Cutting pain in left chest. Heart pain: when inhaling, sharp, pressing, aching, stabbing, how to distinguish from non-heart pain

Pain under the left sternum often indicates a specific disease and is a symptom of pathologies of the heart and other organs. If this symptom appears repeatedly, it is necessary to promptly seek medical help and carry out diagnostic measures. There may be disturbances in the functioning of not only the heart, but also the lungs, certain parts of the gastrointestinal tract, and the development of an oncological tumor. Pain syndrome may also indicate disturbances in the structure of the mammary gland and nearby tissues.

If the pain is localized under the left sternum, it is necessary to diagnose the condition of the stomach, heart, and spleen. If you have diseases of the musculoskeletal system, you should diagnose inflammatory reactions. Pay attention to the probable risk of oncological processes.

Spleen disorders:

1. With pathologies in the structure of the spleen, a characteristic symptom is radiating pain.
2. Spleen cyst, possible abscess formation.
3. Traumatic organ damage.
4. An increase in organ size, the development of infectious mononucleosis.

Gastrointestinal diseases:

Symptoms indicating the presence of disturbances in the structure of the bronchi and lungs:

1. Pneumonia localized on the left side. It is characterized by a dull pain syndrome, unpleasant sensations that are not severe, but spread to the area under the chest and back.
2. Left-sided pleurisy, which, in addition to unpleasant symptoms in the form of pain, is characterized by the formation of a severe cough. It intensifies during coughing attacks and radiates to the chest and back.

Diseases developing in the mammary gland:

1. Cyst, another tumor accompanied by the formation of an abscess.
2. Fibromyalgia.
3. Oncology.

Cardiac disorders:

Aching nature of pain

If the pain syndrome occurs in a mild form, this often indicates the development of chronic inflammatory processes. Possible inflammation of the stomach, which occurs in slow motion, pathologies of the large intestine, disorders of the spleen. In this case, along with such pain, nausea and vomiting appear. This violation indicates the development of a stomach ulcer.

Important! Often, chronic aching pain signals ischemia or angina. In rare cases, with pathologies of the pancreas, the pain has a girdling character.

If you experience discomfort after stress or physical activity, you may develop cardiac disorders, for example, myocarditis. If even a slight pain syndrome is detected, you should consult a doctor and perform a set of diagnostic examinations.

Sharp pain

If acute pain syndrome develops, measures should be taken immediately to relieve it. If you do not seek medical help in a timely manner, a sharp deterioration in the patient’s condition may occur. Severe pain indicates the onset of spasm of the coronary arteries, the development of an aortic aneurysm, heart attack, perforation of the stomach and intestines. In this case, along with pain, a person notices a strong increase in temperature, and pancreatitis is likely to occur. When this disease develops, the nature of the pain is unbearable and cannot be relieved with standard analgesics.

Important! If mediastinal emphysema develops, the pain radiates to the retrosternal space, and a typical crunching sound appears when breathing. In a hospital setting, measures are taken to relieve severe pain, as well as to prevent the worsening of the patient’s general condition.

If the pain becomes stabbing in nature, this disorder indicates the presence of inflammatory processes in the muscles, the development of neuralgia, and in some cases, angina. The patient is not always able to accurately determine the nature of the pain syndrome. You should undergo an examination to exclude perforation of the stomach wall and various traumatic injuries.

Strong pain

Severe pain is associated with disruption of nerve endings, which indicates the development of pericarditis, pneumonia, as well as deterioration of the patient’s condition with chronic angina. If these symptoms occur during physical activity, such a violation indicates a worsening of osteochondrosis.

Important! Severe pain is a sign of pulmonary embolism. In this case, the newly appeared painful sensations quickly worsen and radiate to other areas of the body. This disease is often confused with myocardial infarction, but with thromboembolism the patient suffers from severe shortness of breath, blood escaping through the mouth, and possible loss of consciousness.

Myocardial infarction is suspected if pain develops from the middle of the chest and then moves to the left side. As symptoms intensify, it radiates to the arm and back. If you notice similar symptoms in yourself or someone you know, you must seek medical help promptly, since an acute condition requires urgent treatment measures.

Blunt pain

Dull pain indicates osteochondrosis and is a sign of chronic gastrointestinal pathology. With aching pain, patients may suffer from pancreatitis, cholecystitis, but in this case these diseases have atypical symptoms. Unpleasant sensations of a dull nature indicate the development of cardialgia of the vegetative type. Additionally, patients feel a rapid heartbeat and suffer from severe shortness of breath. An increase in blood pressure is diagnosed, which cannot be reduced with validol or other similar medications. With this disease, discomfort can be relieved with the help of sedatives.

In case of severe pain, follow these rules:

1. Elimination of the primary pathology that caused the pain. It is necessary to carry out surgical measures if there is a risk of splenic rupture or aortic aneurysm. A number of therapeutic measures are also carried out if the patient is in a pre-infarction state.
2. If the patient is 40 years of age or older, doctors decide on emergency hospitalization to avoid the development of acute or irreversible processes.
3. The use of strong analgesics is not recommended. The use of drugs is especially dangerous when disorders in the gastrointestinal tract are detected, since in the case of complete relief of the pain syndrome it is impossible to determine the exact clinical picture.
4. Strong painkillers are used if the pain is due to problems with the heart, as well as in case of traumatic injuries.
5. First aid involves independently performing the following actions:
6. Use of heart medications. You can often find Validol, Nitroglycerin or similar medications in your home medicine cabinet.
7. Move the patient to a horizontal position. Turn off the lights, you should also reduce the patient’s nervous excitability, and ensure silence around the patient.
8. If the pain does not become moderate, you should immediately call an ambulance.
9. If the pain is caused by disorders in the gastrointestinal tract, you must stop eating for a while and call a competent specialist or an ambulance. The hospital undergoes various diagnostic measures to determine the location of the pathology. If the pain is girdling, acute, and localized on the left side, self-treatment of the disease is completely prohibited, since rash actions can provoke a number of serious complications.
10. If the pain syndrome has developed as a result of neuralgia, the patient should be provided with complete rest, periodically consult a doctor, and, if necessary, conduct diagnostic tests. In the future, you can select a suitable therapy, thanks to which the general condition of the patient significantly improves.

Video - 3 tests for chest pain. How to find out what hurts behind the sternum

Prevention of pain under the left sternum

A number of standard measures are used as prevention. A clinical examination is required, carried out at least once a year. Seek medical help if you notice negative symptoms to prevent the development of a dangerous disease. Pain prevention is carried out in conjunction with procedures aimed at preventing the worsening of the underlying disease.

If pain is provoked by the development of cardiopathy, the following activities should be carried out daily:

1. Use cardioprotectors, Aspirin Cardio, and other medications prescribed by your doctor. They should not be canceled if an improvement in the general condition is detected. It is advisable to consult with a specialist in advance. Not only observe the frequency of taking medications, but also do not refuse to take the full course.
2. Take measures aimed at getting rid of bad habits. First of all, this is excessive consumption of alcoholic beverages, as well as smoking.
3. Balance your diet, take time to select the optimal products to normalize your overall health.
4. Pay attention to physical activity, but do not overdo it, engage in physical exercise until discomfort appears.
5. Be in a positive mood, learn to independently normalize the activity of vital organs, including with the help of breathing exercises.
6. When leaving home, take with you a standard set of cardiac medications that help relieve an acute attack.

If the pain under the left sternum is associated with the development of osteochondrosis, you should spend time doing therapeutic exercises every day and ensure moderate physical activity. After going to the doctor, take medications prescribed to strengthen the musculoskeletal system. If possible, take a swimming course.

Important! If breast diseases are detected, regular visits to a mammologist are required. Do not forget to undergo diagnostic examinations in a timely manner and consult with your doctor. In some cases, surgical treatment of the pathology is indicated.

Pain under the left sternum may indicate both the development of neuralgia and more serious disturbances in the functioning of internal organs. Pay attention to the prevention of this deviation; if negative symptoms appear, seek medical help to diagnose and treat dangerous diseases. read on our website.

If breathing causes pain, this does not necessarily mean that it is the respiratory organs that are hurting. Chest pain on the left side when taking a deep breath, which is extremely similar to heart pain, also does not always mean that it is a sign of heart disease.

Pain in the chest area, which gets worse during deep inspiration, is often caused by neurological problems, injuries or diseases of the spine.

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There are so many provoking factors that differentiating the diagnosis requires in-depth research and testing, which indicates the impossibility of independently identifying the causes. But getting acquainted with their diversity still makes sense.

General idea of ​​chest pain when inhaling

What causes pain in the left side of the chest when inhaling? The respiratory process involves and interconnects many more organs and muscles than the average person can imagine.

1. The breathing function depends not only on the work of the lungs, but also on the muscular layer of the diaphragm, which either stretches into the abdominal cavity or is pressed towards the chest, ensuring a balance of internal pressure in the thoracic and abdominal sections of the body.
2. The breathing process is impossible without the measured work of the heart, which ensures “pumping” of blood and filling it with oxygen.
3. Breathing would be impossible without the ability of the bones and muscles of the thoracic skeleton to expand and contract as necessary.

If at least one point in this entire system of vessels, tissues and nerve processes appears as a focus of inflammation or compression, the nerve receptors will begin to send their signals to the body in the form of pain when breathing in the chest on the left.

Why does it hurt on the left side of the chest near the heart when breathing?

What specific problems provoke pain in the left chest when inhaling? Judging by the frequency of diagnoses recorded by doctors, neuralgic diseases most often contribute to this.

Neuralgia and osteochondrosis

Acute “shooting” pains are characteristic of diseases associated with pinched nerves in the intercostal muscles (with intercostal neuralgia) or with chronic damage to the intervertebral discs and cartilage, called osteochondrosis.

A distinctive feature of intercostal neuralgia is increased pain in the left side of the chest with a deep breath, which is explained by pinching of the nerve when the ribs and muscles between them move to expand.

The provocateur of an acute attack of pain during neuralgia (also called thoracalgia) is a muscle spasm that occurs:

• during physical overload;
• from hypothermia (if you “stretched out” in a draft);
• due to sleeping in an uncomfortable position;
• due to unsuccessful or too sudden movement of the body.

In turn, a tendency to muscle spasm often develops due to:

• diseases of the nervous system: polyradiculitoneuritis, multiple sclerosis;
• various curvatures of the spinal column;
• salt deposits or inflammatory processes in the spine, ligaments and joints;
• herpetic, influenza or tuberculosis infection.

Reduced immunity, allergies, poisoning, stress and even excessive alcohol consumption can provoke an attack of neuralgia in the form of acute pain in the chest on the left when inhaling and moving.

The muscle corset and ribs reliably protect the thoracic spine, so osteochondrosis of this section is a rather rare phenomenon (cervical is more common). But it also cannot be excluded from the list of provoking factors for chest pain.

Inflammation of the lung and its membrane

If the left chest hurts when you inhale, this symptom may be a sign of the onset of inflammation in the left part of the pleura - the pulmonary membrane. Inflammation usually comes from the lung itself, but since the organ is not innervated by neurons sensitive to irritation, it itself cannot hurt.

When the pathological process spreads to the serous membrane enveloping the lung, the left side of the chest begins to hurt when inhaling, intensifying with coughing and deeper inhalation.

Since it is accompanied by a general deterioration in well-being and other striking symptoms, the development of left-sided pleurisy can be suspected if the listed symptoms preceded the appearance of pain in the chest during deep inhalation or exhalation.

Consequences of injury

Deep or hidden traumatic damage to bone or muscle tissue in the left chest also often causes pain. Moreover, not only may pain be felt when taking a deep breath, but also pain may appear when exhaling in the chest on the left, which gives good reason to assume its traumatic nature.

The danger of a chest injury lies in the high probability of developing a dangerous complication, which is characterized by the accumulation of air or other gases in the pleural cavity.

The consequences of pneumothorax can be a severe lack of oxygen with a sharp drop in blood pressure. Lack of treatment and progression of this condition can lead to cardiac arrest, which indicates the danger of such a complication.

Cardiovascular problem

Can your heart hurt from taking a deep breath? What does it mean if, when breathing deeply, you experience pain in the chest on the left side of the heart when inhaling? This symptom is often the only sign of a condition such as precordial syndrome. Manifestations of precordial syndrome differ:

• suddenness, sharpness;
• duration (30–180 seconds);
• associated with breathing (intensifies with deep inspiration);
• “causelessness” (it is not provoked by physical exertion, but occurs in a calm state).

Another cardiac cause of pain in the thoracic region when breathing (and taking a deep breath) on the left is inflammation of the pericardium, called dry pericarditis. Distinctive characteristics of this pathology:

• the pain radiates to the left shoulder or left side of the neck, has a pronounced constant stabbing-cutting or burning character;
• may not be too pronounced or, on the contrary, similar to an angina attack or heart attack;
• pain in the chest intensifies with a deep breath on the left, lying on the left side, coughing, swallowing;
• It is relieved by sitting, leaning forward, in a position where the elbows rest on the knees, while lying on the right side.

Symptoms of dry pericarditis may be supplemented by weakness, sweating, nausea, elevated body temperature, shortness of breath, shallow breathing, chills, and sometimes hiccups.

Embolism of the artery of the left lung

Blockage of the artery of the left lung or its branches by an embolus (thrombus), or is also a common cause of pain in the left thoracic region, which intensifies with deep inspiration. This disease poses a serious threat to human health and life, since blockage of the most important vessel of the lung impedes blood flow in the organ and increases the load on the right heart.

1. This can lead to acute right ventricular failure.
2. Embolism threatens a reflex release of vasoconstrictors into the bloodstream - active substances that promote vasoconstriction.
3. Increased blood pressure can cause the right chambers of the heart to enlarge and dilate, causing a phenomenon called cor pulmonale.
4. As a result of gas exchange, the overall enrichment of organs and tissues with oxygen deteriorates.

The main provoking factor in the development of pulmonary embolism is thrombosis of the veins of the pelvis or lower extremities.

Bronchopulmonary tumor

The worst diagnosis, the symptom of which is chest pain, especially with a deep breath on the left, is undoubtedly a tumor lesion of the respiratory system. This pathology is called bronchopulmonary cancer and, as a rule, has a poor prognosis.

That is why it is so important to promptly pay attention to pain in the chest on the left or right, under the ribs or behind the sternum; this can be a signal of a serious illness.

If there is pain on the left side when moving

1. What can be said about increased pain in the left chest when taking a deep breath, as well as when moving your arms, neck or head? Most often, an increase in the intensity of pain during movement occurs with traumatic lesions of the chest and neuralgic conditions.
2. The pain may increase when moving the left hand and due to left-sided pleurisy, it can be muffled by finding a comfortable position in which the pleural membrane will not be too irritated by friction against neighboring organs of the thoracic region.

Making a diagnosis requires an in-depth examination and a thorough study of the medical history, so you should explain your feelings to the doctor in detail.

If it hurts on the right when inhaling

Almost all of the reasons listed above can cause pain in the chest with a deep breath and on the right side, if it is:

• right-sided pneumonia, developing into;
• injury to the right side of the body;
• intercostal neuralgia in the right side of the chest, etc.

Wherever pain is detected, the patient’s task is to grasp the nature of this pain in the chest, its localization (left or right), the reasons for the increase (with a deep breath, with movement, in a calm state). This is necessary in order to provide the doctor with the clearest possible picture of pain. After all, the sooner the diagnosis is made, the sooner adequate treatment will begin, which in most cases is decisive for the outcome of the disease.

Useful video

For information on the most common causes of chest pain, see the following video:

Conclusion

1. Pain in the chest with a deep breath on the left most often occurs due to neuralgia, pulmonary embolism, cardiac pathologies, inflammation of the respiratory system or bronchopulmonary tumors.
2. To determine the exact cause of pain, you need to contact a therapist who primarily sees patients with similar symptoms. After the necessary examinations, the patient is referred to a specialist - a pulmonologist, phthisiatrician, cardiologist, or oncologist.
3. The sooner the diagnosis is determined, the more success can be expected from treatment procedures.

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Pain behind the sternum. Basics of differential diagnosis

Chest pain can indicate both deadly conditions when the patient needs emergency medical care (myocardial infarction, pulmonary embolism), and predominantly functional disorders that do not require immediate hospitalization (neurocirculatory dystonia).

Therefore, it is advisable to know the basics of differential diagnosis for chest pain not only for doctors, but also for people without medical education, in order to know how urgently and which doctor should seek help.

First of all, it is necessary to detail the signs of pain.
It is necessary to take into account the type of pain (sharp or dull), its nature (pressing pain behind the sternum, burning, stabbing, etc.), additional localization (behind the sternum on the right, behind the sternum on the left), irradiation (radiates between the shoulder blades, under the left shoulder blade, in the left hand, in the left little finger, etc.).

It is necessary to pay attention to the time of pain occurrence (morning, afternoon, evening, night), connection with food intake or physical activity. It is advisable to know the factors that relieve pain (rest, forced positioning, a sip of water, taking nitroglycerin), as well as factors that increase it (breathing, swallowing, coughing, certain movements).

In some cases, passport data (gender, age), family history data (what diseases the patient’s relatives suffered from), information about occupational hazards and addictions can help in making a diagnosis.

It is necessary to collect an anamnesis of the medical history, that is, pay attention to previous events (infectious disease, injury, errors in diet, overwork), and also find out whether similar attacks have happened before and what could have caused them.

Detailing the patient's pain syndrome and other complaints, taking into account passport data and carefully collecting anamnesis in many cases allows us to quite accurately make a preliminary diagnosis, which will then be clarified during a medical examination and various types of research.

Angina pectoris as a typical cause of pressing pain in the chest

Typical angina attack

Angina pectoris (angina pectoris) and myocardial infarction are manifestations of coronary heart disease (CHD). IHD is an acute or chronic insufficiency of blood supply to the heart muscle, caused by the deposition of atherosclerotic plaques on the walls of the coronary vessels that supply the myocardium.

The main symptom of angina is pressing pain behind the sternum on the left, radiating under the left shoulder blade, into the left arm, left shoulder, and left little finger. The pain is quite intense and makes the patient freeze in place with his hand pressed to his chest.

Additional symptoms of an angina attack: a feeling of fear of death, pallor, cold extremities, increased heart rate, possible arrhythmias and increased blood pressure.

An attack of angina occurs, as a rule, after physical activity, during which the heart's need for oxygen increases. Sometimes an attack of typical chest pain can be triggered by cold or eating (especially in weakened patients). A typical angina attack lasts two to four minutes, up to a maximum of 10 minutes. The pain subsides with rest, the attack is well relieved with nitroglycerin.

It should be taken into account that due to the peculiarities of the blood supply to the female heart and the anti-atherosclerotic effect of female sex hormones, angina pectoris is rarely found in women of childbearing age (under 35 years of age it is practically not diagnosed).

If you suspect angina pectoris, you should contact a general practitioner or cardiologist, who will prescribe a standard examination (general and biochemical blood tests, general urinalysis, ECG).

Basic treatment when the diagnosis of angina is confirmed: diet, healthy lifestyle, taking nitroglycerin during attacks.

In the presence of concomitant diseases such as hypertension, diabetes mellitus, obesity, treatment of these diseases will simultaneously treat angina pectoris and prevent further development of coronary artery disease.

Chest pain with Prinzmetal angina

Unlike typical angina, attacks of Prinzmetal's angina occur at night or in the early morning hours. The cause of attacks of coronary circulatory insufficiency is acute vasospasm.

Patients with atypical angina, as a rule, tolerate physical and psycho-emotional stress well. If overexertion causes attacks in them, it happens in the morning.

Pain behind the sternum with Prinzmetal's angina is similar in nature, localization and irradiation to typical angina, and is well relieved with nitroglycerin.

A characteristic feature is the cyclical nature of attacks. They often occur at the same time. In addition, anginal attacks with atypical angina often follow one after another, combining into a series of 2-5 attacks with a total duration of about 15-45 minutes.

With spontaneous angina, heart rhythm disturbances are more often observed.

Mostly women under 50 years of age are affected. The prognosis for Prinzmetal's angina largely depends on the presence of concomitant diseases such as hypertension and diabetes mellitus. Sometimes special angina is combined with attacks of typical angina - this also worsens the prognosis.

If you suspect spontaneous angina, you should immediately consult a doctor, since this kind of anginal attacks can occur with small focal myocardial infarctions.

Attending physician: therapist, cardiologist. Examination and treatment: if there are no special indications, the same as for typical angina. Atypical angina belongs to the class of unstable angina, and requires constant monitoring.

Chest pain requiring emergency medical attention

Symptoms of myocardial infarction

In mild cases, pressing pain behind the sternum during myocardial infarction is similar in nature, localization and radiation to angina, but significantly exceeds it in intensity and duration (30 minutes or longer), is not relieved by nitroglycerin and does not decrease with rest (patients often rush around the room, trying to find a comfortable position).

With extensive heart attacks, chest pain is diffuse; the maximum pain is almost always concentrated behind the sternum on the left, from here the pain spreads to the entire left and sometimes right side of the chest; radiates to the upper limbs, lower jaw, interscapular space.

Most often, the pain increases and decreases in waves with short breaks, so the pain syndrome can last about a day. Sometimes the pain reaches such intensity that it cannot be relieved even with the help of morphine, fentaline and droperidol. In such cases, the heart attack is complicated by shock.

Myocardial infarction can occur at any time of the day, but more often in the early morning hours. Increased nervous or physical stress, alcohol intake, and changes in weather can be identified as provoking factors.

The pain is accompanied by such signs as various cardiac arrhythmias (increased or decreased heart rate, palpitations, interruptions), shortness of breath, cyanosis (cyanosis), cold perspiration.

If you suspect a myocardial infarction, you should seek emergency medical help. The prognosis depends both on the extent of damage to the heart muscle and on the timeliness of adequate treatment.

Dissecting aortic aneurysm

The aorta consists of three membranes - inner, middle and outer. A dissecting aortic aneurysm develops when blood gets between the pathologically altered membranes of the vessel and dissects them in the longitudinal direction. This is a rare condition and is often misdiagnosed as myocardial infarction.

Pain behind the sternum with dissecting aortic aneurysm occurs suddenly and is described by patients as unbearable. Unlike myocardial infarction, which is characterized by a gradual increase in pain, retrosternal pain with dissecting aortic aneurysm is most intense at the very beginning, when the primary dissection of the vessel occurs. Another very significant difference is the irradiation along the aorta (first the pain radiates between the shoulder blades, then along the spinal column to the lower back, sacrum, inner thighs).

Dissecting aortic aneurysm is characterized by symptoms of acute blood loss (pallor, drop in blood pressure). When the ascending aorta is damaged and the great vessels extending from it are blocked, asymmetry of the pulse in the arms, puffiness of the face, and visual impairment are observed.

There are acute (from several hours to 1-2 days), subacute (up to 4 weeks) and chronic course of the process.

If a dissecting aortic aneurysm is suspected, emergency hospitalization is necessary. To stabilize the process, patients are prescribed drugs that reduce cardiac output and blood pressure; further operation is shown.

The prognosis depends on the severity and localization of the process, as well as on the general condition of the patient (absence of severe concomitant diseases). Mortality in surgical treatment of acute aneurysms is 25%, chronic - 17%.

After surgery for dissecting aortic aneurysm, most patients remain functional. Much depends on correct diagnosis and availability of adequate treatment.

Pulmonary embolism

Most often (about 90% of cases), pulmonary embolism complicates the course of thrombotic processes in the veins of the lower extremities and pelvis (thrombophlebitis of the veins of the leg, inflammatory processes in the pelvis, complicated by thrombophlebitis).

Often the cause of PE is severe heart damage, occurring with congestion and atrial fibrillation (rheumatic carditis, infective endocarditis, heart failure due to coronary heart disease and hypertension, cardiomyopathies, severe forms of myocarditis).

PE is a serious complication of traumatic processes and postoperative conditions; about 10-20% of victims with a femoral neck fracture die from it. More rare causes: amniotic fluid embolism, cancer, some blood diseases.

Chest pain occurs suddenly, most often has a sharp stabbing nature, and is often the first symptom of pulmonary embolism. Approximately a quarter of patients develop acute coronary insufficiency syndrome due to circulatory disorders, so some clinical manifestations are similar to those of myocardial infarction.

When making a diagnosis, anamnesis is taken into account (severe illnesses that can be complicated by pulmonary embolism, surgery or injury) and symptoms characteristic of pulmonary embolism: severe inspiratory shortness of breath (the patient cannot inhale air), cyanosis, swelling of the jugular veins, painful enlargement of the liver. In case of severe damage, signs of pulmonary infarction are observed: sharp chest pain, aggravated by breathing and coughing, hemoptysis.

If pulmonary embolism is suspected, emergency hospitalization is indicated. Treatment includes surgical removal or lysis (dissolution) of the blood clot, anti-shock therapy, and prevention of complications.

Spontaneous pneumothorax

Most often occurs in men 20-40 years old. As a rule, spontaneous pneumothorax develops in the absence of complete health. Chest pain occurs suddenly and is most often localized in the anterior and middle parts of the chest on the affected side. It can radiate to the neck, shoulders, and arms.

Such patients are often mistakenly diagnosed with myocardial infarction. The diagnosis can be helped by the symptom of increased chest pain when breathing, as well as the fact that positioning on the affected side brings significant relief to the patient. In addition, you should pay attention to the asymmetry of the chest, widening of the intercostal spaces on the affected side.

The prognosis with timely diagnosis is favorable. Emergency hospitalization and aspiration (pumping out) of air from the pleural cavity are indicated.

Spontaneous rupture of the esophagus

The clinical picture is very clear and resembles the symptoms of myocardial infarction: sudden sharp pain behind the sternum and in the lower left side of the chest, pallor, tachycardia, drop in pressure, perspiration.

For differential diagnosis, the symptom of increased pain when swallowing, breathing and coughing is important. In 15% of cases, subcutaneous emphysema (swelling) occurs in the cervical region.

It should be taken into account that this pathology occurs predominantly in men 40-60 years old, often with a history of alcoholism.

Treatment: emergency surgery, antishock and antibacterial therapy.

The prognosis for timely diagnosis is favorable, however, according to some data, about a third of patients die as a result of late and inadequate treatment.

Chest pain requiring a doctor's home visit

Myocarditis

The causes of myocardial inflammation are most often viral diseases, less often other infectious agents. Allergic and transplant myocarditis are also distinguished. In some cases, a causal relationship cannot be traced, so there is such a nosological unit as idiopathic myocarditis.

Often chest pain is the first symptom of myocarditis. The pain is usually localized behind the sternum and on the left side of the chest. Often the intensity is quite high.

The main difference between pain syndrome during myocarditis and angina attacks is duration. With myocarditis, the pain lasts for hours or even days without easing.
The age of the patient matters. Angina pectoris affects middle-aged and elderly people, myocarditis occurs more often in young people.

In typical cases of myocarditis, it is possible to trace a connection with an acute viral disease, after which there was a clear period, and then a pain syndrome appeared. Often, chest pain with myocarditis is accompanied by elevated temperature; with angina, the temperature remains normal.

In severe and moderate myocarditis, symptoms such as shortness of breath and cough with little physical exertion, swelling in the legs, heaviness in the right hypochondrium, indicating an enlarged liver, quickly increase.

If myocarditis is suspected, bed rest, careful examination and treatment are indicated, taking into account the form of the disease.

In the absence of adequate treatment, myocarditis often progresses to cardiomyopathy.

Rheumatic carditis

Pain behind the sternum and in the chest on the left with rheumatic carditis, as a rule, is not intense, accompanied by a feeling of interruptions.

With focal damage to the heart muscle, pain in the heart area of ​​low intensity and unexpressed nature may be the only symptom of rheumatic carditis.

With diffuse rheumatic carditis, shortness of breath, cough during physical activity, and swelling in the legs are pronounced. The general condition is serious, the pulse is frequent and arrhythmic.

With rheumatic lesions of the coronary vessels, the symptoms of rheumatic carditis are supplemented by typical anginal attacks characteristic of angina pectoris.

For differential diagnosis, the connection of the disease with a recent sore throat, scarlet fever or exacerbation of chronic ENT pathology (tonsillitis, pharyngitis) is important.

Patients often experience polyarthritis characteristic of rheumatism.

In controversial cases, attention is paid to age (the peak incidence of esophageal cancer occurs at the age of 70-80 years, while angina pectoris usually develops earlier) and gender (mostly men are affected).

Attention should be paid to predisposing factors, such as alcoholism, smoking, occupational hazards (for example, dry cleaning workers have an increased risk of this disease).

There is evidence that people who were poisoned by alkali in childhood are more likely to develop esophageal cancer, and the time interval between chemical injury and tumor development reaches 40 years.

Some diseases of the esophagus are considered as a predisposing factor, in particular, achalasia cardia (a chronic disorder of motility of the esophagus with a tendency to spasm of the sphincter that passes food from the esophagus into the stomach) and gastroesophageal reflux (chronic reflux of acidic contents from the stomach into the esophagus).

Often attention is drawn to the patient's emaciation. Rapid, unexplained loss of body weight should always alert you to cancer.

The prognosis for esophageal cancer diagnosed at this stage is usually unfavorable. However, a correctly made diagnosis can adjust palliative treatment aimed at alleviating the patient's suffering.

Chest pain caused by acidic stomach contents refluxing into the esophagus
Gastroesophageal reflux disease (reflux esophagitis) is the second most common disease of the esophagus, which is a tendency for retrograde reflux of stomach contents into the esophagus.

Pain behind the sternum with reflux esophagitis is strong, burning, intensifies when bending forward and in a horizontal position. Removable with milk and antacids.

In addition to pain, reflux esophagitis is characterized by symptoms such as belching, heartburn, and pain when food passes through the esophagus.

The causes of reflux esophagitis are varied: from errors in diet (abuse of foods rich in caffeine, spices, mint, etc.) and bad habits (smoking, alcohol) to various diseases (cholelithiasis, stomach ulcers, systemic connective tissue diseases, etc. .d.). Reflux esophagitis often accompanies pregnancy.

Since reflux esophagitis is often a consequence of many serious diseases, if its symptoms are detected, a thorough examination is necessary.

Pain behind the sternum of a spastic nature caused by impaired motility of the esophagus
Pain behind the sternum of a spastic nature often occurs when there is an obstacle to the movement of food through the esophagus. Such an obstacle may be functional (for example, a spasm of the sphincter, through which food from the esophagus enters the stomach), or there may be organic obstruction of the esophagus (tumor, scar deformity). In such cases, an attack of pain is associated with eating.

However, esophageal spasm can be caused by gastroesophageal reflux (as a reflex response to irritation of the esophageal mucosa by gastric acid). In addition, there are many functional disorders of esophageal motility that occur with spasms (esophagospasm, esophageal dyskinesia, cardial achalasia). With such pathologies, there is no clear connection between a painful attack and food intake.

Meanwhile, the pain caused by spasm of the esophagus is very similar to an anginal attack during angina pectoris. The pain is localized behind the sternum or to the left of it, has a pressing nature, radiates to the back, as well as to the jaw and left arm. Often the pain syndrome is well relieved with nitroglycerin.

Attacks vary in duration from several minutes to several hours and even days, which may have diagnostic significance. In addition, the fact that attacks are often relieved with a sip of water or analgesics can help in making a diagnosis.

Sometimes a painful attack due to spasms of the esophagus is accompanied by pronounced vegetative manifestations, such as a feeling of heat, sweating, trembling throughout the body.

For attacks of chest pain caused by spasms in the esophagus, a combined examination of the cardiovascular system and gastrointestinal tract is indicated.
Attending physician: therapist, gastroenterologist, cardiologist. Treatment is prescribed based on the results of the examination.

Hiatal hernia

The causes of a hiatal hernia may be congenital structural features of the diaphragm and/or diseases of the abdominal organs that contribute to the development of the pathology.

Pain behind the sternum with diaphragmatic hernia is most often moderate, without pronounced irradiation. The pain is provoked by eating and physical activity, disappears after belching or vomiting. Leaning forward worsens the pain, while standing up relieves it.
In addition, diaphragmatic hernia is characterized by symptoms such as: belching of air and eaten food, rapid satiety, repeated regurgitation at night (wet pillow symptom). Later vomiting occurs, often mixed with blood.

A hiatal hernia is usually complicated by reflux esophagitis; esophageal motility disorders with a pronounced spasmodic component are often observed, so the clinical picture often requires differential diagnosis with angina attacks.

Thus, if a diaphragmatic hernia is suspected, a joint examination of the cardiovascular system and gastrointestinal tract is also indicated.
Attending physician: therapist, gastroenterologist, cardiologist.

If a hiatal hernia is suspected, it is recommended to sleep in a semi-sitting position, placing 2-3 pillows under the head end. Gastroenterologists advise in this case to avoid overstraining the abdominal muscles and forcing the body to bend forward. Fractional meals are shown.

Diseases of the cardiovascular system associated with impaired neuroendocrine regulation

Pain in the heart (with its epicenter at the apex of the heart or behind the sternum) is one of the leading symptoms of the disease. The intensity of the pain syndrome, along with the severity of other symptoms of neurocirculatory dystonia, plays a role in the classification of this pathology by severity.

With severe neurocirculatory dystonia, the pain syndrome strongly resembles acute myocardial infarction. Characteristic pain in the heart area is of a pressing or squeezing nature, increasing and decreasing in waves, which can last for hours and days. The pain syndrome is accompanied by severe palpitations, fear of death, and a feeling of lack of air; resistant to nitroglycerin.

Often, patients with neurocirculatory dystonia indicate that pain in the heart area is relieved by various sedatives (validol, valerian root, etc.).

The presence of other symptoms of neurocirculatory dystonia also helps to make a differential diagnosis with coronary heart disease.

A characteristic feature of this disease: a multiplicity of subjective symptoms with a paucity of objective data (most indicators are within normal limits). Very often, patients complain of dysfunction of many organs and systems: respiratory disorders with attacks reminiscent of bronchial asthma; lability of blood pressure with a tendency to hypertension, less often to hypotension; spontaneous fluctuations in body temperature (from 35 to 38); disorders of the gastrointestinal tract (nausea, vomiting, constipation followed by diarrhea, etc.); rich psychoneurological symptoms (dizziness, headaches, insomnia, weakness, lethargy, cardiophobia (fear of dying from heart disease), depression).

Chest pain can manifest as diseases of the heart, respiratory system, gastrointestinal tract, spine, mediastinum, and central nervous system. All human internal organs are innervated by the autonomic nervous system, the trunks of which arise from the spinal cord. When approaching the chest, the nerve trunk gives off branches to individual organs. That is why sometimes pain in the stomach can be felt like pain in the heart - they are simply transmitted to the common trunk, and from it to another organ. Moreover, the spinal nerve roots contain sensory nerves that innervate the musculoskeletal system. The fibers of these nerves are intertwined with the fibers of the nerves of the autonomic nervous system, and therefore a completely healthy heart can respond with pain in various diseases of the spine.

Finally, chest pain may depend on the state of the central nervous system: with constant stress and high neuropsychic stress, a malfunction occurs in its functioning - neurosis, which can also manifest itself as pain in the chest.

Some chest pains are unpleasant, but not life-threatening, but there are chest pains that need to be relieved immediately - a person’s life depends on it. In order to figure out how dangerous chest pain is, you need to see a doctor.

Chest pain caused by obstruction of the coronary (heart) arteries

The coronary arteries bring blood to the heart muscle (myocardium), which works nonstop throughout life. The myocardium cannot do even for a few seconds without a new portion of oxygen and nutrients delivered with the blood; its cells immediately begin to suffer from this. If blood delivery stops for several minutes, myocardial cells begin to die. The larger the coronary artery suddenly becomes obstructed, the more of the myocardium is affected.

Spasms (compression) of the coronary arteries usually occur against the background of coronary heart disease (CHD), the cause of which is partial blockage of blood vessels by atherosclerotic plaques and narrowing of their lumen. Therefore, even a minor spasm can block blood access to the myocardium.

A person feels such changes in the form of an acute piercing pain behind the sternum, which can radiate to the left shoulder blade and left hand, right up to the little finger. The pain can be so severe that the patient tries not to breathe - breathing movements increase the pain. During severe attacks, the patient turns pale, or, on the contrary, turns red, and his blood pressure, as a rule, increases.

Such chest pain can be short-term and occur only during physical or mental stress (angina pectoris), or can occur on its own, even during sleep (angina at rest). Angina attacks are difficult to get used to, so they are often accompanied by panic and fear of death, which further intensifies the spasm of the coronary vessels. Therefore, it is so important to clearly know what to do during an attack and to have everything you need at hand. The attack ends as suddenly as it began, after which the patient feels a complete loss of strength.

The peculiarity of these pains is that a person should under no circumstances endure them - they must be relieved immediately. You can’t do this without consulting a doctor - he will prescribe both the course of basic treatment and the medicine that needs to be taken when pain occurs (the patient should have it with him at all times). Usually, in emergency cases, a nitroglycerin tablet is taken under the tongue, which relieves pain within 1 to 2 minutes. If after 2 minutes the pain does not go away, then take the tablet again, and if this does not help, then you must immediately call an ambulance.

What can happen if you endure chest pain? The cells of the area of ​​the myocardium that is supplied by the affected artery begin to die (myocardial infarction) - the pain intensifies, becomes unbearable, a person often experiences painful shock with a sharp decrease in blood pressure and acute heart failure (the heart muscle cannot cope with its work). Such a patient can only be helped in a hospital setting.

A sign of the transition of an angina attack to myocardial infarction is an increase in pain and the lack of effect from the use of nitroglycerin. The pain in this case has a pressing, squeezing, burning character, begins behind the sternum, and then can spread to the entire chest and abdomen. The pain can be continuous or in the form of repeated attacks one after another, increasing in intensity and duration. There are cases when the pain in the chest is not very severe and then patients often suffer a myocardial infarction on their legs, which can cause immediate disruption of the heart and the death of the patient.

There are also atypical (atypical) forms of myocardial infarction, when pain begins, for example, in the area of ​​the anterior or posterior surface of the neck, lower jaw, left arm, left little finger, left scapula, etc. Most often, such forms occur in older people and are accompanied by weakness, pallor, cyanosis of the lips and fingertips, heart rhythm disturbances, and a drop in blood pressure.

Another atypical form of myocardial infarction is the abdominal form, when the patient feels pain not in the heart area, but in the abdomen, usually in its upper part or in the area of ​​the right hypochondrium. Such pain is often accompanied by nausea, vomiting, loose stools, and bloating. The condition sometimes closely resembles intestinal obstruction.

Chest pain caused by changes in the central nervous system

Chest pain can also occur with other diseases. One of the most common diseases that causes frequent and prolonged pain in the chest is cardioneurosis, which develops against the background of a temporary functional disorder of the central nervous system. Neuroses are the body’s response to various mental shocks (intense, short-term or less intense, but long-lasting).

Pain due to cardioneurosis can have a different character, but most often it is constant, aching and is felt in the area of ​​the apex of the heart (in the lower part of the left half of the chest). Sometimes pain due to cardioneurosis may resemble pain due to angina pectoris (short-term acute), but taking nitroglycerin does not relieve it. Often attacks of pain are accompanied by reactions from the autonomic nervous system in the form of facial flushing, moderate heartbeat, and a slight increase in blood pressure. With cardioneurosis, other signs of neuroses are almost always present - increased anxiety, irritable weakness, etc. Helps with cardioneurosis are the elimination of traumatic circumstances, the correct daily routine, sedatives, and for sleep disorders - sleeping pills.

Sometimes cardioneurosis is difficult to distinguish from coronary heart disease (CHD); the diagnosis is usually made based on careful observation of the patient, since there may be no changes on the ECG in either case.

A similar picture can be caused by changes in the heart during menopause. These disorders are caused by changes in hormonal levels, resulting in neurosis and metabolic disorders in the heart muscle (menopausal myocardiopathy). Pain in the heart is combined with the characteristic manifestations of menopause: flushing of the face, bouts of sweating, chills and various sensory disturbances in the form of “goosebumps”, insensitivity of certain areas of the skin, etc. Just as with cardioneurosis, heart pain is not relieved by nitroglycerin; sedatives and hormone replacement therapy help.

Chest pain caused by inflammatory processes in the heart area

The heart has three membranes: outer (pericardium), middle muscular (myocardium) and internal (endocardium). The inflammatory process can occur in any of them, but pain in the heart is characteristic of myocarditis and pericarditis.

Myocarditis (an inflammatory process in the myocardium) can occur as a complication of certain inflammatory (for example, purulent tonsillitis) or infectious-allergic (for example, rheumatism) processes, as well as toxic effects (for example, certain medications). Myocarditis usually occurs a few weeks after the illness. One of the most common complaints of patients with myocarditis is pain in the heart area. In some cases, chest pain may resemble the pain of angina, but it lasts longer and does not go away with nitroglycerin. In this case, they can easily be confused with pain during myocardial infarction. Pain in the heart may occur not behind the sternum, but more to the left of it; such pain appears and intensifies during physical activity, but is also possible at rest. Chest pain may recur many times throughout the day or be almost continuous. Often chest pain is stabbing or aching in nature and does not radiate to other parts of the body. Often heart pain is accompanied by shortness of breath and attacks of suffocation at night. Myocarditis requires careful examination and long-term treatment of the patient. Treatment primarily depends on the cause of the disease.

Pericarditis is an inflammation of the outer serous membrane of the heart, which consists of two layers. Most often, pericarditis is a complication of various infectious and non-infectious diseases. It can be dry (without accumulation of inflammatory fluid between the pericardial layers) and exudative (inflammatory fluid accumulates between the pericardial layers). Pericarditis is characterized by dull, uniform pain in the chest, most often the pain is moderate, but sometimes it becomes very severe and resembles an angina attack. Pain in the chest depends on respiratory movements and changes in body position, so the patient is tense, breathes shallowly, and tries not to make unnecessary movements. Chest pain is usually localized on the left, above the heart area, but sometimes spreads to other areas - to the sternum, upper abdomen, under the shoulder blade. These pains are usually combined with fever, chills, general malaise and inflammatory changes in the general blood test (high number of leukocytes, accelerated ESR). Treatment of pericarditis is long-term, it usually begins in a hospital, then continues on an outpatient basis.

Other chest pain associated with the cardiovascular system

Often the cause of chest pain is diseases of the aorta, a large blood vessel that arises from the left ventricle of the heart and carries arterial blood through the systemic circulation. The most common disease is aortic aneurysm.

A thoracic aortic aneurysm is an enlargement of a section of the aorta due to a disruption of the connective tissue structures of its walls due to atherosclerosis, inflammatory damage, congenital inferiority, or due to mechanical damage to the aortic wall, for example, due to trauma.

In most cases, the aneurysm is of atherosclerotic origin. In this case, patients may be bothered by prolonged (up to several days) chest pain, especially in the upper third of the sternum, which, as a rule, does not radiate to the back and left arm. Often the pain is associated with physical activity and does not improve after taking nitroglycerin.

A terrible consequence of an aortic aneurysm is its breakthrough with fatal bleeding into the respiratory organs, pleural cavity, pericardium, esophagus, large vessels of the chest cavity, out through the skin in case of chest injury. In this case, there is a sharp pain in the chest, a drop in blood pressure, shock and collapse.

A dissecting aortic aneurysm is a channel formed in the thickness of the aortic wall due to its dissection by blood. The appearance of dissection is accompanied by sharp bursting retrosternal pain in the heart area, severe general condition, and often loss of consciousness. The patient needs emergency medical care. Aortic aneurysm is usually treated with surgery.

An equally serious disease is thromboembolism (blockage by a detached blood clot - embolus) of the pulmonary artery, which extends from the right ventricle and carries venous blood to the lungs. An early symptom of this serious condition is often severe chest pain, sometimes very similar to the pain of angina, but usually not radiating to other areas of the body and increasing with inspiration. The pain continues for several hours, despite the administration of painkillers. The pain is usually accompanied by shortness of breath, bluish skin, palpitations and a sharp decrease in blood pressure. The patient requires emergency medical care in a specialized department. In severe cases, surgery is performed to remove the embolus (embolectomy)

Chest pain due to stomach diseases

Stomach pain can sometimes feel like chest pain and is often mistaken for heart pain. Typically, such chest pain is the result of spasms in the muscles of the stomach wall. These pains are longer lasting than heart pain and are usually accompanied by other characteristic features.

For example, chest pain is most often associated with eating. Pain can occur on an empty stomach and go away with food, occur at night, after a certain time after eating, etc. Symptoms of stomach disease such as nausea, vomiting, etc. also appear.

Stomach pain is not relieved by nitroglycerin, but it can be relieved with the help of antispasmodics (papaverine, no-shpa, etc.) - medications that relieve spasms of the muscles of internal organs.

The same pain can occur with certain diseases of the esophagus and diaphragmatic hernia. - This is an exit through an enlarged opening in the diaphragm (the muscle that separates the chest cavity from the abdominal) part of the stomach and some other parts of the gastrointestinal tract. When the diaphragm contracts, these organs are pinched. A diaphragmatic hernia manifests itself as a sudden onset (often at night, when the patient is in a horizontal position) of severe pain, sometimes similar to the pain of angina pectoris. This pain does not go away from taking nitroglycerin, but it becomes less when the patient moves to a vertical position.

Severe chest pain can also occur with spasms of the gallbladder and bile ducts. Despite the fact that the liver is located in the right hypochondrium, pain can occur behind the sternum and radiate to the left side of the chest. Such pain is also relieved with antispasmodics.

It is quite possible to confuse pain with acute pancreatitis with heart pain. The pain is so severe that it resembles a myocardial infarction. They are accompanied by nausea and vomiting (this is also common with myocardial infarction). These pains are very difficult to relieve. Usually this can only be done in a hospital during intensive treatment.

Chest pain due to diseases of the spine and ribs

Chest pain, very similar to heart pain, can occur with various diseases of the spine, for example, with osteochondrosis, herniated discs, ankylosing spondylitis, etc.

Osteochondrosis is dystrophic (metabolic) changes in the spine. As a result of malnutrition or high physical activity, bone and cartilage tissue, as well as special elastic pads between individual vertebrae (intervertebral discs), are gradually destroyed. Such changes cause compression of the spinal nerve roots, which causes pain. If changes occur in the thoracic spine, the pain may be similar to pain in the heart or pain in the gastrointestinal tract. The pain can be constant or in the form of attacks, but it always intensifies with sudden movements. Such pain cannot be relieved with nitroglycerin or antispasmodics; it can only be relieved by painkillers or heat.

Pain in the chest area can occur when a rib is fractured. These pains are associated with injury and intensify with deep breathing and movement.

Chest pain due to lung diseases

The lungs occupy a significant part of the chest. Chest pain can occur against the background of inflammatory diseases of the lungs, pleura, bronchi and trachea, with various injuries to the lungs and pleura, tumors and other diseases.

Chest pain occurs especially often when there is a disease of the pleura (the serous sac that covers the lungs and consists of two layers, between which the pleural cavity is located). With inflammation of the pleura, pain is usually associated with coughing, deep breathing and accompanied by fever. Sometimes such pain can be confused with heart pain, for example, with pain due to pericarditis. Very severe chest pain occurs when lung cancer grows in the pleural area.

In some cases, air (pneumothorax) or fluid (hydrothorax) enters the pleural cavity. This can happen with a lung abscess, pulmonary tuberculosis, etc. With spontaneous (spontaneous) pneumothorax, sharp sudden pain appears, shortness of breath, cyanosis, and blood pressure decreases. The patient has difficulty breathing and moving. The air irritates the pleura, causing severe stabbing pain in the chest (in the side, on the affected side), radiating to the neck, upper limb, and sometimes to the upper abdomen. The patient's chest volume increases and the intercostal spaces widen. Help for such a patient can only be provided in a hospital.

The pleura can also be affected by periodic disease - a genetic disease manifested by periodic inflammation of the serous membranes covering the internal cavities. One of the variants of the course of periodic disease is thoracic, with damage to the pleura. This disease manifests itself in the same way as pleurisy, occurring in one or the other half of the chest, rarely in both, causing the same complaints in patients. As with pleurisy. All signs of exacerbation of the disease usually disappear spontaneously after 3 to 7 days.

Chest pain associated with the mediastinum

Pain in the chest can also be caused by air entering the mediastinum - the part of the chest cavity limited in front by the sternum, behind by the spine, on the sides by the pleura of the right and left lungs and below by the diaphragm. This condition is called mediastinal emphysema and occurs when air enters from the outside during injuries or from the respiratory tract, esophagus during various diseases (spontaneous mediastinal emphysema). In this case, there is a feeling of pressure or pain in the chest, hoarseness, and shortness of breath. The condition can be severe and requires immediate attention.

What to do for chest pain

Chest pain can be of different origins, but at the same time very similar to each other. Pains that are similar in sensation sometimes require completely different treatments. Therefore, if chest pain occurs, you should consult a doctor who will prescribe an examination to identify the cause of the disease. Only after this will it be possible to prescribe the correct adequate treatment.

Let's look at the characteristics of pain in the left side of the chest, their causes, symptoms, diagnosis, and prevention.

The types and nature of such unpleasant sensations are presented in the table.

Cardiac reasons

Among them, retrosternal discomfort associated with the pathology of the coronary vessels predominates. The main reasons are presented in the table.

Extracardiac pathologies

They do not often cause left-sided chest pain, but it is still worth noting the main causes that are localized outside the heart muscle.

Other reasons worth noting include:

• psychovegetative symptoms – occurs with severe overexertion, requires rest;
• musculofascial syndrome, which has a precise localization point where discomfort intensifies with pressure;
• herpes zoster is a herpetic lesion of the skin along the nerve trunks, causing painful symptoms of intoxication and discomfort radiating to the heart area.

For accurate diagnosis, clinical and laboratory examination is required.

First aid

There are several conditions that require calling an ambulance. This:

• when discomfort on the left side of the chest is not relieved by Nitroglycerin;
• if the discomfort in the left chest is acute, accompanied by shortness of breath, fainting;
• upon loss of consciousness.

In all other cases, to relieve chest discomfort you need: a horizontal position, rest, an open window, loose clothing, taking sedative drops (Corvalol), tone and pulsometry.

Diagnostics

The algorithm takes into account the examination of all interested organs in case of discomfort on the left and right:

• physical examination, medical history;
• tonometry, pulsometry;
• UAC, OAM, biochemistry;
• X-ray examination: image, CT, MSCT;
• ECG, EchoCG, Holter (if necessary);
• MRI of the chest;
• Ultrasound of the thoracic and abdominal organs;
• electro-beam tomography to assess the condition of the coronary arteries;

The scope of the study can be expanded, consultation with specialists is mandatory.

Prevention

Of course, it is unrealistic to prevent any unpleasant sensation in the chest. But a possible sudden outbreak requires preventive measures. This:

• a healthy lifestyle with the abandonment of all bad habits;
• moderate sports without hypertension and overload;
• optimal microclimate in the home (humidity, fresh air);
• refusal of harmful atherogenic foods in favor of fruits, vegetables, whole grain baked goods;
• minimizing stressful situations;
• rehabilitation of chronic foci of infections;
• timely treatment of somatic pathologies and their exacerbations.

Self-medication is dangerous, since the root cause can only be determined after a complete clinical and laboratory examination.

Last updated: August 22, 2019