Heart pain can arise from completely different reasons. Some pains do not pose a danger and can simply be tolerated, while other pains are strictly contraindicated and must be relieved immediately. How to find out what kind of pain you have? You need to see a doctor and undergo an examination, without waiting for obvious signs, at the slightest suspicion.
Diagnosis of heart pain
An experienced doctor can determine its origin based on the description of the pain. But to confirm the diagnosis you need to undergo an examination. First of all, an electrocardiogram (ECG) is done, including with physical activity. If no abnormalities are detected, the ECG is recorded throughout the day (24-hour monitoring).
If pain in the heart appears after a sore throat, then an ECG, echocardiography (ultrasound examination of the heart), and blood tests are required, which can reveal inflammation in the heart muscle.
If you have pain in the heart area, be sure to consult a doctor - he will help you figure out how serious it is. What methods are used today to study cardiac activity? There are quite a few of them, and the specific diagnostic set in each case is determined by the attending physician.
- The well-known ECG - taking a cardiogram - is a mandatory technique for any suspicion of heart disease. Stress ECG is also widely used - recording data during physical activity (usually velometry or treadmill test), as well as Holter ECG (when an electrocardiogram is taken during the day).
- Often, the doctor prescribes a graphical recording of heart sounds and noises (phonocardiography), a study of the valves and muscles of the heart, as well as the speed of blood flow in the heart cavities using ultrasound waves (echocardiography). Coronary arteries are studied using a radiopaque method (coronary angiography). How well the myocardium is supplied with blood can be determined by radionuclide diagnostics (scintigraphy).
- To exclude damage to other organs as the cause of heart pain, patients are prescribed a spinal examination (X-ray, computed tomography, MRI), consultation with an orthopedist, neurologist, gastroenterologist, and even a psychotherapist.
Experienced doctors know that some (and fairly accurate) conclusions can be drawn by listening carefully to the patient. When a person describes his feelings in detail, keeps and shows the doctor a kind of diary of the occurrence and nature of pain in the heart area, most likely the heart itself has nothing to do with it. Also, an “external” source of pain is indicated by patient reports of varying durations of attacks, a strong and very disturbing heartbeat - of course, if the person does not have heart failure. But if the patient perfectly remembers all his painful sensations, but describes them sparingly and reluctantly, there is a high chance of diagnosing serious heart disease.
In any case, remember: the main thing to do if your heart hurts is to consult a specialist and give him the right to draw conclusions about your health.
Heart pain can be a consequence of cardioneurosis, a disease of the nervous system. They intensify under stress and have a constant aching character. Such pain is relieved with sedatives (for example, valocardine or valerian). But you need to remember that only a doctor can make a diagnosis of cardioneurosis after an examination.
Pain in the heart due to inflammation of the heart muscle (myocarditis) is prolonged, aching, sometimes it is combined with stabbing pains, they are usually felt not behind the sternum, but to the left of it. The pain intensifies with physical activity, usually combined with shortness of breath, a feeling of “interruptions” in the heart’s work and its “fading”, weakness, malaise, and sometimes with a slight fever. Such pains often appear 2-3 weeks after a sore throat or other illness. You can’t joke with these pains - you need to see a doctor immediately, the treatment will be long-term.
Heart pain can occur when the arteries that supply nutrients and oxygen to the heart muscle spasm (compress). Such attacks of pain are called angina pectoris, they are very dangerous and cannot be tolerated.
What are the main causes of pain and heaviness?
Pain in the hypochondrium may intensify after physical activity
Pain, heaviness and other types of discomfort in the left hypochondrium are nonspecific symptoms that may indicate a number of different types of diseases.
This part of the body contains many nodes, the most significant of which are:
- left lung and its appendages of the respiratory system;
- tail of the pancreas;
- middle wall zone of the heart;
- the upper part of the stomach and the bend of one of the intestines;
- upper part of the left kidney;
- a small part of the diaphragm;
- left uterine appendages in females.
In addition, under the left rib in the front there are numerous nerves, vessels, lymph nodes, muscular sections of the torso and subcutaneous tissue, as a result of which the pathogenesis of discomfort in this area of the body can indeed be extremely wide.
To determine the exact cause of pain and heaviness in the left hypochondrium, it is necessary to assess the overall clinical picture of the problem and conduct a series of examinations in the clinic.
We’ll talk about diagnosing the possible pathogenesis of discomfort a little later, but now we’ll look at the main reasons for its occurrence. As practice shows, most often pain and heaviness in the anterior part of the left hypochondrium arise due to:
- swelling of inflamed body tissues;
- insufficient blood supply to those, which provokes improper functioning of nerve endings;
- impaired integrity of organs located under the left rib;
- muscle problems;
- recent surgery;
- typical overeating or overload during physical activity.
Pain under the left rib can be of different types
As for specific pathologies, their list is truly enormous. In modern medicine, the pathogenesis of discomfort in the left hypochondrium usually comes down to the development of:
Angina pectoris
Attacks of angina pectoris occur first during exercise or stress (this is called angina pectoris), and then at rest (rest angina pectoris). In typical cases, the pain is squeezing or pressing in nature and manifests itself either in the upper part of the sternum or to the left of it. Pain can radiate to the left arm, the left half of the face and neck, to the lower jaw, left ear, to the left shoulder blade, sometimes to the right shoulder or both shoulders and both arms, and the back. Sometimes the pain spreads to the left side of the abdomen and lower back, and to the legs. The onset of pain is rarely sudden; usually the pain is of an increasing nature, lasts for several minutes, then disappears. This pain is different in that it can be relieved with nitroglycerin, a drug that relieves spasm of the coronary arteries (which supply blood to the heart muscle).
If such pain occurs at least once, the patient should consult a doctor, get examined and clearly know what to do during an attack. During an attack of angina, you need to:
- take a nitroglycerin tablet (under the tongue);
- lie down, open a window or window;
- if after 2 minutes the pain has not decreased, then take another nitroglycerin tablet and call an ambulance. Nitroglycerin begins to act within 1-2 minutes, its vasodilating effect lasts 20-30 minutes. Remember: neither Corvalol nor validol will help with angina - only nitroglycerin!
Causes of pain in the left chest:
1. Diseases of the cardiovascular system:
- cardiac ischemia
- inflammatory heart diseases (myocarditis, pericarditis)
- dissecting aortic aneurysm
2. Respiratory diseases:
- pneumonia
- pneumothorax
3. Diseases of the gastrointestinal tract:
- stomach ulcer
- gastroesophageal reflux disease (GERD)
- inflammation, trauma, tumors of the esophagus, stomach
- acute pancreatitis
- sliding hiatal hernia
4. Diseases of the musculoskeletal system:
- inflammatory diseases of the spine and ribs
- spinal and rib injuries
- degenerative diseases of the spine (osteochondrosis, spondylosis)
5. Infections of the soft tissues of the chest - herpes zoster
6. Diseases of the breast
CLINICAL depends on the cause of chest pain.
Coronary heart disease
can manifest itself as pain in the chest of a pressing, burning nature, in the left half of the chest, which can radiate to the left arm and/or both arms, throat, and lower jaw. Usually occurs during physical activity and stops when it is completed, or after taking nitroglycerin or administering analgesics. Such pain is accompanied by shortness of breath, weakness, sweating, and fear of death.
For inflammatory heart diseases
pain in the left chest occurs after an acute respiratory viral infection and is varied in nature (aching, stabbing, pressing, cutting). They are associated with body position and breathing, last for many hours, are in no way related to physical activity and disappear while taking anti-inflammatory drugs.
Dissecting aortic aneurysm
characterized by sudden, sharp, dagger-like pain of a diffuse nature in the chest, occurring after a sharp rise in blood pressure, intense jerking load (heavy lifting), accompanied by weakness, sweating, loss of consciousness, and a drop in blood pressure.
Pneumonia (pneumonia)
accompanied by cough, increased body temperature, stabbing, cutting, aching pain associated with coughing and breathing.
Against the background of tuberculosis
, chronic obstructive pulmonary disease, bronchiectasis, bullae - large bubbles - can form in the lungs. With a sharp cough or injury to the chest, they burst, air from them escapes into the chest and causes displacement of the internal organs located in it. This condition is called “pneumothorax” and is manifested by sharp, high-intensity chest pain, shortness of breath, a drop in blood pressure and even loss of consciousness.
Any disease of the gastrointestinal tract
may be accompanied by chest pain, especially in the left half. The fact is that all organs of the chest and abdominal cavity are closely connected to each other through innervation. And very often with gastroenterological disease there is “referred” pain. That is, the “epicenter” of the disease is in the abdominal cavity, and pain is felt in the chest.
The pain syndrome itself in this case is varied (stabbing, aching, pressing, cutting, bursting pain, etc.), and is not associated with physical activity. But it is associated with eating or feeling hungry, usually for many hours. It often goes away after eating or taking antispasmodics, and may be accompanied by nausea, vomiting, weakness, and the urge to defecate.
For pathology of the musculoskeletal system
(osteochondrosis, spondylosis) pain in the left chest is often local (point-like), although often diffuse, mostly sharp, piercing, sharp, associated with breathing and body position. It is not associated with physical activity and goes away on its own, or when changing body position, when taking anti-inflammatory drugs (Nise, diclofenac, ibuprofen).
Chest pain following injury
, may be associated with post-traumatic inflammation or fracture. The characteristics of this pain syndrome are similar to those described for osteochondrosis and spondylosis.
For herpes zoster
pain in the chest is burning, intense, sometimes unbearable, lasts for many hours, and is difficult to relieve with analgesics. On the second or third day of the pain syndrome, rashes appear on the chest. They resemble blisters, cause unbearable itching and go away after a while.
Breast diseases
(mastopathy, mastitis, oncological pathology) can also be accompanied by pain in the left half of the chest and under it. The pain is also absolutely varied, but more often it is local (small in area), sharp, stabbing, and often just discomfort in the breast area. In this case, the mammary gland itself may become engorged (increase in volume); it is possible to detect a focal compaction in it, often dense and painful.
Myocardial infarction
If an attack of angina pectoris lasts a long time, then the heart muscle, not receiving nutrients and oxygen, begins to quickly deteriorate, its necrosis (death) occurs, this is myocardial infarction. That is why you should never tolerate pain due to angina pectoris.
Myocardial infarction is manifested by attacks of severe pain in the chest, which are not relieved by nitroglycerin. The duration of this pain is from 20-30 minutes to several hours. In such cases, the sooner the patient receives medical assistance, the greater the chance of recovery.
