Heart pain is a symptom faced by each person in one or another period of life.
But only in half of the cases we are talking about the pathological lesion of this organ. Otherwise, the causes of pain syndrome are very different, ranging from the abuse of coffee, and ending with the pathologies of the respiratory or digestive system.
The cause of pain in the heart must be clarified in any case. Sometimes it can signal dangerous pathologies, by identifying and curing them, it is possible to prevent the consequences dangerous to health.
Causes of pain in the heart
Cardialgia can occur in every person, without exception, and under completely different circumstances. But they do not always talk about the presence of heart disease.
Conditionally, the etiology of pain can be divided into cordial and extracardiac. Heart Disease:
- ischemic disease (stenocardia, arrhythmias, myocardial infarction, post-infarction cardiosclerosis);
- myocardial dystrophy;
- secondary lesions on the background of diabetes, uremia, hyperthyroidism;
- heart injury;
- with hypertension;
- irrational physical exertion;
- volume with thyrotoxicosis;
- pressure in case of portal hypertension (for example, in case of liver cirrhosis).
Pathologies of large vessels:
- aortic aneurysm, including its dissection;
- coarctation of the aorta;
- pulmonary artery thrombembolia.
Diseases of the mediastinum:
Damage to the nerve trunks:
- intercostal neuralgia;
- herpes zoster.
Diseases of the stomach and esophagus:
- foreign bodies of the esophagus;
- stomach ulcer;
- esophageal stenosis;
- Mallory-Weiss syndrome;
- chemical burns of the esophagus and stomach;
- gastric bleeding, ulcer perforation.
- tumors of the lungs or large bronchi.
- rib fractures and cracks;
- pain with blood tumors.
- mastopathy (gynecomastia in men);
- benign tumors.
Toxic effects caused by:
- heart poisons;
When visiting the doctor, it is extremely important to correctly describe the symptom of the patient, without losing a single detail. It is thanks to a detailed history that the doctor will be able to understand in which direction to move further in order to help the patient to get rid of unpleasant symptoms.
A further scheme of examination, and then treatment will be based on data on:
- conditions of occurrence of cardialgia;
- the nature of the pain syndrome (stabbing, cutting, intense, dull, etc.);
- duration of pain;
- moment and conditions of the cessation of discomfort.
Only after a diagnosis has been made will the doctor be able to prescribe a treatment that will eliminate not only the symptom itself, but also the cause of its occurrence. If the heart pain is associated with inflammatory lesions of the contractile organ, then the patient may be prescribed a course of antibiotic therapy (with a bacterial etiology of the disease). In case of viral genesis of the disease, antiviral drugs are prescribed. Self-treatment is unacceptable, since the therapeutic scheme is developed strictly for each patient individually.
Sharp pain in the heart indicates the need for immediate medical intervention. Such sensations can be one of the signs:
- Angina pectoris. An acute attack is accompanied by severe pain in the retrosternal space, tremor of the limbs, and a state of panic. With prolonged absence of therapeutic interventions, thrombosis, embolism or stenosis of blood vessels may develop. In this case, nitroglycerin will help get rid of the pain and stabilize the activity of the heart. If within 15 minutes after the resorption of the pill the improvement did not come, this may indicate an acute myocardial infarction.
- Myocardial infarction. This condition can be stopped only in the hospital. When a part of the heart tissue dies off, there is a serious threat to the life of the patient, so self-treatment is unacceptable! The pain in this case is prolonged, burning, sharp, spreading to the left arm and / or scapula. It does not pass when taking nitrodrugs, accompanied by shortness of breath, panic, strong trembling of hands and feet. Often, a heart attack occurs in conjunction with cardiac arrhythmia, convulsions, and involuntary urine. In some cases, the disease develops without intense pain, but its sharpness remains the same.
- Diseases of the esophagus and stomach. A sharp pain in the heart can be the result of perforation of gastric ulcers, localized in the cardiac part of the digestive organ. As a result, the person will have swimming flies before his eyes, bouts of dizziness, and even fainting. Bleeding from the esophagus in Mallory-Weiss syndrome occurs with frequent vomiting. They can also open when the esophageal veins are dilated with portal hypertension that has developed on the background of hepatic cirrhosis. All the above cases are extremely dangerous, and require mandatory medical intervention.
- Pulmonary embolism. A thrombus can move to the pulmonary artery from varicose veins in the legs or pelvic organs. The more veins of the pulmonary artery underwent thrombosis, the more intense and intense the pain. In this case, there is a cough with sputum containing blood impurities. Other symptoms include shortness of breath, palpitations, and protrusion of the neck veins. Thrombosis of large trunks entails the development of collapse and loss of consciousness.
- Aortic aneurysm dissection. The disease often affects older men, and may be the result of prolonged untreated hypertension, ASB, vasculitis, or aortic coarctation. Most often, the ascending aortic region undergoes dissection. Longitudinal rupture of the vessel lining causes blood to accumulate between the aortic layers. Patients complain of a sharp pain in the area of the heart, which can give to the scapula. At the same time, breathing quickens first, then decreases. Pulse on the extremities is different, there is blue skin. A person sweats heavily, may lose consciousness, his physical activity is disturbed. Hematoma can cause heart tissue hypoxia, shortness of breath, hoarse voice. Often against this background a coma develops.
This nature of pain speaks of hypoxia of the heart muscle. This symptom is noted in almost all forms of IHD. Angina pectoris is accompanied by constricting pain in the heart, giving to the left arm or shoulder blade. It occurs suddenly, but passes independently when a person is at rest. Sometimes it may be necessary to take nitroglycerin to relieve an attack.
Such pain may accompany:
- fibrillation of the ventricles or atria;
- frequent bouts of extrasystole;
- paroxysmal tachycardia;
- atrial fibrillation;
- intracardiac blockade.
Quite often, such pains are accompanied by the patient's fear of the possibility of sudden death. Sometimes, instead of pain, the patient manifests shortness of breath, indicating blood circulation insufficiency.
With Prinzmetal angina pectoris, squeezing pain occurs in the region of the heart or the left subscapularis. It can occur when the patient is in a state of complete physical rest, especially in the morning. The development of pain syndrome is associated with spasm of the coronary arteries.
If such pain appears rarely and is not accompanied by vegetative disorders, then it is not dangerous. This symptom may accompany:
- Neurocirculatory dystonia. The disease is characterized by a mismatch in the work of the vascular and nervous systems, so the blood vessels do not have time to narrow or expand in time in response to a certain load.
- Extrasystoles, tachycardia, myocarditis. With such pathologies, stabbing pains in the region of the heart occur infrequently.
- Myositis, muscle strain. This is the most common cause of such pains in the heart.
- Intercostal neuralgia. It develops due to hypothermia or pinching the nerve.
- Herpes zoster. This is a disease of viral etiology caused by the herpes virus 3 type Varicella-Zoster. The pathological process affects the nerve endings, so acute and very severe pain can be felt in any area of the body, including the left side of the chest.
It is important to differentiate heart pain from chest pain accompanying pleurisy, pneumonia, tuberculosis or cancer. Of course, it is impossible to do this on your own, therefore it is better not to let the situation take its course, but seek qualified medical assistance.
Aching pain in the heart
Cardioneurosis is the main cause of aching heart pain. Usually there are no organic changes in the heart or vessels, but if they occur, they are very minor. Neuroticism can occur due to:
- anxiety disorders;
- somatized depressive state.
Dissatisfaction with oneself and the world around us often leads to the appearance of weak aching pains in the region of the heart. Patients complain of a feeling of pressure, heart fading with a sigh, general anxiety over their condition.
The obsession with the presence of cardiac pathology in such patients can turn into an obsessive state, forcing him to be repeatedly examined and undergo consultations with different doctors. Such actions further aggravate the situation, and the signs of frustration begin to appear much brighter. The psychologist and group psychological trainings can help solve the existing problem.
Pain in the heart during deep inspiration and movement
Intercostal neuralgia is the main cause of chest pain in the projection of the heart. This symptom can occur at any time of the day, but most often it bothers a person at night. The nerve can be chilled after a long supercooling, or it can be trapped.
In addition to neuralgia, chest pain may result from:
- suffered injuries;
- pathologies of the broncho-pulmonary system.
But an accurate diagnosis can be made only after a thorough examination. In many patients, these symptoms indicate the presence of cardiac diseases.
How to distinguish heart pain from other chest pains?
Since there are quite a few reasons for the appearance of pain in the heart area, it is not always possible from the first time, without having the results of research, to determine the disease that caused the onset of a symptom. It is extremely important to describe the exact place of localization of pain, to indicate the presence of associated symptoms - irradiation to other parts of the body, autonomic disorders, etc.
If the pain is pressing, arising after physical exertion, food or stress, then it can last from 5 to 20 minutes. It tends to disappear independently after the cessation of exposure to the body of the provoking factor. Sometimes you may need to take nitroglycerin.
What heart pains require emergency care?
If in the area of the heart appeared burning, pressing pain, giving to the left hand and subscapularis, the intensity of which increases, and nitroglycerin does not help, then you should immediately call a doctor.
Such unpleasant symptoms as weakness, excessive sweating, dizziness, panic attacks, low blood pressure, fainting require special attention. Such ailments may indicate a myocardial infarction, PE or spontaneous pneumothorax.
These situations are extremely dangerous, so do not hesitate to call an ambulance.
Diagnosis at the doctor
Preliminary measures - anamnesis and auscultation - help to understand the direction in which the specialist should move to make a correct diagnosis. The usual scheme of examination in such cases is based on:
- general analysis of urine and blood;
- biochemical study of blood for transaminases, potassium, sodium, troponin, myoglobin, D-dimer, creatine phosphokinase, lactate dehydrogenase.
This is only the initial stage of laboratory diagnosis. As new circumstances are revealed that are important for the diagnosis and prescription of treatment, the doctor may prescribe many other procedures.
Equally important are instrumental diagnostic methods:
- Radiograph of the chest. It is carried out in order to identify pathological foci in the area of the lungs and bronchi, cardiac tissue, size of the contractile organ, the presence of air (or fluid accumulation) in the pleural cavity. In some cases, radiography is prescribed with contrast. It is carried out with suspected esophageal bleeding. Barium is used as a contrast agent.
- Electrocardiogram. It is necessary to confirm or refute the doctor's suspicions about the presence of a cardiac arrhythmia in a patient. Also, this instrumental procedure helps to identify angina pectoris.
- Echocardioscopy, or EchoX. This manipulation helps to thoroughly examine the heart, to determine how it copes with its functions. On the obtained images, the specialist notes the state of the pericardium, myocardium, aorta, snorts (valves), atria, ventricles, and other parts of the organ. In addition, the ECHO-CS makes it possible to determine the pressure in the pulmonary artery, to identify structural changes after a heart attack, to detect tumor lesions of the heart.
- Holter ECG. This is a device that monitors all indicators of the patient's cardiogram throughout the day.
The results can lead to the need for the appointment of additional diagnostic procedures for the patient: SCT for pulmonary artery thromboembolism, coronary angiography, FEGDS.
Given the fact that the causes of the symptom in question may be completely different, you should not try to figure them out yourself. Such measures can lead to serious consequences, so a visit to the doctor in this case is strictly necessary!