Update: October 2018
Soая симптоматика, как боли и жжение в грудной клетке, является
pretty frightening. After all, we all know that there is a heart
whose diseases are dangerous. But there are other organs there: large
vessels, lungs, esophagus. TOроме того, стенки грудной клетки
are made with bones, muscles and ligaments, and in women there are
the mammary glands abundantly penetrated by nerve fibers. All these
organs can hurt.
To differentiate the “terrible” pain from the “scary”
we propose the following algorithm: first we determine where it hurts, then
focus on additional symptoms. For some states
need ambulance transportation, for others – specialists
Pain syndrome, localized in the right side of the chest,
usually make themselves felt:
Diseases of the liver and biliary tract
In this case, the pain is usually:
- does not depend on the movement of the body;
- gives to shoulder blade, half of neck, arm – to the right;
- has a connection with food intake: increases with eating
fat and fried, which is why such dishes often arise
Wherein на языке появляется налет желтого цвета, во рту может
be bitterness If a в желчевыводящих путях «завелся» камень (или
swelling) that interfere with the passage of bile in its natural ways,
first the whites of the eyes will become yellow, then the skin. Urine becomes
dark, feces – light. The same can be observed when
damage to the liver itself by hepatitis, hepatosis or cirrhosis.
Differentiate the states in the state only qualified
specialists: surgeons and infectiologists (see also pain in right
hypochondrium, pain in left hypochondrium).
Другие заболевания ЖTOТ
Gastritis, ulcers of the upper digestive tract, intestinal
colic can also manifest as pain or a burning sensation in
right side of the chest, but more often localized to the left or
directly behind the sternum. These pathologies are associated with taking
food. Consider them in more detail in the part devoted to pain in
the rest of the chest.
So называется состояние, когда нервы, идущие к межреберным
muscles (they “fill” with breathing), become inflamed or
infringed upon. The most common cause of the disease is
herpes zoster caused by chickenpox virus. In this case, to
The following symptoms add a rash in the form of bubbles in
one or more intercostal spaces.
The main signs of intercostal neuralgia are:
- pain is severe, can be described as a burning sensation, but – in
strictly localized place, which can be probed;
- pain when breathing in, turning the body, coughing,
If a «родоначальник» межреберной невралгии – остеохондроз, то
chest pain can also be supplemented by “lumbago” in the right arm
or the right half of the neck. And if you ask a helper to press
fingers on each vertebra, ranging from cervical, in one place pain
Inflammation of the right lung if it proceeds with inflammation
shell of the lung, pleura (this complication is called pleurisy),
may also be accompanied by chest pain on the left. If a у Вас
– It is this disease, even before the appearance of pain
weakness, fatigue, appetite lost, sick, sore
muscle and / or bone. Almost always the temperature rises, appears
cough, sometimes with blood, sometimes with sputum mucous
or purulent character, or dry cough. Directly
before the pain in the chest becomes hard
Pain during premenstrual syndrome
One of the signs of mastopathy is pain in the premenstrual
period. Usually it is localized in both mammary glands, but it can
affect only the right that can be recognized as pain in
In favor of mastopathy will say that pain manifests itself
especially before menstruation, with the chest swelling (“poured”) and in
one or several nodules can be felt there.
Myositis is an inflammation of a single muscle, in this case –
intercostal space. The pain at the same time has a clear localization. Can
note that there is no pain alone, but it appears at a certain
movement, accompanied only by a deep breath or cough.
Curvature of the thoracic spine to the side
extremely rare: this pathology is more susceptible
�Its “mobile” parts are cervical and lumbar. But if the chest
scoliosis still develops, and it has a C or S shape,
convex side facing right, then when one of the
intercostal nerves pain appears in the right side of the thoracic
Wherein возникают такие симптомы:
- localized pain: a person can clearly indicate the point where
- pain increases with breathing and coughing;
- weakness, nausea, and no cough.
This may indicate a lack of cough, increased
температуры, связи с дыханием или с приемом food. Human can
feel difficulty breathing, but if you ask the assistant to calculate
the number of respiratory movements per minute in an arbitrary period
time when the patient himself will not know about it, it turns out
that it is in the normal range (12-16 per minute). While listening
the lung the doctor objectively does not hear any pathological noise, and
X-ray, MRI or CT scan of the chest pathology is not
Such diseases can be suspected if they started after
severe nervous stress or summed up chronic fatigue. TO
A psychiatrist is directed when other causes of pain are excluded.
rib cage on the right.
Pain in the remaining parts of the chest: in the middle, on the left
Due to the characteristics of the anatomical course of the nerves going to
internal organs, chest pain in the middle and left can
have common reasons. We list the possible diseases of the leading
Have a cough
If a burning sensation in the chest area is accompanied by a cough, it may
- Pneumonia complicated by pleurisy. In this case, burning is usually
is localized on the left, in a larger or smaller area, but:
- not behind the sternum;
- not in the region from 3 to 5 intercostal space to the left of the sternum to the middle
Pain or burning is constant, but worse with breathing. Wherein
there are weakness, fatigue, lack of appetite,
feeling short of breath. Usually – high temperature, but if
pneumonia with pleurisy were complications of tuberculosis, she
may not rise at all. In some cases it may occur
diarrhea with no symptoms of breathing.
- Bronchitis. There will be a chest pain in the middle, a cough
(usually moist when mucopurulent sputum is coughing),
loss of appetite, temperature rise.
- Flu. This disease is based on a special virus.
structures causing more or less in the upper respiratory tract
minor hemorrhages. Such a hemorrhagic soaking mucous
trachea and causes pain or burning sensation behind the sternum. TOроме этого, грипп
manifested by high body temperature, weakness, pain in the muscles and
bones. A runny nose with this disease does not appear immediately, but on
the second or third day of the disease, but a cough may occur in
If the initial symptoms were very similar to the flu: increased
temperature, there was an ache in the bones and muscles, simultaneously with
this or a little later there was pain behind the sternum, and then she
moved to the side it hardly means development
hemorrhagic pneumonia. Last caused by soaking cloth
lung blood, manifested by difficulty in breathing and symptoms
intoxication rather than movement of pain.
Pain after overwork
So can be IRR, mental illness:
Vegetative-vascular dystonia – in the first case, it hurts in the area
heart pain is not intense and has no connection with the load, position
body or breathing. TOроме боли человек часто краснеет/бледнеет, его
throws in sweat or fever.
When mental disorders such vegetative disorders are not,
but there is a change in mood, a decrease in desire for something
make, loss of appetite. But there is no nausea, weakness, increase
Causes of chest pain during exercise, arising as in
Left side and behind the sternum, these are mainly diseases.
hearts. This may include ischemic disease and its subspecies –
angina pectoris and myocardial infarction. Also pain during physical
tension occurs in myocarditis and cardiomyopathy. Wherein
load must be considered not only the performance of physical work, but
- climbing stairs;
- walking against the wind (especially cold);
- performance of even minimal work after the cold.
If it hurts to perform only certain movements, then
most likely in myositis or intercostal neuralgia.
- The pain is localized in the region of the heart, i.e. approximately
one of the places of such a square: horizontally – from the right edge
the sternum to the line through the middle of the clavicle, vertically –
from 3 to 5 intercostal spaces;
- The pain gives or in the left side of the jaw, or in the left shoulder blade;
irradiation can also go on the inside of the left hand to
- feels like pressure, compression, heaviness, dull pain;
- provoked by exercise, sometimes by excitement or
- pain or burning pass through time or after rest, or –
due to taking nitroglycerin tablets under the tongue;
- cough, change in body position does not increase pain.
This is a pathology that rarely appears abruptly: it is usually
preceded by warning “signs” in the form of strokes,
while for their provocation, over time, less and less
The heart attack is characterized by a sharp pain in the region of the heart, which,
arising on the background of the load (not always significant), does not pass
after resting and not taken even a few pills
nitroglycerin under the tongue. Gives pain to the left side of the body: hand,
scapula, jaw. Often the pain is accompanied by cold
then, heart rhythm disturbances, dizziness and shortness of breath.
So called inflammation of the heart muscle due to
infection process (flu, tonsillitis, diphtheria, scarlet fever),
intoxication, systemic autoimmune pathologies. Develops more often in
young people (see myocarditis).
There is a disease of pain behind the sternum or elsewhere.
areas of the heart, interruptions in the work of this muscular organ, dyspnea,
swelling on the legs. Such symptoms may periodically
regress and then recur.
Pain / burning associated with food
Soим образом проявляются патологии желудочно-кишечного тракта:
esophagitis, foreign bodies in the esophagus, esophageal cancer, gastritis,
peptic ulcer, pancreatitis, intestinal colic. TOаждое из
diseases has its own characteristic symptoms.
So, при поражении пищевода боль в средине грудной клетки
occurs when swallowing.
The inflammation of the stomach makes itself felt by the pain that is developing
after eating, located just below the chest. Suffering
Duodenal ulcer, on the contrary – pain, developing on
empty stomach. Pancreatitis and intestinal colic react with pain.
1-1.5 hours after eating. Localized pain syndrome
with inflammation of the intestine and pancreas also slightly below the costal
If baking behind the sternum after taking the horizontal
Strong burning sensation behind the sternum, appearing after a person
for half an hour before he ate, and then decided to lie down, is
a symptom of gastroesophageal reflux, i.e. food reflux
(water) from the stomach to the esophagus (see heartburn medications). TOроме
retinal burning sensation in a person has no loss of appetite, nor
temperature, no weakness. Only gradually hoarseness grows.
voices, he begins to periodically “cough up” dry cough. If a
in the esophagus, “burned” with acid, a tumor begins to grow,
there is a constant lump in the throat, violation of passage first
solid, and then – liquid food.
Pain associated with breathing
Similarly, pathologies appear on the left side of the chest.
organs whose membranes are in contact with the inner side of the ribs.
This is an inflammation of the heart bag, pleura, the presence of free
air in the pleural cavity. Soим же симптомом будет сопровождаться
intercostal neuralgia, previously described.
This disease has two subspecies:
- Dry pericarditis when the outer lining of the heart (its “bag”)
inflamed, while the release of inflammatory fluid it does not
going on. The disease manifests itself weakness, cough, pain in
the area of the heart is constant, dull, intensifies with deep
breathing, swallowing and coughing. Pain syndrome is slightly relieved with
принятии сидячего provisions, но усиливается при лежании.
- Pericardial effusion – inflammation of the heart bag, with
where it secretes an inflammatory fluid (exudate). is he
accumulates inside her and, in case of a large number, is capable
squeeze the heart and large vessels emerging from it. Manifests itself
the disease is a diffuse squeezing pain in the region of the heart, shortness of breath,
fever, hiccups, a feeling of a lump in the esophagus at
swallowing solid food.
Inflammation of the double-layer “cover” for the lung, like pericarditis,
may be dry and sweaty. The symptoms of these subspecies are different.
The disease occurs only as a complication: or pneumonia, or
cancer, or a manifestation of tuberculosis.
Dry left-sided pleurisy will manifest with sticking pains in
left half of the chest, extending in the hypochondrium and abdomen. is he
worse if the person coughs, breathes deeply, and
turns all torso. It becomes easier if you lie on
If a же плеврит имеет экссудативный характер, то есть между
two layers of “cover” appears inflammatory fluid,
symptoms are different. The person feels aggravated by
breathing dull pain in the chest (described by the word “heaviness”),
shortness of breath increases, there is weakness, the temperature rises to
high numbers, sweating, feeling short of breath.
Sternum pain or in the left side of the chest, with nothing
- Mitral valve prolapse and atrial fibrillation – can
manifest pain behind the sternum. In both cases, the pain is not pronounced,
There is no visible connection with breathing, position of the body, or the work performed.
Atrial fibrillation requires early diagnosis and treatment, so
as a life threatening condition.
- Diseases of the aorta and pulmonary artery in the same way
diseases of the large vessels passing in the thoracic
- Aortic dissection is an extremely life-threatening condition requiring
emergency, manifested by strong, tearing pain in the middle
chest or with the displacement of pain in the left side.
- Pulmonary thromboembolism if leaves a person in
can be manifested by severe chest pain that does not
responds to taking nitroglycerin. TOроме этого, появляется одышка,
feeling short of breath, coughing when “rusty” leaves
- Aortic dissection is an extremely life-threatening condition requiring
- is heкология:
- Malignant neoplasms of mediastinal organs – not
respiratory-related dull, pressing pain that is growing very
gradually, a tumor of one of the organs of the thoracic can appear
cavities. It may be cancer lung, pleura, bronchus, myxedema
heart metastases in lymph nodes in the mediastinum.
- Tumor in the left mammary gland, if it has germinated in the pectoral
the cage will also manifest pain. Wherein железа должна быть
deformed, it can be determined seal, fused with
tissue, there may be nipple discharge (see breast cancer
- Malignant neoplasms of mediastinal organs – not
Chest pain treatment
As the causes of the symptom, we have described many diseases,
each of which is treated in its own way. Therefore, before embarking
to treatment, you need to establish a diagnosis. В этом помогут врачand:
general practitioner, gastroenterologist, pulmonologist, surgeon, oncologist or
psychiatrist. Our tips are:
- TOогда боль – в левой стороне или середине грудной клетки,
stop and rest. If a это помогло, дойдите до аптеки и
buy Nitroglycerin – you will need it for such situations.
Сделайте ЭTOГ и обязательно сходите на прием к терапевту или
- If a остро вместе с болью стало тяжело дышать, вызывайте
- TOогда боль возникла слева или посредине, она сильная, откройте
window, take a half-sitting position, take “Nitroglycerin.” If a
he is not there, or he did not help, call “Ambulance”, but for now drink
(Chew) 1-2 tablets of “Aspirin” (“Aspécarda”, “Aspeter”,
«TOардиомагнила») в общей дозе до 300 мг.
- If a боль – скорее в молочной железе, connected с менструациями
or discharge from the nipples (even in men), you need to visit
mammologist. Soие специалисты или ведут частный прием, или работают
в местных is heкодиспансерах.
- TOогда болевой синдром связан с кашлем, нужна рентгенография
lungs or computed tomography, and then visited
first the therapist, who will recommend where to go next – to
pulmonologist, oncologist, gastroenterologist or surgeon.
- If a вы стали хуже переносить физическую нагрузку после
infectious disease, urgently contact
cardiologist. Можете в тот же день, до врача, сделать ЭTOГ и пройти
- Intense, arching pain, with physical
before the load, nothing bothered you – a reason to call “Ambulance
help “and talk about suspicion of aneurysm of the thoracic region
In any case, do not take any painkillers before
when you come to the doctor’s appointment, it will be harder for you to help.
Eat more fresh vegetables and less meat, go every day
less than 2 km slow pace and be healthy!
Автор: TOривега Мария Салаватовна врач-реаниматолог