Pain in the heart area - types of problems that have this symptom

Intercostal neuralgia

Intercostal neuralgia is a pain syndrome: the sensation of pain occurs along one of the intercostal nerves. Acute, “shooting” pain in itself is a rather unpleasant factor, but in the case of intercostal neuralgia it is especially frightening. We usually interpret acute pain in the chest area as cardiac pain. If the nerve running between the lower ribs or the subcostal nerve (running under the lower rib) is affected, we may mistakenly believe that the source of pain is in the abdominal cavity.

Causes of heart pain

Acute aching pain in the heart area occurs in a person regardless of age, conditions and circumstances. However, not every one of them may indicate heart problems. Depending on the mechanism of formation, all chest pains can be divided into cardiac and non-cardiac etiologies.

Stitching pain in the heart area can occur for various reasons, with diseases of other organs with irradiation of the pain syndrome into the chest.

Diseases of the neuromuscular system:
Pain in the cervical spine;
Myalgia;
Intercostal neuralgia.
Pathologies of large vessels:
Pulmonary embolism.
For pathology of the digestive system:
Pancreas;
Esophagus;
Gallbladder.
Diseases of the respiratory system:
Pneumothorax;
Pneumonia;
Pleurisy;
Tuberculosis.
Nervous system diseases:
Panic attacks.
Diseases of viral etiology:

If, with pain in the heart area, there is pressure and radiates to the left hand and little finger, this may result in angina pectoris. Acute pain syndrome develops with myocardial infarction, dull pain characterizes chronic ischemic heart disease.

Causes of intercostal neuralgia

All causes of intercostal neuralgia can be reduced either to a pinched nerve root (the nerve is compressed at the point of exit from the spinal canal) or to irritation or compression of a nerve already in the intercostal space.

Intercostal nerve radicular syndrome is usually caused by one of the following:

osteochondrosis of the thoracic spine;
intervertebral hernia;
tumor processes;
other diseases of the spine.

Much more often, intercostal neuralgia occurs as a result of factors affecting the nerve in the intercostal space. The main reasons here are:

chest injuries;
herpes infection (herpes zoster);
muscular-tonic syndrome due to excessive physical activity or working in an awkward position;
hypothermia;
for women - wearing tight underwear (bra). First of all, those who have a poorly developed subcutaneous fat layer should be careful;
compression of the nerve by a growing tumor (pleura, chest wall) or an aneurysm of the descending thoracic aorta;
factors affecting the entire nervous system (poisoning, hypovitaminosis).

Factors that increase the risk of intercostal neuralgia are:

diabetes;
problems with immunity;
age-related changes in blood vessels;
alcoholism;
hormonal disorders;
stress, depressed mental state;
long-term use of potent medications.

What are the symptoms of pain in different diseases?

Often, pain in the heart area when inhaling is attributed to purely heart diseases, without even suspecting that the real reason lies in something completely different.
How the pain syndrome manifests itself depends on the causes and level of progression of the disease. For example, with heartburn, a burning sensation also occurs in the sternum area. They occur when gastric juice enters the esophagus. Heartburn is also characterized by the appearance of belching and an unpleasant sour taste. These symptoms appear after eating, when bending the body, or in a lying position. In this case, antacid medications are prescribed for relief. When heartburn occurs and pain radiates to the heart area, the cause does not always lie in the esophagus.

These may be symptoms of gastroesophageal reflux disease (GERD), which is also characterized by heartburn;
Spasm of the esophagus with disruption of muscle function, which leads to problems with swallowing and moving food in the stomach;
With achalasia, this pathology manifests itself in disruption of the valve between the stomach and esophagus, with food retention and the appearance of pain in the chest.

Depending on the nature of the pain in the heart area, inflammatory diseases can be diagnosed:

Gall bladder with the development of cholecystitis;
Pancreas and acute manifestations of pancreatitis;
Gallstone disease (GSD).

Painful symptoms in these diseases can radiate into the chest cavity and resemble heart pain.

Pulmonary diseases can also be accompanied by sharp and dull pain in the chest. These signs can occur with pneumonia, pleurisy , with characteristic inflammation of the lungs and tissues that line the chest cavity, respectively. These diseases are characterized by increased pain when inhaling, the appearance of a cough, and an increase in temperature to critical values. Also, diseases can accompany each other and after pneumonia complications arise, which manifest themselves in the form of pleurisy.

Pain or heaviness in the right hypochondrium

Hepatitis

Jaundice

Vomit

33489 05 April

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Pain or heaviness in the right hypochondrium: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.

Definition

The right hypochondrium is one of nine areas into which the anterior abdominal wall is conventionally divided. This area belongs to the so-called “upper floor” of the abdominal cavity.

In the right hypochondrium there are the liver, gallbladder, hepatic angle of the colon, and swollen loops of the small intestine can also be projected into this area. The organs listed above belong to the digestive system.

The liver is a parenchymal (spongy) organ with a very good blood supply. The outside of the liver is covered with a capsule in which nerve endings are located. The liver is involved in the metabolism of proteins, fats, carbohydrates, vitamins, and plays a vital role in detoxification of the body.

Harmful substances that enter the liver are subjected to “chemical” processing, which makes them less toxic to the body and promotes faster elimination through the gastrointestinal tract and urine.

In addition, liver cells produce bile necessary for digesting food, primarily fats. Bile enters the gallbladder, located on the lower surface of the liver, where bile accumulates, which is released from it into the duodenum during the next meal.

From above, the liver is adjacent to the diaphragm - a kind of muscular partition between the abdominal and thoracic cavities. From below, from the side of the abdominal cavity, the diaphragm is lined with peritoneum (which covers the entire abdominal cavity and organs located in it from the inside), and from above, from the side of the lungs, by the pleura, which lines the pleural cavity from the inside and covers the lungs from the outside. Both the pleura and peritoneum have good innervation, which is important to know to understand the causes of pain and heaviness in the right hypochondrium. The peritoneum also covers the gallbladder and intestinal loops.

Types of pain or heaviness in the right hypochondrium

The pain in the right hypochondrium can be acute, sometimes “dagger-like”, which makes you think about a serious illness. This pain is characteristic of hepatic colic and is often accompanied by nausea, vomiting, increased sweating, increased heart rate and a drop in blood pressure.

In chronic diseases and the gradual development of acute diseases, the pain is often dull, bursting in nature, or is described by the patient as “heaviness, discomfort” in the area of the right hypochondrium.

Pain syndrome can be spontaneous, or it can be provoked by food intake, alcohol, physical activity, change in body position, etc.

Possible causes of pain or heaviness in the right hypochondrium

There is only one mechanism for the development of pain: stimulation of pain receptors. As mentioned above, the peritoneum has good innervation. Also, a large number of nerve endings are localized in the wall of hollow organs (intestines, gall bladder). Therefore, inflammatory processes in these organs naturally manifest themselves as pain.

Pain also occurs when the liver capsule is stretched. This can occur due to an increase in the volume of the organ (which in most cases is associated with tissue swelling), due to the accumulation of any fluid (most often blood) under the capsule (with a traumatic rupture of the liver), or damage to the capsule.

Unpleasant sensations in the area of the right hypochondrium are caused by excessive distension of the intestinal loops by intestinal contents or gases. In addition, since the organs of the chest are located close to the right hypochondrium, in case of development of pleurisy (inflammation of the pleura), the pain syndrome can also be localized in the right hypochondrium and imitate diseases of the abdominal organs.

Diseases that cause pain or heaviness in the right hypochondrium

Among acute diseases accompanied by pain in the right hypochondrium, it is worth mentioning first of all those that require emergency surgical intervention.

These include
acute calculous cholecystitis
and
renal colic
.
Both conditions are a consequence of cholelithiasis
. Inflammation of the gallbladder (cholecystitis) develops against the background of an already advanced process of stone formation or, conversely, is the cause of the formation of stones. With renal colic, a calculus (stone) becomes wedged into narrow segments of the biliary tract, which is accompanied by severe pain, impaired bile outflow, and in more severe cases – jaundice (yellowing of the sclera and skin).

Other diseases of the biliary tract, such as
biliary dyskinesia
,
chronic cholecystitis
, cause recurrent pain in the right hypochondrium, usually associated with an error in diet.

Another disease classified as an “acute abdomen” that can cause pain in the right hypochondrium is appendicitis.

(inflammation of the appendix).

Despite the fact that the classic position of the appendix corresponds to the right iliac region, an abnormal position of the appendix in the right hypochondrium is quite common, especially in children.

Overdistension of intestinal loops can develop as part of
intestinal obstruction
.

Swelling of the liver tissue is characteristic of hepatitis (inflammation of the liver parenchyma). Hepatitis can have a variety of origins: viral hepatitis A, B, C, etc., autoimmune, toxic, incl. alcoholic. These diseases are usually accompanied by pain, as well as weakness, nausea and vomiting, yellowing of the skin and sclera, change in the color of urine and feces.

Subcapsular hematomas of the liver (accumulation of blood between the liver tissue and its capsule), as well as ruptures of the liver capsule, are usually traumatic in nature.

Among the diseases of the chest that can cause pain in the right hypochondrium, it is worth mentioning pleuropneumonia (inflammation of the lung tissue and pleura), heart failure, intercostal neuralgia and herpes zoster. The latter is characterized by the appearance of blistering-type skin rashes, which are preceded by severe pain.

Which doctors should you contact if you experience pain or heaviness in the right hypochondrium?

If sudden, progressively increasing pain appears in the area of the right hypochondrium, you should contact a doctor to exclude acute surgical pathology. If the pain is not acute, the examination can begin at or. If necessary, the patient can get advice from a hepatologist (a specialist in liver diseases) and other specialized specialists.

Diagnostics and examinations for pain or heaviness in the right hypochondrium

After a detailed survey and comprehensive clinical examination, the doctor, as a rule, needs laboratory and instrumental confirmation of the diagnosis. For this purpose, the following studies are used:

A clinical blood test with determination of the leukocyte formula, based on the results of which one can suspect the presence of an inflammatory process in the body and determine its severity.

How to help with acute pain in the heart?

It is no coincidence that when pain appears in the heart area, they do not know what to do until the doctor arrives. Call the hotline number +7 (863) 226-18-17 , which is best entered into the phone’s memory in advance. Experienced private medical doctors help in emergency situations and transport the patient to the hospital. Emergency medical care is provided in clinics, hospitals and at home.

Before the doctor arrives, you should stop moving and take a lying position, and be sure to call a specialized ambulance. If your heart hurts, self-medication can end sadly and lead to death.

In case of high or low blood pressure, take the tablet as indicated. The patient is prescribed sedative drops , Corvalol, motherwort, valerian, and nitroglycerin. If the pain has passed, there is no need for nitroglycerin; it is also contraindicated for low blood pressure. You can put validol under your tongue. Treatment of cardiac pathologies is prescribed by a doctor according to indications.

What diseases cause pain in the heart?

Acute pain syndrome can also appear with pulmonary diseases such as bronchial asthma and pneumothorax. Asthma attacks cause pain throughout the chest cavity. An equally severe form and painful condition is characterized by pneumothorax , in which air penetrates from the outside into the chest cavity and the lungs can collapse with the appearance of pain.

Among the main causes of painful attacks in the sternum area is also pathology of the peripulmonary vessels. They intensify when inhaling with the formation of a cough with pulmonary embolism , pulmonary hypertension with increased pressure in the vascular system supplying blood to the lungs.

Painful vascular diseases include dissecting aortic aneurysm with characteristic damage to large vessels. This emergency condition can be life-threatening. In this case, the pain is initially felt in the heart area and gradually moves down the abdomen. The patient's blood pressure drops sharply, tachycardia occurs and he loses consciousness.

A classic example of the appearance of pain in the chest area is osteochondrosis , which occurs in the thoracic and cervical spine. The pain is reminiscent of angina attacks with radiation to the left shoulder blade and arm. The difference lies in the intensification when moving, raising arms, turning the head, bending the body.

Sharp stabbing pain is characteristic of intercostal neuralgia, Tietze syndrome . It occurs at the joints and spaces between the ribs and becomes more intense when inhaling. The patient cannot take a deep breath, shallow breathing is observed. In case of pathology, strong anti-inflammatory and painkillers are prescribed.

An extremely painful condition in the heart area is characterized by inflammation of the muscle fibers of the chest and back . It resembles similar acute pain in intercostal neuralgia and osteochondrosis.

Shingles , which occurs as a result of infection of the body with the herpes virus, is no less painful In this case, the nerve endings are affected, characteristic rashes appear on the skin, which becomes sensitive, and this whole clinical picture is accompanied by acute pain in the chest.

Painful attacks can occur during panic attacks, nervous disorders of various etiologies. This category of patients is often young, with an unstable nervous system, and in a depressed state after stress. In this case, pain can appear spontaneously or be systematic.

Treatment methods for intercostal neuralgia

Treatment of intercostal neuralgia is complex. The doctor solves several problems simultaneously.

It is necessary to reduce the severity of the pain, and preferably completely eliminate the pain syndrome. For this purpose, anti-inflammatory therapy is prescribed.

It is important to eliminate the cause of the nerve damage. If the disease is viral in nature, antiviral therapy is carried out. For muscular-tonic syndrome, muscle relaxants are prescribed. If a nerve is pinched at the point where it exits the spinal canal, manual therapy may be prescribed. For tumor processes, surgical treatment is necessary.

Treatment is also carried out to strengthen the nerve tissue.

Treatment during periods of acute pain

During periods of acute pain, bed rest should be observed for at least several days. The bed should be flat and firm. “Dry heat” helps a lot. For example, you can wrap a woolen scarf around your chest. Warm compresses, pepper plaster, and mustard plasters are used (it is necessary to avoid placing mustard plasters directly on the spinal column). Massage with anti-inflammatory and warming ointments is recommended. Sedatives and non-steroidal analgesics are used as prescribed by the doctor.

During this period, it is necessary to avoid physical activity and stress. You can't drink alcohol.

Subsequent treatment

Further treatment includes:

physiotherapy (methods such as UV therapy, UHF, electrophoresis, darsonvalization, magnetic therapy are used);
massage;
reflexology;
physical therapy.

Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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How to understand that your heart hurts?

Pressing sharp pain in the heart occurs with angina pectoris or “angina pectoris,” which is the main precursor to the development of coronary heart disease (CHD). It radiates to the shoulder, left hand and little finger, and can radiate to the jaw. The intensity increases with nervous tension and physical activity. It occurs as a result of coronary vascular spasm and insufficient oxygen supply to the heart muscle due to atherosclerosis. The pain may go away on its own with rest and rest.

Among the most dangerous heart diseases associated with the cardiovascular system of the body is myocardial infarction . It occurs as a result of blockage (thrombosis) of a coronary artery by an atherosclerotic plaque and cessation of blood supply to an area of the heart muscle. In this case, necrosis occurs and part of the muscle dies.

Pain during myocardial infarction causes severe weakness, lack of air, radiates to the left arm, encircles the shoulder and spreads under the left shoulder blade, sometimes to the neck, jaw, and can form far from the heart area. Sometimes the temperature rises. The person breaks into a cold sweat, shortness of breath, and in some cases nausea.

Chest pain occurs in the case of cardiac pathologies of inflammatory etiology, these include endocarditis , myocarditis , pericarditis. They appear after illnesses caused by viral and bacterial infections.

How is differential diagnosis carried out?

If chest pain occurs, you should immediately call an emergency doctor. Before the specialist arrives, if possible, relieve emotional and physical stress, calm down, lie down and understand the nature of the pain in order to properly notify the doctors.

The doctor's examination includes consultations with specialized specialists, instrumental studies, and an electrocardiogram. It shows how the heart works, detecting signs of a heart attack depending on the stage and location.

Medical care and consultations can be prescribed by various specialists, a neurologist, cardiac surgeon, infectious disease specialist, pulmonologist, surgeon, gastroenterologist, psychiatrist. In case of nervous experiences, you may need the help of a psychologist.

Prevention methods

Most diseases that cause pain in the head and heart can be prevented. To do this, it is enough to follow a set of simple rules recommended by cardiologists around the world:

give up bad habits - smoking and drinking alcohol are dangerous for the heart and have a detrimental effect on the condition of blood vessels;
eat right, avoid excess fat, salt and sugar in the diet;
lead an active lifestyle - moderate physical activity improves the condition of the myocardium and strengthens the vascular walls.

The Clinical Brain Institute specializes in the diagnosis and treatment of diseases that cause pain and discomfort in the head and heart. Our center has all the conditions for conducting examinations of various levels of complexity, as well as for treatment and rehabilitation. Specialist and generalist doctors are specialists with many years of experience. However, it is important to seek medical help promptly, since the effectiveness of treatment decreases as the disease worsens.

Instrumental studies

In addition to an electrocardiogram (ECG), in case of cardiac pathology, various instrumental diagnostic studies .

Ultrasound of the abdominal cavity;
FEGDS examination of the digestive organs;
Ultrasound of the heart, pulmonary vessels and aorta;
FVD, examination of external respiration functions;
Chest X-ray;
CT, computed tomography;
MRI, magnetic resonance imaging;
EchoCG, echocardiography and others.

Methods for diagnosing intercostal neuralgia

If you suspect intercostal neuralgia, you should consult a neurologist.

In most cases, the diagnosis is established based on the patient’s complaints, medical history and examination of the patient directly at the appointment. The doctor pays attention to the patient’s posture: in an effort to reduce pain by reducing pressure on the affected nerve, the patient tilts the body in the opposite direction. The intercostal spaces are palpated in the area where the pain is located. Loss of sensitivity and blanching of the skin is established.

Sometimes instrumental and laboratory diagnostics may be required:

ECG

An ECG is performed in case of pain on the left side. The goal is to rule out heart problems. In combination with an ECG, echocardiography (ultrasound of the heart) may be prescribed. More information about the diagnostic method

Chest X-ray

A chest x-ray is performed to exclude diseases of the lungs and pleura.

More information about the diagnostic method

Ultrasound of the abdominal organs

A survey ultrasound examination can exclude diseases of the abdominal organs.

More information about the diagnostic method

Neuromyography

Electroneurography is prescribed, as a rule, if the traumatic nature of intercostal neuralgia is suspected.

X-ray of the spine

X-ray of the thoracic spine allows us to determine the causes of radicular syndrome. A CT scan or MRI may also be ordered to evaluate the condition of the spine.

More information about the diagnostic method

Blood test for antibodies to the herpes virus

It is carried out if there is a suspicion of a viral origin of intercostal neuralgia.

Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.

What signs confirm heart pain?

Critical conditions are caused by cardiac pathologies, which can be determined using simple manipulations. It is necessary to understand whether the pain intensifies when inhaling, when raising your arms, bending your torso, or whether you can take a deep breath. An increase in pain may indicate the presence of intercostal neuralgia or osteochondrosis.

The pain may intensify with physical exertion and decrease at rest when angina pectoris , with insufficient blood supply to the heart muscle in an active state.

Cardiac pathologies are often accompanied by sharp pressing pain, difficulty breathing, stress, discomfort in the chest, cold sweat, irradiation to the left shoulder, arm and under the left shoulder blade.

An emergency call to a private medical ambulance allows you to help in emergency situations, do an ECG, a rapid blood test for the protein troponin to determine myocardial infarction, and transport the patient to the hospital.

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Symptoms of intercostal neurosis

Only a doctor can make a correct diagnosis after a complete examination of the body. However, characteristic symptoms that will help you recognize intercostal neurosis yourself are:

voluntary twitching muscles;
pain between the ribs, in the area of the shoulder blades and lower back;
discomfort when coughing, sneezing and sudden movements. The pain may be sharp, dull or aching;
numbness at the site of damage to nerve fibers;
During palpation of the ribs, sternum and lumbar region, pain may intensify.

Neurosis of the ribs is similar in symptoms to diseases of the heart, stomach and lungs. But the main distinguishing symptom of this disease is constant aching pain, which can intensify with sudden movements, palpation, sneezing or coughing. No painkiller can relieve these painful sensations.