Chest pain. Causes of pain in the chest area: which doctor to consult

Chest pain

(chest pain) is a common symptom. In many cases, chest pain can be caused by heart disease, and this makes it especially serious. However, the list of causes of chest pain is much wider. This area contains the heart, lungs, esophagus, large vessels, bones and muscles - and any of these organs can be a source of pain. Chest pain can also be caused by the diaphragm and abdominal organs, primarily the stomach. Finally, pain can be caused by problems in other organs, and its localization in the chest is explained by the complex arrangement of nerves and muscles.

Possible nature of chest pain - what you should pay attention to

Chest pain can be aching, stabbing, shooting, squeezing, burning. In some cases it can be acute, intense, even intolerable.

It is important where exactly the pain is localized. Usually the pain can be quite clearly localized as follows:

in one half of the chest - right or left. Sometimes the localization of pain can be more specific, for example, in the ribs;
behind the sternum. Pain behind the sternum, especially when it hurts both behind the sternum and to the left of it, is characteristic of heart disease;
just below the sternum (in the epigastric region). Such pain is typical for diseases of the digestive tract (stomach or esophagus).

Chest pain without a clear localization may indicate lung cancer or tuberculosis.

Chest pain may be accompanied by symptoms such as:

shortness of breath, difficulty breathing;
cough, increased body temperature;
weakness, cold sweat;
belching, heartburn, nausea, vomiting;
changes in blood pressure.

The distribution of pain is also important for diagnosis. The pain may radiate to the arm. This type of pain is observed with myocardial infarction and osteochondrosis.

What can hurt your chest?

Diagnosis of air shortage

The initial stages of diagnosis are usually carried out by a therapist. He carries out an examination and collects anamnesis, after which, after analyzing the data obtained, he sends the patient to specialized specialists. To clarify the diagnosis, the latter prescribe the following studies:

Chest X-ray to detect diseases and injuries;
Electrocardiography - aimed at identifying heart disease;
Spirometry - examines the functions of external respiration;
Laryngoscopy - detects foreign bodies and diseases of the larynx.

Causes

Chest pain due to heart disease

Chest pain is a characteristic symptom of heart disease. It is observed, in particular, when:

coronary heart disease (caused by insufficient oxygen supply to the heart muscle). The most common form of coronary artery disease is angina pectoris, which manifests itself in the form of discomfort, a feeling of heaviness or compressive pain behind the sternum and to the left of it. An attack of pain is usually provoked by physical activity or emotional stress. The duration of the attack usually ranges from several minutes to half an hour. Relief occurs after taking nitroglycerin. The pain may be accompanied by shortness of breath, radiating to the left arm, under the shoulder blade, and the left half of the lower jaw;
acute myocardial infarction. Myocardial infarction is also a form of coronary heart disease that requires immediate medical attention. The pain during myocardial infarction is very intense and has a compressive, pressing or bursting character. It is observed behind the sternum and to the left of it, and can radiate to the left arm, under the shoulder blade, to the left side of the neck and lower jaw. The pain is accompanied by shortness of breath, fear of death, weakness, and cold sweat may appear. The pain lasts more than 15-30 minutes (i.e. longer than during an attack of angina) and is not relieved by nitroglycerin. If you suspect a myocardial infarction, you should immediately call an ambulance;
pericarditis (inflammation of the outer lining of the heart - the pericardium). In this case, the pain may be constant or intermittent. It is usually localized behind the sternum. The pain increases when lying down, and decreases if you lean forward;
myocarditis (inflammation of the heart muscle). Myocarditis occurs most often as a complication of an infectious disease. With myocarditis, chest pain is combined with fever and shortness of breath;
mitral valve prolapse. In most cases, this disease is asymptomatic, but sometimes there is pain in the left side of the chest, which may be accompanied by a feeling of shortness of breath, a feeling of rapid or slow heartbeat, dizziness and fainting.

Chest pain due to respiratory diseases

Chest pain can occur with diseases such as:

pleurisy (inflammation of the membrane of the lung - pleura). In case of pleurisy, the pain is usually acute and one-sided. Intensifies with deep breaths, laughter, and movement. The pain intensifies when bending to the healthy side. The pain decreases if you lie on the side where it hurts. Chest pain is combined with other symptoms - fever, chills, weakness, cough;
pneumonia (pneumonia). Chest pain with pneumonia is a concomitant symptom that occurs against a background of cough and fever. The pain is usually one-sided - corresponds to the side on which inflammation develops. The nature of the pain is sharp or aching;
bronchitis;
tracheitis;
pulmonary tuberculosis;
lungs' cancer.

Chest pain due to diseases of the digestive tract

Pain in the chest area can be caused by diseases such as:

stomach ulcer. With a stomach ulcer, the pain is usually described as “burning.” It is localized in the epigastric region and can radiate to the left half of the chest. Occurs after eating;
gastroesophageal reflux disease (reflux of stomach contents back into the esophagus). Acidic or alkaline contents irritate the lining of the esophagus, causing bloating and severe pain in the epigastric region and the left side of the chest. An attack can be triggered by eating too much at night, strong coffee, or alcohol abuse. In addition to chest pain, heartburn and belching may occur;
hiatal hernia. In most cases, the disease is asymptomatic. In some cases, aching or burning pain behind the sternum and in the epigastric region may be observed. Pain usually occurs after eating in a horizontal position. May be accompanied by hiccups, heartburn, belching, and sometimes vomiting (in obese women).

Other Possible Causes of Chest Pain

Chest pain can also be caused by:

osteochondrosis of the cervical and thoracic spine. Pain with osteochondrosis can be similar to an angina attack and can radiate to the shoulder blade, arm, or shoulder. Sometimes there is numbness in the hand. Another option for pain with osteochondrosis is lumbago. It is provoked by turns of the body, movement of the arms, prolonged exposure to a lying position (during night sleep);
intercostal neuralgia. In this case, the pain is usually limited to one intercostal space. The nature of the pain is “shooting”;
shingles. The disease is caused by one of the varieties of the herpes virus. The pain is intense, burning. After 7-10 days, blistering rashes appear along the affected nerves;
vegetative-vascular dystonia.

Prevention and recommendations for shortness of breath

Physiological shortness of breath goes away on its own after the person has rested. However, if the problem arose acutely and suddenly, the following measures should be taken to alleviate his condition:

Calm down and sit on a sofa or chair, comfortably resting your back;
Remove or unfasten tight clothing, a belt that is too tight;
Provide fresh air by opening a window or door;
Humidify the air by hanging a pre-wetted sheet near the patient;
Offer a herbal sedative.

If a person knows about his illness and he has drugs that alleviate his condition, he should be offered to drink them. If he does not feel better within fifteen minutes, he will have to call an ambulance.

There is no specific prevention in this case. However, you can minimize the risk of developing this condition by following these rules:

Maintaining an active, healthy lifestyle;
Avoiding excessive physical activity and stress;
Body weight control;
Timely treatment of diseases;
Systematic completion of preventive studies.

Remember: lack of air can be a sign of serious pathological conditions. That is why CELT specialists recommend promptly finding out its causes and taking appropriate measures!

Make an appointment through the application or by calling +7 +7 We work every day:

Monday—Friday: 8.00—20.00
Saturday: 8.00–18.00
Sunday is a day off

The nearest metro and MCC stations to the clinic:

Highway of Enthusiasts or Perovo
Partisan
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Driving directions

Which doctor should I contact for chest pain?

If you have chest pain, you should first consult your general practitioner.

If you have chest pain, you should first consult a general practitioner - family doctor or therapist. It is he (and not the patient himself) who should draw up the examination plan. Your GP can refer you to:

to a cardiologist - if there is reason to believe that the pain is caused by heart disease (localized behind the sternum and to the left of it, relieved with nitroglycerin, accompanied by shortness of breath, etc.);
see a pulmonologist if you suspect pneumonia or pleurisy (if pain is accompanied by cough and fever);
to a gastroenterologist - if you suspect diseases of the esophagus and stomach (if the pain is accompanied by belching, heartburn, or occurs after eating);
see a neurologist in case of “shooting” pain.

When is emergency medical attention required?

If the pain in the middle of the sternum radiates to the back, slightly to the right, and at the same time it becomes difficult to take a breath, then you need to call a doctor. This is especially true if the pain is severe and the person has an attack of suffocation.

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If the patient is able to sit down, then you need to sit him on a chair and ask him to tilt his head forward. If it is difficult to sit, you should lay it horizontally and raise your legs, placing, for example, books under them. The patient must remove any jewelry or ties that put pressure on the skin, and, regardless of the time of year, open the windows, while avoiding drafts.

Of the medications, you can give only 1 tablet of Nitroglycerin, placing it under the tongue. If it doesn’t get easier, after 5 you can offer another tablet. Other medications may only be given if they are prescribed by a medical professional.

Pressing pain in the middle of the sternum can be a sign of serious diseases, such as pulmonary and cardiac diseases, that threaten a person’s life. Therefore, if discomfort occurs, you must immediately go to a medical facility, and in some cases, call emergency help.

What tests may be needed for chest pain?

If you complain of chest pain, the following may be prescribed to diagnose the disease:

chest x-ray;
computed tomography (MSCT chest);
ECG;
Holter monitoring (24-hour ECG monitoring);

stress tests (treadmill test);

general blood test (allows you to determine the presence of inflammation);
gastroscopy (if diseases of the esophagus or stomach are suspected).

Treatment of the disease

Only doctors, based on diagnostics and a comprehensive examination of the body, can make the correct conclusion - chest neurosis. Treatment methods differ depending on the course of the disease. They mean relieving pain and spasms, strengthening the nervous system, and improving blood circulation. There are several ways to treat intercostal neurosis:

Blockade. It does not eliminate the main cause of neurosis, but this method allows you to relieve pain for several days. A blockade is done when non-steroidal anti-inflammatory drugs do not help.
Injections. They are used only in extreme cases. For example, for radiculopathy, spinal pathologies and myelopathy, steroid injections are prescribed.
Physiotherapy. It also relieves pain symptoms due to chest neurosis. This category includes electrophoresis, UHF and other thermal procedures. Doctors prescribe such treatment methods for incarceration, arthropathy and spondyloarthrosis.
Training. To prevent and treat the disease, doctors recommend physical exercise. Among them are hyperextension, which serves to strengthen the back muscles, and stretching to relieve tension.
Massage. This method helps relax muscles and also helps relieve pain. Massage is prescribed for the initial stage of intercostal neurosis, osteochondrosis, displacement of the vertebrae and spinal discs, as a preventive measure or as a method of treatment in combination with medications.
Taking medications. B vitamins and ascorbic acid nourish nerve fibers with useful elements and strengthen the immune and nervous systems.

At the first sensation of pain, it is recommended to go to the doctor. This will allow you to prescribe timely treatment and eliminate the disease at the initial stage. Contacting a specialist will help you completely get rid of the disease. Save your health with I.G. Gernet is a psychotherapist with 20 years of experience!

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