How to distinguish heart disease from others. Pain in the heart: nature, causes, treatment

Chest pain is a symptom of many diseases, not necessarily heart diseases. Thus, diseases of the musculoskeletal system, respiratory and digestive organs, neurological disorders, and injuries may manifest themselves. However, you need to know how to determine if your heart is hurting, since this is where immediate help may be needed. It is especially important not to miss dangerous condition, for example myocardial infarction.

Only a doctor can make a diagnosis, but some specific signs will help you understand that your heart is hurting.

The nature of pain in cardiac diseases

Angina attack

The pain occurs behind the sternum, it can be squeezing, squeezing, sometimes cutting, but never sharp, but always dull. It arises exactly where the heart is. The person cannot pinpoint exactly where it hurts and puts his hands all over his chest. The pain radiates to the area between the shoulder blades, in left hand, jaw, neck. Usually appears during emotional stress, physical exertion, when leaving a warm room in the cold, while eating, at night. When your heart hurts, the discomfort lasts from a few seconds to twenty minutes. Usually the patient freezes in place, he develops shortness of breath, a feeling of lack of air, and a feeling of fear of death. Significant relief or complete relief of the attack occurs immediately after taking nitroglycerin. Pain in the heart does not depend on the position of the body, inhalation or exhalation.

Myocardial infarction

Sudden sharp pain behind the sternum of a pressing or burning nature, radiating to left side chest and back. The patient feels as if there is a very heavy burden on his heart. A person experiences a feeling of fear of death. During a heart attack, breathing quickens, and the patient cannot lie down; he tries to sit up. Unlike angina, pain during a heart attack is very sharp and can be aggravated by movement. They cannot be removed with the usual medications for the core.

Inflammatory heart diseases

Heart pain occurs during inflammatory processes such as myocarditis and pericarditis.

With myocarditis, the sensations are almost the same as with angina pectoris. The main signs are aching or stabbing pain, radiating to left shoulder and neck, a feeling of pressure behind the sternum, usually a little to the left. They are almost continuous and long-lasting, and can intensify with physical activity. After taking nitroglycerin, do not release it. Patients suffer from attacks of suffocation and shortness of breath when physical work and at night, swelling and painful sensations in the area of the joints.

Signs of pericarditis are moderate dull monotonous pain and elevated temperature. Painful sensations can be localized in the left side of the chest, usually above the heart, as well as in the upper left part of the abdomen, the left shoulder blade. They intensify when coughing, when changing body position, when deep breathing, while lying down.

Aortic diseases

Aortic aneurysm is expressed by pain in the upper chest, which lasts several days and is associated with physical effort. It does not spread to other parts of the body and does not go away after nitroglycerin.

Dissecting aortic aneurysm is characterized by severe bursting pain behind the sternum, which may be followed by loss of consciousness. Emergency assistance required.

Pulmonary embolism

An early sign of this serious illness– severe chest pain that gets worse when you inhale. Resembles the pain of angina, but does not radiate to other parts of the body. Doesn't go away with painkillers. The patient experiences severe shortness of breath and palpitations. There is a bluish appearance of the skin and rapid decline pressure. The condition requires immediate hospitalization.

Pain of non-cardiac origin

Intercostal neuralgia

Intercostal neuralgia is often mistaken for heart pain. It does resemble angina, but there are significant differences. Neuralgia is characterized by a sharp shooting pain, which intensifies with movements, turns of the body, coughing, laughter, inhalation and exhalation. The pain may go away quickly, but can last for hours or days, intensifying with every sudden movement. Neuralgia is localized locally on the left or right between the ribs; the pain can radiate directly to the heart, lower back, back or spine. Usually the patient can pinpoint the exact location of the pain.

Osteochondrosis

At thoracic osteochondrosis a person experiences pain in the heart, which radiates to the back, upper abdomen, shoulder blade and intensifies during movement and breathing. There may be a feeling of numbness in the interscapular area and left arm. Many people mistake their condition for angina, especially if the pain occurs at night and there is a feeling of fear. You can distinguish heart pain from osteochondrosis by the fact that in the latter case nitroglycerin will not help.

Digestive diseases

Chest pain usually occurs due to muscle spasms stomach walls. Symptoms such as nausea, heartburn, and vomiting will help you find out their true origin. These pains last longer than heart pains and have a number of features. They depend on food intake: for example, they appear on an empty stomach and disappear after eating. Nitroglycerin does not help with such conditions, but antispasmodics are effective.

Symptoms of acute pancreatitis are very severe pain that can be mistaken for heart pain. The condition is similar to a heart attack, and in both cases nausea and vomiting are possible. It is almost impossible to remove them at home.

With gallbladder spasm and bile ducts It seems like my heart hurts. Liver and gallbladder although they are on the right, the severe pain radiates to the left side chest. In this case, antispasmodics help.

Severe pain due to a hernia of the esophagus (the opening of the diaphragm) is similar to angina. It appears at night when a person is in a horizontal position. Once you take a vertical position, your condition improves.

central nervous system

With disorders of the central nervous system, frequent and prolonged pain is observed in the chest area, namely in the apex of the heart, that is, in the chest from the bottom left. Patients describe the symptoms differently, but, as a rule, these are constant aching pains, which are sometimes acute and short-lived. Pain due to neuroses is always accompanied by sleep disturbances, irritability, anxiety and other manifestations of autonomic disorders. In this case they help sedatives and sleeping pills. A similar picture can be observed during menopause.

In some cases, cardioneuroses are difficult to distinguish from ischemic heart disease, since there may be no changes on the ECG in both cases.

Finally

In any case, you need to go to the hospital. Even an experienced doctor without instrumental examination will not be able to accurately determine the origin of the pain. In addition, any disease may have atypical symptoms.

Chest pain is associated with symptoms of many diseases, and it does not have to be signs of heart pain. Very often, this is how diseases of the digestive and respiratory organs, problems of the musculoskeletal system, injuries and neurological disorders manifest themselves.

Therefore, it is very important to know how to identify heart pain, distinguishing it from others, since in this case immediate help is needed. This is especially true for signs of such dangerous exacerbations as the development of myocardial infarction. Although the final diagnosis can only be made by a doctor, its specific signs will help classify the pain as a heart patient.

Signs of pain associated with cardiology

Angina attack

It is always a dull pain: squeezing, squeezing or cutting, but not sharp. Angina pectoris pain occurs at the location of the heart. The patient does not know exactly how to identify pain in the heart, and may point to any part of the chest. Often the pain radiates to the neck, jaw, left arm or between the shoulder blades. Its causes can be physical activity, emotional stress, eating, going out of the heat into the cold, even night sleep. This pain in the heart area can last for seconds or up to 20 minutes. The patient often freezes in place, feels short of breath, shortness of breath and a specific feeling of fear of death. Taking nitroglycerin immediately stops the attack and brings significant relief. This pain continues with inhalation and exhalation and does not depend on the position of the body.

If, during various physical activities (lifting weights or playing sports), a spasm occurs that extends to the lower jaw or left arm and a burning sensation is felt, then you should see a cardiologist. He will refer you for a regular or stress ECG, as this may be the first hint of the onset of angina.

Myocardial infarction

Behind the sternum during MI there is an acute, sudden pain of a burning or pressing nature, radiating to the back and left side of the chest. The patient feels as if there is a heavy weight on his chest, preventing him from breathing, as well as a distinct fear of death. During a heart attack, breathing becomes more frequent, and the patient sometimes tries to sit up because he cannot lie down. The pain during a heart attack is more severe than during angina, and movement intensifies it. In this case, nitro drugs do not help.

Inflammatory heart diseases (including myocarditis and pericarditis)

With myocarditis, a relatively mild pain is felt in the heart area, similar to angina pectoris: aching or stabbing in nature, with a feeling of pressure behind the sternum and radiating to the neck and left shoulder. The pain is constant and continuous, increases with physical activity and is not relieved by nitroglycerin. While working or sleeping, the patient experiences shortness of breath and attacks of suffocation; limbs may swell and joints may ache.

With pericarditis, monotonous dull pain is observed at elevated temperatures. The pain may be localized above the heart, in the left chest, left shoulder blade, or left and upper abdomen. When coughing, deep breathing, in a horizontal position and when changing positions, the pain intensifies.

If the appearance of heart pain was associated with a cold, then this may indicate either an inflammatory process affecting the heart, or be a sign of osteochondrosis. Accurate diagnosis This is where the joint efforts of a rheumatologist and a cardiologist can be put in place. Moreover, in addition to undergoing a regular ECG examination, you will also need to do an ultrasound of the heart and pass all blood tests.

Aortic diseases

In this case, pain appears in the upper chest. She is connected with physical activity and lasts several days, does not spread to other parts of the body and is not relieved by nitroglycerin. A dissecting aortic aneurysm is characterized by severe bursting pain in the chest, which can lead to loss of consciousness. Emergency help is needed here.

Pulmonary embolism

At an early stage it manifests itself strongly chest pain, intensifying with inspiration, reminiscent of angina pectoris, but without rebound to other places. It is not relieved by painkillers. The patient has a strong heartbeat and shortness of breath, a rapid decrease in blood pressure and cyanosis of the skin. Urgent hospitalization is required.

Pain of non-cardiac origin

Intercostal neuralgia

It is very often confused with pain in the heart. Although it resembles angina pectoris, it has significant differences. With neuralgia, the pain is sharp, shooting, aggravated by movements, laughter, coughing and simply inhaling. More often, this pain goes away quickly, but sometimes it can drag on for a day, intensifying with sudden movements. The pain is localized between the ribs on the right or left, but can radiate to the heart, back, lower back or spine. The patient usually indicates the exact location of the pain.

Osteochondrosis

A person experiences heart pain with osteochondrosis (thoracic), radiating to the back, shoulder blade, upper abdomen and intensifying with deep breaths and movement. Sometimes the left arm and the area between the shoulder blades go numb. Patients often confuse this pain with angina, especially if it comes at night and causes a feeling of fear. But these periodic pains in the heart area are not relieved by nitroglycerin.

Diseases of the digestive organs

Spasms of the muscles of the stomach walls very often cause painful sensations in the chest. But they are distinguished from heart diseases by the accompanying nausea, vomiting and heartburn. These pains last longer than heart pains and have their own characteristics, for example, they are associated with meals - they appear on an empty stomach, but disappear after eating. Nitro drugs are powerless here, unlike antispasmodics.

In the acute form of pancreatitis, very severe pain is observed, which can easily be confused with heart pain. The condition is very similar to a heart attack, in which vomiting and nausea are also sometimes observed. It is almost impossible to relieve such pain at home. Throbbing pain in the heart can also be caused by spasm of the bile ducts or gallbladder. Although it and the liver are located on the right, nevertheless, the pain radiates to the left side of the chest. Antispasmodics can help with them.

With a hiatal hernia in the diaphragm, severe pain occurs, reminiscent of angina pectoris. Such pain often appears during sleep, when a person is in a horizontal state, and as soon as he gets up, his condition immediately improves.

Central nervous system disorders

With this disease, prolonged and frequent heart pain is observed. nervous soil, which are localized in the lower left part of the chest, where the apex of the heart is located. Patients describe their symptoms in different ways: most often as constant aching pain, but sometimes they can be short-term, but more acute. Pain in the heart after stress almost always causes sleep disturbances, anxiety, irritability and other phenomena characteristic of autonomic disorders. Sleeping pills and sedatives help with these pains.

A very similar picture is observed during menopause. Sometimes cardioneuroses are difficult to distinguish from coronary disease hearts even after taking an ECG, since there may be no changes on it in both cases.

If a person periodically feels a slight pain in the area of the heart of an aching nature at rest during bad mood, then it can be caused autonomic dysfunction or depression. In this case, a psychoneurologist will help prevent emotional problems from developing into physical ailments.

Diseases of the musculoskeletal system

If young people experience pain in the left side of the chest, this does not necessarily mean the presence of heart disease. If it appears when you hold your breath, make sudden movements, or lift heavy objects, then most likely the cause lies in the musculoskeletal system. Very often, scoliosis, the most common spinal defect, can be the culprit of pain. Inflammation of the intercostal muscles can have a similar effect. Therefore, it is better for young people to first consult an orthopedist or neurologist, rather than a cardiologist. Will help you cope with such problems manual therapy and gymnastics, and for office employees the use of a corset is often recommended. The latter should be chosen in consultation with a specialist, since this professional fixative, used without recommendations, can be harmful.

Viral diseases

Sharp pain in the ribs, accompanied by a rash, may indicate chickenpox in children, and herpes zoster in adults. IN in this case You should contact a therapist and dermatologist, since such pain is unlikely to be related to cardiology.

Simple attempts to identify heart pain

Take Corvalol or put validol under your tongue. If the pain subsides quickly, then most likely it is related to the heart.
Hold your breath for a while. If the pain does not subside, then this may also indicate heart problems, and if it subsides, it may be neuralgia or muscle problems.
Often heart pain is accompanied by aches, bone pain, and numbness in the muscles of the forearms. Gradually it rises to the shoulder muscles, everything behind the sternum begins to “burn”, sweat appears, breathing becomes difficult, and the limbs become unruly.

No matter how the chest pain is expressed, it is better to consult a doctor about it. After all, even an experienced doctor will not be able to accurately determine its origin without results. instrumental studies. In addition, many diseases have atypical symptoms.

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 most upper 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 his fist, positioned so that the most protruding forefinger directed 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
pulmonary trunk: it is located in front of the other vessels, goes 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 chest 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 in shoulder joint or raising your arm), pain most often appears after physical activity;
there may be a connection with food intake - heart pain with angina pectoris can be associated with food intake copious amounts eating or walking immediately after eating, but then it is not accompanied by heartburn, belching or bowel problems;
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?

Can be called following reasons pain caused by diseases of the heart itself:

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. Develops when those plaques or arteries that caused short-term, only during emotional or physical stress, oxygen starvation 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 not treated within an hour professional help, after administering blood clot-dissolving drugs, he 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, disturbance heart rate;
appears everywhere on the skin cold sweat.

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 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) has or congenital cause, or develops after rheumatism, mycardial infarction or myocarditis, against the background of lupus, coronary heart disease or other heart diseases.

Characterized by:

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 prolapse mitral valve prone to depression and periods of bad mood.

Dissecting aortic aneurysm

This is the name of the condition when in the aorta - the largest vessel in which the most high pressure, expansion occurs - 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 experiences increased arterial pressure, or he suffers from atherosclerosis, when plaques form in the aorta area, 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 thoracic aorta. The cause of the disease can 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;
pulse on sleepy and radial arteries not symmetrical, 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 without visible reasons;
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;
are affected small joints hands;
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.

Besides the 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. Any other specific to aortic stenosis no signs.

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. Do they have a stabbing aching character, occur both in connection with physical activity and in a state of relative rest, after exercise. Also noted increased fatigue, increased body temperature. 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 may be due to 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 easy ones physical exercise, 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, look for local remedy which helps relieve pain. When taking Nitroglycerin, the effect does not occur after 1.5-3 minutes, as with angina pectoris, but almost immediately or after long time. Such people are more effectively helped by drugs such as Valocordin, Gidazepam or valerian tincture.

Cardiopsychoneurosis– the second main pathology, in which there are no changes in either the function or structure of the 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 species 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 hypersensitivity intercostal spaces when palpating them. 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 may occur from nervous system: 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 top corner shoulder blades 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 manifest themselves severe pain which extends 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. On late stages There is swelling in the area of the affected rib.

Osteochondrosis

When squeezing the beams spinal nerves On the left there is pain in the ribs. 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 her muscles
there may be pain in the left arm,
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 there is too much in the bones (including ribs). low content calcium. 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 in the region of the ribs, which then persists even when the position of the body 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 trouble falling asleep, 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 the whole lobe is inflamed ( lobar pneumonia) lung. 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 – chronic illness, caused by inhalation of industrial dust, which the lungs try to delimit 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 tuberculous process spreads to the pleura enveloping the lungs or the chest wall (costomuscular frame). Before this, pay attention to weight loss, sweating, lack of appetite, increased fatigue, low-grade fever, cough. The pain increases with breathing, coughing, and pressing on the chest.
Lung tumor. Noted constant pain of a different nature: aching, pressing, dull, burning or boring, aggravated by coughing and deep breathing. It can radiate to the shoulder, neck, head, stomach; may radiate into right side or be shingles.
Pleurisy is an inflammation of the pleura, that is, the film covering the lungs. It is almost always a complication of pneumonia, tumors lung tissue or her 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) – entry of air into fatty tissue, which 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.
Embolism pulmonary artery. 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 - expansion hiatus 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 chronic cholecystitis most often accompanied by pain under the ribs on the right, but it can also radiate to the left half of the chest. In addition, there is a bitterness in the mouth and loose stools.
Exacerbation chronic pancreatitis if the inflammation is localized in the tail of the pancreas, in addition to nausea, vomiting and loose stools, it 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 a similar nature, there is general deterioration conditions, cold sweat, lightheadedness, 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 there is a feeling in the heart area Blunt pain, it could 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 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 hernia cervical region 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. More pills You can’t drink them - among other things, they lower your blood pressure (P.S. headache after taking nitroglycerin - a normal phenomenon, can be removed 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 to the right specialist. This will be a better solution than undergoing examinations yourself, wasting time and money.

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Types of heart pain

Pain in the heart can be varied in nature, and the correct diagnosis of the causes of the disease depends on this. They are characterized by their intensity:

long-term;
aching;
piercing;
compressive;
permanent;
short-term;
concentrated in the heart area;
giving somewhere (to the arm, shoulder, neck, jaw, etc.).

When the heart aches, reasons feeling unwell It is recommended to find out as soon as possible. To do this, you need to contact a cardiologist. Next, the doctor will order an electrocardiogram and, if necessary, other tests, which will help make the correct diagnosis to determine the appropriate treatment.

Ignoring the problem can lead to a worsening of the patient's condition.

Causes of discomfort

Pressing and aching pain in the heart area is characteristic of a process such as angina pectoris. Unpleasant feelings can be localized not only in the heart area, but also spread to the arm, leg, stomach and even jaw. With angina pectoris, the patient does not feel stabbing pain, but of this disease This is not typical. An attack may begin after physical activity. Its duration ranges from 5-10 minutes. If you take a nitroglycerin tablet (put it under your tongue), the symptoms of angina disappear.
Another reason that causes aching pain in the heart area is myocardial infarction. With a heart attack, the symptoms are similar to angina pectoris, but the distinctive feature of this pathology is that it can begin at any time, regardless of the state of rest or wakefulness. That is, a person can relax in a chair, go for a walk or actively engage in sports. If the victim is given a nitroglycerin tablet, his condition does not improve. When a myocardial infarction is diagnosed, the patient requires hospitalization.
Myocarditis is another one unpleasant illness, which provokes an aching condition in the area of the heart muscle. The provocateur of the development of the pathological process is inflammation, which occurs due to infectious diseases or occurs after them as a complication. In addition to aching pain, the patient experiences a disturbance in heart rhythm, dullness of tones and noises. Heavy current The disease is considered to be the formation of blood clots in the cardiac cavity. With myocarditis, pain accompanies a person constantly, that is, it may not subside for several days. To get rid of pathology, treatment is carried out comprehensively. It is aimed not only at eliminating unpleasant symptoms, but also at suppressing inflammatory process and normalization of the functioning of the entire body.
The inflammatory process occurring in the pericardial layers, with possible accumulation of fluid in the pericardial cavity, which is accompanied by aching pain in the heart area, indicates pericarditis. The peculiarity of this disease is that aching pain is characteristic only at the initial stage of development of the disease. Other symptoms include rapid heartbeat, shortness of breath and cough.
Feelings of discomfort and pain can be caused by cardiomyopathy. This is a pathological process in which sclerotic and dystrophic lesions of the heart cells are observed. The patient often experiences chest pain, shortness of breath, tachycardia, and swelling of the legs. Treatment of cardiomyopathy is selected according to the stage and severity of the disease. It can be conservative, that is, medication, or radical, such as a heart transplant.
A constantly present aching pain that does not subside after taking nitroglycerin may indicate mitral valve prolapse. This pathology in most cases does not require treatment, but it is possible that it may even be required. surgical intervention. Mitral valve prolapse is more common among the younger population.
Other diseases such as anemia, vitamin deficiencies, bad habits etc., can lead to the development of myocardiostrophy. This disease It is more common in men over 40 years of age. In addition to aching pain, low blood pressure, shortness of breath and atrial fibrillation are observed.

Other pathologies

Other reasons that cause aching pain in the area of the heart muscle may not be related to diseases of the heart itself, but may be caused by other factors.

Aching pain in adolescence, which is short-term in nature and most often occurs after emotional overexcitation, is provoked by changes hormonal levels. IN puberty The body experiences a lot of changes associated with growing up. When the process of puberty is completed, all symptoms go away on their own.

You can alleviate a teenager’s condition; for this it is recommended to take a pill sedative previously prescribed by a doctor. Additionally, you need to monitor your diet. Food should be balanced and contain sufficient amounts of vitamins. The regime of rest and wakefulness during this period of life is also very important.

Due to reasons such as changes in hormonal levels, aching pain, shortness of breath, etc. may accompany a woman during menopause.

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Article publication date: 02/08/2017

Article updated date: 12/18/2018

From this article you will learn: what diseases can be accompanied by pain in the heart area, whether it is possible to find out from the characteristics of pain how the heart hurts, and how other organs hurt. Why do you need to pay attention to additional symptoms? What to do when heart pain occurs, and which specialist to contact.

Heart is vital important organ, connected to all organs and tissues through a system of blood vessels and nerve plexuses. Therefore, pain in the area of the chest where it is located is always perceived as a signal of cardiac pathology. But it is only 60–70% of such a sign. About 30–40% of pain is of non-cardiac origin and is associated with pathology of other systems.

It is possible to completely stop (relieve) pain in the heart, but this is not enough to get rid of causative disease, of which they are a symptom. In order to solve this problem, you need to contact a specialist who has the greatest knowledge about the origin of heart pain. This could be a cardiologist, internist or family doctor.

Characteristics of pain in cardiac pathology

The heart can hurt in different ways - it presses, stabs, aches, burns, bakes; and with varying strength - from mild discomfort to intense, pronounced pain. Localization can also be different, but always corresponds to the location of the heart: the sternum area, the left half of the chest and areas located next to it (the left half of the neck, shoulder, scapula, paravertebral and interscapular region).

If it presses

The most common pain that occurs in cardiac pathology is pressing (in 95–99%). It indicates a circulatory disorder coronary arteries, coronary disease and angina pectoris.

Her typical characteristics such:

It is provoked and intensified by any physical activity, experience or psycho-emotional stress.
Localized clearly behind the sternum or to the left of it.
It can radiate to the left arm and shoulder blade.
Accompanied by a feeling of lack of air, shortness of breath and weakness.
It goes away with rest after stopping exercise or taking nitroglycerin.

Similar manifestations are possible when inflammatory lesion myocardium - myocarditis. Additional criteria given in the table will help to distinguish angina from inflammation.

- a reliable sign of cardiac pathology.

If he bakes

The pain behind the sternum or in the left side of the chest can be sharp and burning. Patients say that their heart hurts, it feels like it’s burning, it’s burning in their chest. Such characteristics of the pain syndrome in 95–99% indicate a particularly dangerous cardiac pathology:

1. Myocardial infarction

It burns behind the sternum and radiates to the left half of the neck, shoulder blade, and shoulder.
Occurs suddenly or after a previous pressing pain more often during physical or psycho-emotional stress.
Accompanied by a drop in blood pressure, sweating, fear of death, and severe shortness of breath.
Symptoms are not relieved by taking painkillers or nitroglycerin.

2. Pulmonary embolism

This is a blockage of the blood vessels of the lungs with blood clots that enter them from the veins lower limbs. According to the characteristics of pain and clinical manifestations the disease is difficult to distinguish from myocardial infarction (they are almost identical).

3. Dissecting aortic aneurysm

With this pathology, an abnormally dilated section of the largest vessel in the body ruptures, close to the point of exit from the heart.

Burning pain is similar to a heart attack, but:

rarely radiates to the left half of the body;
accompanied by pain between the shoulder blades in the spine;
occurs and intensifies after a previous episode of high blood pressure.

In case of acute burning pain in the heart, first of all you need to think about the most serious illnesses which can result in death if the patient is not provided with emergency care.

If it stings

Stitching pain is not specific for, but in 20–25% it may indicate them. It can be:

If stabbing sensations are associated with these diseases, they are:

constant and do not depend on the position of the body or certain movements (turning or tilting the body, raising the arm);
may intensify when walking or psycho-emotional stress;
accompanied general weakness or irritability;
the heartbeat is rapid or the rhythm is disturbed;
may intensify at the height of deep inspiration.

About 80% stabbing pains in the heart area - a symptom of conditions not associated with cardiac pathology.

If there is aching or discomfort

Aching pain and discomfort in the heart are the most nonspecific types of cardialgia, the characteristics of which cannot be used to determine what they are associated with and what to do about them. They equally often indicate that the heart hurts, as well as diseases of other organs and systems (muscles and nerves, lungs and pleura, stomach and esophagus). Therefore, you cannot focus only on them. The main attention should be paid to the general condition, age of the patient, and other manifestations that are characteristic of cardiac pathology:

increased, slow or interrupted rhythm;
shortness of breath and feeling of lack of air;
swelling in the legs;
pressure changes (increase or decrease).

All these symptoms, combined with aching pain or discomfort in the heart, may indicate any heart disease: from harmless secondary cardialgia in healthy people against the background of body overload to a painless form of myocardial infarction and. to install the real reason, you need to do examinations, the scope of which can only be decided by a specialist (cardiologist, therapist, family doctor).

If not the heart, then what?

In general, pain localized in the area where the heart is located - behind the sternum and the anterior surface of the left half of the chest - in 30% of cases does not indicate a pathology of this organ. They can be caused by the lesions described in the table.

Diseased organs and tissues	Diseases and causes of heart pain	Features of pain syndrome: when it occurs and how it proceeds
Spine, ribs, intercostal muscles and nerves	Osteochondrosis	More often it is sharp, stabbing, like a lumbago when turning the body, taking a deep breath, or a constant aching along the ribs on the left from the spine to the sternum.
	Hernia
	Myositis
	Intercostal neuralgia
Lungs and pleura	Left-sided pneumonia	Most often aching, heaviness or discomfort is constant, but can be severely acute during each breath, accompanied by shortness of breath, cough, high temperature bodies.
	Left-sided dry and exudative pleurisy
	Injuries
Esophagus and stomach	Diaphragmatic hernia	Aching pain and discomfort behind the sternum, possibly heartburn. Occurs after eating (especially overeating), accompanied by belching, heaviness, and bloating.
	Peptic ulcer
	Reflux esophagitis, erosions and ulcers of the esophagus

Possible reasons pain in the heart

To understand exactly why pain in the heart occurred, pay attention not only to its nature (sharp, burning, aching, etc.), but also to other existing symptoms. But remember that they are not always interconnected, as they can be combined manifestations various diseases in one person (for example, pathology of the esophagus and ischemic disease or pleuropneumonia and intercostal neuralgia).

Diagnosis: main signs of cardiac and non-cardiac pain

The table describes the most common criteria and signs by which you can determine whether pain in the heart area is associated with its damage or not. This data will help you understand what to do with a sick person and whether he needs emergency help.

Heart pain	Non-cardiac pain
Behind the sternum or to the left of it along the anterior surface	Dotted in one area of the left half of the chest
Gives to the left arm, neck, shoulder blade	Gives along the ribs on the left, into the spine
Pressing, burning, stabbing	Stitching, aching, shooting
Provoked or aggravated by exercise (walking)	Provoked by sudden turns of the body, take a deep breath, eating
More often paroxysmal	Paroxysmal or constant
Decreases at rest	Decreases in a certain body position (motionless on the left side, half-sitting)
Removable (stopped) with nitroglycerin	Does not decrease after nitroglycerin, relieves painkillers
Pressing on the chest does not increase pain	Pressing on pain point, painful near the spine and along the ribs
Accompanied by symptoms: shortness of breath or shortness of breath; palpitations or irregular heartbeats; high or low pressure; sweating and weakness; violation of the general condition.	Possible additional symptoms: curvature and crunch of the spine; cough and fever; heartburn, feeling of sourness in the mouth; belching, abdominal discomfort; general condition is rarely disturbed.

What to do, how to help

If the cause of the pain is unknown to you

If you cannot determine what is causing the pain in the heart, regardless of the cause of its occurrence, do the following:

Don't panic, calm down, don't be nervous, breathe smoothly and shallowly.
Physical rest - it is better to lie down or sit down so that the torso is slightly elevated, in as a last resort just stand if you feel like you won't fall.
Access fresh air– on the street, simply unfasten the top buttons or tie, which can put pressure on the neck and chest; indoors, additionally open a window, window or door.
If possible, measure your heart rate and blood pressure. If the pulse is above 90–95 or less than 55–60 per minute, and the pressure is above 140/90 mm Hg. Art. or below 100/60 (more or less than the numbers you are used to) - call ambulance(phone 103), as there is a high risk of serious heart disease.
If the pain does not decrease after a few minutes, take a painkiller (Ketanov, Panadol, Imet, Diclofenac) in combination with Aspirin or chew and place Aspirin only under the tongue.
If after 15-20 minutes the pain in the heart does not go away or gets worse, this may indicate a heart attack - call an ambulance. This can be done when it first arises, if the pain is burning, severe, accompanied by shortness of breath, pallor and sweating of the skin, a feeling of fear of death, high or low blood pressure.

If you have any cardiac or non-cardiac pain in the chest, you should never take Citramon, Copacil or other drugs containing caffeine!

If you know the cause of the pain

If you know the probable or exact cause of pain in the heart, in addition to the main measures, you need to do the following:

For angina pectoris:

take Nitroglycerin under the tongue;
chew Cardiomagnyl or another drug containing acetylsalicylic acid;
with normal or high blood pressure and pulse, you can take beta blockers (Metoprolol, Bisoprolol, Nebival);
pain persisting for more than 30 minutes is a reason to call an ambulance;
If the pain goes away, contact a cardiologist, general practitioner or family doctor.

For myocarditis and pericarditis, all that can be done at the first stage of help is to take a pain reliever. Be sure to contact a cardiologist, the sooner the better.
If you have intercostal neuralgia, osteochondrosis or other problems with the spine, take painkillers (Analgin, Diclofenac, Dolaren, Nimid) and consult a neurologist.
For problems with the stomach and esophagus, stick to dietary nutrition, for pain, you can take drugs Omez, Famotidine, Maalox, Motorix, Motilium. Behind specialized assistance contact a gastroenterologist.

Pain in the heart area is a symptom of diseases not only of the heart. Whenever it appears, first of all it is necessary to exclude its pathology (this condition is the most dangerous and more often than others requires emergency medical care).