Causes of pain in the left side of the chest. Pain in the left side of the chest: causes and treatment

Chest pain can occur in people of all ages. It not only brings with it unpleasant sensations, but also a signal that it is necessary to undergo a thorough examination by a doctor in a medical institution.

As you know, the chest contains organs that are very important for life, and a malfunction of one of them can lead to death. Let's consider all the possible causes of chest pain and methods for eliminating it.

What characteristics of pain should you pay attention to:

1. The nature of the manifestation of pain: pulls, pricks, aches, burns.
2. Type of pain: dull or sharp.
3. Location: right, left, center of the chest.
4. Where does it give: hand, shoulder blade.
5. When it appears most often: day or night.
6. What can cause pain: cough, physical activity, breathing or anything else. Read about it here.
7. What helps relieve pain: change of body position, medications.

Pressing pain on the left

When you feel a pressing pain in the left side of the chest You must consult a doctor without delay.

The main reasons for its development:

1. Aortic aneurysm. A very serious illness. There is an accumulation of blood in the vessel as a result of the fact that their membranes are stratified.
2. Myocardial infarction or angina attack. The condition requires immediate hospitalization. Pain in this condition indicates a problem with a large muscle.
3. Stomach ulcer. Pain occurs after eating. Often, a regular antispasmodic drug (no-spa) can alleviate a person’s condition.
4. Inflammatory process in the pancreas (pancreatitis). Pain in this organ is projected onto the left side of the chest and is severe. In most cases, discomfort is caused by eating.
5. Hernia in the diaphragm. This pathology occurs due to prolapse of intestinal loops through weakened areas in the diaphragm into the chest cavity. As a result, the patient finds it very difficult to breathe.

Presses from the right

There are many reasons for feeling pain on the right side, both easily removable and very serious:

1. Intercostal neuralgia or panic attack.
2. If, with pain on the right side, the heart contracts very quickly, this may be a signal of the development of cardiac pathologies.
3. An accompanying cough, sputum production and fever may indicate lung problems.
4. and rapid breathing indicate tracheitis.
5. In case of pathological processes in the stomach and esophagus, the food eaten will cause discomfort.
6. If you feel pain when swallowing and compression of the chest on the upper right side, then this may be a symptom of ordinary laryngitis. Visit an otolaryngologist to confirm the diagnosis.
7. Right-sided rib fractures also cause discomfort in the chest.

Presses in the middle

The sensation of pain in the central part of the chest signals all of the above diseases.

In addition to them will be:

Stress.

Nervous breakdowns and anxiety states.

In the presence of these factors, muscle spasms may develop and unpleasant pain may occur.

Also, pinched nerves and pain in the middle of the chest are affected by:

1. Scoliosis.
2. Osteochondrosis.
3. Hernias of small vertebrae.

Symptoms of diseases

When chest pain occurs, the symptoms can be quite different. This is explained by a wide range of diseases that provoke unpleasant pain.

Dangerous symptoms, if they appear, you should immediately consult a doctor:

1. A sharp jump in body temperature.
2. Nausea and urge to vomit.
3. Increased sweating.
4. The appearance of shortness of breath and impaired breathing.
5. Loss of consciousness. It can become one of the main symptoms of myocardial infarction.
6. Increased or decreased heart rate.
7. When changing body position, coughing or active movement, the pain may increase.
8. Muscle weakness.
9. Body aches.

Symptoms are rarely isolated; they are often combined and interfere with proper first aid.

If the following symptoms appear, you should immediately call an ambulance:

1. When the nature of pain changes.
2. Painful sensations either in the left side of the chest or in the right.
3. Increased pain when lying down.
4. First aid medications do not show effectiveness.

After all possible types of diagnostics have been carried out, the patient is sent to a specialist to prescribe treatment.

Treatment

Treatment begins only after the attending physician makes a diagnosis.

Depending on the causes of pressure behind the sternum, the following drugs are used:

1. Angina pectoris. It is possible to relieve an attack with nitroglycerin.
2. Cerebral atherosclerosis. First aid for reducing high blood pressure is Farmadipin drops, and for normal blood circulation in the brain, Glycine is prescribed.
3. Myocardial infarction. Taking medications at home is prohibited. The patient must be urgently placed in a hospital setting. Often such patients end up in the intensive care unit.
4. Osteochondrosis. For this disease, non-steroidal anti-inflammatory drugs (diclofenac, ibuprofen) are used (). Actovegin is prescribed to improve blood circulation. Massage and acupuncture also have a positive effect in the treatment of this disease.
5. Intercostal neuralgia. This disease is often confused with a heart attack. To relieve pain, muscle relaxants (tizanidine), corticosteroids (dexamethasone) are used, a warming patch is glued to the rib area or rubbed with anesthetic ointment.
6. Gastritis in the acute stage. The first aid will be antispasmodics (no-spa, bellasthesin), sorbents (smecta, enterosgel, phosphalugel).
7. Angina. When treating a sore throat, it is important to provide the patient with comprehensive treatment: antibiotics (Flemoxin, Summamed), gargling (Givalex), use sprays (Bioparox, Septolete).
8. Pulmonary embolism. First aid is provided only by the ambulance team. If treatment is not done in a timely manner, it will not be possible to save the patient.
9. Depression, stress, hysteria. It is necessary to calm the person down with special medications (Persen, Dormiplant) and provide psychological assistance.

Let’s summarize all of the above and find out what needs to be done to provide first aid:

1. Call an ambulance.
2. While the team is driving, give the patient a semi-sitting position. Never place him on his back or stomach.
3. Help you breathe evenly and calmly.
4. For heart pathologies, place a tablet of validol or nitroglycerin under the tongue.
5. If the patient faints, moisten a cotton swab with ammonia and bring it to the nose.
6. Do not leave the person alone, wait together for the doctors to arrive.
7. Never set fractures or dislocations yourself.
8. If the cause of chest pain is unknown, then warm compresses cannot be used.

It is worth noting that among the listed symptoms of chest pain there are very severe and life-threatening ones. Do not self-medicate, consult a doctor for advice. Only he can give practical advice and make a diagnosis. There is no need to rely on the old woman at the entrance, according to whose stories she had the same symptoms. Think for yourself and take care of your lives.

Since heart diseases are the most serious, it is necessary to take preventive measures to prevent them:

1. Lose weight.
2. To refuse from bad habits.
3. Be physically active.
4. Harden up.
5. Take vitamin complexes regularly and monitor your diet.

If you follow these rules, you will not be bothered by any pain behind the sternum.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Pain behind the sternum. Basics of differential diagnosis

Chest pain- extremely common symptom. It is generally associated with cardiac lesions. However, the causes of chest pain are very diverse, including many diseases that are not associated with damage to the cardiovascular system.

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, trauma, 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

Chest pain is so characteristic of angina that some internal medicine diagnostic guidelines refer to an attack of angina as typical chest pain.

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

Prinzmetal's angina (atypical, special, spontaneous angina) is one of the variants of coronary heart disease.

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

Myocardial infarction is the death of a section of the heart muscle due to cessation of blood flow. The cause of a heart attack, as a rule, is thrombosis or, less commonly, spasm of a coronary artery damaged by atherosclerotic plaques.

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

Dissecting aortic aneurysm is a critical condition caused by a threatening rupture of the largest blood vessel in the human body.

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

Pulmonary embolism (PE) - blockage of the pulmonary trunk running from the right side of the heart to the lungs, with a thrombus or embolus - a particle freely moving through the bloodstream (amniotic fluid during amniotic fluid embolism, inert fat during embolism after fractures, tumor particles during oncological pathologies) .

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

Spontaneous pneumothorax occurs when lung tissue ruptures, causing air to enter the pleural cavity and compress the lung. The causes of pneumothorax are degenerative changes in the lung tissue, leading to the formation of air-filled cavities, much less often - severe bronchopulmonary diseases (bronchiectasis, abscess, pulmonary infarction, pneumonia, tuberculosis, oncopathology).

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

A typical cause of spontaneous rupture of the esophagus is an attempt to stop vomiting (has diagnostic value). Predisposing factors: excessive absorption of food and alcohol, as well as chronic diseases of the esophagus (inflammation caused by reflux of gastric contents, esophageal ulcer, etc.).

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

Myocarditis is a group of inflammatory diseases of the heart muscle, unrelated to rheumatism and other diffuse connective tissue diseases.

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

Rheumatic carditis is one of the manifestations of rheumatism, a systemic inflammatory disease of connective tissue, which is based on disorders of the immune system (aggression against proteins of one’s own body) caused by infection with group A beta-hemolytic streptococcus. It occurs in genetically predisposed individuals, mainly at a young age.

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

A hiatal hernia (diaphragmatic hernia) is a disease based on upward displacement of the abdominal part of the esophagus and the cardiac part of the stomach through the diaphragmatic opening. In severe cases, the entire stomach and even intestinal loops may become displaced.

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

Neurocirculatory (vegetative-vascular) dystonia
Neurocirculatory (vegetative-vascular) dystonia is a functional disease of the cardiovascular system, which is based on disorders of 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 on the left is a symptom of many diseases. It appears in diseases of the heart, osteoarticular system, respiratory organs, and abdominal cavity. In order to analyze all the causes of the disease, an encyclopedia is not enough, so in this article we will focus on the most common of them.

When deciding why the chest hurts on the left, you should differentiate the causes between:

diseases of the heart and circulatory system; diseases of bone tissue; nervous disorders; organic pathology of the brain; myofascial syndromes; compression-radicular reactions; pathology of the abdominal cavity.

Heart diseases

The left half of the chest cavity with heart disease hurts due to:

coronarogenic; non-coronary lesions.

Coronarogenic causes are directly related to disturbances in the delivery of blood to the heart muscle through the coronary artery when:

atherosclerosis and thrombosis of the lumen of the vessel; myocardial infarction.

Atherosclerosis (cholesterol deposition) and coronary artery thrombosis lead to a decrease in the volume of circulating blood in the myocardium. This condition is medically called ischemia. Clinical symptoms of ischemic damage to the heart muscle: pain behind the sternum with radiation to the left half of the chest. The pain increases with stress and nervous disorders. The pathology is eliminated by taking nitroglycerin under the tongue, as the drug dilates the blood vessels.

Chest pain on the left with myocardial infarction is quite severe. When it appears, patients fear for their lives. After resting or taking nitroglycerin, the pain syndrome during a heart attack does not disappear.

Non-coronary causes of chest pain:

Pericarditis (inflammation of the outer membrane of the pericardium) is accompanied by periodic aching pain. They appear against the background of intense physical activity. In this case, the doctor listens to a specific sound - a pericardial friction noise. The inflamed leaves cause pain when they come into contact with each other. Myocarditis (inflammatory changes in the heart muscle) leads to aching pain in the left side of the chest (where most of the heart is located). The pain does not disappear under the influence of physical activity. Taking nitrates does not eliminate pain. The disease is specific to the lack of connection between the pain syndrome and changes in the cardiogram. Cardiomyopathy (a general disease of the heart muscle) develops with myocardial hypertrophy (excessive thickening). It occurs in athletes who do strength training and in older people. The localization of pain in this pathology may vary, but pain on the left is most typical. Acquired defects form various clinical symptoms depending on the type of pathology and the degree of its severity. With mitral valve prolapse, the left side often hurts, and aortic insufficiency “makes itself known” on the right. High blood pressure puts strain on the heart muscle. The consequence of the situation is pericardial pain. Excessive tension of the aortic walls leads to ischemic changes in the myocardium.

Neurological disorders

Answering the question of why pain occurs in the left half of the chest wall during neurological disorders, the following reasons should be highlighted:

cardiopsychoneurosis; cardialgia; intercostal neuralgia; musculofascial syndromes; psychovegetative syndrome.

Neurocirculatory dystonia (NCD) is of 4 types:

Simple cardialgia. Prolonged cardialgia. Sympathalgic form. Pseudoangina.

Of these forms, aching pain in the left side of the chest is observed with simple and prolonged cardialgia. Pseudoangina is characterized by sharp and short-term attacks of “clamps” behind the sternum.

The sympathetic form of neurocirculatory dystonia is accompanied by pain in the periosternal region with increased sensitivity of the intercostal spaces, mainly in the left half of the chest.

Musculofascial syndromes occur due to traumatic or inflammatory changes. Their pain intensifies with physical activity. They are not eliminated by taking nitroglycerin.

Psychovegetative disorders appear in various brain diseases. They are accompanied not only by algesia (pain), but also by variability of associated symptoms. Thus, a person with Parkinson's syndrome may experience pain attacks on the left side, radiating to the right leg and left ear. Such widespread pain makes the doctor think about its causes and compare the disease with mental disorders.

Respiratory diseases

In diseases of the respiratory system, pain in the left side of the chest appears due to concomitant changes in the soft tissues. Doctors associate pain in the chest with respiratory diseases in the last place, which is why there are cases of late diagnosis of pathology.

Lung tissue does not have pain receptors, so it rarely hurts. For clinical symptoms to occur in the chest, inflammatory or traumatic injuries to the soft tissue are necessary.

Why does the left half of the body hurt with lung diseases:

pleurisy (inflammation of the pleura) with accumulation of infiltrative fluid in the pleural sinus; pneumothorax - release of air from the bronchus into the pleural cavity during the destruction of lung tissue; tumor formation of the mediastinum with compression of surrounding structures; inflammatory diseases (tuberculosis, hydatid cyst, purulent abscess, lobar pneumonia).

Pulmonary pathology is characterized by a relationship with breathing or coughing. So, with coughing shocks and increased breathing, the left side of the chest hurts more.

Pleurisy is accompanied by inflammation of the pleural layers. In this case, the infiltrative exudate irritates the proprioceptive receptors of the pleura. If during inflammatory changes there is no fluid in the pleural sinus, dry pleurisy. With it, the left side of the chest hurts severely with every act of breathing.

Mediastinal tumors compress mediastinal structures: vessels, nerves, lymph nodes. Against the background of the formation, an extensive clinical picture develops, often manifested by pain.

Intestinal diseases

With intestinal diseases, there is pain under the left side of the chest. The stomach is located in this area and the pancreas is projected.

All stomach pains are characterized by a relationship with food intake:

worse when eating; after eating there is a burning sensation, itching behind the sternum; dysphagia – digestive disorder; pain in the pit of the stomach.

What intestinal diseases cause pain under the sternum on the left:

hiatal hernia; stomach ulcer; cholecystitis; narrowing of the esophagus; enterocolitis.

A hiatal hernia manifests itself as increased pain after eating. Symptoms intensify in a horizontal position and decrease with a sudden change in body position.

With a stomach ulcer, there is quite a lot of pain under the left side of the “chest corset.”

Similar sensations appear with cholecystitis. Due to the similarity of the clinical picture of both diseases, it is difficult for doctors to establish a diagnosis, which is why fibrogastroscopy is performed. Only with the help of a probe inserted into the stomach can the cause of the pathology be established.

Narrowing of the esophagus in the lower part can also lead to pain on the left side of the body, but the symptoms in this case are more related to the irradiation of nerve impulses along the phrenic nerve.

Spine pathologies

In diseases of the spine, the left side of the chest hurts only when pathological changes are localized at the Th4-L3 level. True, the therapist cannot establish a direct relationship between algesia and spinal pathology, which is why diagnostic errors occur.

The following specific features are characteristic of spinal pain:

constant localization of pain; connection of sensations with muscle fiber tension and body position; identification of paravertebral pain points at the exit site of inflamed nerves; decreased sensations during massage or application of mustard plasters; acute onset; associated neurological symptoms.

When analyzing the reasons described above, there is no clear relationship between pinched spinal root and pain on the left side. This localization of symptoms is associated with the irradiation of a nerve impulse along the intercostal nerves (with pathology of the thoracic spine).

Particular attention should be paid to a rare pathology – Tietze syndrome. It appears when the nerve is pinched at the junction of the sternum with the 3-4th rib. The disease causes inflammation of the costal cartilages, which is accompanied by pain in the lower part of the sternum. When pressure is placed on the xiphoid process (lower part of the sternum), the pain intensifies.

Sharp pain over the upper part of the sternum or to the left of it appears when the nerve bundle between the anterior and middle scalene muscles is compressed - scalenus syndrome.

When determining why the left chest part of the body hurts, you should first analyze all the reasons described above. A qualified doctor only needs 15 minutes to do this. If you are going to find out the etiological factor of the disease yourself, you will have to monitor your health for several days!

Pain that occurs on the left side near the heart is an extremely frightening symptom. It may mean that something is wrong with your heart. For example, coronary or hypertension disease, heart disease or cardiomyopathy has developed. But this same symptom may be a manifestation of pathologies of the spine and ribs on the left. Pain from internal organs: stomach, spleen, colon can radiate to the left side.

Where is the heart really located?

The topmost bone running horizontally on the chest wall is the collarbone. Behind it is the first rib, below you can feel a small soft muscle gap, and below it is the second rib. Then at intervals there are 3, 4, 5, 6, 7 and 8 ribs. The following guidelines will also help you get your bearings:

nipple in a man: it is at the same level with the 5th rib; the angle of the scapula directed downward corresponds to the 7th rib in individuals of both sexes.

A person's heart is approximately the size of their fist, positioned so that the most protruding index finger points down and to the left. The heart lies as follows (point by point):

from the upper edge of the second rib, where it attaches to the sternum on the right side; the next point to which the line goes is the upper edge of the 3rd rib, 1-1.5 cm to the right of the right edge of the sternum; next point: in an arc from the 3rd to 5th ribs on the right, 1-2 cm to the right of the right edge of the sternum.

This was the right border of the heart. Now let’s describe the lower one: it runs from the last described point on the right side of the chest and goes obliquely to the space between the 5th and 6th ribs on the left, to the point that lies 1-2 cm to the right of the left midclavicular line.

Left border of the heart: from the last point the line runs in an arc to a point 2-2.5 cm to the left of the left edge of the sternum, at the level of the 3rd rib.

This position is occupied by the heart along with the large vessels flowing into and leaving it:

superior vena cava: it is located at the right edge of the sternum, from 2 to 3 ribs; brings oxygen-poor blood from the upper half of the body; aorta: localized at the level of the manubrium of the sternum, from 2 to 3 ribs on the left. It carries oxygenated blood to the organs through the pulmonary trunk: it is located in front of the other vessels, running in front of the aorta to the left and back. Such a vessel is needed to carry blood to the lungs, where it will be saturated with oxygen.

If it hurts in the heart area

Pain syndrome in the left half of the chest is caused by two types of reasons:

cardiological, caused by diseases of the heart and the vessels that supply it; non-cardiological, initiated by many other pathologies. They have their own division depending on the organ system that caused the syndrome.

The following signs indicate that the heart hurts:

localization of pain: behind the sternum and to the left, to the left edge of the collarbone; the character can be different: aching, stabbing, pressing or dull; not accompanied by pain in the intercostal spaces or in the vertebrae; there is no connection with a certain type of movement (for example, turning the arm at the shoulder joint or raising the arm), pain most often appears after physical activity; there may be a connection with food intake - heart pain with angina pectoris is associated with eating a large amount of food or walking immediately after eating, but then it is not accompanied by heartburn, belching or stool disorders; may radiate to the left hand (especially the little finger), the left half of the lower jaw, the area of ​​the left shoulder blade, but at the same time there is no impairment of the sensitivity of the hand, it does not freeze, does not weaken, the skin on it does not begin to turn pale and hair falls out.

Cardiac pain: what kind of heart pain?

The following causes of pain caused by diseases of the heart itself can be named:

Angina pectoris

This is a type of coronary heart disease. It is connected with the fact that due to the atherosclerotic plaque, thrombus or spasm located in the coronary artery, the diameter of this vessel that feeds the structures of the heart decreases. The latter does not receive enough oxygen and sends pain signals. Characteristics of the latter:

occur most often after physical or emotional stress: lifting heavy objects, climbing stairs, fast walking, walking against the wind (especially cold, especially in the morning), walking after eating; may appear at night in the morning or after waking up, when the person has not yet gotten out of bed (this is Prinzmetal's angina); after resting or stopping in the first case or taking Corinfar, Nifedipine or Phenigidine in the second, the pain goes away; squeezing, burning pain; localized either behind the sternum or to the left of the sternum, its area can be indicated with a fingertip; may radiate to the area of ​​the left arm, shoulder blade; left half of the jaw; removed with Nitroglycerin after 10-15 seconds.

Myocardial infarction

This is the second and most severe form of coronary artery disease. It develops when those plaques or arteries that caused short-term, only during emotional or physical stress, oxygen starvation of the myocardium grew and blocked the artery almost completely. This condition can happen when a blood clot or a piece of fat comes off from somewhere (from some vein, most often in the legs), which clogs the artery. As a result, the area of ​​the heart, if professional assistance is not provided within an hour by introducing clot-dissolving drugs, will die.

Myocardial infarction can manifest itself in different ways. In the classic version it is:

strong, burning, tearing pain on the left side in the region of the heart. It is so strong that a person can even lose consciousness; is not relieved by Nitroglycerin and rest; radiates to the left arm, shoulder blade, neck and jaw - on the left side; the pain increases in waves; accompanied by shortness of breath, nausea, heart rhythm disturbances; Cold sweat appears everywhere on the skin.

A heart attack is an insidious disease: if it manifests itself typically, it gives a person a chance for salvation. But also with this dangerous disease, only the arm, jaw, or even one little finger on the left hand may hurt; Heart rhythm disturbances may occur or suddenly, for no apparent reason, your stomach may begin to hurt or you may experience loose stools.

Pericarditis

This is the name for inflammation of the heart sac caused by an infectious cause. People describe this pain as:

chest pain (or they say: “Localized in the depths of the chest”); piercing nature; worsens when lying down; weakens if you lean forward while sitting or standing; long-term, in many cases passes from time to time; does not give anywhere; cannot be removed by nitroglycerin; occurs after an acute respiratory infection, pneumonia, or other diseases caused by microbes; accompanied by weakness and fever.

Mitral valve prolapse

This “bending” of the valve into the left atrium (normally its petals should open in systole and close tightly in diastole) either has a congenital cause, or develops after rheumatism, mycardial infarction or myocarditis, against the background of lupus, coronary artery disease or other heart diseases.

not intense bursting heart pain; attacks of rapid heartbeat; interruptions in heart function; dizziness; fainting; nausea; feeling of a “lump” in the throat; increased sweating; Due to insufficient blood supply to the brain, a person with mitral valve prolapse is susceptible to depression and periods of low mood.

Dissecting aortic aneurysm

This is the name of the condition when an expansion occurs in the aorta - the largest vessel in which the pressure is highest - an aneurysm. Then, against this background, between the layers forming the wall of the aneurysm, an accumulation of blood appears - a hematoma. It “creeps” down, peeling off the layers of the aortic wall from each other. As a result, the vessel wall becomes weak and can be torn at any time, causing massive bleeding.

A dissecting aneurysm rarely occurs “on its own”; most often it is preceded by a period when a person constantly has high blood pressure, or suffers from atherosclerosis, when plaques form in the aorta, or the cause of the condition is syphilis or Marfan syndrome.

Pain with dissecting aortic aneurysm:

strong; located behind the upper part of the sternum; may radiate to the neck, lower jaw; can be felt throughout the chest; lasts from several hours to several days; cannot be removed by nitroglycerin; may be accompanied by a blue discoloration of the face and swelling of the jugular veins located on the lateral surfaces of the neck.

Aortitis

This is the name for inflammation of all three (panaortitis) or parts (endaortitis, mesaortitis, peraortitis) of the membranes of the thoracic aorta. The cause of the disease may be:

infection (streptococcus, syphilis, tuberculosis, brucellosis); autoimmune diseases (Takayasu's disease, collagenosis, ankylosing spondylitis, thromboangiitis obliterans); inflammation can “transition” from inflamed organs located next to the aorta: with pneumonia, lung abscess, infective endocarditis, mediastinitis.

The disease is manifested by a group of symptoms: some of them are signs of the underlying disease, others are manifestations of impaired blood supply to internal organs or the brain, and others are symptoms of direct inflammation of the aorta. The latter include:

pressing and burning pain in the chest; most often - behind the manubrium of the sternum, but the pain can radiate to the left; radiates to the neck, between the shoulder blades, and to the “epigma” region; the pulse in the carotid and radial arteries is not symmetrical and may be completely absent on one side; blood pressure may not be determined in one arm.

Endocarditis

This is the name for inflammation of the inner lining of the heart, from which the valves, the chords of the main “pump” of a person, are made. Pain in this disease rarely occurs - only in its later stages, when the patient performs physical activity or experiences a strong emotion. It is aching, not intense, and can radiate to the arm and neck.

Other signs of endocarditis are:

temperature rise, often to low levels; body temperature decreases and increases for no apparent reason; fever is accompanied by a feeling of cold or severe chills; the skin is pale, maybe sallow in color; nails thicken, becoming like watch glass; if you pull back the lower eyelid, in some people you can find pinpoint hemorrhages on the conjunctiva; small joints of the hands are affected; rapid weight loss; periodically I feel dizzy and have a headache, but in a horizontal position these symptoms go away.

Cardiomyopathy

There are 3 types of this disease, but pain in the heart area is characteristic only of the hypertrophic version. The pain syndrome does not differ from that of angina pectoris, and even appears after physical exertion.

In addition to pain, hypertrophic cardiomyopathy manifests itself:

shortness of breath; increased heart rate; cough; dizziness and fainting; swelling of the legs (see cardiac edema); increased fatigue.

Heart defects

They are either congenital or develop against the background of rheumatism. Heart pain most often accompanies only aortic stenosis - a decrease in diameter in the place where the aorta exits the heart.

The pain syndrome in this case is constant, its character is pinching, stabbing, pressing. In addition, blood pressure often rises and swelling appears in the legs. There are no other signs specific to aortic stenosis.

Myocarditis

Inflammation of the heart muscle, which is most often a consequence of influenza or enterovirus infection, also manifests itself in 75-90% of cases as pain in the heart. They have a stabbing or aching character and occur both in connection with physical activity and in a state of relative rest, after exercise. Increased fatigue and increased body temperature are also noted. Nitroglycerin does not help relieve pain.

Myocardial dystrophy

This is the name of a group of heart diseases in which the heart muscle is not inflamed and does not undergo degeneration, but the basic functions of the heart associated with its contractility and rhythm suffer.

The disease can manifest itself as pain of a different nature. Most often these are aching or pinching pains that appear against the background of a feeling of heat or, conversely, increased chilliness of the limbs, sweating. In addition, weakness, increased fatigue, and frequent headaches are noted.

Hypertonic disease

Constantly high blood pressure can manifest itself not only as a headache, “spots” before the eyes or a feeling of “hot flashes”. In this case, pain may appear in the left half of the chest, which has an aching, pressing character or a feeling of “heaviness” in the chest.

These are, in principle, all heart diseases that can be accompanied by pain in the left half of the chest. There are much more non-cardiological pathologies that cause this symptom, and now we will look at them.

Non-cardiological diseases

They are divided into several groups, depending on which organ system caused the symptom.

Psychoneurological pathologies

Painful sensations in the heart area can be caused by cardioneurosis and cyclothymic conditions, which are identical in their manifestations. In these cases, despite the richness of symptoms, examination of the heart and internal organs does not reveal any pathology. The person notes the following symptoms:

pain in the left side of the chest appears in the morning before waking up or during it; attacks almost always occur when overheated, rather than on cold and windy days, as happens with angina pectoris; it can be triggered by depression or a conflict situation; the pain does not go away if you stop or take nitroglycerin; it can last up to several days, and can appear several times a day (up to 5), lasting 1-2 hours. In this case, the nature of the pain may change each time; If you do a few light physical exercises, this can relieve pain; the nature of the pain can be different: compression, heaviness, tingling; it can be described as “emptiness” in the chest or, conversely, fullness. There may be a “pinching pain” or a pronounced intensity syndrome accompanied by fear of death; the pain radiates to the neck, both shoulder blades, can involve the right half of the chest, the spine area; you can accurately indicate the point at which maximum pain is noted; increased sensitivity of the left nipple; the condition worsens when experiencing any – positive or negative – emotions; during an attack, a person begins to breathe quickly and shallowly, as a result of which the carbon dioxide content in the blood decreases, which is accompanied by dizziness, a feeling of fear, and can serve as the basis for the development of arrhythmia; despite the frequency and intensity of attacks, drugs such as Nitroglycerin or Anaprilin do not affect them; lasting for years, do not lead to the development of symptoms of heart failure: shortness of breath, swelling in the legs, changes in the X-ray of the lungs or ultrasound picture of the liver.

Patients with cardioneurosis are talkative, fussy, change body position during an attack, and look for a local remedy to help relieve pain. When taking Nitroglycerin, the effect does not occur after 1.5-3 minutes, as with angina pectoris, but almost immediately or after a long time. Such people are more effectively helped by drugs such as Valocordin, Gidazepam or valerian tincture.

Neurocirculatory dystonia is the second main pathology, in which there are no changes in either the function or structure of internal organs, but at the same time the person suffers from “heart” pain. They may be of the following nature:

Localized in the area near the nipple, have a mild or moderate severity, last several minutes - several hours. Validol and nitroglycerin help relieve pain. This is the most common type of cardialgia. Be aching or pressing, accompanied by increased blood pressure, fear, trembling, sweating, shortness of breath. You can relieve such an attack with the help of “Anaprilin” (“Atenolol”, “Metoprolol”, “Nebivolol”) in combination with tincture of valerian or motherwort. Have a burning character, be localized behind the sternum or to the left of it, accompanied by increased sensitivity of the intercostal spaces when palpated. Nitroglycerin, validol or valocordin do not stop the attack. This is done by mustard plasters applied to the heart area. Have a pressing, squeezing, aching character, localized behind the sternum, aggravated by walking and physical stress.

Pain due to diseases of the musculoskeletal system and nerve endings

Pain syndrome can occur with irritation of the nerves innervating the intercostal muscles, with inflammation of the costal and cartilaginous parts of the ribs

Neuralgia of the intercostal nerves

The pain is constant, intensifies with breathing (especially deep breaths), and bending the body in the same direction. One or more intercostal spaces are painful. If intercostal neuralgia is caused by the herpes zoster virus, then in one intercostal space you can find vesicles filled with clear liquid.

Apart from such pain, there are no other symptoms. Only if the neuralgia is caused by the varicella-zoster virus can the temperature be elevated. In the case of a weakened body, complications from the nervous system may occur: meningitis, encephalitis.

Myositis of intercostal muscles

In this case, there is pain in the muscles of the heart area. It intensifies with a deep breath and when the body tilts in a healthy direction. If you begin to touch the affected muscle, pain is felt.

Scapular-costal syndrome

In this case, pain occurs under the shoulder blade, radiates to the neck and shoulder girdle (what we used to call the “shoulder”), and the anterolateral part of the chest wall. The diagnosis is quite simple: if the patient places his palm on the opposite shoulder, then at the upper corner of the scapula or at the spine in this place you can feel the point of maximum pain.

Interscapular pain syndrome

This condition occurs when the complex of structures located between the shoulder blades: muscles, ligaments and fascia becomes inflamed. It begins with the appearance of heaviness in the interscapular area. Then a pain syndrome develops, which has an aching, boring, burning character. Its intensity increases during emotional stress, during night sleep, when breathing and turning the body, and radiates to the neck, shoulder, forearm and arm. What distinguishes the syndrome from intercostal neuralgia and heart pain is that pain points can be found in the area of ​​the scapula, and the intercostal muscles are painless.

Inflammation of the costal cartilages (chondritis) on the left side

It is manifested by the appearance of swelling of one of the cartilages; she is painful. Over time, the swollen area softens and can open with the release of pus. In this case, the temperature may rise to subfebrile levels. Even after opening the abscess in the area of ​​the inflamed rib, pain persists, which can bother you for 1-3 years.

Tietze syndrome

This is the name of a disease of unknown cause in which one or more costal cartilages become inflamed in the place where they connect to the sternum. The syndrome manifests itself as pain in the localized inflammation, which intensifies when pressing on this area, sneezing, movements, and also with deep breathing.

The disease occurs with periods of exacerbation, when all symptoms appear, and remission, when the person feels healthy.

Injuries, fractures, bruises of ribs

If an injury has been caused, and then there is pain in the chest, it is impossible to differentiate by symptoms whether it is a bruise or a fracture. Both of these pathologies are manifested by severe pain that spreads to the entire chest; it intensifies with breathing. Even if it was a fracture and it has healed, chest pain will still be present for some time.

Tumor of one of the ribs on the left - osteosarcoma

It can appear in people of any age. Oncopathology manifests itself as pain syndrome localized in the ribs. It intensifies at night and is characterized by a pulling character. In later stages, swelling is noted in the area of ​​the affected rib.

Osteochondrosis

When the bundles of spinal nerves are compressed on the left, pain appears in the rib area. She:

aching; constant; changes intensity when changing body position; increases with physical activity, overheating, drafts and hypothermia;

Additional symptoms include:

tingling and numbness in the left hand, weakness of its muscles, there may be pain in the left hand, which has three distribution options: along its outer surface to the thumb and index finger; along the inner area of ​​the hand closest to the little finger; along the posterior-outer part, heading towards the middle finger - this will depend on which of the roots is pinched.

Osteoporosis

This is the name of a pathology in which the calcium content in the bones (including ribs) is too low. It occurs due to insufficient intake, poor absorption or increased destruction.

The pathology is asymptomatic, you can find out about it if you perform ultrasound densitometry of the ribs (to find out their density). The first symptoms appear when small cracks or fractures appear on the ribs that appear when the body bends or turns sharply. During such movements, a strong, sharp pain usually appears in the rib area, which then persists when the body position changes.

Herniated disc

This pathology, similar to osteochondrosis, is associated with impaired nutrition of the intervertebral disc with its subsequent destruction. Only in the case of a hernia does that part of the disc that cannot undergo destruction begin to protrude beyond the vertebrae and put pressure on the nerves passing there.

A hernia manifests itself as a pain syndrome:

growing gradually; intensifying to a pronounced degree, even leading to loss of consciousness; gives to the neck or arm, where it has a shooting character.

Symptoms may be confused with myocardial infarction. The main difference is the fact that when a disc herniation occurs, the person’s general condition does not suffer.

Fibromyalgia

This is the name for chronic musculoskeletal pain that occurs for no apparent reason in symmetrical areas of the body. In this case, the pain syndrome appears after stress or emotional trauma. The ribs hurt not only on the left, but also on the right; the pain intensifies with rain and similar changes in weather conditions.

The person notes a feeling of tightness in the chest, complains of difficulty falling asleep, and periodic headaches. The coordination of his movements decreases; quality of life suffers.

Musculofascial syndrome

This disease is not rare. Its cause is an injury to the soft tissues of the chest (in this case, on the left), in which blood comes out into the muscles, its liquid part sweats out and the protein fibrin is deposited, which the blood needs to ensure the coagulation process. As a result of this soaking of the muscles, their tone sharply increases, which causes pain, described as “in the muscles” or “in the ribs,” of varying intensity, changing with movement.

All of the above diseases from the described group, pain in the ribs is noted. This symptom will also be observed with pleurisy, pleural tumors and cardioneurosis. We'll talk about diseases of the pleura below.

When the cause is a disease of one of the internal organs

Pain syndrome localized near the heart can be caused by pathology of the lungs and pleura in which they are wrapped. It can occur as a result of diseases of the mediastinal organs - that complex of organs that is located between the two lungs, next to the heart. Diseases of the esophagus, stomach, gallbladder and liver can also cause pain resembling heart pain.

Lung diseases

Pneumonia. Most often, the heart area will hurt if an entire lobe of the lung is inflamed (lobar pneumonia). Less commonly, “cardialgia” will be observed with focal pneumonia. The pain syndrome is of a stabbing nature, intensifies with inhalation and coughing. In addition, there is an increase in temperature, weakness, cough, nausea, and lack of appetite. Lung abscess. In this case, fever, lack of appetite, nausea, pain in muscles and bones come to the fore. The pain syndrome to the left of the sternum differs in intensity, especially if the abscess is about to break into the bronchus. If the abscess is located near the chest wall, increased pain will be noted when pressing on the rib or intercostal space. Pneumoconiosis is a chronic disease caused by inhalation of industrial dust, which the lungs try to separate from healthy areas using connective tissue. As a result, the breathing zones become smaller and smaller. The disease manifests itself as shortness of breath, cough, stabbing chest pain, which radiates to the interscapular area and under the scapula. The progression of the disease is characterized by an increase in temperature to 38 degrees, weakness, sweating, and weight loss. Pulmonary tuberculosis. Chest pain in this case appears only when the specific inflammation characteristic of the tuberculosis process spreads to the pleura enveloping the lungs or the chest wall (costomuscular frame). Before this, attention should be paid to weight loss, sweating, lack of appetite, increased fatigue, low-grade fever, and cough. The pain increases with breathing, coughing, and pressing on the chest. Lung tumor. There is constant pain of various types: aching, pressing, dull, burning or boring, aggravated by coughing and deep breathing. It can radiate to the shoulder, neck, head, stomach; may radiate to the right side or be encircling. Pleurisy is an inflammation of the pleura, that is, the film covering the lungs. It is almost always a complication of pneumonia, tumors of the lung tissue or injuries. If left-sided pleurisy develops, the pain syndrome may be localized in the heart area. It is associated with breathing and is also aggravated by coughing. In addition, there is an increase in temperature and shortness of breath. Pneumothorax. This is the name of a condition in which air gets between the pleura and the lung. It is incompressible, therefore, as its volume increases, it compresses the lung, and then the heart and blood vessels. The condition is dangerous and requires urgent hospitalization. The pathology manifests itself as stabbing pain on the affected side. It radiates into the arm, neck, and behind the sternum. Intensifies with breathing, coughing, movements. May be accompanied by fear of death.

Mediastinal pathologies

There are not very many of them:

Pneumomediastinum (mediastinal emphysema) is the entry of air into the fatty tissue that is located around the heart and blood vessels. It occurs as a result of injury, damage during surgery or purulent melting of air-containing tissues - the esophagus, trachea, bronchi or lungs. Symptoms: feeling of pressure behind the sternum, difficulty breathing, shortness of breath. Pulmonary embolism. This is a life-threatening condition characterized by sudden, sharp pain in the chest, which is aggravated by deep breathing and coughing. Shortness of breath, palpitations, and loss of consciousness are also noted. Tracheitis is inflammation of the mucous membrane of the trachea. It manifests itself as a cough, dry burning pain behind the sternum. Esophageal spasm. The symptoms of this condition are difficult to distinguish from an attack of angina: the pain syndrome is localized behind the sternum, in the area of ​​the heart and shoulder blade, and is relieved with nitroglycerin.

Diseases of the abdominal organs

The following pathologies can cause pain similar to heart pain:

Esophagitis is inflammation of the mucous membrane of the esophagus. It is characterized by a burning sensation behind the sternum, which intensifies when swallowing especially hard, hot or cold foods. Achalasia cardia is an enlargement of the esophageal opening of the stomach. Substernal pain syndrome is associated with food intake. Heartburn and nausea are also noted. Hiatal hernia. The pain syndrome appears or intensifies after eating, as well as in a horizontal position. The pain goes away when changing body position. Peptic ulcer of the stomach or duodenum. The pain either occurs on an empty stomach or 1-2 hours after eating. Heartburn is also noted. Exacerbation of chronic cholecystitis is most often accompanied by pain under the ribs on the right, but can also radiate to the left half of the chest. In addition, there is a bitterness in the mouth and loose stools. Exacerbation of chronic pancreatitis, if the inflammation is localized in the tail of the pancreas, in addition to nausea, vomiting and loose stools, is accompanied by pain in the left side of the chest.

Diagnosis depending on pain characteristics

We looked at pathologies that cause pain localized in the left half of the chest. Now let's look at what pain each of them gives.

It's a dull pain

Aching pain is typical for:

angina pectoris; myocarditis; cardioneurosis; peptic ulcer of the stomach and duodenum; scoliosis; osteochondrosis of the thoracic spine; exacerbation of pancreatitis.

Stitching nature of the pain syndrome

Stitching pain occurs with:

myocardial infarction; pericarditis; cardioneurosis; hypertrophic cardiomyopathy; neurocirculatory dystonia; intercostal neuralgia; pneumonia; pleurisy; tuberculosis; herpes zoster; lung or bronchus cancer.

Pressing character

Pressing pain can be a manifestation of:

angina pectoris; myocarditis; mitral valve prolapse; pericarditis; foreign body of the esophagus (in this case, the fact of swallowing some inedible object, for example, a fish bone, is noted); cardiomyopathy; myocardial dystrophy; heart tumors (for example, myxoma); poisoning with medications, alcohol, drugs, organic phosphorus compounds, poisons. In this case, there is the fact of taking medications, alcohol, treating plants for pests, and so on; ulcers in the stomach at the junction with the esophagus.

If the nature of the pain is sharp

I usually use the word “sharp pain” only to describe myocardial infarction. In addition to cardialgia of this nature, there is a general deterioration in condition, cold sweat, lightheadedness, and heart rhythm disturbances. Cardialgia irradiates to the left shoulder blade and arm.

If the pain feels "severe"

Severe pain occurs with:

myocardial infarction; osteochondrosis of the cervical and thoracic regions; intercostal neuralgia, especially caused by herpes zoster; pulmonary embolism; rupture of dissecting aortic aneurysm; myocarditis.

Pain is felt all the time or most of the time

Constant pain is characteristic of osteochondrosis. In this case, there is no deterioration in the condition, but there may be “goosebumps” and numbness in the left hand, and a decrease in its strength. A similar complaint describes pericarditis - inflammation of the outer lining of the heart - the cardiac sac. It is also characterized by general malaise and increased body temperature. Pericarditis can also cause frequent pain that goes away from time to time. This is how pain syndrome can be described during menopause or anxiety disorders.

Dull pain syndrome

If you feel a dull pain in the heart area, it may be:

anterior chest wall syndrome; arterial hypertension (in this case, high blood pressure is recorded); overload of the intercostal muscles, for example, during very active physical training or prolonged playing of wind instruments.

Acute pain in the heart area

Acute pain is observed with pleurisy or pericarditis. Both diseases are characterized by fever and weakness.

Nagging pain

It is typical for:

thrombosis; neuro-circulatory dystonia; angina pectoris; osteochondrosis; diseases of the gastrointestinal tract.

Burning pain syndrome

This symptom is observed during myocardial infarction, in this case there will be a sharp deterioration in the condition, and there may be clouding of consciousness due to painful shock. Pain in neurosis is described in a similar way, when psycho-emotional disorders come to the fore.

Diagnosis depending on the conditions of pain syndrome occurrence and accompanying symptoms

Let's consider additional characteristics of the pain syndrome:

If the pain radiates to the shoulder blade, it could be: angina pectoris, esophageal spasm, myocardial infarction, cardioneurosis. When the pain intensifies with inspiration, this indicates: intercostal neuralgia, pleurisy or myositis of the intercostal muscles. When the intensity of the pain increases with deep inspiration, it may be pneumonia or pulmonary embolism. In both cases, there is a deterioration in the general condition, but with pneumonia this happens gradually, and with pulmonary embolism the minutes count. If pain intensifies with movement, this may be a sign of osteochondrosis of the cervical or thoracic spine. When pain radiates to the arm, a person may have one of the following diseases: osteochondrosis; myositis of the intercostal muscles on the left side; myocardial infarction; angina pectoris; interscapular pain syndrome; endocarditis; pneumothorax. When pain is accompanied by shortness of breath: myocardial infarction; pneumothorax; pulmonary embolism; pneumonia; rupture of an aortic aneurysm. If both weakness and pain appear in the heart area, it may be tuberculosis, pleurisy, pericarditis, dissecting aortic aneurysm, pneumonia. The combination of “pain + dizziness” is typical for: mitral valve prolapse; cardiomyopathy; cardioneurosis; osteochondrosis or cervical hernia, accompanied by compression of the vertebral artery.

What to do for cardialgia

If you have pain in the heart area, what to do:

Stop performing any activity, take a semi-lying position, place your legs slightly lower than your body (if there is dizziness, higher than your torso position). Unbutton all obstructive clothing and ask to open the windows. If the pain is similar to that described for angina pectoris, take Nitroglycerin under the tongue. If the syndrome is relieved with 1-2 tablets (they act within 1.5-3 minutes), consult a physician on the same day or the next to diagnose coronary heart disease and prescribe appropriate treatment. You can’t take more pills - among other things, they lower your blood pressure (P.S. a headache after taking nitroglycerin is normal and can be relieved with Validol or Corvalment, which contain menthol). If nitroglycerin does not help, and there is difficulty breathing, weakness, faintness, severe pallor, call an ambulance, be sure to indicate that there is pain in the heart. You can first take a painkiller tablet: Diclofenac, Analgin, Nimesil or another. If the pain in the heart area has disappeared after you stopped, this condition requires prompt diagnosis using a cardiogram and ultrasound of the heart. Failure to pay attention may aggravate the situation with the development of heart failure.

Treatment is prescribed only by a doctor, based on the results of the examination. Self-medication is unacceptable, since the diseases manifested by this symptom are radically different. Self-medicating, for example, osteochondrosis, which actually turns out to be myocarditis, can lead to the development of heart failure, when any incorrect movement is accompanied by shortness of breath, a feeling of lack of air and swelling.

Thus, pain localized in the heart area can be caused not only by heart diseases. Much more often, its causes are pathologies of the ribs and intercostal muscles, spine, esophagus and stomach. In order to start moving towards a diagnosis, you need to express your complaints to the therapist. The doctor will either figure out the troubling problem on his own or refer you to the right specialist. This will be a better solution than undergoing examinations yourself, wasting time and money.

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If there is pain in the sternum on the left, the causes of this phenomenon may be different. Most people associate this symptom with dysfunction of the cardiovascular system. They panic and rush to take heart medications. However, chest pain is sometimes caused by disorders of a different nature.

Angina attack

Ischemic heart disease is a condition when the blood supply to the myocardium (the middle muscular layer of the heart) is severely or slightly impaired due to damage to the coronary vessels.

With the development of coronary artery disease, patients periodically experience attacks of angina. During their appearance, they feel an excruciating pain syndrome in the chest on the left side in the area of ​​the heart, which is characterized by cutting, stabbing pains. Severe spasms squeeze a person’s sternum like a vice. Patients may experience pain in the upper left limb and part of the back near the shoulder blade. Pain sensations are observed in the neck and even jaw.

The patient experiences shortness of breath and may feel as if there is not enough air. Frequent symptoms are excessive weakness, sweating, in addition, dizziness and chest pain. He may feel nauseous and vomit. During a heart attack, there is a rapid heartbeat (tachycardia), arrhythmia, or a feeling that the heart is stopping. The patient often experiences panic and an unreasonable feeling of anxiety. He becomes irritable and restless. An attack of angina lasts from 5 minutes to half an hour. It goes away on its own or under the influence of medications.

The discomfort usually occurs suddenly during active physical exercise or after emotional stress. Provoking factors are low air temperature and windy weather. After rest, unpleasant symptoms disappear.

In the early stages of the disease, a heart attack is caused by excessive physical exertion. As ischemia develops, pain in the sternum begins to occur with minor everyday activities.

Often the attack suddenly appears while walking quickly. It takes the patient with ischemia by surprise in hot or cold windy weather. People suffer from an attack of angina immediately after eating or when climbing stairs. At this moment, the person is forced to stop, trying to reduce the strength of the unpleasant symptoms.

If coronary heart disease is left untreated, it will progress. In the later stages of development of coronary artery disease, attacks are also observed during rest. They can attack immediately after smoking or at night.

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What if it's a heart attack?

Myocardial infarction is a consequence of exacerbation of coronary heart disease. Due to the absence or insufficiency of blood supply in the myocardial area, ischemic necrosis occurs. Symptoms of the disease often appear very clearly. A burning, sharp, “dagger” pain occurs in the chest. Patients who have survived a heart attack call it the most severe they have ever experienced. It is almost impossible to relieve such pain with medications. Rest does not bring relief.

The pain presses on the chest, as if a heavy stone had been placed on it. The patient reflexively presses his hand to his chest and begins to rub his left forearm. There may be pain in the left arm. It is often accompanied by tingling in the wrist and fingers. The left upper limb may become partially numb. Pain sometimes extends to the neck and jaw. The pain squeezes the shoulders. A painful spasm can occur under the right rib, in the upper middle part of the abdomen and in the navel area.

Simultaneously with the pain syndrome, a severe psychological condition occurs. The patient experiences severe fear and anxiety. He has a premonition of imminent death. A heart attack has a wave-like character. Each subsequent wave of pain lasts about 10-15 minutes. The pressing pain may wax and wane.

During a heart attack, the patient may experience tachycardia, dizziness, and fainting. Gastrointestinal problems such as nausea and vomiting are observed. Patients experience a feeling of fullness in the stomach. They experience increased sweating: the skin becomes covered with cold, sticky sweat. Harbingers of an impending crisis are breathing problems. The patient suffers from shortness of breath, his breathing becomes intermittent. He can't take a deep breath.

In some cases, myocardial infarction does not cause severe pain. It can be quite tolerable. It can be eliminated with painkillers. The person feels weak and tired. This picture of the disease is more often observed in female patients.

At the first signs of myocardial infarction, you should immediately call an ambulance. The attack often causes life-threatening conditions. They can develop in the first hours after the acute period.

Manifestations of myocarditis

Myocarditis is called damage to the heart muscle. Most often, myocarditis is inflammatory in nature. It develops against a background of persistent chest pain and shortness of breath. With myocarditis, there is a pulling on the left side of the chest. A dull pain is accompanied by a burning sensation. It develops gradually. The paroxysmal nature of pain is not typical for the disease.

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With myocarditis, the patient may experience pain in the joints and the body temperature may rise. A characteristic feature of myocarditis is heart rhythm disturbances. The pulsation can be rapid, slow or arrhythmic. Periodically there are sensations of cardiac arrest.

In acute myocarditis, cyanosis (blue discoloration of the skin and mucous membranes) sometimes occurs, the veins in the neck swell and the legs swell. Myocarditis often develops after infectious diseases.

Symptoms of pericarditis

Pericarditis is an inflammatory process in the outer lining of the heart. This is a sac that covers the organ. With this disease, fluid may accumulate in its cavity.

Acute cutting and stabbing pain in the left side of the chest increases. It is localized on the left side behind the sternum. The pain syndrome has many similarities with the sensations that a person experiences during a heart attack. Unpleasant sensations are localized in the upper dorsal part and lower border of the neck. With the disease, pain can be observed not only on the left side of the chest, but also on the right.

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The pain associated with pericarditis decreases while bending forward. The patient's condition is alleviated by lying on his stomach. Unpleasant pain increases when a person tries to roll over onto his back.

With pericarditis, a person may experience alternating waves of fever and chills. He has difficulty breathing. When you sigh, the pain in the chest on the left near the heart intensifies. It also increases when swallowing or sneezing.

Consequence of mitral valve prolapse

The disease is a consequence of dysfunction of the valve apparatus. Due to pathology of the heart muscle or connective tissue, the valve cannot ensure tight closure of the valves. They bend into the left atrium, allowing blood into it.

Mitral valve prolapse causes chest pain on the left side.

It may disappear after a few seconds. It happens that an attack of pain lasts for a very long time. The patient suffers from lack of air and shortness of breath. Heart rhythm is disturbed. The patient experiences weakness and dizziness. He may faint. During an attack, a panic and anxiety state appears. A person suffers from excessive sweating.

Pain increases after psycho-emotional stress. Seizures occur extremely rarely after physical activity. Mitral valve prolapse can develop against the background of another cardiac pathology. The strength of painful manifestations depends on the stage and form of concomitant diseases. If prolapse is a secondary disease, the pain may be more intense.

Ruptured aortic aneurysm

An aortic aneurysm is an excessive expansion of the walls in a certain area of ​​the vessel. Due to unnatural expansion, the walls become very thin and vulnerable. Even a small external impact (shock, injury, physical activity, psycho-emotional stress) can cause them to rupture.

A ruptured aneurysm causes unbearable pain in the heart area. They have an aching, boring and pulsating character. Some patients experience intense, tearing pain that they compare to a fire burning inside. Pain may be felt near the abdomen and in the back.

When an aortic aneurysm ruptures, the pressure drops at lightning speed and signs of shock appear. The patient experiences tachycardia, weakness, dizziness or fainting. His skin turns pale, his limbs become cold, his fingers darken and turn blue. The person does not respond to pain and does not answer questions. He may have trouble breathing, shortness of breath, cough, discomfort or pain when swallowing. With the inflammatory nature of the aortic aneurysm, fever is observed.

In the absence of immediate medical care, the patient may die. If signs of a ruptured aortic aneurysm are detected, the patient must be hospitalized immediately.

Acid reflux

Pain in the upper left side of the sternum may have nothing to do with the heart.

The cause of pain in the left side of the chest may be acid reflux. This is the name for a condition when the contents of the stomach enter the esophagus. Gastric juices are highly acidic. Aggressive substances cause irritation and inflammation of the vulnerable walls of the esophagus.

Acid reflux is accompanied by severe heartburn. Heartburn refers to a burning sensation in the middle of the lower chest.

At times, gastric masses may reach the pharynx. Then painful and burning feelings spread to the upper part of the chest. A characteristic sour or bitter taste appears in the mouth. Burning masses can provoke irritation of the mucous membranes of the throat and mouth. During swallowing, an unpleasant “lump” is felt. With acid reflux, a cough often appears and the voice becomes hoarse. Shortness of breath may occur.

In severe forms of the disease, discomfort can become excruciating. Chest pain is aching and squeezing. They often calm down after eating. This is caused by the fact that food partially neutralizes the effect of hydrochloric acid that enters the tissue of the esophagus.

Diaphragmatic hernia

With a diaphragmatic hernia, the abdominal organs penetrate or are displaced towards the chest cavity. This occurs due to deformation of the diaphragm-septum, which separates the peritoneum from the sternum.

Painful sensations behind the sternum are caused by compression of internal organs trapped in the hernial sac. The nature of pain with a diaphragmatic hernia resembles that of the heart. Sharp, cutting, burning “dagger” pain sensations are difficult to bear. The upper left limb and the area between the shoulder blades hurt, as if it were a heart attack. Against the background of pain, the skin turns pale, blood pressure drops and it’s hard to breathe.

With increasing physical activity, the severity of pain increases. Pain from a diaphragmatic hernia depends on the position of the body. It occurs when a person lies down, leans forward or down. With flatulence, the pain increases. A diaphragmatic hernia is accompanied by bloating, heartburn and frequent belching of air. After the air comes out, the pain decreases. Relief occurs after drinking water and alkaline drinks. Taking heart medications does not relieve pain.

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Peptic ulcer

A stomach ulcer is considered to be pathological changes in the gastric mucosa. The malaise is characterized by heartburn, belching and gagging. Against the background of the development of a peptic ulcer, localization of pain in the chest is possible. It is caused by stomach cramps.

Aching and nagging pains are directly related to eating food. Unpleasant sensations and severe cramps usually appear one to one and a half hours after eating. The location of the pain depends on the area of ​​the stomach where the ulcer has formed. After eating food, the pain gradually subsides. When the ulcer opens, a sharp cutting pain pierces the chest. The pain syndrome becomes unbearable. This condition is dangerous for humans. He needs to be hospitalized urgently.

Acute pancreatitis

Pancreatitis is inflammation of the pancreas. In acute pancreatitis, severe nagging pain occurs in the upper abdomen and directly under the rib on the left side. Often painful spasms spread to the entire chest area. The pain syndrome can become shingles. It is felt in the back and shoulder girdle. A patient with pancreatitis suffers from nausea and repeated vomiting. It occurs 20-25 minutes after eating a large amount of food and does not bring relief to the person.

The patient experiences an increase in body temperature. Pain relief from pancreatitis occurs when a person sits, leaning forward, or lies on his stomach. Trying to relieve unbearable pain, the patient tries to press his legs to his stomach. He can remain in this position for hours. His face turns blue. The skin on the left hypochondrium darkens or acquires a yellow-bluish tint. After the intensity of the pain decreases, diarrhea may develop.

If the inflammatory process has spread to the gallbladder, pain may appear under the right rib.

In chronic pancreatitis, moderate aching pain is localized in the abdomen, under the left rib, in the chest and in the back near the scapula. Patients complain that their heart is “troubled.” Less commonly, painful sensations spread to the right side of the sternum, shoulder and shoulder blade.

Effect of cholecystitis

Cholecystitis is an inflammation of the gallbladder. During an exacerbation of the disease, the patient experiences severe aching pain in the right hypochondrium. Often the pain is localized on the right shoulder, forearm, scapular region, and neck. They often appear in the side and chest on the left side.

Aching pain in the heart area increases immediately after a heavy meal, especially if the patient is in a supine position. A person has pain in the chest area, as if a stake had been driven into it. He may have an irregular heartbeat. The heart stops periodically.

Chest pain on the left is cramping in nature. The spasms of the gallbladder either intensify or subside a little. They may disappear after taking antispasmodics. However, the intensity of the pain may not decrease if there are stones in the gallbladder.

Spasms appear an hour after eating and do not depend on physical activity. Alcohol, fatty and smoked foods provoke pain. First, a person experiences nausea, then vomiting with bitterness. After this, pain occurs. It can last from several hours to several days.

The pain increases with shaking, sudden turns and bending of the body. Patients pay attention to distension and heaviness in the stomach. They may experience heartburn and the unpleasant sensation of “food getting stuck” in the esophagus.

A person may refuse food in an attempt to avoid suffering. During an exacerbation of cholecystitis, the walls of the peritoneum are tense and painful. The temperature may rise slightly. With cholecystitis, yellowness of the epidermis and mucous membranes is sometimes observed.

If pleurisy develops

The causes of pain in the sternum on the left often lie in diseases and pathologies of the respiratory system. Chest pain is caused by diseases that affect the pleura or bronchi. The pleura is the membrane that lines the inner surface of the chest cavity and covers the lungs. She has many nerve endings. There are no nerve endings in the lungs, so damage to these organs is not accompanied by pain.

Pleurisy is inflammation of the pleura. With the disease, severe chest pain increases sharply. It is localized on the affected side.

Diseases of the respiratory system are characterized by a connection between pain and breathing. The main symptom of pleurisy is a sharp increase in chest pain when inhaling. It increases during coughing, laughter and screaming. When breathing stops, the pain disappears.

With shallow breathing, the discomfort becomes a little less intense. The pain subsides when the body is tilted to the healthy side. Due to the dependence of the intensity of pain on the position of the body, the patient tries to constantly be in a position in which it bothers the least. He lies on the painful side, breathing quickly and shallowly.

The inflammatory process causes an increase in body temperature in the evening. The patient suffers from excessive sweating. It happens that with pleurisy there is shortness of breath. The patient complains of heaviness in the chest area. The veins in his neck swell, and his skin takes on a bluish tint.

Spontaneous pneumothorax

Spontaneous pneumothorax is a sharp violation of the integrity of the visceral layer of the pleura, which results in the movement of air from the lung into the pleural cavity. The air irritates the membrane, causing severe stabbing and squeezing pain in the chest. Attempts to take a deep breath provoke a sharp increase in the intensity of pain. It goes to the shoulder, forearm, neck, stomach and lower back. Sometimes it is so strong that loss of consciousness is possible. The attack is accompanied by shortness of breath and tachycardia. The patient has difficulty moving and breathing. The chest expands.

Unpleasant sensations gradually decrease or disappear completely throughout the day. Shortness of breath and difficulty breathing occur only during physical activity.

Pulmonary embolism

Pulmonary embolism is a pathological condition that occurs suddenly as a result of blockage of a blood vessel located in the lungs. An air bubble, a piece of fatty tissue, a blood clot, or a foreign body that accidentally enters the bloodstream can block the blood flow.

With pulmonary embolism, the symptoms appear clearly. One of the first signs is severe shortness of breath. When trying to take a deep breath, the patient experiences sharp pain in the chest on the side where the blockage occurred. Pain syndrome forces a person to breathe shallowly and frequently. The pathological condition can provoke feelings of fear, worry and anxiety in the patient. He may experience weakness and dizziness. There is a loss of consciousness. With pulmonary embolism, convulsions are also common.

Poor circulation causes interruptions in the functioning of the cardiovascular system. The rate of contraction of the heart muscle may increase or decrease. The pulse becomes uneven.

The appearance of cyanosis on the skin may indicate approaching respiratory arrest and death of the patient. Pulmonary embolism is constantly progressing. If the patient is not provided with timely medical care, he will die.

Pneumonia and emphysema

Pneumonia develops due to damage to lung tissue. Signs of pneumonia may appear suddenly or appear gradually, worsening over time. The patient experiences chest pain, dry cough, shortness of breath and excessive sweating. Sweating increases at night. The patient is forced to change wet clothes at night. The skin turns pale and acquires a bluish tint. The temperature can rise to 38-39 degrees or stay at 37 degrees. When coughing and deep breathing, the patient's pain intensifies. Patients with pneumonia quickly get tired, they have to make an effort to move around the house.

Mediastinal emphysema can cause pain. It develops when air bubbles move into the mediastinum (chest area). Air enters it from the outside due to injury and from the esophagus or respiratory tract.

With emphysema, there is a stabbing sensation on the left side of the sternum. There is a feeling of constriction of the chest. The patient's breathing becomes difficult and he experiences shortness of breath. The neck takes on a puffy appearance, and the voice becomes hoarse and nasal. Pain may be experienced in the throat, shoulder, back and lower back. The patient may have a cough.

Intercostal neuralgia

Unbearably strong sharp cutting or dull aching pain occurs with intercostal neuralgia. This condition occurs when the intercostal nerve endings are compressed or irritated. It can occur due to poor posture during sleep, awkward movement, as well as hypothermia and physical overload. Intercostal neuralgia can be caused by certain diseases.

The pain appears suddenly for no apparent reason. It becomes unbearable when trying to take a deep breath. Sometimes even shallow breathing is accompanied by severe pain. A severe attack can leave a person struggling to breathe.

Pain that permeates the entire body occurs when sneezing, laughing, screaming, and even when moving carelessly. In some cases, the patient cannot breathe strongly for several hours.

During an attack, heavy sweating occurs and muscles may twitch uncontrollably. There is a tingling sensation in the chest. The skin turns pale or pink. Pressing on the chest and back area in some places can cause pain.

Heart neurosis

Cardioneurosis occurs after traumatic factors of a psychological nature. It can appear abruptly after severe stress (for example, after the death of a loved one) or develop gradually due to constantly recurring stressful situations.

With cardioneurosis, dull aching pain is usually observed in the upper left chest. However, short-term severe and sharp pain may periodically appear. When pain occurs, the patient's skin may turn red. His heart rate quickens and his blood pressure rises. The person becomes irritable, restless and anxious.

Other origins of development

Painful spasms in the chest are often the result of diseases of the spinal column and ribs. Herniated intervertebral discs or osteochondrosis can provoke painful sensations in the chest. Osteochondrosis causes the destruction of cartilage and bone tissue in the body. Deformed cartilage and bones in the chest area compress the nerve roots and cause severe pain.

The syndrome is a sign of the development of Parkinson's disease. In this case, the patient may feel painful spasms in the ear and leg.

Pain in the left breast occurs in women before menstruation. The appearance is associated with hormonal fluctuations characteristic of the menstrual cycle. With the appearance of bleeding, the painful spasm disappears.

The syndrome may be one of the signs of acute leukemia. It occurs against the background of general intoxication of the body, accompanied by lethargy, fever, rapid and arrhythmic heartbeat.

The cause of pain is injury. A minor blow may go unnoticed and manifest itself later in the form of aching chest pain. The presence of a hematoma will be indicated by a painful touch to the area that hurts. The consequence of a fall is often a rib fracture. In this case, the injured person may experience increased pain during movement and even during breathing.

Symptoms reminiscent of cardioneurosis are observed during menopause. Pain near the heart appears due to fluctuations in hormones characteristic of the menopause. Along with the pain, the woman experiences fever, blood rushes to her face, she shudders and sweats. She develops “goosebumps” and numbness in some areas of the skin.

If you experience pain in the heart area, you should definitely contact a medical professional. Only a doctor can determine what pain in the left sternum means. A diagnosis can be made and the correct therapy can be prescribed after a thorough examination.

And a little about secrets...

Have you ever suffered from HEART PAIN? Judging by the fact that you are reading this article, victory was not on your side. And of course you are still looking for a good way to get your heart functioning back to normal.

Then read what Elena MALYSHEVA says about this in her interview about natural methods of treating the heart and cleaning blood vessels.

How to distinguish heart pain from others? What examination do you need to undergo? The editors of Vesti talk about all this. Medicine toldNeurologist, Candidate of Medical Sciences, Head of the Yusupov Hospital Sergey Vladimirovich Petrov.

Sergei Vladimirovich Petrov

Pain is a signal from the body that indicates a problem. There are several organs located in the chest and each can be a source of pain. When a person experiences pain in the chest, this may be due to the manifestation of an inflammatory process in the lungs, a disease of the esophagus, but it can also be heart pain.

Typically, any pain leads to a decrease in quality of life, but not all pain is life-threatening. Some types of pain indicate a serious problem in the body. And if you do not respond correctly to this pain, then not only your quality of life may suffer, but you will also suffer enormous harm to your own health, and even death is possible. One of these types of pain is heart pain.

Heart pain (in medicine called angina pectoris or “angina pectoris”) occurs when there is insufficient oxygen supply to the heart muscle. Most often this occurs due to a narrowing of the lumen of the vessel that feeds one or another part of the heart muscle. In most cases, the way the patient describes his pain is sufficient to diagnose angina.

What are the signs of heart pain?

Photo: : Kaspars Grinvalds/Shutterstock.com

Firstly, this localization. Most often this is pain behind the sternum or in the left side of the chest. The pain may radiate to the left arm, between the shoulder blades, or to the lower jaw. Secondly, characteristic. In the classic version, it is a pressing, squeezing, baking or dagger pain.

The next important point is that angina most often has provoking factors– physical or emotional stress. This means that there is no pain at rest, but during physical or emotional stress they appear. With a critical narrowing of the vessel supplying the heart muscle, angina pectoris can occur with minimal exertion at rest and even at night.

When assessing the origin of chest pain, one always takes into account time factor. True heart pain is not long-lasting; minutes count. In other words, the heart cannot “ache, pull, prick” for several hours, days, or day after day. Such pain is often a manifestation of pathology in the musculoskeletal system. However, true heart pain lasting more than 20 minutes indicates the possible development of a serious complication - myocardial infarction.

It is worth paying attention to the circumstances under which the pain goes away. Angina stops on its own within about a few minutes, for example, if the patient stops or calms down. Some patients benefit from nitroglycerin, which reduces or completely relieves angina pain within 1-2 minutes. If a person has developed a myocardial infarction, then the chest pain will not be relieved and will not go away after taking nitroglycerin; in this case, emergency help is needed.

With angina pectoris, a temporary disturbance of blood flow occurs in the coronary artery affected by atherosclerotic plaque. Taking nitroglycerin allows you to expand the lumen of the vessel, improve blood flow and thereby the pain will go away, which leads to pain regression. During a heart attack, the narrowing of the lumen is so pronounced that it leads to irreversible damage to the heart muscle. In this situation, the pain has another cause and taking nitroglycerin will no longer have an effect.

In addition to the classic characteristics, angina pectoris can have so-called atypical forms, including manifestations in the form of shortness of breath or abdominal pain.

Thus, we see that heart pain, on the one hand, in most cases can be easily recognized, but on the other hand, it is not always so easily recognizable. That is why it is important that if you have pain in the chest or feel short of air, you should immediately consult a doctor.

What can a doctor do when a patient comes to him with chest pain?

First of all, the doctor will carefully ask the patient to tell about all the symptoms. If, as a result of the interview, the doctor gets the impression that the pain may be angina, then it is necessary to conduct a diagnosis to confirm the patient’s complaints.

Photo: Image Point Fr/Shutterstock.com

What examinations are needed to confirm or refute the diagnosis?

When it comes to heart disease, an important test is a resting electrocardiogram (ECG). In many diseases, the ECG changes, but in the presence of angina in a patient at rest without pain, the ECG may be completely normal. This means that the ECG data will be within normal limits, and the patient will feel angina. Thus, if you suspect angina pectoris, you cannot limit yourself to just performing a resting ECG.

An important stage of examination in determining the genesis of chest pain is a stress test. The most commonly used combination of exercise (treadmill or bicycle) in combination with ECG recording. Changes in the ECG during exercise and complaints from the patient with a high degree of probability allow us to judge the presence or absence of angina. If there are associated complaints, for example, interruptions in heart function, the doctor may prescribe daily ECG monitoring. It will allow you to record rhythm disturbances, if any. And in some cases, heart rhythm disturbances may indicate a problem in the blood supply to the heart muscle.

In addition, cardiovascular risk factors are assessed: age, sex of the patient, heredity, blood pressure level, the presence of certain diseases, as well as a number of blood parameters, the increase of which is associated with an increased risk of angina pectoris (blood lipids, glucose, creatinine).

There are typical manifestations of heart pain, but the disease can also be atypical. That is why doctors do not recommend self-medication, but rather trust qualified specialists. If you have chest pain that you have not previously experienced, make an appointment and discuss it with your doctor. It is quite possible that already at the initial consultation the doctor will tell you that there is no threat from the heart. But it is quite possible that a more complete examination may be required. It is important to consult a doctor in a timely manner. And the doctor will assess the symptoms, risks, conduct the necessary examinations and, if necessary, develop a treatment plan or a plan of preventive measures together with the patient, so that the patient lives as long as possible and the quality of life is not affected.

Hello dear readers. Pain in the mammary gland on the left is not uncommon in women. It frightens not so much the possibility of developing cancer as the fear of a heart attack.

If such pain has knocked on your door, and you want to know why your breasts are bothering you, is the pain always associated with pathology of the mammary gland, and which specialist should you contact? Then this article is for you.

Today we are reviewing the causes of pain, both related to breast pathology and not related to negative processes in the glandular tissues.

Discomfort associated with changes in the mammary gland

Unilateral pain, as a rule, is acyclic mastodynia. It bothers women more often after 40 years. Although this phenomenon cannot be ruled out at an earlier age. In this case, both the left and the right breast can hurt with equal success.

If the left breast hurts in a nursing mother, or in a woman immediately after cessation of lactation, it may be a blockage of the milk duct. Develops - a rather painful phenomenon that can easily develop into.

If the gland is hard, the skin of the bust is red and feverish, it is probably mastitis. Less commonly, an abscess develops as a result. Inflammation of the mammary gland can be treated conservatively. If an abscess has formed, the pus, unfortunately, will not go anywhere; you will have to open the tissue and cleanse the chest of suppuration.

The causes of non-cyclic mastodynia in older age are often tumors developing in the mammary gland:

1. (papillary, cysts, fibroadenomas and others). The neoplasms themselves are not painful and lead to discomfort when they reach large sizes, squeezing surrounding tissues. If, when you press on the gland, a chocolate secretion comes out of your nipple or you feel dense formations, you should hurry to see a mammologist.
2. Malignant neoplasms. , makes itself felt by pain at a late stage of the pathological process. The pain is accompanied by changes in the shape of the nipple and breast, peeling and hyperemia of the skin.

Injuries to the chest area can have long-term consequences. Internal hematomas may fester. Connective tissue may grow at the site of the injury. This causes discomfort. Traumatization of the delicate tissues of the bust can even serve as an impetus for the development of cancer.

The cause of discomfort may be an anatomical defect of the lobules of glandular tissue, leading to disruption of the patency of the intraglandular ducts, swelling and pain. Another cause of pain may be the sebaceous duct. In the latter case, there is a risk of developing atheroma. Inflammatory processes affecting the apocrine sweat glands under the armpit lead to hidradenitis (bitch udder) and pain in both the armpit and chest area.

If you experience itching and burning in the nipple area, the skin around the areola turns red, and there is slight swelling, you most likely have thrush or another fungal infection. Less commonly, these symptoms may be a sign of an allergy (contact dermatitis).

Before menstruation, one-sided is rare. Usually the glands become engorged, sore and ache under the influence of an increase in the level of hormones in the blood of both mammary glands. If only your left breast hurts, the pain radiates to the armpit, contact a mammologist. Perhaps you are developing cystic fibrosis disease and the process is more active in the left gland. are more often diagnosed in patients aged 30-50 years. But it can develop at the age of 20. The sooner you start treatment, the better.

If before your period your left one usually becomes a little tighter and seems to be increasing in size, but now you notice a delay, feel aching in the lower back, weakness in the legs and nagging pain in the lower abdomen, run to the gynecologist, perhaps:

• you are pregnant and have implantation pain;
• your pregnancy is in danger of failure;
• the embryo is fixed in the tube.

Gynecological ailments can cause mastalgia. Moreover, the pain can be not just noticeable, but irritating. But more often than not, in this case, both glands hurt.

Discomfort not associated with breast pathology

If you are over 50 years old and the peak of hormonal disturbances is behind you, and you feel pain on the left side of your chest, why is this?

You are in the prime of your life, you have no problems with the glandular tissue of your breasts, your gynecology is normal, but under your left breast there is a painful “pin” persistently sticking out, what could it be?

After 50 years, there are many reasons for pain behind the sternum and in the mammary glands:

• osteochodrosis and cervical-brachial syndrome;
• myositis of the pectoral muscles, their stretching or microtears;
• pathologies of the heart and blood vessels (heart attack, thromboembolism, aortic aneurysm, angina pectoris);
• diseases of internal organs (pancreas, liver, gastrointestinal tract, spleen);
• hidradenitis;
• diseases of the respiratory system (pneumonia, pleurisy, tuberculosis);
• neuroses, dystonia.

All these reasons are not obligatory for the period of menopause and the postmenopausal stage of a woman’s life. They can also appear at a young age.

If you are easily excitable, it is easy to make you cry or be upset; dull, aching pain from the heart is a sign of dystonia or neurosis. Pain in the area of ​​the left breast is often a companion to depression.

If there is an acute, sharp pain radiating to the left arm and shoulder blade, especially if it intensifies during inhalation, this is one of the leading signs of a heart attack. At the same time, you may experience difficulties with fine motor skills of your fingers (it is difficult to hold a pen, you drop cups and plates that literally “jump out” of your hands).

Severe chest pain on the left with cardialgia caused by rheumatic carditis, NCD, angina pectoris, hypertension. In this case, the pain is often localized over the left gland, and there is a feeling of lack of air and fear.

Aortic rupture is accompanied by unbearable pain paroxysm, high heart rate, aortic pulsation and even low-grade fever. Probably, what to do in this case doesn’t even need to be said. Calling an emergency team would be the best solution.

If the skin of your hand tingles, you feel pain in your left arm and the mammary gland area, this arm does not function normally - these are signs of damage to the nerve endings in the cervicothoracic area of ​​the spinal column due to osteochondrosis.

Tingling on the left side of the chest in the area of ​​the gland and with cervical-brachial syndrome, if the nerves and vessels in the area of ​​the left brachial plexus are affected. At the same time, the left arm becomes noticeably numb, and blood pressure when measured on this side is reduced. The reasons for this unpleasant phenomenon:

• carrying heavy weights on the shoulders;
• work with arms raised up.

Aching pain on the left side in the bust area may indicate chronic inflammation of the pancreas or unpleasant processes in the digestive system as a whole. It is usually accompanied by nausea, impaired appetite and digestion, stool upset and even vomiting. The same symptoms can occur with severe anemia. At the same time, weakness “piles up” such that the pillowcase seems like a heavy object.

Pain appears on the side or under the gland due to pancreatitis, gastrointestinal ulcer. With the development of esophagitis, in addition to nausea and heartburn, you may be bothered by burning pain in the chest, which must be differentiated from cardiac pain.

The causes of pain in the area of ​​the left mammary gland do not end there. Pleurisy and tracheobronchitis are very painful, because the pleura is rich in nerve receptors. The pain usually occurs in the upper chest and is accompanied by a painful cough.

If you have pain on the left side of your chest, usually above or below the mammary gland. When pressing, the pain intensifies; most likely, you have a “cold” or stretched pectoral muscle.

Even infectious diseases can cause severe pain in the left side of the chest, which is poorly eliminated by analgesics, even serious ones. For example, herpes zoster (herpesvirus) may appear as patches on the upper chest, to the left of the chest, and below the mid-nipple line.

Having considered why the left breast may hurt, let’s say a few words about treatment. You can see for yourself how many serious and not so serious pathologies can cause discomfort. Therefore, the sooner you see a doctor, the better. If you don’t know which specialist to go to, start with a therapist and mammologist.

This concludes our review and says goodbye to you. Share information that is interesting to you with your friends and visit our website as often as possible.