and place stress on the costochondral junctions. In addition to painkillers, patients must also try simple home remedies such as applying heat pads on the affected area or seek out alternative treatments such as acupuncture.

In cases where patients experience intractable chest pain, specialist treatments such as intercostal nerve blocks using anesthetic agents may be performed. The techniques may help though further treatments may be required.

The majority of cases of costochondritis resolve within a few weeks and the long-term prognosis is excellent.

90,000 Chest pain can be a sign of heart, spine and lung problems | Healthy life | Health

A word to our expert, an angioneurologist, author of books on a healthy lifestyle, Doctor of Medical Sciences Evgeny Shirokov .

Every one of us faces pains in the chest area from time to time. However, finding out what causes them is not an easy task. There are many reasons for such pain. It could be:

Diseases of the lungs also often give pain in the chest area.Most often it is pleurisy (inflammation of the pleura – the membrane that lines the chest cavity from the inside and covers the lungs). Severe pain occurs with pneumothorax (penetration of air into the pleural cavity). This happens with infectious diseases of the lungs (tuberculosis). But with pneumonia, chest pains are rare: there are no pain receptors in the lung tissues.

How it manifests : Acute, paroxysmal pain in the right side of the chest, often accompanied by shortness of breath.

Whom to contact : To a therapist or a pulmonologist who will conduct an examination (pneumothorax is easy to recognize by its characteristic signs when listening with a phonendoscope), and, if necessary, will prescribe an X-ray of the lungs.

Radiculitis of the chest , associated with irritation or damage to the nerve root from which the intercostal nerve is formed, is a less common cause of chest pain. The impetus for their occurrence can be hypothermia, excessive physical activity or injury.

How manifests itself: Most often, such pains from the spine pass to the front or lateral surface of the chest and are sharper, one-sided (either to the right or to the left). Sometimes, with such pains, a violation of sensitivity occurs in the corresponding zone, which may be associated with nerve damage and requires urgent medical attention.

Whom to contact : To a neurologist, vertebroneurologist, neurosurgeon.

Intercostal neuralgia (not contrived, but very real) can also cause chest pain.Most often it occurs as a consequence of herpetic ganglioneuritis, which is popularly called herpes zoster. It can be recognized by itchy crusts or blisters located along the lines of the ribs.

How it manifests itself : Affecting the nodes of the nerves, the virus causes quite severe pain. With herpetic ganglioneuritis, the pains are sharp, burning, sometimes occur at the slightest touch to the skin and require the use of pain relievers, and sometimes novocaine blockades.

Whom to contact : To a neurologist.

Heart disease. Pain in the chest area can be a manifestation of cardiovascular problems. First of all – ischemic heart disease. The slightest violation of the blood supply to the heart muscle is enough, and the “hungry” heart begins to “scream”, announcing the lack of oxygen by paroxysmal pain (angina pectoris), shortness of breath, arrhythmia (heart rhythm disturbance).

How it manifests : Most often, such pain occurs in the left side of the chest, is paroxysmal in nature and is associated with physical and / or emotional stress.Although in the case of angina pectoris, it is sometimes difficult to carry out differential (clarifying) diagnostics even in a hospital setting. More often, with angina pectoris, there is a burning sensation, discomfort, compression in the center of the chest, behind the sternum, and even in the esophagus.

Whom to contact : To a cardiologist who will prescribe a comprehensive examination of the heart.

Diseases of the spine (spondylosis, scoliosis, etc.) Occur in 60–80% of adults and most often cause pain in the chest area.Congenital anomalies of the osteoarticular apparatus, trauma, sedentary work, carrying heavy loads lead to disruption of the usual configuration of the spine. When the weather changes, the load on the intervertebral joints causes inflammation in them, and then pain.

How it manifests itself : Pain associated with diseases of the spine can be very long and, as a rule, do not have a clear localization – they give it to the arm, then to the shoulder girdle, then to the region of the heart – and depend not so much on movements as on positional load (for example, after a long sitting on an airplane, etc.)etc.).

Whom to contact : To a neurologist, vertebroneurologist, chiropractor.

90,000 Why does a child complain of heart pain? Doctor tells – Ulyanovsk today

The other day we celebrated World Heart Day. This is another reason to talk about the health of the most important organ in the human body. Especially with regard to children.

In recent years, worried parents of little patients with children’s complaints of pain in the heart began to turn to pediatric cardiologists more and more often.Experts note that the heart itself in children almost never hurts. Ischemic pains, heart attacks are a rare pathology. The localization of ischemic pain is retrosternal, and not under the left nipple, which is most often shown by young patients. Children with heart disease usually do not complain of pain. They are worried about general weakness, inability to perform physical activity on a par with their peers, shortness of breath, sensations of interruptions in the heart.

Interview with the head of the cardiology department of the Ulyanovsk Regional Children’s Clinical Hospital named after Yu.F. Goryachev, the chief freelance pediatric cardiologist of the regional Ministry of Health Tatyana Pavkhun, was published by the relevant department.

– Tatyana Viktorovna, please tell us, how often do children complain of heart pain?

– Indeed, recently, many children have been making such complaints routinely to district pediatricians and urgently to the admissions departments of the children’s regional and city hospitals. I must say that in childhood, pain in the heart is extremely rare.These are the priorities of the adult population. Most often, these pains are not associated with heart disease. As a rule, these are non-cardiac manifestations and diseases.

– What is the pathology that causes pain in the heart?

– Preschool children most often complain of pain in the heart if they have congenital anomalies in the development of the heart, or inflammatory cardiopathies (carditis), as well as pericardial disease, which is accompanied by the appearance of fluid around the heart, compressing the organ, therefore, there are unpleasant sensations in area of ​​the heart.It can also be heart rhythm disturbances, recently they have begun to occur even in preschool children. The most common causes of pain in the heart area include the intense growth of the heart compared to the growth of blood vessels that supply it with blood. Such growth is noted between the ages of six and ten. The pain caused by this reason, more often appears in emotional and rather mobile children of asthenic constitution – thin, flexible, tall.

Another cause of pain in the area of ​​the heart can be vegetative-vascular changes, which often occur in adolescence.They are manifested by stabbing pains in the left side of the chest, which often occur at rest, but more often after psycho-emotional stress.

Problems with the spine can also be the cause. Any pathology of its development, for example, scoliosis or early osteochondrosis, can provoke the appearance of pain in the chest, which the child associates with the heart. Computers, especially fashionable gadgets, play a negative role in the development of chest pain symptoms in the modern world.Prolonged use of smartphones and tablets leads to the development of muscular-tonic syndrome, incorrect installation of the cervical spine, and, consequently, malnutrition of the brain and nerves extending from the spine to internal organs, including the heart. This leads to the development of painful sensations in the chest, what children and adolescents call “heartache”.

Neurosis or other problems with the nervous system can also provoke a sensation of pain: if the nervous system is affected, pulling or stabbing pains appear in the region of the heart after physical activity or emotional manifestations.

Cholecystocholangitis or dyskinesia of the ways through which bile is excreted can also respond to pain in the chest. At the same time, many children cannot determine the exact source of pain, pointing to the chest if the stomach hurts.

– What specialist should a parent contact if a child complains of heart pain?

– Given that there are so many causes of heart pain, parents need to show their children to more than one specialist. First of all, you need to contact your local pediatrician, who will refer them to a cardiologist.Due to the many reasons that cause this condition, the circle of specialists who will surround the child during the examination is quite wide. The cardiologist will prescribe an examination, including an ECG, an ultrasound of the heart, it may be necessary to pass biochemical markers in order to exclude inflammatory changes in the heart. Consultations of a gastroenterologist, endocrinologist, orthopedist, and neurologist will be scheduled. These specialists will help the pediatric cardiologist to understand the causes of pain in the heart.

As a reminder, on behalf of the President of Russia Vladimir Putin, a national project “Health” is being implemented in the Ulyanovsk region, one of the tasks of which is to combat cardiovascular diseases.

90,000 Chest Pain – New Hospitals

Chest pain can be caused by any cause – from chest pain to heart attack or chronic heart disease, therefore should not be ignored under any circumstances.

When to seek emergency medical attention?

Get emergency medical attention immediately if you have sudden, severe chest pain, especially if:

• You feel heavy, tight, or similar;
• The pain began suddenly and lasts 2-15 minutes or more;
• Pain spreads to other parts of the body, such as one or both arms, back, neck or jaw;
• You have other symptoms – shortness of breath, nausea, vomiting, cold sweats, dizziness, or severe weakness;
• You have a risk of heart disease; for example, you smoke or are overweight, have high blood pressure (hypertension), diabetes, high cholesterol, or a family history of heart disease.

Call 112 immediately or see a doctor, even if the pain or discomfort is not severe, quickly relieved or completely resolved, as this could be the first manifestation of a dangerous heart disease.

Could this be a heart problem?

Chest pain does not always start as a result of heart problems. Sometimes it is difficult to distinguish between pain in the heart and pain caused by abnormalities in other organs.Therefore, we must always remember that it can be caused by such heart pathologies as:

• Angina pectoris – when the blood supply to the heart muscle is partially restricted due to narrowing of the blood vessels (arteries) supplying the heart muscle;
• Heart attack – when the blood supply to a specific part of the heart muscle is suddenly completely restricted due to a blockage in the blood vessel supplying the heart muscle;
• Other heart conditions – e.g. aortic dissection, pericarditis, etc.d.

Both angina pectoris and heart attack are different manifestations of coronary artery disease, which is based on damage to the heart blood vessels and a restriction of the supply of oxygen-rich blood to the heart muscle. Both of these conditions can cause dull, severe, pressing, tight chest pain that can spread to the arms, neck, jaw, or back. Sometimes this pain can develop in the abdomen as well. These symptoms may be accompanied by shortness of breath and nausea / vomiting.

Unlike a heart attack, which is an acute condition and necessarily requires urgent hospitalization in a specialized clinic, chest pain caused by angina pectoris is triggered by physical activity, various types of stress or emotional stress and decreases with the cessation of stress and after a few minutes of rest.

If you have already been diagnosed with angina, your pain may be relieved by taking prescribed medication for angina.

If the above symptoms persist for 2-15 minutes or more at rest, there is a high likelihood that they can be caused by a heart attack – at this time, immediate medical attention and hospitalization are required.

What diagnostic tools are there?

• Electrocardiography (ECG) – this method records the electrical activity of the heart. Heart damage is detected and recorded, since damaged and healthy tissues of the heart conduct electrical impulses differently.Continuous ECGs are often recorded over 24 or 48 hours.
• Exercise Test – During this test, the patient receives physical activity on a treadmill or stationary bike; an electrocardiogram is recorded in parallel. The method is used to determine how the blood supply to the heart responds to increased demand associated with exercise. If the blood vessels in the heart are narrowed, this is reflected in the electrocardiogram.
• Ultrasound examination – high-frequency sound is used for examination, with the help of which a video image of the heart is obtained.As a result, doctors can observe the structure, contractility and other parameters of the heart. Abnormal contraction of any part of the heart often indicates a blockage of the blood vessels that supply the heart.
• Cardiovascular angiography (coronary angiography) – through a special long catheter, a special radiopaque substance is injected from the artery of the limb (arm or leg) into the artery of the heart. Then, through an X-ray machine, the degree of narrowing (damage) of the arteries and complete blockage of the artery (if any) is observed, studied and recorded on a digital medium.

What treatments are there?

• Coronary angioplasty with stenting – This procedure is similar to coronary angiography, and as a result, the conduction of the blood vessels of the heart is restored. The manipulation is carried out using a long catheter, at the end of which a special balloon is installed. Upon reaching the narrowed part of the blood vessel, the balloon inflates until the patency of the blood vessels is restored.The balloon is then removed and a so-called stent (mesh rigid tube) is placed in its place, which permanently remains in the damaged part of the blood vessel and prevents re-stenosis (narrowing). The patient may need one or more stents, depending on the number of constrictions. There are many types of stents, many of which are made of metal or drug-eluting material. Depending on the course of the patient’s illness and the pattern of coronary angiography, the doctor will advise the patient on the type of stent.
• Coronary artery bypass grafting – an operation in which blood supply to the heart occurs by bypassing the narrowing of the coronary vessel – bypass grafting. A blood vessel taken from other parts of the body is used for bypass surgery. For example, a vein from a leg or an internal thoracic artery can be used for bypass surgery. During bypass surgery, depending on the number of blood vessel constrictions, the patient may need one or more bypass grafts.

How is drug treatment carried out?

Many medicines can be used during a heart attack, including:

• Vasodilators such as nitroglycerin – These small tablets are taken under the tongue. They expand the blood vessels that feed the heart, reduce stress on the heart and improve blood circulation in the tissues.
• Medicines that prevent blood clot formation, for example, Aspirin, Clopidogrel.
• Beta-blockers – are often used to treat angina pectoris. They lower heart rate and blood pressure, thereby reducing the heart’s need for oxygen, and even with damaged arteries can improve the patient’s condition.
• Thrombolytic drugs – used to destroy an already formed blood clot; drugs in this group can also be prescribed to prevent new blood clots from forming.
• Drugs that thin the blood, for example, Rivaroxaban – if a blood clot forms in the artery, then drugs of this group may also be prescribed to prevent the formation of new blood clots.
• Drugs that lower cholesterol levels, eg Atrovastatin, Simvastatin – high cholesterol levels are an important factor in atherosclerotic vascular lesions. If the result cannot be achieved with a healthy diet and physical activity, your doctor may prescribe a daily medication to help normalize your cholesterol levels.

In addition to the above medications, depending on the patient’s condition, other groups of drugs may be prescribed, such as: calcium antagonists, ACE inhibitors, various antiarrhythmic drugs, etc.

If you think that you or someone else has had a heart attack, call 112 immediately!

Don’t worry if you are not sure if this is indeed a heart attack. It is better for the medical staff to arrive at the place of the call and make sure that this was only your guess, than to arrive when it is too late to save a life.

Please note that the above information is for educational purposes only, to give you an idea of ​​the symptoms, causes, diagnosis and treatment of angina pectoris and heart attack.

Remember that a patient with chest complaints should definitely consult a doctor for a diagnosis – do not try to make a diagnosis yourself! Self-medication can be fatal!

90,000 Chest pain does not always indicate heart problems

Pain behind the breastbone is always alarming, sometimes even frightening.But do not immediately grab the heart drops! First, listen to yourself, advises leading researcher of the Republican Scientific and Practical Center “Cardiology”, associate professor, candidate of medical sciences Irena Karpova:

express.co.uk

– Chest pain has many faces. And anything can cause it. For example, painful sensations in muscles, cartilage and ribs, which even doctors often mistake for angina pectoris, or angina pectoris.

Another provocateur of pain is shingles. And the culprit is the herpes virus, which, like a fiery hoop, takes the body in a vice.True, it is possible to understand what exactly this infection is attacking only after 7-10 days, when a scattering of small herpes bubbles characteristic of the virus appears on the skin in the intercostal spaces. An infectious disease specialist will have to treat this infection.

Behind the breastbone, there may also be unpleasant painful sensations caused by esophageal spasm, or esophagitis, due to irritation of the esophageal mucosa with acidic gastric juice. They are also easy to confuse with an attack of angina pectoris. And to recognize esophagitis allows the relationship of pain with eating and reducing pain after a few sips of water or taking antacids.These drugs reduce the acidity of gastric juice, thereby relieving heartburn, feeling of heaviness, discomfort and abdominal pain after eating.

Tingling, piercing, dagger-like, aching and stringy, but almost always quite short – it’s all about chest pain. Fortunately, most of them have nothing to do with the heart itself. And here’s an example. With a deep breath and sneeze, you can find painful areas on the chest yourself. Or by pressing on them with your hand. Pain will immediately appear, similar to the one you have already experienced.And non-steroidal anti-inflammatory drugs help to calm it down.

According to an experienced cardiologist, heart pains are special, they differ from all others. For example, with ischemic heart disease, they are provoked by physical exertion, emotional stress, if it is not a heart attack. In this case, the pains last from 3 to 10 minutes, quickly disappearing if the person took nitroglycerin.

Generally, nitroglycerin can be considered a heart pain tester. To determine if the heart is troubling or something else, you can take this remedy.But the first time you need to consult a doctor. Heart pain usually goes away in 5 minutes, while another remains.

One of the important symptoms of ischemic heart disease is an attack of angina pectoris, during which there is a sharp pain behind the breastbone. It usually occurs while walking, accelerating a step, or climbing stairs. As soon as the person increases the load, the pain is right there. She can give to the back, neck, lower jaw, shoulder, arm (more often to the left). Shortness of breath, shortness of breath, rapid pulse are often accompanied by angina pectoris.If suddenly, lifting weights, you experienced something similar, hurry to the cardiologist, because this condition can lead to myocardial infarction at any moment.

And yet there are more pains of non-cardiac origin in the chest. Most often they are caused by cervicothoracic osteochondrosis, which is able to “be silent” for the time being. Even if an X-ray of the spine is taken and there are no signs of osteochondrosis in the picture, the person can still be haunted by pain. And here, too, you cannot do without consulting an experienced neurologist.

In ordinary life, we do not even notice how many movements we make per minute. Everything happens naturally. But sometimes an uncomfortable position of the body, an awkward turn of the head and even deep breathing or coughing cause pain in the chest. Because of them, a person suffers at night or in the morning after sleep. At the same time, if the position of the body changes, the pain will disappear. Only not immediately, but within 15-20 minutes, although they may remind of themselves a few days later.

With intercostal neuralgia, the pain increases if you press on this place with your fingers.Nitroglycerin does not relieve spasm. In this case, pain medications, massage, physical exercises help to get rid of suffering – they will certainly be advised by a neurologist.

Quite intense and prolonged pain in the left half of the chest, less often in the left arm and between the shoulder blades is called “vertebral cardialgia”. She usually pursues those who like to hang out in one position for a long time in front of the TV or computer. But once you change your posture, the pain disappears.

“Our spine gets tired of staying in one position for a long time, so we need to get up and move,” advises Irena Karpova.- Moreover, if chest pains are provoked by cervical osteochondrosis, then knead the neck carefully and carefully. You should not turn your head, throw it back. If, during the execution of the movements, pain appears behind the sternum, this is another proof that it was not a heart problem that manifested itself, but the spine was to blame for everything. In this case, MRI (magnetic resonance imaging) of the spine will help to confirm the diagnosis.

Pain behind the breastbone often occurs in the illness of civilization – vegetative vascular dystonia with its faithful companions – panic attacks.By the way, this is the second most common cause of chest pain. This condition occurs in young people with an unstable nervous system, for whom stress is an unbearable burden and an exorbitant load. Vegetovascular dystonia is accompanied not only by chest pain, but also by heart palpitations, lack of air, reddening of the skin, and sweating. And although it is often called “cardiac neurosis”, it does not lead to disruption of the work of the heart.

And this, of course, is not all the causes of chest pain.