Chest pain - causes, symptoms and diagnosis, indications for seeing a doctor

Almost everyone perceives chest pain as a potential heart problem. However, there can be many reasons for discomfort. In any case, it is impossible to determine on your own what causes the discomfort. Only a qualified doctor can determine the cause.

Incorrect diagnosis, lack of treatment, and uncontrolled attempts to relieve pain at the site of discomfort often lead to the development of severe pathologies.

To make sure that pain is not a sign of serious illness or to select treatment for identified pathology, it is better to visit a doctor. The causes of pain can be caused by diseases of the heart, lungs, gastrointestinal tract and neurological problems. If you don’t know which doctor to make an appointment with first, come to the Kutuzov Diagnostic and Treatment Center. We have all the specialists who can help you make an accurate diagnosis. Start by making an appointment with your GP and follow their instructions.

Such different chest pains

Thoracalgia is a term for chest pain (from the words “thorax” - chest and “algia” - pain).

It can hurt either on one side of the chest or in the middle, in the upper or lower part. The nature of the pain is:

Sharp and burning.
Dull and aching.
Stabbing.
Compressive.

Among the main reasons for the appearance of a disturbing symptom in the chest are diseases, injuries and pathologies:

Heart and blood vessels.
Lungs.
Musculoskeletal system - muscles, ribs and spine.
Nervous system
Gastrointestinal tract.

Let's look at them in more detail.

Hernia of the thoracic spine

Intervertebral herniation of the thoracic spine (thoracic) is a disease in which parts of the intervertebral discs fall out into the spinal cord. The cause of this disease is:

scoliosis;
osteochondrosis;
other vertebral pathologies leading to metabolic disorders in the tissues of the intervertebral disc, which leads to their thinning.

As a consequence, at first there is a protrusion of the fibrous ring, and as the disease progresses, a crack appears, from which the nucleus pulposus stands out. Compression of the nerve endings also occurs, which causes severe back pain.

In the absence of therapy, the pain syndrome increases and becomes permanent. The danger of a hernia is that it can easily be confused with other diseases, including heart pathologies. In addition, at an early stage the disease is asymptomatic, which complicates diagnosis.

With a hernia of the thoracic region, pain is observed that resembles a heart attack. Occasionally, intercostal neuralgia develops as a complication.

Heart problems

Pain in the chest in the middle or on the left side occurs with various heart diseases:

IHD, angina pectoris - a violation of blood flow in the heart arteries. Often an attack of sharp pain lasts up to 15 minutes. Occurs during physical activity, stress, anxiety, and goes away after rest.
Myocardial infarction is the death of cells and the formation of scars on the heart muscle. It is characterized by severe pain in the chest on the left and in the middle, which does not go away after 15-20 minutes. Additional symptoms include weakness and fear of death.
Pericarditis or myocarditis is an inflammatory process in the muscle or lining of the heart. They are characterized by acute or aching pain in the chest when inhaling in the middle of the chest, which intensifies while eating or lying down.
Mitral valve prolapse - in addition to chest pain, it causes shortness of breath, dizziness, even fainting.
Pulmonary hypertension is increased pressure in the pulmonary arteries, an attack similar to a heart attack.

A characteristic feature of heart pain is that it often occurs against a background of emotional or physical stress and is accompanied by a feeling of panic and fear of death.

Heart reasons

If a person’s heart hurts when inhaling, this alarming symptom cannot be ignored. In this case, the pain can be stabbing, pressing, burning in nature, which often indicates the presence of such pathologies:

rheumatism;
myocardial inflammation;
functional disorders of the cardiovascular system;
weakening of the tone of the heart muscle during anemia.

Important! It is impossible to make a diagnosis on your own, since each of the diseases has its own causes and characteristic clinical signs, which should be considered exclusively by a doctor.

Rheumatism

Rheumatism is a disease accompanied by inflammation of the connective tissues of the body, which affects the heart, blood vessels and musculoskeletal system. Among the signs of pathology are:

joint pain;
pain in the heart when inhaling and at rest;
fatigue;
formation of rheumatoid nodes;
rashes on the skin of a pale pink color - annular rash.

Rheumatic myocardial damage is a common consequence of infectious diseases

Rheumatism occurs against the background of damage to the body by a bacterial infection or due to the development of an allergic reaction. Treatment is carried out with the help of antibacterial agents, hormonal drugs and immunomodulators. If left untreated, the disease becomes chronic, causing heart failure and many other complications.

Myocarditis

One of the symptoms of inflammatory myocardial damage is pain in the heart area during deep inspiration, walking, physical activity, and even at rest. A patient with myocarditis is concerned about the following manifestations:

fast fatiguability;
excessive sweating;
shortness of breath, headache;
attacks of increased or, conversely, slowed heart rate.

The pathology is toxic, allergic or infectious in nature. Treatment is carried out by getting rid of the underlying disease that provoked myocardial damage.

Functional disorders of the cardiovascular system

Dysfunction of the heart and blood vessels or inconsistency of their activities in medical practice is called a functional disorder of the cardiovascular system. The condition occurs as a result of disruption of the sympathetic or parasympathetic division of the human autonomic nervous system. This occurs against a background of stress and excessive emotional stress. More often, the pathology occurs in children, adolescents and women.

Symptoms of the disease include:

pain in the heart when inhaling and moving;
headache;
dizziness;
sweating;
emotional instability;
chronic fatigue;
sleep disturbance.

Dysfunction of the heart and blood vessels causes many unpleasant symptoms in humans

Therapy of the disease is carried out by improving the psychological and physiological state of the patient, which often requires the participation of a therapist, psychologist, neurologist, cardiologist and other specialists.

Heart dysfunction due to anemia

Anemia or anemia is a pathology accompanied by a violation of the qualitative composition of the blood, which often causes serious biological changes in myocardial tissue. In turn, a deficiency of certain substances entails oxygen starvation of the heart and other internal organs, which causes chest pain, apathy, irritability, loss of strength, dizziness and many other negative manifestations.

Lung diseases

This is a common cause of chest discomfort. Main causes and characteristic symptoms:

Inflammation or abscess of the lung - the process occurs with severe pain in the chest (right or both parts of the chest), fever, cough.
Pleurisy (inflammation of the pleura) - pain appears when taking a deep breath, usually accompanied by an increase in body temperature and cough.
Thromboembolism of the pulmonary artery with a blood clot - severe chest pain, tachycardia, difficulty breathing.
Pneumothorax is the accumulation of air in the pleural cavity when the lungs are damaged due to injuries to the ribs and spine. Pain appears when inhaling, shortness of breath, dry cough, and blood pressure may decrease.
Bronchial asthma - acute spasms occur with pain and wheezing in the chest, wet cough, attacks of difficulty breathing

Why does my left chest hurt when I breathe?

To inhale, the muscles contract, which leads to the raising of the ribs, enlargement of the sternum, expansion of the lungs with a decrease in pressure in their cavity. This is how air enters the body.

If there are altered organs in the chest area, damaged vascular or pinched nervous tissue, or, for example, injured ribs, mechanical impact causes pain of a different nature against the background of lung expansion.

In comparison with pain sensations that have no connection with breathing, such manifestations can occur or increase with deep breaths.

Intercostal neuralgia

The cause of this disease lies in pinching of the intercostal nerves or nerve endings and roots between the ribs or near the spine. This disease is characterized by the appearance of subcostal compressive, dull or stabbing, aching or burning pain during deep breaths. The pain syndrome can be localized both near the heart and in the collarbone area. It grows against the background of sudden movements, palpation, and can radiate to the scapular region.

This disease develops as a concomitant if the patient:

suffers from osteochondrosis;
injured;
exposed to excessive physical exertion;
hypothermia;
suffered stress;
suffered from a cold, which led to complications;
suffers from damage to metabolic processes, etc.

This disease is treated in two stages. The first involves pain relief, after which they begin directly to treat the pathology that provoked the infringement of the nervous tissue.

The most common source of pain in the left half of the sternum is the development of osteochondrosis, against the background of which the structure and functionality of the cartilage tissue of the joints is disrupted. Most often, such a disease develops against the background of:

impaired metabolic processes;
hereditary predisposition;
spinal injuries;
curvature of the spinal column, flat feet;
hard work accompanied by physical overload;
prolonged stay in the wrong position;
age-related changes.

Due to such disorders, intervertebral discs are damaged, which causes the vertebrae to gradually move closer to each other and, as a result, leads to pinching of the nerve roots. This is accompanied by pain and numbness of muscle tissue.

Patients with this pathology are usually prescribed medication, therapeutic massage and special exercises. In addition, you can resort to folk remedies and acupuncture.

Consequences of chest injury

One of the common sources of pain during sighing in the left part of the sternum is all kinds of injuries to this part of the body. In such a situation, constant pain is a concern, and tension, coughing or deep breathing provokes its increase.

Thoracic trauma can be open or closed. The open form includes wounds of a penetrating or non-penetrating nature. Closed injuries leading to discomfort can be caused by:

fracture;
bruise;
rupture;
concussion.

With rib fractures, in addition to pain, a crunching sensation when rubbing the edges of the injured rib is disturbing. In case of serious injuries under the influence of fragments, injury to internal organs, vascular and pleural tissue is possible. X-rays are used to detect a fracture.

Pain in the area of the left collarbone accompanied by a sigh, movement of the shoulder, or raising the arm is often evidence of a fracture or dislocation of this bone. The cause of such an injury can be a fall, accompanied by a blow to the shoulder, elbow or hand, if the person extended his arm forward during the fall, as well as a direct blow to the collarbone. Such damage is accompanied by swelling, hemorrhage and visible displacement of bone fragments. When a dislocation occurs, the acromial or sternal end of the clavicular bone is displaced.

The cause of the bruise is usually a blow. This damage manifests itself in the form of pain that increases with inspiration. For a simple uncomplicated bruise, no special treatment is required. In case of a bruise accompanied by extensive hemorrhage and tissue rupture, the patient must be hospitalized.

A concussion is considered a serious illness. With it, there are no changes in the structure of the organ, but the pulsation is rapid, the skin of the extremities becomes cold, breathing is accompanied by pain. In such a situation, the person must be urgently hospitalized.

Respiratory diseases as a cause of pain when inhaling

Often painful symptoms in the left side of the sternum appear accompanied by shortness of breath, cough, hemoptysis, elevated temperatures, and cyanosis of the skin. Similar symptoms are characteristic of the following pathologies:

tuberculosis or pneumonia (when inflammation covers the pleural cavity);
pulmonary infarction;
pleurisy;
pneumothorax;
processes of a malignant nature.

With pleurisy, inflammation of the pulmonary membranes is noted. With such a disease, a deep breath provokes the formation of pain in the dry form of the disease, that is, in the absence of fluid accumulated in the pleural cavity. In such a situation, the patient complains of pain in the lumbar region during inspiration. The development of a dry form of pleurisy is often observed as a complication of tuberculosis or pneumonia.

When the pulmonary membranes become infected, the permeability of the pleural vessels increases, which leads to the penetration of blood plasma and proteins into the pleural cavity. Subsequently, fluid is absorbed, and dry protein accumulates on the pleural layers, causing them to thicken and making lung mobility difficult. To alleviate the patient’s condition, they resort to symptomatic treatment (painkillers and antitussives are prescribed).

Diseases that provoke the appearance of pleurisy and some other factors (trauma, emphysema) can lead to pneumothorax, in which air appears between the pleural layers. This pathology is characterized by:

shallow breathing, pain in the left sternum near the heart when inhaling;
shortness of breath;
increased sweating, excited state.

The development of the disease is caused by an open injury to the sternum and the penetration of air into the pleural cavity. Pneumothorax can also form if the surface of the lung is broken and gas escapes from it. This provokes a change in pressure in the cavity, collapse of the lung, due to which the organ stops participating in the respiratory function. This disease requires immediate medical attention.

Painful manifestations in the left part of the sternum when sighing can appear due to malignant damage to the lung or the membranes of the organ. Based on the location of the pain, you can determine the location of the damaged tissue. The progression of the pathology leads to the development of a constant pain syndrome, independent of the respiratory process.

Cardiovascular pathologies

Patients rarely perceive the appearance of pain in the left side of the sternum as a signal of heart problems. Cardiovascular diseases are usually accompanied by continuous pain in the center of the chest or back (often slightly to the left), in the area of the shoulder blade, radiating to the arm and shoulder, not related to breathing.

This pattern of pain is typical for angina pectoris and is evidence of the development of ischemia or myocardial infarction. Occasionally, painful manifestations when sighing can occur against the background of myocarditis and pericarditis.

Serious heart diseases usually do not manifest themselves at first, but minor disturbances in well-being are noted:

increased fatigue;
shortness of breath;
increased heart rate;
dizziness.

Angina pectoris with a deep breath is not accompanied by increased pain. The pain syndrome radiates to the area of the shoulder blade, neck, left shoulder, lasts for a short time and is relieved after taking nitrates (Nitroglycerin).

Angina develops against the background of vasoconstriction due to cholesterol deposits (atherosclerosis). This leads to a decrease in the volume of blood entering the heart, and as a result, hypoxia. With this disease, the patient often complains of a burning sensation in the sternum, compression of the heart that occurs during physical exertion.

As a complication of angina, the development of myocardial infarction is possible - the heart muscle is damaged due to a severe lack of oxygen. This is due to impaired blood circulation, the cause of which lies in the blockage of the coronary vessels. The disease is characterized by:

cutting chest pain;
pain syndrome that does not subside when taking nitrates;
cold sweat;
pale skin;
fainting state.

With myocardial infarction, other signs may also appear: discomfort behind the sternum, interruptions in cardiac function, shortness of breath, and sometimes pain in the abdominal area. Untimely or incorrect therapy can cause the development of acute heart failure or cardiogenic shock. If such signs are detected, the patient should be hospitalized.

The development of myocarditis (infection of the myocardium) is noted as a complication of a number of pathologies of an infectious nature, most often of viral origin. The disease is accompanied by aching heart pain (increasing with a sigh), lethargy, increased sweating, and dysfunction of the organ.

For myocarditis, therapy involves taking medications to suppress the infection (antibacterial, antiviral agents), antiviral and antihistamines are also prescribed. If the disease is severe, treatment with glucocorticoid hormones is indicated. To improve metabolism, products containing potassium and vitamin preparations are prescribed. Symptomatic therapy is prescribed.

The formation of pericarditis (an inflammatory process in the lining of the heart - the pericardium) is observed as a complication of myocarditis or rheumatoid arthritis. This pathology is characterized by the appearance of stabbing pain when sighing in the left half of the sternum and in the center, low-grade fever, cough in a supine position, and shortness of breath. For therapeutic purposes, anti-inflammatory drugs and symptomatic treatment are used.

Gastrointestinal diseases

Major diseases that cause pain in the esophagus, or can spread from the abdomen to the chest area:

Gastroesophageal reflux disease (GERD) is irritation of the esophageal mucosa due to the reflux of gastric contents.
Dyskinesia or esophageal perforation is increased pressure in the esophagus due to slow movement of food or its rupture due to injury.
Stomach ulcers.

Gastrointestinal diseases are characterized by pain that appears before, after or during meals; they may be accompanied by heartburn and other symptoms.

Injuries and diseases of the musculoskeletal system

Thoracalgia appears due to injuries, diseases of the spine, and worsens after physical activity. Main causes and symptoms:

Osteochondrosis, hernias and protrusions of intervertebral discs in the thoracic spine, scoliosis - cause chest pain, which intensifies with movement or prolonged immobility.
Rib fractures.
Muscle spasms, sprains, intercostal neuralgia - cause pain in the chest on the right or left, depending on the location where the pathology occurred.
Tietze's syndrome or inflammation of the costochondral joints.
Neurological pain - from “pins and needles” in the chest to severe pain occurs due to mental disorders, with panic attacks.

Pain in the right or left side of the chest may have other causes: tumors in the lungs or mammary gland, herpes zoster and other diseases.

The doctor’s task is to make a timely and correct diagnosis. This will help: heart examinations, ultrasound, radiography and other diagnostic procedures.

Emergency medical care is needed if:

Acute chest pain does not go away after 15 minutes and after rest.
There is dizziness, shortness of breath, increased sweating, and palpitations.

In other cases, it is also advisable not to delay consulting a doctor for too long. Who to contact - a cardiologist, a neurologist, a gastroenterologist - depends on the symptoms. But it is not always possible to determine this on your own. In this case, start by consulting a therapist who will help you understand the issue and, if necessary, refer you to a specialist.

Diagnosis of any disease requires modern equipment and extensive medical experience. Especially when it comes to chest pain.

Our clinic offers its patients a full range of medical tests using high-precision equipment. Our doctors select the most informative and safe diagnostic methods.

By contacting us, you can be sure that the cause of the pain will be determined as quickly and accurately as possible. High-tech diagnostic devices allow you to monitor the functioning of all organs and systems without causing you unnecessary discomfort.

We value our patients' time, so all consultations and procedures are by appointment. By booking a visit, you can be sure that the doctor will be waiting for you. Come to the clinic to find out the cause of your pain and discuss treatment options.

Causes of chest pain

Heartburn. Acidic stomach acid that flows from the stomach into the esophagus (the tube that connects the mouth to the stomach) can cause heartburn, a painful burning sensation in the chest. It is often combined with a sour taste and belching. Heartburn chest pain is usually associated with food intake and can last for hours. This symptom most often occurs when bending or lying down. Taking antacids relieves heartburn.
Panic attacks. If you experience attacks of unreasonable fear, combined with chest pain, rapid heartbeat, hyperventilation (rapid breathing) and profuse sweating, you may be suffering from “panic attacks” - a unique form of dysfunction of the autonomic nervous system.
Pleurisy. Sharp, localized chest pain that gets worse when you inhale or cough may be a sign of pleurisy. The pain occurs due to inflammation of the membrane lining the inside of the chest cavity and covering the lungs. Pleurisy can occur with various diseases, but most often with pneumonia.
Tietze syndrome. Under certain conditions, the cartilaginous parts of the ribs, especially the cartilage that attaches to the sternum, can become inflamed. Pain in this disease can occur suddenly and be quite intense, simulating an attack of angina. However, the location of pain may vary. With Tietze syndrome, pain may increase when pressure is placed on the sternum or ribs near the sternum. Pain during angina pectoris and myocardial infarction does not depend on this.

Osteochondrosis of the cervical and thoracic spine leads to so-called vertebrogenic cardialgia, which resembles angina pectoris. In this condition, there is intense and prolonged pain behind the sternum, in the left half of the chest. There may be irradiation into the arms and interscapular area. The pain increases or decreases with changes in body position, head turns, and arm movements. The diagnosis can be confirmed by performing an MRI of the spine. Magnetic resonance imaging of the spine will help determine the cause of pain in the chest if it is caused by pinched nerve roots or the presence of herniated intervertebral discs.

Pulmonary embolism. This type of embolism occurs when a blood clot enters the pulmonary artery, blocking the flow of blood to the heart. Symptoms of this life-threatening condition may include sudden, sharp chest pain that occurs or gets worse with deep breathing or coughing. Other symptoms are shortness of breath, palpitations, anxiety, loss of consciousness.
Other lung diseases. Pneumothorax (collapsed lung), high pressure in the blood vessels supplying the lungs (pulmonary hypertension), and severe asthma may also cause chest pain.
Muscle diseases. Pain caused by muscle diseases usually begins to bother you when you turn your body or raise your arms. Chronic pain syndrome such as fibromyalgia. May cause persistent chest pain.
Damage to ribs and pinched nerves. Bruises and fractures of the ribs, as well as pinched nerve roots, can cause pain, sometimes very severe. With intercostal neuralgia, pain is localized along the intercostal spaces and intensifies with palpation.
Diseases of the esophagus. Some diseases of the esophagus can cause difficulty swallowing and therefore chest discomfort. Esophageal spasm can cause chest pain. In patients with this disease, the muscles that normally move food down the esophagus work uncoordinated. Since esophageal spasm can resolve after taking nitroglycerin - just like angina - diagnostic errors often occur. Another swallowing disorder known as achalasia can also cause chest pain. In this case, the valve in the lower third of the esophagus does not open as it should and does not allow food to pass into the stomach. It remains in the esophagus, causing discomfort, pain and heartburn.
Shingles. This infection, caused by the herpes virus and affecting the nerve endings, can cause severe chest pain. The pain can be localized in the left half of the chest or be of a girdling nature. This disease can leave behind a complication - postherpetic neuralgia - the cause of prolonged pain and increased skin sensitivity.
Diseases of the gallbladder and pancreas. Gallstones or inflammation of the gallbladder (cholecystitis) and pancreas (pancreatitis) can cause pain in the upper abdomen that radiates to the heart.
Myocardial infarction - a blood clot that blocks the movement of blood in the arteries of the heart can cause pressing, squeezing chest pain that lasts more than a few minutes. The pain can radiate to the back, neck, lower jaw, shoulders and arms (especially the left). Other symptoms may include shortness of breath, cold sweats, and nausea.
Angina pectoris. Over the years, fatty plaques can form in the arteries of your heart, limiting the flow of blood to the heart muscle, especially during exercise. It is the restriction of blood flow through the arteries of the heart that causes attacks of chest pain - angina. Angina is often described by people as a feeling of tightness or tightness in the chest. It usually occurs during physical activity or stress. The pain usually lasts about a minute and goes away with rest.
Other causes of chest pain include inflammation of the lining of the heart (pericarditis), most often due to a viral infection. Pain with pericarditis is most often acute, stabbing in nature. Fever and malaise may also occur. Less commonly, the pain may be caused by a dissection of the aorta, the main artery in your body. The inner layer of this artery can separate under blood pressure and the result is sharp, sudden and severe pain in the chest. Aortic dissection can be the result of chest trauma or a complication of uncontrolled hypertension.

Because chest pain can have many different causes, do not self-diagnose, self-medicate, or ignore severe or prolonged pain. The cause of your pain may not be so serious - but in order to establish it, you need to contact a specialist.