Pain in the heart is always considered by the patient as an immediate threat to life. The subsequent development of autonomic reactions as a result of fear, an increase in heart rate, and a feeling of dissatisfaction with inspiration reinforce such fears. Meanwhile, there are more than 100 causes of pain in the chest, and only 6 of them require emergency assistance and directly threaten health. Therefore, you need to correctly understand how to distinguish heart pain from osteochondrosis or fibromyalgia, how to suspect emergency pathology and what symptoms can be neglected.
Self Diagnosis Issues
Due to the need to relieve pain, medication is required, for which you need to clearly understand the reason for these sensations. An incorrect interpretation of the source and cause of the symptom leads to the fact that after taking the drug they do not subside and bother further. Many types of chest pain are completely impossible to eliminate with a single dose of medicines, and therefore almost every episode of their occurrence requires a doctor.
Stereotypical anginal pains of cardiac localization or previously unknown and sharply arisen severe chest pains require emergency treatment, and skeletal or vertebrogenic low-intensity sensations require routine examination and treatment. Each patient must understand this simple thesis in order to exclude inappropriate behavior and attitude to their health.
Self-diagnosis has two manifestations: the first is an underestimation of the severity of the condition, and the second is a panic (sometimes intentional) exaggeration and distortion of the nature of heart pain. The latter occurs with the development of mild, but unfamiliar or unpleasant symptoms. Then the imposition of thoughts and thoughts about the incredible severity of the symptoms that arose, the inevitability of a formidable pathology, the need for emergency treatment in an ambulance occurs.
Reasons for overdiagnosis
This happens due to ignorance of the differences in heart pain from other types of pain in the chest, and, succumbing to incredible fear and panic, the patient imposes on others the need for urgent medical care. It is important that an adequate, self-disciplined patient uses the materials, diagnostic criteria, and symptom descriptions specified in this publication.
It will be wrong to tear out any part of the publication from the context and interpret the severity of its condition only on the basis of individual phrases and sentences. The material on how to distinguish heart pain from osteochondrosis should be fully mastered. It is necessary to clearly distinguish between the pressing, stitching, cutting, and other nature of the unpleasant sensation, to highlight the accompanying symptoms, not to exaggerate or downplay the significance of each manifestation.
Osteochondrosis of the spinal column
In a disease such as osteochondrosis of the thoracic spine, the symptoms and treatment of which will be discussed below, differential diagnosis is required so as not to confuse it with injuries of the ribs or spinal column, myocardial infarction, pulmonary embolism, stratified aortic aneurysm, acute surgical diseases of the abdomen. In this case, the concept of osteochondrosis is more collective and simplified for the understanding of the patient.
In fact, the term refers to a group of degenerative diseases of the spine and intervertebral discs, the defeat or gradual destruction of which with age leads to compression of the roots of the spinal nerves. From exposure to them, as well as due to venous edema of the nerve roots, painful sensations develop. Their nature and patterns of appearance clearly demonstrate how to distinguish heart pain from osteochondrosis.
In case of damage to the cervical spine, dizziness, numbness and parasthesia in the shoulder region, sharp stitching and cutting pains in the chest and heart during movement of the neck or upper limbs, on inspiration and exhalation occur. Pain with osteochondrosis of the thoracic spine is approximately the same as with damage to the cervical spine due to the fact that the disease rarely affects only one area.
Treatment tactics
With a disease such as osteochondrosis of the thoracic spine, symptoms and treatment are not directly related to each other. That is, often the number of symptoms and the intensity of unpleasant sensations do not depend on the quality and duration of treatment. Low-intensity pains can even bother for a long time or constantly. But this is observed in a situation of inadequate diagnosis (or patient failure to comply with recommendations), when a more severe disease of the musculoskeletal system proceeds under the mask of osteochondrosis. In particular, the presence of a hernia of the intervertebral disc, which is characterized by a prolonged pain syndrome.
If all available treatment methods have not yielded results, it makes sense to perform an MRI of the spinal column and identify abnormalities in the structure of the intervertebral discs. Thoracalgia, intercostal neuralgia and dorsalgia, myofascial syndromes and fibromyalgia, that is, all those diseases that are called osteochondrosis, are treated with NSAIDs (Nimesulide, Aceclofenac, Ibuprofen, Ketoprofen pain relievers), Torelax ), B vitamins, physiotherapy.
Sources of Heart Pain
There are about 100 private causes of pain in the chest, so it is not possible to describe each of them in the framework of this publication. Therefore, it is reasonable to indicate all the sources of such sensations that will be considered as their significance decreases. Most often, the above skeletal pains are observed, grouped into the general concept of fibromyalgia. Vertebral and neurological occur less often, and even less often unpleasant sensations in the structures of the digestive system.
The rarest, but most significant, are anginal pain in the heart, pain with pulmonary thromboembolism, similar sensations arise with stratified aortic aneurysm. Below, each of these conditions will be considered in private. The severity of the diseases associated with them will decrease from top to bottom (higher will be severe pathologies that threaten life and require emergency treatment for help with SMP).
Sore throat
Pain in the chest often does not come from the muscles, bones and nerves, but from the heart, where they arise as a result of insufficient blood supply to the organ. And the most serious pathology is myocardial infarction, the complexity of the treatment of which patients most often underestimate. The main danger of a heart attack is cardiogenic shock, the development of which cannot be predicted at the stage of pain. This is probabilistic and requires urgent appeal for help.
As a primary diagnosis, the patient needs to evaluate heart pain: what are their intensity (strong or weak), duration (persistent or paroxysmal), how long the attack lasts and what kind of pain in nature (constricting and burning), whether there is an improvement after taking short nitrates actions. In addition, the following indicators are assessed: whether the level of blood pressure has changed, whether shortness of breath or a feeling of dissatisfaction with the breath appeared.
It is necessary to recall whether such symptoms were felt earlier and what was their previous cause. When exactly anginal pains occur during myocardial infarction, their certain stereotype is observed. That is, these are pressing constant pains without any connection with the phases of breathing and movement in the chest, they slightly decrease after taking nitroglycerin or briefly subside, may be accompanied by shortness of breath and a feeling of dissatisfaction with the inspiration.
Tactics for anginal pain
Myocardial infarction is not the only pathology that can cause anginal pain. With angina pectoris, including its progression, the symptoms are similar. However, in this case, after taking nitrates, heart pain is relieved. Unlike angina pectoris, with a heart attack, this is rare. If after taking nitroglycerin after 5-7 minutes, the condition has not changed and repeated taking the pill did not give an effect after another 5-7 minutes, then it is reasonable to seek emergency medical attention for a heart attack.
It can be caused by myocardial infarction, progressive or unstable angina, as well as a prolonged angina pectoris against the background of a hypertensive crisis. Each of these conditions requires medical attention, sometimes hospitalization in a cardiology hospital. All heart pains, the symptoms and treatment of which are indicated above, require attention due to the risk of cardiogenic shock or left ventricular failure. And with the appearance of such sensations in the chest, it should be remembered that anginal pain is stereotyped and manifests itself as a feeling of strong compression and burning behind the sternum, accompanied by shortness of breath or a feeling of dissatisfaction with the breath, squeezing in the neck, sometimes in the interscapular space, accompanied by fever in the face, tachycardia .
Combined pain
It is important that heart pain is not excluded when confirming osteochondrosis, thoracalgia or neuralgia of the intercostal nerves. Since several organs and systems can be affected simultaneously, anginal pain often occurs along with skeletal. They are more difficult to distinguish between each other due to the simultaneous presence of pressing and burning sensations in the heart, and stitching pains along with parasthesia or "backache" in the back or intercostal space.
In such situations, a careful separation of symptoms is required, each type of which, together with the patterns of their occurrence, should be described by a doctor. It is necessary to perform an ECG and compare it in dynamics. The appearance of new changes on the ECG or a clear picture of the acute coronary syndrome indicates heart disease. Then, regardless of the severity of skeletal pathology (osteochondrosis, thoracalgia, trauma), priority in treatment should be given to heart disease.
What to drink with heart pain and how to stop it in this case will be thoroughly explained by the attending physician before discharge from the hospital. It is not recommended to make changes to his prescribing scheme on his own because new drugs may affect the likelihood of repeated coronary artery thrombosis.
Emergency vascular pathology
In this group, there are two diseases that are manifested by pain in the chest and often pain in the heart. This is pulmonary embolism and exfoliating an aortic aneurysm. The intensity of pain varies from discomfort to severe intolerable, accompanied by tachycardia and shortness of breath at high or low blood pressure. The prognosis mainly depends on the extent of the lesion (total or subtotal pulmonary embolism), the speed of treatment and treatment.
With stratified aortic aneurysm, pain of a constant nature is severe and localized behind the sternum, in the interscapular region and sometimes just to the right of the sternum. The pain is stronger the higher the blood pressure, and as it decreases, it weakens. The urgency of the pathology is due to the risk of rupture of the stratified aneurysm, which will immediately cause shock symptoms: sharp pallor and moisture of the skin, lethargy, lethargy, tachycardia, rare breathing.
Pulmonary embolism
With pulmonary embolism, clinical manifestations depend on the extent of the lesion. With total pulmonary embolism, the patient feels a sharp pain in the chest and heart, after which he almost instantly loses consciousness due to developing shock and arrhythmia. With subtotal pulmonary embolism, the sensations are less intense, accompanied by severe shortness of breath, tachycardia. The risk of shock is also great, which requires seeking emergency medical care.
In this case, one does not have to think about how to distinguish heart pain from osteochondrosis, since the nature of the sensations in the first and second cases is fundamentally different. They cannot be confused with vertebrogenic pains, if only because they are not dependent on movement and are accompanied by other severe symptoms (shortness of breath, loss of consciousness, tachycardia) and are accompanied by shock.
Abdominal Surgical Diseases
This group of diseases should include rupture of the esophagus, ulcer of the esophagus, stomach ulcer and 12 duodenal ulcer, gastrointestinal bleeding, pancreatitis, cholecystitis. In the vast majority of cases, these pains are similar to cardiac, although they rarely mimic vertebrogenic pain or fibromyalgia. However, they differ in that they require emergency care, and patients almost always confuse them with pain in the heart and pain with osteochondrosis.
All diseases of the abdominal cavity are accompanied by dyspepsia in 90% of cases (vomiting, belching, or nausea develops), and in 75-90% of cases, aggravation of pain can be associated with eating. So, if the patient is concerned about chest pain, nausea and vomiting (sometimes with blood or fetid discharge), then the likelihood of heart disease (like osteochondrosis, fibromyalgia or thoracalgia) becomes minimal. In 3-5% of cases of myocardial infarction, posterior localization is noted, which can sometimes be characterized by clinical signs of acute abdominal disease, imitate pancreatitis, cholecystitis, renal colic, appendicitis and others.