Update: October 2018
A healthy heart is a prerequisite for a long and full
of life. Heart pains, at a minimum, require careful attention.
relationship to yourself. If they occur, it always appears.
alertness and anxiety. “Heart, heart, what happened, what
embarrassed your life? ”Does cardiac pain always indicate
heart problems and how to distinguish them from other pains – in
Heart area – where is it?
The projection of the heart on the anterior chest takes the area from
the upper edge of the cartilage 3 ribs to the lower edge of the body of the sternum. Top
projected in 5 intercostal space on 2 cm inwards from the line crossing
the middle of the clavicle. The right border goes from cartilage 3 ribs to 5
intercostal space on the right.
Usually, any discomfort in the left is taken for heart pain.
half of the chest, regardless of the nature and intensity. But
The typical location for heart pain is the area behind the sternum and
to her left to the middle of the armpit.
Features of the spread of heart pain are
the appearance of reflected pains (left in the shoulder blade and under it, in the hand).
Sometimes the reflection is isolated, for example, by 4-5 fingers of the left hand,
left jaw. Rarely pain gives to the right or left hand.
Nature of pain в области сердца
The description of the suffering by the patient is very important in the first stage.
diagnostics. It is a detailed description of the pain allows the doctor
navigate in the direction of the search and reduce to the necessary
minimum additional survey methods.
When questioning the patient are taken into account:
- conditions of pain (in the load or after, at rest,
connection with food, at night or during daytime hours)
- nature of sensations (pricks, squeezes, whines, cuts, crushes,
constantly or periodically)
- duration of pain
- then cease.
Causes of pain in the heart
|Heart Disease:||Diseases of the stomach and esophagus:||Toxic effects:|
|Heart overload:||Pulmonary pathology:||Pathologies of large vessels:|
|Diseases of the mediastinum:||Damage to the nerve trunks:||Bone lesions:|
|Muscle damage:||Skin lesions:||Breast pathology:|
This is a typical cardiac pain, informing about oxygen
deficiency of the heart muscle. Она свойственна пcrayfishтически всем формам
coronary heart disease. With angina, compressive
pain in the chest in the heart or behind the sternum gives the typical
reflections under the scapula and left hand. It occurs in the process.
load and passes alone at rest or from reception
nitroglycerin, dilates blood vessels and redistributes blood
между слоями myocardium.
Patients with a variety of
options for rhythm disturbances:
- most typical of atrial fibrillation or
- frequent extrasystoles
- paroxysmal tachycardia
- atrial fibrillation
- intracardiac blockades
- often the pain is accompanied by the fear of death and necessarily
- the equivalent of pain in some cases is shortness of breath,
indicative of circulatory failure.
Atypical compressive pain under the left shoulder blade, in the region of the heart
may occur at rest in the early morning hours on the background of a spasm
coronary arteries (Prinzmetal’s angina).
This kind of pain always signals
emergency needs, and therefore does not allow to switch
what else. The condition can also be described as acute pain.
how it arises suddenly.
A prolonged angina pectoris with typical location and
reflection of squeezing expressed pains – the result of beginning
thrombosis, embolism or acute stenosis of the coronary vessels. On this
Stage helps poorly nitroglycerin, but timely
medical aid can prevent cardiac death
muscle. If, after twice taking nitroglycernia with a break in
five minutes the pain did not go away. It is necessary to call an ambulance.
Heart attack myocardium
This is actually a necrosis of the heart wall. Here is the only treatment in
a specialized hospital can save a patient’s life and
maintain its continued quality. При инфарцировании myocardium боль
very pronounced, prolonged, uncapable of nitropreparations,
accompanied by the fear of death, the feeling of lack of air.
sweating, tremor of the hands. It may be atypical, for example
give to the stomach or imitate intestinal colic, accompanied by
nausea and vomiting, loss of consciousness, heart rhythm disorders,
cramps, involuntary urination. Part of heart attack
pass with little pronounced pain syndrome that does not lose
its sharpness, but the pain is more tolerable. При инфаркте myocardium боль
It is stopped only by neuroleptoanalgesia using powerful
Diseases of the esophagus and stomach
The second variant of a dangerous sharp pain in the region of the heart is
catastrophes with the esophagus and the cardia of the stomach. Perforation
cardiac ulcers will give a dagger pain that will entail
vegetative disorders in the form of nausea. flicking flies before
eyes, dizziness, or loss of consciousness.
For the esophagus more typical bleeding due to frequent vomiting
(Mallory-Weiss syndrome) or from dilated esophageal veins with
portal hypertension on the background of liver cirrhosis. From volume
blood loss will depend on the rate of loss of consciousness and severity
circulatory disorders. In any case, ulcer perforation or
bleeding is a cause for surgical care.
Pulmonary artery thrombembolia
It is a blood clot that has come from the system of the small pelvis or varicose veins.
legs in the artery of the lung. More branches of the pulmonary artery
cluttered out and the larger they are, the more pronounced and intense
pain. Besides her, there is a cough with blood, shortness of breath, rapid
palpitations, swelling of the neck veins. Thrombosis of large trunks
developing collapse and loss of consciousness. It is also an emergency.
a condition requiring emergency care and hospitalization.
Aortic Aneurysm Stratification
Occurs more often in older men amid prolonged
unregulated arterial hypertension, atherosclerosis, vasculitis
or coarctation of the aorta. Operation may be a provoking factor.
on the heart or aorta. Most often stratified ascending part
vessel. In this case, the longitudinal rupture of the inner shell leads to
accumulation of blood between the layers of the aorta. Suddenly there is a sharp
rending pain in the chest or in the region of the heart;
scapula. At the same time, the pressure first increases. and then sharply
is falling. There is asymmetry of the pulse on the extremities, the skin turns blue.
Sweating appears, fainting may develop. Neurological
manifestations become disorders of motor activity. Hematoma
can lead to oxygen starvation of the heart, shortness of breath, hoarseness
vote. Often patients fall into a coma.
Sharp pains are also characteristic of rib fractures. Afterwards
the nature of the pain changes to whining or gnawing.
In cases of overloading the heart, pressure may be felt on it or
- This variant of pain can also occur in healthy people, for example, with
excessive physical activity, playing wind instruments,
increase the pressure in the small circle of blood circulation.
- With hypertension, the heart has to pump
blood versus pressure gradient that impairs its blood supply and
increases the load.
- Thyrotoxicosis causes heart palpitations and overloads
- Heart tamponade is the result of wounds and squeezing of the heart with blood.
Also, the heart can squeeze effusion with pericarditis of various
origin (tuberculosis. tumor).
- With myocarditis infectious or allergic nature
non-intensive pressing pains are accompanied by shortness of breath, disturbances
rhythm, heart failure.
- Myocardiopathy, myocardiodystrophy, cardiac neoplasms
also give a pressing feeling without a clear connection with the load,
long or episodic.
- Pressing pain behind the sternum imitate foreign bodies of the esophagus or
- Intoxication of various nature (medicinal, narcotic,
alcoholic), as well as organophosphate poisoning,
ether, chloroform, neurotoxic plant poisons give
severity of pressure on the heart, combined with arrhythmias and cardiac
failure, fraught with sudden cardiac arrest.
- Purulent pathologies of soft tissues, mastopathy. Breast cancer
the glands will also give excessive pressure in the projection of the heart.
- High cardiac ulcers also lead to
situations when pressing pains imitate heart pathologies.
To avoid the situation of Tom Sawyer, who was not strong in
anatomy and hid the donated flower closer to either the heart or to
stomach, to distinguish stomach pain from the heart can
use the comparative table.
Heart pain with coronary artery disease
Stomach pains with cardiac ulcer
|Arise||In the process of loading, less often at rest||On an empty stomach or in the first half hour after meals|
|Night pain||Uncharacteristic. Rarely – in the early morning hours||Are characteristic|
|Nature of pain||Compressive||Pressing or sucking|
|Duration||From minutes to half an hour||Long lasting|
|What are eliminated||Nitroglycerin. Sidnofarm||Gastrocepin, Omeprazole, Metacin|
If the heart hurts occasionally, the pain is not accompanied
blood flow disorders (no fainting, dizziness,
memory or speech disorders) is generally not dangerous.
- The most common stitching pain in the heart is neurocirculatory.
dystonia, in which the vessels do not have time to narrow properly or
expand when load changes.
- Rarely stabbing pains are accompanied by infrequent extrasystole,
- The most likely cause of stabbing pains in the left half
chest – myositis due to hypothermia or stretching
- Stitching in the heart can also be due to intercostal neuralgia, when
inflamed nerve. Also shingles, affecting the ganglia and
нервы дает режущую и колющую pain.
- Pain in the heart when breathing in or coughing must be differentiated.
with pleural lesions in pneumonia, pleurisy, tuberculosis, cancer
bronchus or lung. This pain is combined with a dry cough or
wet cough, temperature rises (see causes of low-grade fever
- Unbearable pain can be with a heart attack, pulmonary embolism, exfoliation
aortic aneurysm. Often this is 10 out of 10 points. Patients are excited,
are torn. Experiencing intense fear of dying.
- 10-9 points on the intensity scale gives mediastinitis –
inflammation of the mediastinum. When the purulent process develops due to
complications of surgical treatment, injuries of the esophagus, the collapse of tumors,
then pain causes patients to take a forced position with
pressed to his chest chin. It is enhanced by swallowing and
throwing back the head. There is also a fever, sweating,
excitement or confusion, swelling of the upper half
- Angina gives pain from 6 to 8 points.
- Myocarditis and pericarditis from 5 to 2.
Aching pain in the heart
The more intense the rhythm of modern life becomes, the more
the number of patients complains of pain in the heart in
the cardioneurosis program. No organic change at all
in the organ or in the vessels that feed it in such patients or not
- there is only a high degree of neuroticism
- anxiety disorder
- often cardioneurosis develops within a somatised
Dissatisfaction with oneself and the world around, not going out
outwardly in behavioral features, it erupts in the form of pain in
areas of the heart. At the same time, patients are haunted by many unpleasant
sensations: pressure on the heart, fading with a sigh, aching pain
and anxiety for their health.
Often fixation on non-existent cardiac pathology
makes a person repeatedly examined, change specialists
and clinics, significantly poisoning his life. At the same time
an experienced psychotherapist or group correction might decide
problem in a short time.
Pain in the heart: what to do
If you suspect a heart failure, it is better to overestimate the risks and
Seek immediate attention to a general practitioner or cardiologist. After
the doctor will prescribe and examine:
- urine and blood tests
- chest X-ray
- ECG (transcript)
- if necessary, veloergometry, treadmill and
Such tactics will allow time to react to a real disease.
heart or in a short time to ensure its absence and
save excess nerve cells. In addition, under the cardiac
pathologies are often masked by other serious and not very
diseases that are also desirable to diagnose and treat