Very often chest pains are associated with heart and lung diseases. Indeed, this is one of the most important symptoms of various pathologies of these organs. But often the appearance of this pain has a completely different origin.
Three mechanisms are the cornerstone of the appearance of chest pain: irritation of the peripheral nerves, irritation of the spinal nerves and afferent fibers, which are part of the sympathetic and vagus nerve. Chest pain can be of coronary and non-coronary genesis: cardialgia, pain associated with diseases of other organs located in the chest, lesions of the musculoskeletal system of the chest wall.
Heart diseases accompanied by chest pain:
- angina pectoris
myocardial infarction
- pericarditis
- stratified aortic aneurysm
All these diseases are characterized by severe chest pain of varying intensity. With angina pectoris, it is of a compressive nature, giving to the left hand, is removed by taking nitroglycerin. Pain with myocardial infarction is more intense than with angina pectoris, prolonged, cannot be relieved by taking nitroglycerin and is accompanied by the development of heart and vascular insufficiency.
Diseases of the respiratory system are accompanied by chest pain only if the disease affects the pleura. This is because a large number of nerve receptors are located in the pleura, and the lung tissue almost does not contain them.
Chest pain in respiratory diseases associated with such diseases:
- pleurisy
- pneumonia
- lung tumor
- pulmonary embolism
- pneumothorax.
With pathology of the respiratory system, chest pain is localized in the lateral parts of the chest, becomes more intense with deep breathing and coughing, often accompanied by fever, cough, shortness of breath.
Diseases of the spine (osteochondrosis, herniation of the intervertebral disc) lead to the appearance of pain, reminiscent in nature of pain in angina pectoris. It is localized in the region of the heart, often intensifies with movements and deep breathing. You can differentiate the nature of pain by removing an ECG, echocardiography. The simplest breakdown, which allows to differentiate the pathology of the heart and spine, is palpation of the intercostal spaces on the left in the direction from the spinal column to the sternum. With diseases of the spine, chest pain increases when pressed, which is not observed with heart diseases.
Some diseases of the digestive system can also cause chest pain. It can be a peptic ulcer, reflux esophagitis, pancreatitis, cholelithiasis, complicated by hepatic colic. With pancreatitis, the pain can be located on the left side of the chest or may be girdle-like. With cholelithiasis, it hurts in the chest on the right. This disease is often associated with errors in food, physical activity, accompanied by nausea and bitterness in the mouth, yellowness of the skin and mucous membranes. In peptic ulcer disease, there is a close relationship between the appearance of pain and eating. The pain, as a rule, appears after eating, can be accompanied by heartburn, belching, nausea.
Differential diagnosis of heart pain is necessary for the early detection of diseases that threaten the patient's life. Great importance is given to additional diagnostic methods. Be sure to conduct electrocardiography. In the absence of changes on the ECG, other instrumental studies of the organs of the chest, liver, gall bladder and stomach are prescribed.
We examined the causes of chest pain. All of them necessarily require a different approach to treatment, which can be prescribed with timely and correct diagnosis.