Heart pain includes:
- Pain due to coronary heart disease (angina)
. The cause of these pains is oxygen “starvation” of the heart cells when the load on it increases. The lack of oxygen supply is caused by a narrowing of the vessels supplying the heart due to the deposition of fat-like accumulations (atherosclerotic plaques) on their walls, as a result of which they lose the ability to expand and provide blood flow adequate to the needs of the heart. Such pain, as a rule, occurs during physical exertion or psycho-emotional stress, has a pressing or squeezing nature, is often localized behind the sternum, less often in the left half of the chest, is relieved (stopped) by taking nitro drugs or when the load is stopped, and is short-term in nature (several minutes) . - Pain during myocardial infarction.
Their character is similar to the pain of angina pectoris, but they are usually longer lasting, may be accompanied by shortness of breath, cold sweat, and are not relieved by taking nitroglycerin. The cause of such pain is a blockage of one or more arteries supplying the heart by a blood clot (thrombus). - Pain similar to angina pectoris can
also occur in a number of other conditions characterized by an increased load on the heart muscle: for example, with a hypertensive crisis, heart defects (aortic stenosis), hypertrophic cardiomyopathy. In such cases, the cause of pain is overload of the heart with sufficient blood supply. - Cardialgia
is pain in the heart that is not associated with either ischemia or myocardial overload, but occurs in the presence of minimal structural changes in the heart, often congenital (additional chords of the left ventricle, mitral valve prolapse), or when the regulation of its activity through the nervous system is impaired ( vegetative-vascular dystonia).
A large group of causes of chest pain have nothing to do with the heart. In these cases, pain is provoked by damage to other organs. Let's list some of them:
- Osteochondrosis of the cervical and thoracic spine
is the cause of the so-called “vertebrogenic cardialgia,” which also has similarities with angina pectoris. The pain is intense and prolonged, can be localized behind the sternum and in the left half of the chest, and radiate to the left arm. However, unlike angina pectoris, pain in thoracic osteochondrosis is associated with changes in body position and intensifies when turning the head or moving the arms; - Gastroesophageal reflux disease (GERD).
Accompanied by heartburn - a burning sensation in the chest that occurs when acidic gastric juice enters the esophagus from the stomach. May be accompanied by a sour taste in the mouth and belching, most often occurs when bending over or in a lying position, and can be relieved by taking antacids (Almagel, Maalox); - Pleurisy.
In various diseases, but more often with pneumonia, inflammation occurs of the membrane lining the inside of the chest cavity and covering the lungs. This pain is acute, localized in one place, intensifies with breathing and coughing; - Tietze syndrome.
Pain in this condition occurs due to inflammation of the cartilage, most often in the places where it is attached to the sternum, and thus imitates an attack of angina. In such cases, palpation of the site of pain helps differentiate one condition from another - with Tietze syndrome, the inflamed cartilage is sharply painful, with angina pectoris - palpation does not affect the intensity of pain; - Chest pain
can be a consequence of muscle diseases. Such pains, as a rule, are provoked by turns of the torso, movements of the arms; - Bruises and fractures of the ribs
can also cause pain, sometimes very intense; - Diseases of the esophagus.
Pain can also occur with spasm of the esophagus, achalasia (a disease of the lower esophageal valve that interferes with the passage of food), and such pain goes away after the patient takes nitroglycerin, which relaxes the muscles of the esophagus, which makes it difficult to diagnose the condition; - Shingles.
It is a herpetic infection that affects the nerve endings and causes severe pain in the chest; - Diseases of the gallbladder and pancreas.
Gallstones or inflammation of the gallbladder (cholecystitis) and pancreas (pancreatitis) can cause pain in the epigastric region, radiating to the heart; - Pulmonary embolism.
This dangerous condition develops when a blood clot enters the pulmonary artery, through which blood flows to the lungs, blocking the flow of blood through the lungs to the heart. As a result, severe dull pain in the chest, shortness of breath appears, blood pressure drops sharply, and loss of consciousness is possible.
Pain of any nature and location in the chest, especially if it occurs for the first time, should alert a person and cause immediate consultation with a doctor. After which it is necessary to undergo all examinations prescribed by the doctor to determine the cause of the pain. It is most important to diagnose cardiac pathology as early as possible, since it is this pathology that is associated with the greatest risk to the patient’s life.
Causes of myofascial thoracic syndrome
Myofascial syndrome of the thoracic spine has several causes.
All of them can be divided into internal and external. Internal causes develop in muscle tissue. More precisely, where the connection between nerve and muscle fiber occurs. This connection is called a "synapse". Through the synapse, a nerve impulse is transmitted from the brain, through the nerve to the muscle. With pathology of the synapse, impulse transmission is disrupted. In their monograph “Myofascial pain and dysfunction,” J. Travell and D. Simons say that these disorders are neuromuscular dysfunction. This is the internal cause of myofascial syndrome of the thoracic region.
External causes are long-term harmful factors. According to J. Travell and D. Simons, such factors are mechanical stress, poor nutrition, endocrine disorders, psychological factors, chronic infections and others. ["Myofascial pain and dysfunction." Volume I. P. 228].
- Mechanical stress is monotonous postures, an uncomfortable workplace and bed, carrying a bag on one shoulder, scoliosis, flat feet, poor posture and other orthopedic disorders in an uncompensated form. In addition, overload during physical work or during training, injuries, etc.
- Poor nutrition is, first of all, a lack of vitamins and microelements, a passion for exotic diets, etc.
- Endocrine disorders can manifest themselves in the form of various diseases of the endocrine glands and hormonal imbalances.
- Psychological factors such as chronic fatigue, emotional stress, irritability, anxiety, depression, low mood, hopelessness, insomnia, etc.
- Chronic infections - viral (often Herpes), bacterial or parasitic (helminthic infestations).
- Other factors, for example, chronic diseases of internal organs, allergies, smoking, alcohol and other addictions.
J. Travell and D. Simons draw attention to the fact that sometimes these factors are so important in clinical practice that their elimination leads to the spontaneous disappearance of trigger points, but they are either not noticed or neglected" [Ibid. Volume I. P. 230].
In other words, neglect of one or more of these factors prevents a complete and final cure for myofascial syndrome of the thoracic spine.
What is important to the patient?
- pain behind the sternum and in the heart area can be a consequence of angina pectoris or myocardial infarction - conditions that directly threaten a person’s life;
- if chest pain occurs, it is necessary to seek medical help from qualified specialists as soon as possible, since delay in this situation can cost a person’s life;
- Only a cardiologist can decide on a cardiac or non-cardiac cause of chest pain after conducting the necessary examination;
- Treatment of patients with coronary heart disease should be carried out only in the cardiology department of the hospital, equipped with an intensive care ward.
Features of chest spasms
With spasms of the diaphragm, internal organs can be involved in the process, and their work is disrupted.
Involuntary contractions of muscle fibers, spasms, cannot be confused with ordinary muscle tension:
- the muscles seem to turn to stone and cannot be felt;
- they are completely immobilized;
- spasms last from a few seconds to several hours;
- may affect small muscles or large, deep ones;
- intense pain occurs;
- The pain makes the person dizzy, there are interruptions in breathing, and the heart rate increases.
If the spasms are mild, the pain and twitching will not be too intense. If they are strong, panic and loss of consciousness are possible.
With severe muscle spasms, fibers are injured, which causes an acute inflammatory process for a long time. They can be localized on the left, right, in the center of the sternum and even behind. With severe spasms, even internal organs are involved in the process.
Method for treating chest cramps
If there are frequent spasms of the pectoral muscles, an ultrasound of the internal organs is performed.
Spasms in the chest in the middle should not be ignored if it is difficult to breathe or there are other alarming symptoms. In this condition, you should contact an ambulance if there is acute pain, poor health, nausea or vomiting. If the pain is moderate, you need to make an appointment with a therapist, who will provide a referral for further examination. It may consist of a visit to a surgeon, cardiologist, pulmonologist and other doctors.
It is very important to undergo instrumental diagnostics and tests. If certain disorders are suspected, the following may be prescribed: ultrasound of the abdominal cavity, pelvic organs, CT, MRI and X-ray of the chest, as well as other parts of the body.
Principles of First Aid
To make yourself feel better, the patient should immediately lie down and stretch his arms above his head if the spasm occurs acutely and suddenly. You should not massage the chest area where the spasm is concentrated. If the condition does not go away, you should consult a doctor.
If it's a matter of tense muscles, you can take a warm bath, relax, and rest. Physical overexertion and dehydration should not be allowed. If the spasm is severe, you should give up sports for a while; you should drink at least 8 glasses of water a day. If overexertion is caused by physical activity, you can take antispasmodics.
Medicines to relieve muscle spasms
No-Shpa in injections acts faster than in tablets.
Among the most common antispasmodics are Papaverine, No-Shpa and Drotaverine. The first operates on the basis of the substance of the same name, the other two contain drotaverine, a safe substance that can be taken even during pregnancy.
To restore the nervous structure and relieve spasms, magnesium and B vitamins are prescribed: B6, B12, B1. Other medications are prescribed depending on what caused the acute spasm. They must be taken strictly according to the doctor’s recommendations, without ignoring the instructions and other important parameters.
Alternative medicine
Folk remedies based on herbs and plants cannot replace drug therapy. Herbal recipes are most effective in the presence of stress, fatigue, and overexertion.
The most effective are chamomile, lemon balm and valerian. But we must not forget that these products are very dangerous if used incorrectly. It is important to consult a doctor and make sure there are no contraindications.
You need to take medicinal herbs for a long time, at least 1-2 months, followed by a break for the same period. This is due to the fact that all herbs have a cumulative effect and begin to act no earlier than 2-3 weeks after the start of therapy.
Brew chamomile, valerian and lemon balm, 1 tbsp each. l. for 0.5 liters of boiling water. You can prepare separate mixtures or use a mixture of these herbs.
Spasms in the chest can be acute, sluggish, or chronic. This condition is accompanied by a variety of diseases: neurological disorders, gastrointestinal pathologies, disorders in the spine, heart and other body systems. It is important to diagnose them correctly and on time in order to begin effective treatment.