Share:
Chest pain chest pain
Chest pain: cause, diagnosis and treatment
Chest pain is a common complaint, with most people involuntarily thinking of heart disease. But also tension, respiratory, stomach and esophagus disorders can be felt as chest pain. In case of severe and / or recurring pain, a medical examination should be urgently performed to exclude more serious health risks.
contents
- Chest pain: cause, diagnosis and treatment
- Chest Pain: A Brief Overview
- Emergency: immediately call an ambulance with these complaints
- Chest pain as a symptom
- Causes of chest pain
- Diagnosis of chest pain
- Treatment options for chest pain
Chest Pain: A Brief Overview
Chest pain indicates a wide field of possible painful chest discomfort. Many factors can cause this, but a distinction must be made between conditions that affect both men and women and pain that occurs only in the female breast (for example, congestion in nursing mothers). This article deals mainly with the non-gender-specific complaints, which are summarized in the medical literature under the term chest pain. The symptoms may come from rather harmless causes such as tensions, but also from life-threatening illnesses such as a heart attack. Here is a brief overview of the symptoms:
- symptom: Pulling, stinging, or squeezing chest pain, which may be either punctiform, flat, or dependent on certain movements. Similarly, the pain may be related to breathing or radiate into surrounding areas of the body.
- Possible causesMuscle tension, skeletal system damage, heart disease, respiratory disease, chest inflammation, esophageal disease, nerve pain, shingles, cancer, psychosomatic causes.
- emergency: If the pain in the neck, arms, stomach, and / or back radiates, and there are additional symptoms such as severe chest pain, facial puffiness, excessive sweating, difficulty breathing, and nausea, there could be an acute myocardial infarction. It must be called immediately an ambulance!
In a heart attack every minute is important. If suspected, an emergency doctor should be called immediately. (Image: heilpraxis.de/Neyro/fotolia.com) Emergency: immediately call an ambulance with these complaints
If you or a person in your area shows chest pain with the following symptoms, call an ambulance immediately:
- The pains are very strong and spring out of the chest.
- The pain radiates into the upper abdomen, the back, the neck and / or in shoulders and arms (mainly in the left side).
- A feeling of tightness and oppression spreads in the chest.
- There are accompanying symptoms such as paleness, excessive sweating, shortness of breath and nausea.
- Those affected become very scared or show signs of a panic attack.
Chest pain as a symptom
The pain in the chest can occur in different intensity and localization. Some patients have stinging, pulling pain on only one side of their chest, others have more than one puncture in the central thoracic region, and others have pain that radiates from the center to nearly the entire chest. The occurrence of chest pain is primarily dependent on the causes of the discomfort.
Place and type of pain give first indications
The way and the place where the pain occurs, provide first clues as to the cause. But not always the symptoms are clear. Ultimately, a doctor has to make sure of the diagnosis. The following overview shows which symptoms indicate which causes:
- Selective pressure pain indicates a muscle tension or muscle hardening (myogelosis).
- If the symptoms occur more intensely during inhalation and exhalation, are sometimes accompanied by coughing or breathing difficulties and spread throughout the chest, there may be a disease of the lungs or the respiratory tract.
- Burning pain in the central area of the chest as well as ascending pain from the stomach toward the neck indicate a disease of the esophagus.
- Pain along the ribs and pressure pain on the cartilage are an indication of skeletal system impairment.
- Radiation pain in the central chest often indicates cardiovascular disease.
- If severe chest pain is accompanied by tightness of the chest, dyspnoea, sweat attacks and dread, accompanied by palpitations or heart-stomping and onset of panic, there may be a heart attack. Call the emergency doctor immediately!
Already the way, how and where the pain takes place delimits the possible causes. (Image: staras / fotolia.com) Causes of chest pain
The causes of chest pain can be varied. This section shows common symptoms that cause chest pain.
Tight muscles
Although many sufferers immediately fear a heart disease as a trigger, but often only tensions are the cause of the complaints. If the illnesses described above can be excluded in the course of the medical diagnosis, a more detailed examination of the musculature is worthwhile. For example, the pectoral muscles - the pectoralis major muscle and the pectoralis minor muscle - are tense in many people due to their unfavorable posture in everyday life. Here, for example, sitting on the computer with slightly forward sloping shoulders leads to a strain on the muscles. In addition, excessive training of the chest muscles can cause the chest pain. For example, bodybuilders often tend to increase chest muscle training, neglecting the back muscles as their antagonists. The chest muscles become tense and increasingly sensitive to pressure. Also, the excessive strength training can cause painful irritation in the muscle attachments on the sternum.
Diseases of the cardiovascular system
Heart disease such as arteriosclerosis and coronary heart disease are also possible causes of the symptoms. Heart valve diseases or myocarditis may also be associated with chest pain. In the worst case, the symptoms may be due to a heart attack or heart attack. Circulatory problems, high blood pressure or low blood pressure, as well as a fast or irregular heart rate can indicate cardiovascular disease.
Breast pain while breathing
Cause can be, for example, lung diseases such as bronchitis, pneumonia, tuberculosis, pulmonary embolism or lung cancer. In some diseases, such as pulmonary embolism or tuberculosis, bleeding may additionally occur. This symptom should be called immediately an ambulance. Another trigger is the so-called pneumothorax. As a result of injury or lung disease, air gets in between the lungs and the lung skin. This can severely affect the breathing and even lead to the collapse of the lungs. If sufferers suffer from respiratory distress and stinging pain, and if the chest space is unbalanced or only one-sided while breathing, an ambulance should also be called immediately.
Also, diseases of the lungs and respiratory system can cause chest pain. (Image: BigBlueStudio / fotolia.com) Inflammation in the chest area
A pleurisy sometimes leads to massive chest pain. Inflammations of the esophagus are another possible trigger for a painful puncture in the chest. Another possible cause is pericarditis (pericarditis). This manifests itself more by stabbing discomfort in the chest area. Radiation pain is rare in this inflammation.
Diseases of the esophagus
Suffering in the chest can also result from heartburn or reflux disease. The gastric acid enters the esophagus, which has no protective mucous membrane. The result is burning pains rising from the stomach towards the neck. If the mobility of the esophagus is limited, it may cause swallowing problems and painful belching. If severe pain occurs after vomiting, or if vomiting occurs, it could be an esophageal rupture or esophageal cancer. In both cases, an ambulance must be called immediately.
Damage to the skeletal system
Furthermore, misalignments of the spine are sometimes associated with chest pain. Also, fractures or bruises of the ribs lead to severe chest pain, which are perceived rather superficially. Such complaints are further expressed by a violent touch pain.
Nerve pain and shingles
Nerve pain along the intermediate ribs nerves are also perceived by the affected as chest pain. The pain typically increases with coughing or laughing, and runs like a belt along the ribs. These nerve pains, called intercostal neuralgia, are usually due to diseases of the lungs, spine, ribs, or pleura. However, a shingles (herpes zoster) can cause the symptoms.
Psychosomatic causes
Finally, a so-called heart neurosis comes into consideration when all other organic causes have been excluded by different doctors. Affected people focus their attention on the physical activity in the area of the chest. Any deviation and any slight sting is felt as a strong pain. In medicine, this form of pain is also summarized under the names Functional Heart Discomfort. Likewise, anxiety disorder or depression can be painful in the chest.
In some cases, chest pain is also psychologically conditioned. (Image: New Africa / fotolia.com) The female breast
In women, diseases of the mammary glands can trigger a burning sensation in the breast. Also hormone fluctuations during the period can lead to pulling or pushing pain in the breasts or provide for sensitive breasts. In some cases, an abscess in the breast or breast cancer may be responsible for the discomfort.
Other causes
If there is a painful swelling in the area of the sternum approach at the level of the second and third rib without accompanying symptoms of inflammation, the so-called Tietze syndrome is referred to in medical circles. Its causes are not yet finally resolved, but the symptoms usually heal completely after a few months. In addition, the so-called Roemheld syndrome, a stomach disease in which gas accumulations in the intestine and in the stomach lead to heart problems that express themselves painfully in the chest.
Diagnosis of chest pain
At the beginning of the medical examination should be a detailed history, in which patients are not only interviewed on the occurrence, duration, intensity and localization of the condition, but also report on possible pre-existing conditions. Ideally, this already gives first indications as to which cause underlies. In addition, it is usually possible to make a relatively reliable diagnosis of rib bruising or fractures and impairments of the chest muscles by palpating the chest area. For other underlying diseases, other diagnostic methods, such as a blood test or imaging techniques (X-rays, magnetic resonance imaging, computed tomography, ultrasound) are due. If the chest pain is due to a disease of the heart, this can be determined by means of an electrocardiogram (ECG) or by a 1-hour troponin test.
Heart attack diagnosis
Especially with a myocardial infarction usually only little time remains for a diagnosis, so that here the correct interpretation of the symptoms described above is particularly important. First of all, the lives of patients must be saved before laboratory tests and imaging procedures can be used. Typical signs of a heart attack are severe stabbing chest pain in the central thoracic region that radiate into the left arm. Some patients also describe the pain as "there is a great burden on the chest." But not all patients show corresponding complaints. A control of the pulse and blood pressure as well as the listening of the chest by stethoscope must be sufficient here in an emergency as a basis for initial countermeasures. One indication is, for example, the drop in blood pressure. In any case, the emergency call should be notified because in an infarct every minute counts to save lives.
A more recent method for heart attack diagnosis is the so-called 1-hour troponin test, in which the troponin content in the blood is measured. This protein regulates heart contraction and is released into the blood as a result of heart damage.
Chest pain has many different causes. For regular pain, a doctor should be consulted. (Image: Blue Planet Studio / fotolia.com) Treatment options for chest pain
There are many different therapies available, some of which are presented in treatment guidelines, depending on the different underlying conditions that trigger the disease. In diseases of the lung, the esophagus or the stomach as the cause of the complaints, the therapeutic measures are usually relatively clearly defined and promise usually reliable treatment. With treatment of the underlying diseases finally disappear so the complaints. Lung cancer is an exception here, as the chances of recovery even at the level of the latest medical findings are rather low.
Heart Attack Treatment
In a heart attack, primary medical care plays a special role. If a cardiac arrest has already occurred, a cardiopulmonary resuscitation should be carried out immediately. Defibrillators can also stop existing cardiac atrial fibrillation and stabilize the heart rhythm. Subsequently, the initiation of a lysis therapy or a catheter treatment is provided to ensure the blood supply to the heart again to the required extent. The drug treatment of a heart attack is usually based initially on the administration of a nitroglycerin spray and morphine preparations for pain relief. In addition, a broad mix of other preparations is used, which - depending on the individual disease - for example, facilitate blood flow, relieve pain or serve to calm. In addition, surgery may be required to bypass, for example, or to implant a pacemaker.
Treatment: muscles and skeletal system
If the chest pain from the skeletal system or the musculature go out, treatment methods such as physiotherapy, massage, acupuncture or osteopathy offer promising therapeutic approaches. Also, some homeopathic remedies and the so-called Schüßler salts are available for the naturopathic treatment of tension in the chest area. However, the selection of the appropriate preparations should urgently be left to experienced therapists. An accompanying nutritional therapy can counteract the possibly existing acidity of the organism and thus positively support the treatment of muscle-related pain. A balanced acid-base balance in natural medicine in the prevention of muscle problems is generally attributed a high importance. (fp, vb; updated February 11, 2019)