Sharp chest pain causes. Breast pain in women: alarm or normal? Chest pain during exercise

Any pain causes discomfort, but if it is a sudden pain in the chest, intense anxiety is added to the discomfort. What could it be - a heart attack, a heart attack, or maybe intercostal neuralgia? What to do in this case - wait until the pain goes away, go to the doctor or call an ambulance?

The sternum is a flat bone located in the center of the chest that articulates with the ribs. The sternum consists of three parts: the body itself, the handle and the xiphoid process. With excessive physical exertion, all of the above parts can move. With injuries, bruises, pain in the injured area of ​​\u200b\u200bthe sternum, of course, increases. The same pain sensations are observed when pressing on the sternum, bending the torso.

In fact, the causes of pain in the chest can be very different, from heart failure to lung diseases or pathologies of the abdominal cavity. As a rule, angina pectoris, myocardial infarction, osteochondrosis, stomach ulcers or injuries are such an unpleasant symptom, and therefore it is important to pay attention to the nature and localization of pain in order to identify the problem in a timely manner and respond to it correctly. Let's see what chest pain in the middle can talk about?

Causes of chest pain

All causes of pain in the chest can be conditionally divided into:

• pathologies of the cardiovascular system;
• diseases of the bronchopulmonary system;
• diseases of the gastrointestinal tract;
• neurological diseases;
• injury.

1. Diseases of the cardiovascular system

Often, it is heart disease that provokes pain in the middle of the chest. As a rule, these are serious diseases such as a heart attack or angina pectoris. Regardless of what kind of disease struck a person, he feels a sharp pain in the middle of the chest, which radiates to the left side.

A distinctive feature of angina pectoris is a squeezing, pressing pain that simply fetters a person, preventing him from moving. No wonder such an attack is called "angina pectoris." With angina pectoris, pain can occur not only on the left side, but also in the sternum. In this case, the patient feels the presence of a foreign object in the upper chest. The pain may radiate to the left shoulder, hand or shoulder blade, and be accompanied by a burning sensation. To relieve the attack, you need to put a Nitroglycerin tablet under the tongue. Literally in a minute the attack will recede.

Pain, signaling the development of myocardial infarction, manifests itself somewhat differently. As a rule, this is a sharp pain behind the sternum, which increases with physical exertion and can radiate to the inner surface of the left arm or to the left shoulder blade. With the development of an attack, such pain may cover the lower jaw, shoulder and neck, and a tingling or numbness will be felt in the left arm. In a heart attack, the nature of the pain in the chest is sharp, burning and tearing. In addition, such pain is accompanied by cold, sticky sweat, suffocation, anxiety and fear for one's life. At the same time, the patient's pulse quickens, his face turns pale and his lips turn blue. Painkillers and Nitroglycerin do not help in this situation. Faced with a myocardial infarction, you must immediately call an ambulance, because this condition threatens a person's life.

If there is continuous chest pain, predominantly in the upper part of the chest, this may be an indication of an aortic aneurysm. The aorta itself is a large vessel that comes from the left ventricle of the heart. Vessel dilation, or aneurysm, can occur for many reasons. In this case, pain sensations are observed for quite a long time, and with physical exertion they are significantly enhanced. The slightest suspicion of an aortic aneurysm requires immediate hospitalization. Surgical intervention is necessary to overcome the existing ailment.

Also, pain in this part of the chest is sometimes the cause of a disease such as pulmonary embolism, characteristic of the right ventricle of the heart. The pain in this case is strong, resembling angina pectoris, but they do not radiate to other areas. The main symptom of pulmonary embolism is an increase in pain with each breath. Painkillers help relieve pain, but even after taking them, the pain syndrome does not subside for several hours. Immediate medical attention is indispensable.

2. Pathologies of the bronchopulmonary system

Dull pain in the chest can be an alarming bell, talking about serious diseases of the respiratory system. For example, this symptom often accompanies complicated bronchitis, pleurisy, pneumonia or tracheitis. A characteristic feature of pain in such diseases is an increase in discomfort when inhaling, and sometimes the inability to take a deep breath.

It is not difficult to explain the cause of such pain. The fact is that the inflammatory process in the lungs affects the diaphragm and intercostal muscles, which causes pain with every muscle contraction in the respiratory system. An additional symptom in the case of these inflammatory diseases is an increased body temperature, as well as a strong cough that does not go away for a long time.

3. Diseases of the gastrointestinal tract

Pathologies of the stomach often lead to this type of pain. Especially often this symptom appears with an exacerbation of a stomach ulcer, duodenal ulcer or diaphragm abscess. In these cases, aching dull pain in the center of the chest is complemented by pain in the back and intensifies when you press on the stomach area.

In addition, pain in the heart area can appear after eating (especially if a person has eaten a lot of fatty foods), or vice versa, with an increase in hunger. Such pain develops due to the general innervation of the stomach and may be a consequence of diseases such as pancreatitis or cholecystitis.

Feeling pain in the middle of the chest may be due to strong contractions of the gallbladder. Intense pain in the sternum, radiating to its left side, may be a symptom of damage to the bile ducts and bladder. Pain, somewhat reminiscent of the heart, occur in acute pancreatitis. Very often, chest pain becomes simply unbearable. A person often takes it for a heart attack, not taking into account the lack of spread to other organs. Only with the help of intensive treatment in a hospital can suffering be alleviated.

4. Neurological diseases

Stitching pains in the chest during movement, sharp turns of the body and deep breaths are far from always related to a sick heart. It may well turn out that they are caused by neurological diseases, which include intercostal neuralgia, thoracic sciatica and osteochondrosis. The nerve roots connecting the ribs to the spine are compressed and irritated during the movement of the chest, which causes a sharp dagger pain in the sternum.

Symptoms in the case of these ailments are extremely diverse: the pain can be aching, stabbing, dull or pressing. It does not subside in the case of rest and intensifies with movement. Moreover, over time, the nature of the pain may change. Moreover, antispasmodics and painkillers in this case do not bring relief.

5. Injuries

Previous injuries, bruises of the chest, fractures of the ribs or displacement of the vertebrae can also provoke pain of varying intensity in the middle of the chest. Even if the injury did not lead to a fracture, it is quite possible that there was compression of the vessels and a violation of blood flow to the muscle tissues. The result is swelling and aching pain in the chest. And from additional symptoms, a bruise and discomfort may appear when probing the painful area.

Other reasons

There are other reasons for the appearance of pain in the middle part of the chest. Pain in the sternum may be due to an increase in the thyroid gland, disorders in the structure of the spine are also reflected in pain in the middle part of the sternum.

How to distinguish neuralgia from angina pectoris

In the event of an attack of angina pectoris, the patient feels how the pain simply “spreads” throughout the chest, and in the case of neuralgia, it is localized in a certain place. Moreover, at rest, neuralgic pain immediately subsides, but the intensity of pain in the heart does not depend on physical exertion. At the same time, taking a Nitroglycerin tablet, the same pain in angina pectoris will subside. If it is a heart attack or neuralgic pain, the drug will not eliminate pain.

Symptoms requiring an immediate emergency call

With all the symptoms described above, it is very difficult for a person to understand the causes of discomfort and pain in the chest. However, there are a number of characteristic signs that require emergency medical attention. So, you need to call an ambulance if:

• a dagger pain appeared in the chest, from which one can lose consciousness;
• chest pain radiating to the lower jaw and shoulder;
• pain sensations last more than 15 minutes, and do not disappear even at rest;
• when inhaling, there is a feeling of squeezing in the chest, which is complemented by an unstable pulse, dizziness, nausea and vomiting;
• there were sharp dagger pains with intermittent breathing, high fever and bloody cough.

Feeling at least one of the above symptoms, do not try to figure out its causes. Just call an ambulance and take a horizontal position. Before the doctors arrive, try not to take painkillers (only Nitroglycerin is possible) so that they do not affect the diagnosis. And further. Do not try to refuse hospitalization if the attack has already passed by the arrival of specialists. Remember, the disease is better to prevent than to cure later.

Let's figure out why there is aching pain in the chest, and what diseases it may indicate. The chest is an extremely sensitive organ. The mammary glands sensitively respond to all hormonal changes that occur in the body. Therefore, when any unpleasant symptoms appear, it is imperative to find out the cause of the ailment and eliminate it.

The mammary gland is a paired organ belonging to the glands of external secretion. The main purpose of the breast is to secrete milk during lactation. The breast tissue itself is located from the 3rd rib to the 7th rib. The chest is supported by the pectoralis major muscle, which is responsible for the tone and location of the mammary glands.

The protruding part of the mammary gland is called the body by physicians. It is on it that the nipple and areola are located - the complex responsible for the excretion of the lactiferous duct into the environment. Areola is a hyperpigmented area with thin skin. The nipple is an outgrowth that consists mainly of epithelial tissue. In addition to the lactiferous duct, lactiferous pores can be seen on the nipple - these are the outlet areas of the lactiferous canals, which are smaller than the main duct.

Inside the mammary gland consists of lobules. They, in turn, are formed by microscopic alveoli, which are located throughout the breast tissue. Each alveolus is connected to others, together they form lobules. Individual lobules are combined into larger segments. These segments perform the main function of the breast - during lactation they form and excrete milk. And between the segments there are layers of connective and adipose tissue.

The size and shape of the breasts are individual parameters. They can change slightly with the course of the menstrual cycle or during pregnancy, as well as with some diseases, and not only breasts.

It is clear that there can be many reasons for pain, based on the complex anatomical structure. Therefore, if discomfort and pain appear, it is better not to engage in self-diagnosis and consult a doctor. And this article will help you understand what can happen to the chest, and how dangerous the observed symptoms are.

Classification of breast pain

According to the periods of occurrence, two main types of pain in the mammary glands are distinguished:

• Cyclic. Associated with the monthly cycle. Usually appears before menstruation, may increase over time.
• Non-cyclic. It occurs suddenly, is not associated with natural hormonal changes. Usually it is evidence of injuries, bruises, intercostal neuralgia.

It is important to determine not only the frequency of occurrence of painful sensations, but also the nature of the pain. By the nature of the pain is usually divided into the following groups:

• Shooting. Characteristic for inflammatory and purulent processes.
• Dull.
• Acute.
• Stab.
• Cutting.
• Pulsating. Occurs with inflammation or prolonged irritation of tissues.
• Aching.
• Pulling. Often combined with aching.
• Burning.

It is clear that it can be difficult for patients to name the specific nature of the pain, but when visiting a doctor it is important to describe the painful sensations as accurately as possible - this will help in diagnosing the disease.

Symptoms and manifestations

Allocate symptoms of cyclic pain and non-cyclic. A separate group includes the so-called dangerous symptoms - they indicate serious inflammatory or oncological processes.

1. Cyclic pain is either a natural discomfort associated with a change in hormonal levels during menstruation, or evidence of mastopathy - a diffuse form of the disease is often manifested by periodic pain.
2. Non-cyclic pains indicate a sudden injury or the development of a disease. Dangerous symptoms are a series of signs by which the most insidious diseases can be recognized.

Symptoms of cyclic pain syndrome:

• Soreness is closely related to menstruation. The pain appears before menstruation and disappears at the 2nd week of the cycle.
• The pain is aching and dull.
• There are signs of an inflammatory process in the tissues of the mammary gland - swelling, engorgement and swelling of the breast are observed.
• Nodules and seals are felt in the chest - they are easiest to detect in the last days of the cycle.
• The pain is symmetrical, that is, it is observed in both mammary glands.
• Pain in the armpits.
• Age from 20 to 40 years. Doctors have noticed that it is at this age that patients most often suffer from cyclic pain syndrome.

Signs of non-cyclic soreness:

• The pain has nothing to do with the menstrual cycle.
• There is not only pain, but also burning, squeezing the chest.
• The pain is clearly localized - only one mammary gland hurts.
• Quite often, diseases that manifest as a non-cyclic pain symptom occur in women in the menopausal stage and affect women of reproductive age much less frequently.

The most dangerous symptoms:

• Soreness appears daily and does not go away within 10 days.
• The pain does not subside, it intensifies every day.
• The pain is clearly localized.
• Soreness reduces the quality of life and interferes with daily activities.
• To get rid of pain, you have to take analgesics daily.
• Chest pain is accompanied by other persistent skin, kidney, or liver symptoms.

If dangerous symptoms appear, you should immediately consult a doctor. Most breast diseases do not require urgent diagnosis - you can contact a specialist and in a week, nothing bad will happen. But when these symptoms appear, it is better not to postpone the consultation.

Causes of soreness

The causes of pain can be very different. It is more reasonable to talk not only about the causes of the pain itself, but also about the factors that can contribute to the development of diseases of the mammary glands.

These factors include:

• Individual anatomical features. They are provocateurs of non-cyclic soreness. Injuries, operations and diseases act as a trigger, they start the pathological process. Even a large breast size can act as an individual feature of the anatomy.
• Taking various drugs that affect (even indirectly) the hormonal status.
• Acid imbalance - affects the perception of hormones by breast tissue. The imbalance occurs due to a deficiency of fatty acids in the diet.
• Long-term or uncontrolled use of oral contraceptives.
• Various diseases of the mammary gland, gynecological and endocrine, diseases of the liver and kidneys.

To begin the treatment of pain syndrome, it is necessary to establish its cause. If the pain is really bothering, then it is caused by a disease.

Possible diseases

Consider the most common diseases that cause pain in the mammary gland.

Intercostal neuralgia

It develops due to pathologies in individual nerve fibers. The disease itself is not dangerous, but its symptoms can reduce the quality of life. There is not only pain in the mammary gland, soreness spreads over all the ribs, it can radiate to the back and lower back.

The pain comes in bursts. On palpation, the mammary gland is painless. Soreness is aggravated by walking, inhalations and sharp exhalations. If symptoms are observed on the left side, then the patient may suspect a heart problem. When pain occurs on the right side, breast disease is usually suspected.

Mastopathy

This is a benign disease, which, nevertheless, is considered one of the most dangerous. With mastopathy, the mammary gland aches, discomfort is usually observed from both sides at once and intensifies towards the end of the cycle. There are discharges from the nipples, and on palpation, seals can be detected. The pain is aching and dull. In rare cases, there may be no pain at all.

Fibroadenoma

A special case of mastopathy. This is a tumor that is in the capsule. Due to this, its treatment and diagnosis are difficult. The main symptoms: breast engorgement, the appearance of seals, discharge from the nipples, soreness.

Mastitis

Mastitis is an inflammatory disease that is caused by infection in the breast tissue. With mastitis, the pain is strong, aching, does not depend on external factors, increases with pressure on the chest.

Redness occurs, local temperature or general body temperature rises. As treatment, antibiotics are prescribed, selected taking into account the pathogen. Most often, mastitis occurs during lactation, when the breast often receives microtrauma and is open to infections.

Other diseases

There are some diseases that have nothing to do with the physiology of the mammary glands, but can cause chest pain:

1. Shingles.
2. Tietze syndrome.

Shingles is a viral disease that causes itching, burning, and soreness of the skin. If the rash appeared in the area of ​​​​the mammary glands, then the pain will be observed in the chest. The main symptom is the appearance of rashes in the form of small bubbles filled with liquid. For treatment, be sure to contact a dermatologist and pick up an antiviral drug.

Tietze's syndrome is a fairly rare disease that is characterized by benign changes in the ribs. If swelling occurs around the affected rib and nerves are compressed, this can be subjectively perceived as chest pain.

Competent diagnostics is carried out using modern instrumental methods:

• Ultrasound diagnostics.
• Palpation and examination.
• Biopsy - in the presence of cysts or tumors.
• Mammography.
• Ductography - in the presence of pathological changes in the ducts of the mammary gland.
• Thermography is the most modern analogue of mammography.
• Sonography - in addition to the results of ultrasound.
• Pneumocystography - performed to study the contents of the cyst.

Thanks to modern diagnostic methods, it is possible to accurately differentiate all diseases of the mammary gland, even those that have been hidden for a long time. Timely and accurate diagnosis is the key to successful treatment.

At-risk groups

Separately, it is worth talking about risk groups - these are girls and women who need to be as attentive as possible to their health. It is they who should immediately consult a doctor if any unpleasant symptoms appear.

The risk group (according to WHO) includes:

• Non-parous women over the age of 35.
• Women who refuse breastfeeding.
• Patients with unfavorable heredity.
• Girls and women with obesity or diabetes.
• Girls and women who repeatedly resorted to artificial termination of pregnancy.
• Girls who are in a state of prolonged stress or depression.
• Patients with diseases of the liver, kidneys, genital organs, thyroid gland, pituitary gland or hypothalamus.
• After injuries and operations on the mammary gland.
• Anyone who does not adhere to a healthy lifestyle and abuses smoking and alcohol.

It is necessary to know about risk groups in order to consult a doctor in time with an increased likelihood of illness.

Treatment of breast diseases

If the pain syndrome is not associated with functional disorders of the mammary gland, then symptomatic treatment is prescribed. It can be both analgesics, and anti-inflammatory or sedatives - it depends on the symptoms.

If a relationship with an increased level of prolactin is noted, then the appropriate hormonal therapy is selected - antiprolactin drugs normalize the hormonal background by suppressing the secretion of the hormone. The main disadvantage of hormone therapy is the disruption of the menstrual cycle. Therefore, with early diagnosis, they try to use more gentle methods of treatment.

Typical appointments for breast diseases associated with hormonal levels:

• Phytotherapy.
• Dietary supplements to combat the main symptoms.
• Vitamin complexes.
• Regular observation.
• Compliance with a diet with the exception of alcohol, chocolate, coffee.

Conservative treatment consists in relief of symptoms with appropriate groups of drugs: from painkillers to enzymatic ones. If conservative treatment does not help, then resort to surgery. Operations are prescribed to remove tumors and cysts.

There is no specific prevention of breast diseases. The easiest way is to follow the WHO recommendations: follow a healthy lifestyle and regularly attend preventive examinations.

Almost every woman has experienced chest pain in her life. There can be many reasons for this unpleasant phenomenon: from banal osteochondrosis to formidable cancer. Someone has a sore chest on certain days of the cycle and the pain becomes habitual, someone experiences pain while feeding the baby. Let's see what diseases cause mastodynia - pain in the chest and what to do if they do not appear.

Modern medicine is sure of one thing - the breasts of a healthy woman do not cause pain. Any pain is a wake-up call that not everything is safe in the body. You need to undergo an examination, pass tests, sign up for an ultrasound. With painful sensations in the mammary glands, you need to come to an appointment with a gynecologist or, if possible, with a mammologist. If a woman is at risk for oncology, a gynecologist can give a referral to an oncologist. If the gynecologist does not reveal obvious hormonal and other reasons for the appearance of pain, it is worth visiting a neurologist and being examined for osteochondrosis. As well as a cardiologist and do an ECG.

Breast pain and pregnancy

Literally a few hours after conception, the woman's body begins hormonal changes and the mammary glands are the first to react to this. A woman who is especially attentive to herself can even determine the onset of pregnancy by swelling of the breast and an increase in the level of its sensitivity. Chest pain may accompany a woman throughout pregnancy, or it may stop in the first trimester and no longer appear. All of these are variants of the norm.

To reduce pain in the chest, you should carefully consider the choice of a bra. Breast size gradually increases during pregnancy. It is possible that underwear will have to be changed several times. Preference should be given to products made from natural fabrics. From the second half of pregnancy, the bra can not be removed even at night.

However, if the pain is pronounced, the chest thickens and begins to react painfully to any touch, and redness appears on the gland and nodules begin to be felt, it is possible that this is how the onset of mastitis or lactostasis manifests itself. Lactostasis is the stagnation of milk or colostrum in the milk ducts, and mastitis is an inflammatory disease of an infectious and non-infectious nature. With both diseases, it is imperative to urgently consult a doctor and begin treatment.

Breast pain while feeding

When breastfeeding, a young mother may experience pain due to an improperly organized process, non-compliance with feeding hygiene, or simply because of inability. Many hold the baby incorrectly or wean it incorrectly. As a result of this, he bites the nipple with his gums. And this can lead to bruising and abrasions. After feeding, the nipple should be lubricated with special ointments (bepanten, solcoseryl) to prevent it from drying out. If you do not follow the hygiene of the nipples, a painful crack may appear. A cracked nipple is the entrance gate for infection.

Mastitis is an inflammation of the breast tissue caused by Staphylococcus aureus. Mastitis must be distinguished from lactostasis, since the symptoms of the onset of the disease are similar, and the treatment is prescribed differently. Mastitis is characterized by an increase in temperature, a deterioration in general well-being. The chest hurts, its part turns red, begins to gradually thicken. If timely action is not taken, mastitis can lead to the development of an abscess and phlegmon.

Lactostasis is the stagnation of milk in the milk ducts. Lactostasis can develop as a result of the narrowness of the ducts or their blockage. The reason may be an excess of milk. Insufficient pumping of the breast leads to an increase in pressure in its ducts, which causes swelling, inflammation of the tissue and pain. With lactostasis, an increase in temperature is rarely observed. The breast tissue becomes denser, which becomes tense and painful. A venous pattern appears on the skin. To get rid of lactostasis, it is necessary to limit drinking, apply the baby to the breast more often and begin to express milk on your own. Frequent lactostasis is conducive to the development of mastitis.

Breast pain during menstruation

For many women, menstruation also accompanies breast pain. Sensitivity and pain in the chest can be felt as much as 10 days before menstruation, and during them, and even after. Some people have chest pain during ovulation. In general, this disease is called mastopathy and it is associated with the growth of internal tissues, usually against the background of hormonal changes. Mastopathy can lead to constant stress, anxiety, depression, excessive nervous tension.

Mastopathy is characterized by pain in the chest, its increase in size and discharge from the nipples. Unpleasant sensations are aggravated by touch. Pain can be aching, bursting and dull. Sometimes pain can spread to the area under the breast and into the armpits.

The general term mastopathy refers to a number of diseases occurring in the mammary gland. Mastopathy can be:
- diffuse fibrocystic with a predominance of the glandular component or fibrous, or cystic, or a component of a mixed type;
- nodular fibrocystic.

Many forms of mastopathy are not dangerous and only cause discomfort. However, some can lead to the development of a more formidable disease - breast cancer. Therefore, it is necessary to timely identify the causes of mastopathy and eliminate them. Mastopathy can occur at any age, in one form or another it is diagnosed in 90% of women. However, in general, this disease begins to develop after 40 years.

For early detection and diagnosis of mastopathy, as well as early forms of breast cancer, women under 40 should undergo breast ultrasound twice a year, and after 40 - mammography. All studies are carried out on the 8-10th day of the cycle. Mastopathy is caused by hormonal imbalance, therefore, for the purpose of treatment, an analysis of hormones is taken.

Fibroadenomas and cysts

It happens that on an ultrasound examination, a woman is diagnosed with fibroadenoma: a benign formation that occurs against the background of hormonal disorders. This is a nodular pathology of the breast tissue, which occurs due to the abnormal development of cells of the glandular and connective tissue of the breast. Usually, fibroadenoma is not painful, but is felt in the form of a lump in the chest to the touch.

However, there is a form of fibroadenoma in which it grows to a very large size - phyllodes fibroadenoma. It is a risk marker for developing breast cancer. A phyllodes fibroadenoma can involve a very large portion of the breast and cause severe pain. The level of degeneration of this form of fibroadenoma into a malignant form reaches 10%.

Not all fibroadenomas are treated surgically. However, even if a large fibroadenoma is surgically removed, but the hormonal balance is not normalized, the likelihood of new formations is high.

A growing cyst in the chest can also cause a feeling of bursting pain. The cyst is a capsule with a cavity filled with liquid contents. A cyst in the breast can form one or more. Large formations press on nearby tissues, causing pain. Most often, pain occurs before menstruation. The cyst is detected mainly by palpation or ultrasound.

If the cyst suddenly begins to manifest itself as a sharp jerking pain and fever, then its inflammation has begun. It is urgent to see a doctor before an abscess begins. The pain in this case takes on a pulsating hue and gives off to the neck or shoulder blade area. The inflammatory process proceeds against the background of general weakness, sometimes with nausea and vomiting. The chest becomes hot, the skin at the location of the cyst turns red.

Chest pain in breast cancer

As oncologists say: not every mastopathy leads to cancer, but every breast cancer begins with mastopathy. If a woman is at risk for breast cancer, has a hereditary maternal disposition, smokes, suffers from hormonal disorders, obesity, etc., close attention should be paid to the early detection of breast cancer.

Breast cancer at an early stage is not manifested by any sensations, is not palpable and does not hurt. At an early stage, breast cancer cannot be detected even by self-examination methods. It is possible to determine its onset only by diagnostic methods: ultrasound, mammography, CT, MRI and puncture. If there is pain, then usually there is already weight loss, swelling of the arm, swollen lymph nodes. That is, the disease has developed to 3-4 stages.

Other chest pains

Very often, pain of articular or muscular origin can be given to the chest. For example, severe dull pain can manifest osteochondrosis of the thoracic spine. Osteochondrosis is often the cause of myositis of the muscles located around the spine. They can also give severe pain in the chest area. These pains can be easily confused with the pains observed in mastopathy. To detect thoracic osteochondrosis, it is necessary to make an x-ray of the thoracic spine in two projections.

With osteochondrosis and other diseases of the spine, the thoracic nerve roots are pinched and very painful intercostal neuralgia can develop. Pain in intercostal neuralgia is diffuse in nature and can affect not only the mammary glands, but also the back, arms, shoulders, and lower back. Neuralgia is characterized by increased pain during inhalation.

In addition, chest pain can be caused by wearing an incorrectly fitted bra, overly tight bikini and other clothes that do not fit the bust. The chest can hurt for a long time after an injury, a bruise.

Pain in the chest area can be a reason to suspect diseases and disorders of varying severity and risk to the general health of the patient. First of all, when a sharp pain behind the sternum appears, people suspect the worst thing - a heart attack. Of course, chest pain is not a phenomenon that should be ignored, but in addition to a heart attack, there are many more possible pathologies that cause pain.

Pain in the chest area can be caused by pathologies in the lungs, esophagus, muscles, ribs or nerve plexuses. And only some of these conditions are serious and life-threatening, the rest are not a serious cause for concern. However, in any case, if the pain intensifies or recurs, a visit to the doctor is necessary.

If a patient presents with chest pain, our first priority is to identify the underlying cause.

To do this, it is necessary to conduct a full-fledged examination, the features of which may vary, depending on what kind of complaints a person has, his physiological parameters, health status and previously transferred or currently existing concomitant diseases.

Basically, the diagnosis includes: laboratory diagnostic studies, electrocardiogram, chest X-ray, MRI of the chest.

In addition, additional consultation of highly specialized specialists may be required to clarify the diagnosis.

Types of chest pain

As a rule, the sensation can spread all over the area from the neck to the upper abdomen.

Depending on the cause, pain can be characterized by:

• Suddenly appearing, sharp, depending or not on the position of the body or physical activity.
• Dull or sharp, cutting pains.
• Persistent burning sensation in the chest.
• Slight but constant pain.
• Pains that change their character and strength are intermittent.

The specific localization of pain sensations, as a rule, does not specify the cause of their appearance. This is due to the fact that large nerve trunks are often involved in the process, serving as a thread of sensory transmission to other areas. Pain that spreads to areas remote from the pathological focus is called irradiating pain. However, in some cases, the descriptive nature of the pain may actually provide some information for the diagnostician.

According to the patient, the pain may be of the following nature:

1. Pain behind the sternum, radiates to the back.
2. Why does chest pain radiate to the arm?
3. Chest pain with shortness of breath.
4. Pain in the chest on the left or right.
5. Pain in the chest when inhaling, if it hurts to breathe.
6. Why does chest pain occur when coughing?

As a rule, pain associated with the respiratory process is related to the upper respiratory tract and lungs, however, this phenomenon is not always visible - coronary heart disease can also provoke severe pain during inhalation or during the cough reflex.

Diseases in which it hurts in the chest: in the middle, on the right, on the left

One of the most dangerous causes of discomfort in the chest area are disorders in cardiac activity. Causes of pain in heart disease can be as follows.

Ischemic heart disease or ischemic heart disease

Reason - blockage of the heart blood vessels, which causes a decrease in blood flow pressure and, as a result, stimulates oxygen deficiency of the heart muscle itself. This phenomenon can cause severe pain, known as angina pectoris.

Such symptoms indicate disorders in the work of the heart, but, as a rule, do not cause irreversible damage to the tissues of the organ. However, such processes are a sign that the patient may develop a heart attack at some point in the future.

Ischemic heart pain can spread to:

• Left hand.
• Shoulder.
• Jaws.
• Give back.

The patient feels well the pulsation as pain. Angina can be triggered by increased physical activity, excitement, or emotional stress. Pain usually subsides at rest.

myocardial infarction

At the heart of the pathology is a sharp decrease in blood flow through the heart blood vessels, which causes acute oxygen deficiency and subsequent death of heart muscle cells. Although pain is similar to angina pectoris, in a heart attack it is usually more severe, throbbing, located in the center or left side of the chest, and not relieved by rest. Associated symptoms will include:

• Sweating.
• Nausea.
• Labored breathing.
• Increased weakness in all muscles.

Myocarditis

Inflammation of the heart muscle. In addition to persistent, throbbing chest pain, you may experience:

• Fever.
• Fatigue.
• Rapid heartbeat.
• Breathing problems.

Although there is no destruction in the myocardium, the pain symptoms of myocarditis can resemble those of a heart attack.

Pericarditis

Inflammation of the pericardium, the thin membrane that surrounds the outside of the heart. Often infectious. Pericarditis causes pain similar to angina pectoris. However, there may be sharp, sustained manifestations along the top of the neck to the muscles of the shoulder. Sometimes the pain is aggravated by breathing, swallowing or lying down.

Hypertrophic cardiomyopathy

This genetic disorder causes the heart muscle to grow abnormally in thickness.. Sometimes this leads to problems with pumping blood to the heart. Chest pain and difficulty breathing often occur with increased exercise.

Over time, cardiomyopathy causes the development of heart failure, when the heart muscle becomes very thickened, and then becomes thinner and loses tone . This phenomenon increasingly burdens the work of the heart when pumping blood. Along with chest pain, this type of cardiomyopathy can cause dizziness, thought disturbances, fainting, and other symptoms.

Mitral valve prolapse

Mitral valve prolapse is a pathological condition in which a valve in the heart cannot close properly. A variety of symptoms are associated with this heart condition, including chest pain, palpitations, and dizziness, although sometimes the disease is asymptomatic, but with age it will certainly lead to heart failure.

Ischemic rupture of the heart arteries

A variety of factors can lead to this rare but deadly disease, which is based on coronary artery embolism. A sudden blockage of an artery can lead to sudden, severe, tearing pain that radiates up into the neck, as well as into the back and abdomen.

Causes of pain in lung diseases

Inflammation or irritation of the mucosal part of the two-layer film located between the lung and chest. Pleurisy, especially of an infectious nature, is characterized by severe pain at the time of breathing, coughing or sneezing. The most common causes of chest pain in pleurisy are bacterial or viral infections, pulmonary embolism, pneumothorax, or hydrothorax. Other, less common causes include rheumatoid arthritis, lupus, and cancer.

Pneumonia or lung abscess

These infections in the lungs can lead to pleuritic and other types of chest pain, characterized by sensations deep in the chest, directly dependent on the processes of inhalation and exhalation. Pneumonia often comes on suddenly, causing the temperature rises sharply, chills, cough, often mixed with pus and blood.

Pulmonary embolism

When a blood clot travels through the blood and becomes lodged in small blood vessels in the lungs, it can lead to acute pleurisy, breathing problems and heart palpitations. Fever and shock are also possible. Pulmonary embolism is most often caused by deep vein thrombosis, a separate disease, most often in the lower extremities or after an immobile lying position is abruptly changed within a few days after surgery. Thrombosis is often the result of complications of cancer.

Pneumothorax

A frequent result of trauma to the chest is pneumothorax - air entering the pleural cavity from the external environment, or due to partial destruction from the lungs. The compression effect that has arisen in the pleural cavity has a pressing effect on the rest of the lungs and provokes, thereby, severe pain, usually during inhalation. A common accompanying symptom of this condition is low blood pressure.

Pulmonary hypertension

Characterized by chest pain resembling angina pectoris due to abnormally high blood pressure in the arteries of the lungs, which greatly complicates the work of the right side of the heart.

Asthma

Shortness of breath, wheezing, coughing, and sometimes chest pain are common clinical signs of asthma.

Causes of pain in diseases of the gastrointestinal tract

Gastroesophageal reflux disease (GERD)

Also known as acid reflux. Symptoms of GERD are manifested at the time of the return of the contents of the stomach into the lumen of the esophagus. This phenomenon can lead to a sour taste in the mouth and a burning sensation in the chest and throat, a phenomenon better known as. Factors that can cause heartburn include obesity, smoking, pregnancy, and eating large amounts of spicy or fatty foods. Heart pain and acid reflux heartburn pain are similar in part because the heart and esophagus are close together and share a network of nerves.

Hypersensitivity of the esophagus in relation to the mechanical effects of the food coma and gastric acid, with reflux, can also give pain sensations that vary in strength and character and, as a rule, occur during meals.

Esophageal contraction disorders

Uncoordinated muscle contractions (spasms) and high pressure of the food bolus on the walls of the esophagus can provoke the development of intermittent chest pain.

Rupture of the esophagus

Sudden, severe chest pain followed by vomiting can be signs of rupture of the walls of the esophagus.

Peptic ulcer of the stomach and duodenum

Disease is often the source radiating pain in the sternum and can be given to the back. Stomach ulcers often occur in people who smoke, drink a lot of alcohol, or take painkillers such as aspirin or non-steroidal anti-inflammatory drugs. Pain is often relieved with meals or antacid medications.

hiatal hernia

This common pathology occurs when the upper part of the stomach penetrates into the lower part of the chest after eating. The process often leads to reflux symptoms, including heartburn or chest pain. Pain tends to worsen when lying down.

Pancreatitis

Inflammation of the pancreas is characterized pain in the lower chest worse lying down and bending forward.

Gallbladder problems

After eating fatty foods feeling of heaviness or pain in the right lower chest or right upper abdomen. It is these symptoms that can be caused by disorders of the functionality of the gallbladder.

Diseases of other organs and systems that cause chest pain

Sometimes chest pain can be the result of excessive pressure or blunt trauma to the chest area from a fall or accident. Viruses can also cause chest pain.

The pain from intensifies, usually with deep breathing or coughing. The sensations are often limited to one area and intensify when pressed. The area of ​​the fracture is characterized by signs of inflammation on the outside of the chest.

Increased tone of the intercostal muscles

Deviation provokes severe pain even with a slight cough. The disorder occurs, as a rule, in diseases associated with inflammation - intercostal neuralgia, myositis and others. B The pains are aggravated at the time of physical activity and acquire a aching character at night.

smallpox virus

Causes the formation of shingles, can cause a sharp surge in pain before the main symptoms of the rash appear after a few days.

Anxiety and panic disorders

This is another potential cause of chest pain. These pathologies belong to the group of psychopathological conditions and directly depend on the emotional state of the patient. Some associated symptoms may include:

• Dizziness.
• Feeling short of breath.
• Palpitation.
• Tingling in chest.
• Trembling in the region of the heart.

When to See a Doctor for Chest Pain

If doubts prevail, it is worth consulting a doctor for manifestations of any pain in the chest area, especially if it is a sudden manifestation of indomitable pain that does not respond to the use of painkillers.

In addition, it is imperative to go to the hospital if any of these symptoms are present along with chest pain:

• Sudden feeling of pressure, constriction, heaviness under the sternum and a feeling of lack of air.
• Pain in the chest that radiates to the jaw, left arm, or radiates to the back.
• Sudden sharp pain in the chest with shortness of breath, especially after a long period of inactivity.
• Nausea, dizziness, fast heart rate or rapid breathing, confusion, ashy skin or excessive sweating.
• Very low blood pressure or very slow heart rate.

Aching, dull, sharp pain in the chest, superficial or deep, in the back or interscapular region can be a symptom of a variety of diseases. Here we will not touch on cardialgia, that is, the discomfort associated with heart disease, but we will tell you what non-cardiac causes of chest pain are.

Superficial chest pain: causes

Superficial pain, or thoracalgia, is caused by diseases of the skin, muscles, ribs and sternum, peripheral nerves, or spine. In addition, its cause may be secondary changes against the background of diseases of the internal organs, which lead to degenerative changes in the surface structures of the chest, and mask them.

Skin diseases

The cause of pain in the chest can be dermatitis, erysipelas and shingles.

Dermatitis- inflammation of the skin of an infectious, allergic, contact origin. The acute form is characterized by itching, burning, swelling, redness of the skin. In chronic forms, thickening, cracks, redness with a crimson or cyanotic tint appear, and then tissue atrophy. With allergic dermatitis, swollen areas appear on reddened skin, often covered with hives or even vesicles.

Cause erysipelas- the influence of pathogenic bacteria - streptococci. A well-demarcated area of ​​redness is formed, blistering and hemorrhage are possible. These changes persist for up to 2 weeks, then the pathology can turn into a chronic relapsing form. The exacerbation is accompanied by fever and intoxication (nausea, headache, feeling unwell).

Shingles - one of the causes of pain on the surface of the chest

Cause shingles- the herpes simplex virus, which is activated during stress, immunodeficiency, in poor living conditions. First there is a strong burning pain in the chest from the spine along the intercostal nerve to the middle of the chest. After a few days, numerous herpetic vesicles form in this area. After their disappearance, soreness can persist for several months, and persistent neuralgia often occurs in older people.

Muscle diseases

Myositis- inflammation of the muscles, which has different causes, but common symptoms: soreness, weakness and further muscle atrophy in a chronic course. Symptoms become stronger when the affected muscle contracts and when it is felt. The tissues swell a little, the muscles are tense. You can feel the most painful formations up to 1 - 2 cm in size, dense and mobile.

Cause pectoralis minor syndrome– prolonged excessive shoulder abduction, for example, during sleep. It can accompany diseases of the heart, spine, and other organs. Soreness is characteristic from the middle of the collarbone up, above the shoulder and to the middle of the upper edge of the scapula.

Anterior chest wall syndrome(pectalgia) - soreness along the anterior surface of the chest in its upper part, the cause of which is a disease of the cervical or thoracic spine. It is constant, dull, felt along the sternum and along the 6-7th ribs, where the pectoralis major muscle is attached, and increases with hand movements.

Costoclavicular or subclavian syndrome caused by an incorrect structure of the anatomical region between the clavicle and the ribs, due to which the subclavian muscle is tensed and subjected to dystrophy. It compresses the subclavian artery and the brachial plexus. Pain under the collarbone with spread to the arm is characteristic, aggravated by abduction and lowering of the shoulders, straightening of the back. The muscle is painful, numbness of the skin of the hand and part of the forearm is possible.

Mondor disease- a rather rare disease that occurs more often in women after a fever or against a background of complete health. On the anterior surface of the chest, abdomen, axillary region, cord-like seals up to 20 cm long appear, painful on palpation. They are caused by thrombophlebitis and persist for up to several months.

Causes of chest pain: breast diseases

Mastitis usually develops during lactation, accompanied by an increase and soreness of the gland, fever, reddening of the skin, the formation of abscesses.

Mastopathy, or fibrocystic disease associated with hormonal imbalance. It is characterized by a change in symptoms during the menstrual cycle - engorgement, soreness, sometimes discharge from the nipple before the onset of menstruation. The gland is compacted, nodular formations are found in it. After menstruation, the symptoms of the disease disappear for a while.

Mammary cancer does not cause pain in the early stages. It is characterized by the appearance of a dense knot in the tissue of the organ. Then long-term soreness and skin changes, retraction of the nipple, discharge from it join, axillary lymph nodes increase. If cancer is suspected, an oncologist should be contacted immediately.

Pathology of the intercostal nerves

Sometimes acute pain in the lower part of the chest appears when coughing, sneezing, screaming, moving. It's a sign sliding costal cartilage syndrome 8 - 10 ribs, which is usually the result of an injury. It may mimic the symptoms of angina pectoris, epigastric hernia, or pneumothorax. However, it is accompanied by painful sensations on palpation in the 8th - 9th intercostal space near the spine.

Intercostal neuralgia More precisely, neuropathy is caused by compression of the roots of the spinal nerves by a hernia or bone growths in the area of ​​the intervertebral discs. These causes are not as common as this diagnosis is made. Chest pain is either acute, unbearable, but very short-term, or encircling, prolonged, aggravated by coughing, movement. Its zone strictly corresponds to the intercostal space.

Diseases of the ribs, sternum, cartilage

Periostitis- inflammation of the periosteum, its main cause is a bruise or fracture of the rib. It is manifested by pain and swelling over a small area of ​​one or more ribs.

Osteomyelitis- purulent inflammation affecting all layers of the rib or sternum. The disease causes fever, pain in a limited area of ​​\u200b\u200bthe bone, and later fistulas with purulent discharge form on the surface of the chest.

Chest pain occurs when leukemia and multiple myeloma. But the severity of the disease is determined by hematological disorders (anemia, bleeding, decreased immunity).

bone tumors accompanied by pain in a limited area. Metastases enter the skeleton of the chest from the lung, mammary, thyroid or prostate glands, less often from tumors of other organs.

Syndrome of the xiphoid process- one of the causes of pain in the middle of the chest, in its lower part. It usually occurs with diseases of the diaphragm, as well as with gastritis, duodenitis, peptic ulcer, cholecystitis. Soreness is localized behind the xiphoid process, simulating pain in the heart, often accompanied by nausea or vomiting. It is aching, paroxysmal, lasts several hours, aggravated by walking, movements, after eating. On palpation, the area of ​​the xiphoid process is painful, which makes it possible to distinguish this pain from the heart.

Tietze syndrome is another cause of chest pain that mimics heart disease. It is accompanied by thickening and soreness of the cartilages of the ribs, more often on the left, at the place of their attachment to the sternum.

Diseases of the spine

Causes of chest pain can be deforming osteoarthritis, ankylosing spondylitis and rheumatoid arthritis. All these diseases are systemic in nature and are accompanied by discomfort and stiffness in the joints of the limbs, and sometimes changes in the internal organs. These diseases are treated by a rheumatologist.

Shoulder-costal syndrome causes pain in the upper third of the back. Its cause is the difficulty of sliding in the area of ​​scapular-costal contact in the area of ​​​​the upper inner angle of the scapula on the posterior surface of the chest. Dystrophic processes develop in the surrounding muscles, nerves, periosteum. There is discomfort in the scapular region at rest, during movement or load (uncomfortable posture). On palpation of the upper inner corner of the scapula, pain is determined. It spreads to the neck, occiput, subscapular region and shoulder. Sometimes a crunch or clicks are heard when moving the hand. In half of the cases, the pathology affects both shoulder blades.

Interscapular pain syndrome(dorsalgia) is caused by damage to the joints between the vertebrae and the ribs. Diseases of the chest organs contribute to its appearance. The pain is burning, boring, spreads along the spinal column, occurs with a long stay in one position, with hypothermia. With deep probing of the paravertebral region, the soreness of the capsules of the corresponding joints is determined.

Deep chest pain: causes

These reasons are associated with pathology, pleura, mediastinal organs located in the chest.

Acute tracheitis accompanied by sore pain behind the sternum when coughing. If it joins, pain sensations spread to the sides of the sternum, occur in the area of ​​\u200b\u200bthe articulation of this bone and the clavicles and on the front surface of the neck.

Pleural mesothelioma- a malignant tumor that causes very intense unilateral pain. Occurs rarely.

(pencost tumor) can be manifested by severe soreness in the arms, chest, reminiscent of angina pectoris. Discomfort does not decrease after taking painkillers. The muscles of the hands atrophy, the sensitivity of the fingers decreases, a feeling of crawling appears. On the side of the tumor, dry skin often occurs, caused by a local lack of sweating.

Pain behind the sternum occurs when mediastinal tumors. It is constant and may be accompanied by compression of the vessels in this area.

At gap one of the organs of the mediastinum, for example, with a chest injury, spontaneous emphysema occurs. It is manifested by sudden intense pain, swelling of the subcutaneous tissue of the neck and crepitus on palpation of the skin, resembling the crunch of snow.

Dissecting aortic aneurysm- damage to the wall of this large vessel during its thinning. There is severe pain on the left, radiating to the abdomen, back. Pallor, sweating, increased heart rate quickly appear. If the patient is not provided with emergency medical care, he may die.

Aortitis- inflammation of the aortic wall, often due to syphilitic lesions. It is quite characteristic of shortness of breath, discomfort behind the sternum during exercise, a decrease in diastolic pressure, dizziness. If other bacteria have become the cause of the disease in sepsis, fever, severe weakness, signs of damage to other organs, subcutaneous hemorrhages occur.

Aortalgia caused aortic atherosclerosis. It is localized behind the sternum, has a pressing or burning character, radiates to the limbs, neck, abdomen, back. Pain in the chest is not paroxysmal, lasts for hours, does not increase with walking, and does not improve after taking nitroglycerin. In the future, difficulty in swallowing is possible if an overly dilated and compacted aorta begins to compress the esophagus.

- Another serious disease that can cause chest pain. It is accompanied by a sudden attack of shortness of breath or suffocation, the appearance of foamy sputum mixed with blood, dizziness, and loss of consciousness is possible. The disease requires urgent medical attention.

Pain to the right of the sternum may be due to gallbladder diseases.

Causes of chest pain: diagnostic steps

In case of acute excruciating pain, you must immediately call an ambulance. It is required to exclude such causes as myocardial infarction, dissecting aneurysm, pneumothorax, pulmonary embolism, dry pleurisy and spontaneous mediastinal emphysema.

Collection of anamnesis

When clarifying the history of the disease, pay attention to such features:

• thrombophlebitis can cause pulmonary infarction or pulmonary embolism;
• tuberculosis, emphysema, connective tissue diseases can be complicated by spontaneous pneumothorax;
• pneumonia or lung abscess accompanied by fever and chills;
• the cause of sudden pain is often shingles and intercostal neuralgia.

Inspection

Pay attention to such features:

• lag of one half of the chest from the other during breathing (can be determined by placing the palms on the lower scapular angles), pain during breathing, easing on the "sick" side - signs of pleural diseases;
• with pleurisy, pain is aggravated by tilting to the “healthy” side, and with neuralgia - to the “sick” side;
• with pneumonia, a bright blush appears, a herpetic rash on the lips is possible, shortness of breath, cyanosis of the nasolabial triangle (in children);
• severe shortness of breath and blueness of the skin may be a sign of pulmonary embolism.

The doctor also performs palpation, percussion (tapping) and auscultation (listening), determining the symptoms characteristic of a particular disease.

Additional Methods

A blood test, ECG and. Can be used, magnetic resonance imaging, pulse oximetry.

To identify the cause of chest pain, a comprehensive examination is necessary. Timely medical care can not only preserve health, but also save the life of the patient.

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