Very often, chest pain is associated withdiseases of the heart and lungs. 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.
The basis of the appearance of pain in the chest are threemechanism: irritation of the peripheral nerves, irritation of the spinal nerves and afferent fibers passing through the sympathetic and vagus nerve. Pain in the chest can be coronary and non-coronary genesis: cardialgia, pain associated with diseases of other organs located in the chest, lesions of the musculoskeletal apparatus of the chest wall.
Diseases of the heart, accompanied by the appearance of pain in the chest:
- angina pectoris
- myocardial infarction
- pericarditis
- exfoliating aortic aneurysm
All these diseases are characterized by a pronouncedchest pain of varying intensity. When angina pectoris, it compressive nature, giving to the left arm, is removed by taking nitroglycerin. Pain with myocardial infarction is more intense than with angina pectoris, prolonged, it is not removed by taking nitroglycerin and is accompanied by the development of cardiac and vascular insufficiency.
Diseases of the respiratory system are accompanied by painIn the chest 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 contains almost no.
Pain in the chest with diseases of the respiratory system are associated with such diseases:
- pleurisy
- pneumonia
- lung tumor
- pulmonary embolism
- pneumothorax.
With the pathology of the respiratory system, chest painlocalized in the lateral parts of the chest, becomes more intense with deep breathing and coughing, often accompanied by fever, coughing, shortness of breath.
Заболевания позвоночника (остеохондроз, грыжа intervertebral disc) lead to the appearance of pain resembling the nature of pain in angina pectoris. It is localized in the region of the heart, often amplified by movements and deep breathing. Differentiating the nature of pain can be removed ECG, echocardiography. The simplest test, which allows to differentiate the pathology of the heart and spine, is the palpation of the intercostal spaces on the left in the direction from the vertebral column to the sternum. In diseases of the spine, pain in the chest is increased when pressed, which is not observed in heart diseases.
Некоторые заболевания пищеварительной системы can also cause chest pain. It can be peptic ulcer, reflux esophagitis, pancreatitis, cholelithiasis complicated by hepatic colic. With pancreatitis, the pain may be located on the left side of the chest or be shrouded in nature. With cholelithiasis, it hurts in the chest on the right. This disease is often associated with inaccuracies in eating, exercise, accompanied by nausea and bitterness in the mouth, jaundice of the skin and mucous membranes. With peptic ulcer there is a close connection between the appearance of pain and food intake. Pain, as a rule, appears after eating, can be accompanied by heartburn, eructation, nausea.
Differential diagnosis of pain in the heartIt is necessary for the early detection of diseases that threaten the life of the patient. Great importance is given to additional diagnostic methods. Be sure to conduct electrocardiography. In the absence of changes on the ECG, other instrumental examinations 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 assigned with timely and correct diagnosis.
