home Folk remedies Chest pain is the first symptom of a serious illness. Pain in the chest. Symptoms of heart disease Pneumonia or lung abscess

Chest pain is the first symptom of a serious illness. Pain in the chest. Symptoms of heart disease Pneumonia or lung abscess

Pain that occurs on the left side next to the heart is an extremely frightening symptom. It may mean that trouble has happened to your heart. For example, developed ischemic or hypertension disease, heart disease or cardiomyopathy. But the same sign can be a manifestation of pathologies of the spine, ribs on the left. Pain from internal organs can radiate to the left side: stomach, spleen, colon.

Where is the heart actually located?

The topmost bone that runs horizontally on the chest wall is the clavicle. Behind it is the first rib, below you can feel a small soft muscle gap, and below it - the second rib. Further through the intervals follow 3, 4, 5, 6, 7 and 8 ribs. The following guidelines will help guide you:

nipple in a man: it is on the same level with the 5th rib;
the angle of the scapula directed downward corresponds to the 7th rib in persons of both sexes.

A man's heart is approximately the size of his fist, positioned so that the most protruding index finger points down and to the left. The heart lies as follows (point by point):

from the upper edge of the second rib, where it is attached to the sternum on the right side;
the next point to which the line goes is the upper edge of the 3rd rib, 1-1.5 cm to the right of the right edge of the sternum;
next point: an arc from 3 to 5 ribs on the right, 1-2 cm to the right from the right edge of the sternum.

It was the right border of the heart. Now let's describe the lower one: it runs from the last described point on the right side of the chest and goes obliquely to the gap between the 5th and 6th ribs on the left, to the point that lies 1-2 cm to the right of the left midclavicular line.

Left border of the heart: from the last point, the line goes in an arc to a point 2-2.5 cm to the left of the left edge of the sternum, at the level of the 3rd rib.

This position is occupied by the heart along with large vessels flowing in and out of it:

superior vena cava: it is located at the right edge of the sternum, from 2 to 3 ribs; brings oxygen-poor blood from the upper half of the body;
aorta: localized at the level of the manubrium of the sternum, from 2 to 3 ribs on the left. It carries oxygenated blood to the organs
pulmonary trunk: it is located in front of the rest of the vessels, goes ahead of the aorta to the left and back. Such a vessel is needed to carry blood to the lungs, where it will be saturated with oxygen.

If it hurts in the region of the heart

Pain in the left half of the chest is caused by two types of causes:

cardiological, caused by diseases of the heart and blood vessels that feed it;
non-cardiological, initiated by many other pathologies. They have their own division depending on the organ system that caused the syndrome.

The following signs indicate that it is the heart that hurts:

localization of pain: behind the sternum and to the left, to the left edge of the collarbone;
the character can be different: aching, stabbing, pressing or dull;
not accompanied by pain in the intercostal spaces or in the vertebrae;
there is no connection with a certain type of movement (for example, turning the arm in the shoulder joint or raising the arm), pain most often appears after physical exertion;
there may be a connection with food intake - heart pain with angina pectoris is associated with taking a large amount of food or walking immediately after eating, but then it is not accompanied by heartburn, belching or stool disorders;
can give to the left hand (especially the little finger of the hand), the left half of the lower jaw, the region of the left shoulder blade, but at the same time there is no violation of the sensitivity of the hand, it does not freeze, does not weaken, the skin does not begin to turn pale on it and hair fall out.

Cardiac pain: what is heart pain?

The following causes of pain caused by diseases of the heart itself can be named:

angina pectoris

This is one type of coronary heart disease. It is connected with the fact that due to the atherosclerotic plaque, thrombus or spasm located in the coronary artery, the diameter of this vessel that feeds the structures of the heart decreases. The latter receives less oxygen and sends pain signals. Characteristics of the latter:

occur most often after physical or emotional stress: lifting weights, climbing stairs, brisk walking, walking against the wind (especially cold, especially in the morning), walking after eating;
may appear at night in the morning or after waking up, when a person has not yet got out of bed (this is Prinzmetal's angina);
after resting or stopping in the first case or taking "Corinfar", "Nifedipine" or "Fenigidin" - in the second, the pain disappears;
pain squeezing, baking;
localized either behind the sternum, or to the left of the sternum, its area can be indicated with a fingertip;
can give to the area of \u200b\u200bthe left hand, shoulder blades; left half of the jaw;
removed by "Nitroglycerin" after 10-15 seconds.

myocardial infarction

This is the second and most severe form of coronary disease. It develops when those plaques or arteries that caused short-term, only during emotional or physical stress, oxygen starvation of the myocardium, have grown and blocked the artery almost completely. This condition can happen when from somewhere (from some kind of vein, most often in the legs) a blood clot or piece of fat flew off, which clogged the artery. As a result, a section of the heart, if professional help is not provided within an hour by introducing drugs that dissolve the blood clot, will die.

Myocardial infarction can manifest itself in different ways. The classic version is:

violent, burning, tearing pain on left side in region of heart. It is so strong that a person can even lose consciousness;
not removed by "Nitroglycerin" and rest;
gives to the left arm, shoulder blade, neck and jaw - on the left side;
the pain grows in waves;
accompanied by shortness of breath, nausea, heart rhythm disturbance;
cold sweat appears everywhere on the skin.

A heart attack is an insidious disease: if it manifests itself typically, it gives a person a chance to save. But also with this dangerous disease, only the arm, jaw, or even one little finger on the left hand can hurt; there may be a violation of the heart rhythm or suddenly, for no apparent reason, the stomach starts to hurt or loosening of the stool occurs.

Pericarditis

This is the name of the inflammation of the heart bag caused by an infectious cause. People describe such pain as:

chest pain (or they say: "Localized in the depths of the chest");
stabbing character;
aggravated in the supine position;
weakens if sitting or standing to lean forward a little;
long, in many cases passes from time to time;
does not give anywhere;
not removed by nitroglycerin;
occurs after acute respiratory infections, pneumonia, other diseases caused by microbes;
accompanied by weakness, fever.

Mitral valve prolapse

Such a “bulging” of the valve into the left atrium (normally, its petals should open in systole and close tightly in diastole) either has a congenital cause, or develops after suffering rheumatism, myocardial infarction or myocarditis, against the background of lupus, IHD or other heart diseases.

Characterized by:

not intense bursting heart pain;
bouts of rapid heartbeat;
interruptions in the work of the heart;
dizziness;
fainting;
nausea;
sensation of "coma" in the throat;
increased sweating;
due to insufficient blood supply to the brain, a person with mitral valve prolapse is prone to depression, periods of bad mood.

Dissecting aortic aneurysm

This is the name of the condition when in the aorta - the largest vessel in which the highest pressure, an expansion occurs - an aneurysm. Then, against this background, between the layers that form the wall of the aneurysm, an accumulation of blood appears - a hematoma. It "creeps" down, peeling the layers of the aortic wall from each other. As a result, the vessel wall becomes weak and can be torn at any time, causing massive bleeding.

A dissecting aneurysm rarely occurs "by itself", most often it is preceded by a period when a person has constantly high blood pressure, or he suffers from atherosclerosis, when plaques form in the aorta, or syphilis or Marfan's syndrome becomes the cause of the condition.

Pain from a dissecting aortic aneurysm:

strong;
located behind the upper part of the sternum;
can give to the neck, lower jaw;
can be felt throughout the chest;
lasts from several hours to several days;
not removed by nitroglycerin;
may be accompanied by a blue face and swelling of the jugular veins located on the lateral surfaces of the neck.

Aortitis

This is the name of the inflammation of all three (panaortitis) or parts (endoortitis, mesaortitis, peraortitis) of the membranes of the thoracic aorta. The cause of the disease can be:

infection (streptococcus, syphilis, tuberculosis, brucellosis);
autoimmune diseases (Takayasu's disease, collagenosis, Bechterew's disease, thromboangiitis obliterans);
inflammation can "pass" from inflamed organs located near the aorta: with pneumonia, lung abscess, infective endocarditis, mediastinitis.

The disease is manifested by a group of symptoms: some of them are signs of the underlying disease, others are manifestations of impaired blood supply to the internal organs or the brain, and others are symptoms of inflammation of the aorta itself. The latter include:

pressing and burning pains in the chest;
most often - behind the handle of the sternum, but the pain can give to the left;
give in the neck, between the shoulder blades, in the "pit of the stomach" area;
the pulse on the carotid and radial arteries is not symmetrical, may be completely absent on one side;
blood pressure may not be measured on one arm.

Endocarditis

This is the name of the inflammation of the inner shell of the heart, from which the valves are made, the chords of the main "pump" of a person. Pain in this disease rarely occurs - only in its later stages, when the patient performs physical activity or experiences a strong emotion. It is aching, not intense, it can give into the arm and neck.

Other signs of endocarditis are:

rise in temperature, often to low numbers;
body temperature drops and rises for no apparent reason;
fever is accompanied by a feeling of cold or severe chills;
skin is pale, may be sallow;
nails thicken, becoming like glass in a watch;
if you pull back the lower eyelid, some people can find pinpoint hemorrhages on the conjunctiva;
small joints of the hands are affected;
rapid weight loss;
periodically dizzy and headaches, but in a horizontal position, these symptoms disappear.

Cardiomyopathy

There are 3 types of this disease, but pain in the region of the heart is typical only for the hypertrophic variant. The pain syndrome does not differ from that of angina pectoris, and even appears after physical exertion.

In addition to pain, hypertrophic cardiomyopathy manifests itself:

Heart defects

They are either congenital in nature, or develop against the background of rheumatism. Heart pain most often accompanies only aortic stenosis - a decrease in diameter in the place where the aorta leaves the heart.

The pain syndrome in this case is constant, its character is pinching, stabbing, pressing. In addition, blood pressure often rises, swelling appears on the legs. There are no other signs specific to aortic stenosis.

Myocarditis

Inflammation of the heart muscle, which is most often a consequence of influenza or enterovirus infection, is also manifested by pain in the heart in 75-90% of cases. They have a stabbing or aching character, they arise both in connection with physical activity, and in a state of relative rest, after exercise. There are also increased fatigue, increased body temperature. Nitroglycerin does not help relieve pain.

Myocardial dystrophy

This is the name of a group of heart diseases in which the heart muscle is not inflamed and does not undergo degeneration, but the main functions of the heart associated with its contractility and rhythm suffer.

The disease can be manifested by a pain syndrome of a different nature. Most often, these are aching or aching pains that appear against the background of a feeling of heat or, conversely, increased chilliness of the limbs, sweating. In addition, weakness, fatigue, frequent headaches are noted.

Hypertonic disease

Constantly high blood pressure can be manifested not only by a headache, “flies” before the eyes, or a feeling of “tide”. In this case, pain may appear in the left half of the chest, which has an aching, pressing character or a feeling of "heaviness" in the chest.

These are, in principle, all heart diseases that may be accompanied by pain in the left side of the chest. There are much more non-cardiac pathologies that cause this symptom, and now we will analyze them.

Non-cardiac diseases

They are divided into several groups, depending on which organ system was the cause of this symptom.

Psychoneurological pathologies

Pain in the heart area may be due to cardioneurosis And cyclothymic states, which are identical in their manifestations. In these cases, despite the richness of symptoms, no pathology is detected during examination of the heart and internal organs. A person notes the following symptoms:

pain in the left side of the chest appear in the morning before waking up or during it;
attacks almost always occur when overheated, rather than on cold and windy days, as is the case with angina pectoris;
it can be provoked by depression or a conflict situation;
pain does not disappear if you stop or take nitroglycerin; it can last up to several days, or it can appear several times a day (up to 5), lasting for 1-2 hours. In this case, the nature of the pain can change each time;
if you perform a few light physical exercises, it can relieve pain;
the nature of the pain can be different: squeezing, heaviness, tingling, it can be described as an "emptiness" in the chest or, conversely, bursting. There may be a "pressing pain" or a syndrome of severe intensity, accompanied by a fear of death;
pain radiates to the neck, both shoulder blades, can capture the right half of the chest, the region of the spine;
you can accurately indicate the point at which maximum pain is noted;
increased sensitivity of the left nipple;
the condition worsens when experiencing any - positive or negative - emotions;
during an attack, a person begins to breathe often and superficially, as a result of which the content of carbon dioxide in the blood decreases, which is accompanied by dizziness, a feeling of fear, and can serve as the basis for the development of arrhythmia;
with all the frequency and intensity of seizures, drugs such as Nitroglycerin or Anaprilin do not affect them; lasting for years, nor do they lead to the development of heart failure phenomena: shortness of breath, swelling in the legs, changes in the chest x-ray or ultrasound picture of the liver.

Patients with cardioneurosis are talkative, fussy, change body position during an attack, looking for a local remedy to help relieve pain. When taking Nitroglycerin, the effect does not occur after 1.5-3 minutes, as with angina pectoris, but almost immediately or after a long time. Such people are more effectively helped by drugs such as Valocordin, Gidazepam or valerian tincture.

Cardiopsychoneurosis- the second main pathology, in which there are no changes in either the function or the structure of the internal organs, but at the same time the person suffers from "heart" pains. They may be of this nature:

Localized in the area near the nipple, have a mild or moderate severity, last several minutes - several hours. Validol and nitroglycerin help relieve pain. This is the most common type of cardialgia.
To be aching or pressing, accompanied by an increase in blood pressure, fear, trembling, sweating, shortness of breath. You can remove such an attack with the help of Anaprilin (Atenolol, Metoprolol, Nebivolol) in combination with valerian or motherwort tincture.
Possess a burning character, be localized behind the sternum or to the left of it, accompanied by increased sensitivity of the intercostal spaces when they are probed. Nitroglycerin, validol or valocordin do not stop the attack. This is done by mustard plasters applied to the region of the heart.
Have a pressing, squeezing, aching character, localized behind the sternum, aggravated by walking and physical exertion.

Pain in diseases of the musculoskeletal system and nerve endings

Pain syndrome can occur with irritation of the nerves innervating the intercostal muscles, with inflammation of the costal and cartilaginous parts of the ribs

Neuralgia of intercostal nerves

The pain is constant, aggravated by breathing (especially a deep breath), tilting the body in the same direction. One or more intercostal spaces are painful. If intercostal neuralgia is caused by the herpes zoster virus, then in one intercostal space you can find bubbles filled with a clear liquid.

Apart from these pains, there are no other symptoms. Only if neuralgia is caused by the varicella-zoster virus, the temperature can be raised. In the case of a weakened organism, complications from the nervous system may occur: meningitis, encephalitis.

Myositis of the intercostal muscles

In this case, there are pains in the muscles of the heart area. It intensifies with a deep breath and when the body tilts in a healthy direction. If you start to feel the affected muscle, pain is felt.

Shoulder-costal syndrome

In this case, the pain occurs under the scapula, radiates to the neck and shoulder girdle (what we used to call the “shoulder”), the anterior-lateral part of the chest wall. The diagnosis is made quite simply: if the patient puts his hand on the opposite shoulder, then at the upper corner of the scapula or at the spine in this place, you can feel the point of maximum pain.

Interscapular pain syndrome

This condition occurs when the complex of structures located between the shoulder blades is inflamed: muscles, ligaments and fascia. It begins with the appearance of heaviness in the interscapular zone. Then a pain syndrome develops, which has a breaking, boring, burning character. Its intensity increases during emotional stress, during a night's sleep, when breathing and turning the body, it radiates to the neck, shoulder, forearm and arm. What distinguishes the syndrome from intercostal neuralgia and heart pain is that pain points can be found in the area of the scapula, and the intercostal muscles are painless.

Inflammation of the costal cartilage (chondritis) on the left side

It is manifested by the appearance of swelling of one of the cartilages; she is sick. After a while, the edematous area softens, it can open with the release of pus. In this case, the temperature may rise to subfebrile numbers. Even after opening the abscess in the area of the inflamed rib, pain persists, which can disturb for 1-3 years.

Tietze syndrome

This is the name of a disease of unknown cause, in which one or more costal cartilages become inflamed at the point where they connect to the sternum. The syndrome is manifested by pain in the localization of inflammation, which is aggravated by pressing on this area, sneezing, movements, and also with deep breathing.

The disease proceeds with periods of exacerbation, when all symptoms appear, and remissions, when a person feels healthy.

Injuries, fractures, bruises of the ribs

If an injury was inflicted, and then pain is noted in the chest, it is impossible to differentiate by symptoms whether it is a bruise or a fracture. Both of these pathologies are manifested by severe pain that extends to the entire chest; it gets worse with breathing. Even if it was a fracture and it healed, chest pain will still be noted for some time.

Tumor of one of the ribs on the left - osteosarcoma

It can appear in people of any age. Oncopathology is manifested by a pain syndrome localized in the region of the ribs. It intensifies at night, is characterized by a pulling character. In the later stages, swelling is noted in the area of the affected rib.

Osteochondrosis

When squeezing the bundles of the spinal nerves on the left, pain appears in the region of the ribs. She:

aching;
constant;
changes intensity with a change in body position;
increases with physical exertion, overheating, drafts and hypothermia;

Additional symptoms are:

tingling and numbness in the left arm,
her muscle weakness
there may be pain in the left arm,
which has three distribution options:
- along its outer surface to the thumb and forefinger;
- on the inner, closest to the little finger, area of \u200b\u200bthe hand;
- along the back-outer part, heading towards the middle finger - this will depend on which of the roots is pinched.

Osteoporosis

This is the name of the pathology in which the bones (including the ribs) are too low in calcium. It occurs due to its insufficient intake, poor absorption or increased destruction.

The pathology is asymptomatic, you can find out about it if you perform an ultrasound densitometry of the ribs (find out their density). The first symptoms appear when small cracks appear on the ribs or such fractures that appear when the body is tilted or sharply turned. During such movements, a strong, sharp pain usually appears in the region of the ribs, which then persists even when the position of the body changes.

Herniated disc

This pathology - akin to osteochondrosis, is associated with malnutrition of the intervertebral disc with its subsequent destruction. Only in the case of a hernia, that part of the disk that cannot be destroyed begins to protrude beyond the vertebrae and compress the nerves passing there.

Hernia manifests itself as a pain syndrome:

growing gradually;
intensifying to the most pronounced degree, leading even to loss of consciousness;
gives to the neck or arm, where it has a shooting character.

Symptoms can be confused with myocardial infarction. The main difference is the fact that with a herniated disc, the general condition of a person does not suffer.

fibromyalgia

This is the name of chronic musculoskeletal pain that occurs for no apparent reason in symmetrical areas of the body. In this case, the pain syndrome appears after stress or emotional trauma. The ribs hurt not only on the left, but also on the right, the pain is aggravated by rain and a similar change in weather conditions.

A person notes a feeling of stiffness in the chest, complains of poor falling asleep, periodic headaches. Decreased coordination of his movements; quality of life suffers.

Musculoskeletal syndrome

This disease is not rare. Its cause is an injury to the soft tissues of the chest (in this case, on the left), in which blood enters the muscles, sweats out its liquid part and deposits the fibrin protein, which the blood needs to ensure the clotting process. As a result of such impregnation of the muscles, their tone rises sharply, which causes pain syndrome, described as "in the muscles" or as "in the ribs", of varying intensity, which changes with movement.

All of the above diseases from the described group, there is pain in the ribs. This symptom will also be noted with pleurisy, pleural tumors and cardioneurosis. We will talk about diseases of the pleura a little lower.

When the cause is in the disease of one of the internal organs

Pain syndrome, localized near the heart, can be caused by pathology of the lungs and pleura, in which they are wrapped. It can occur due to diseases of the mediastinal organs - that complex of organs that is located between the two lungs, next to the heart. Diseases of the esophagus, stomach, gallbladder and liver can also cause pain resembling heart pain.

lung disease

Mediastinal pathologies

There are not very many of them:

Pneumomediastinum (mediastinal emphysema)- the ingress of air into the fatty tissue, which is located around the heart and blood vessels. It occurs as a result of injury, damage during surgery or purulent fusion of air-containing tissues - the esophagus, trachea, bronchi or lungs. Symptoms: a feeling of pressure behind the sternum, difficulty breathing, shortness of breath.
Pulmonary embolism. This is a life-threatening condition characterized by sudden, sharp pain behind the sternum, which is aggravated by taking a deep breath and coughing. Shortness of breath, palpitations, loss of consciousness are also noted.
Tracheitis is an inflammation of the mucous membrane of the trachea. It is manifested by cough, dry burning pain behind the sternum.
Spasm of the esophagus. The symptoms of this condition are difficult to distinguish from an attack of angina pectoris: the pain syndrome is localized behind the sternum, in the region of the heart and scapula, and is relieved by nitroglycerin.

Diseases of the abdominal organs

The following pathologies can cause pain similar to heart:

Esophagitis is inflammation of the lining of the esophagus. It is characterized by a burning sensation behind the sternum, which is aggravated by swallowing especially hard, hot or cold food.
Achalasia cardia is the expansion of the esophageal opening of the stomach. Retrosternal pain syndrome is associated with food intake. Heartburn and nausea are also noted.
hiatal hernia. Pain syndrome appears or intensifies after eating, as well as in a horizontal position. The pain goes away with a change in body position.
Peptic ulcer of the stomach or duodenum. The pain in this case either occurs on an empty stomach, or 1-2 hours after eating. Heartburn is also noted.
Exacerbation of chronic cholecystitis most often accompanied by pain under the ribs on the right, but can also be given to the left half of the chest. In addition, there is bitterness in the mouth, loosening of the stool.
Exacerbation of chronic pancreatitis if the inflammation is localized in the tail of the pancreas, in addition to nausea, vomiting and loosening of the stool, it is accompanied by pain in the left side of the chest.

Diagnosis depending on the characteristics of pain

We examined pathologies that cause pain syndrome localized in the left half of the chest. Now let's look at what pain each of them gives.

It's a dull pain

Aching pain is typical for:

angina;
myocarditis;
cardioneurosis;
peptic ulcer of the stomach and duodenum;
scoliosis;
osteochondrosis of the thoracic spine;
exacerbation of pancreatitis.

The stabbing nature of the pain syndrome

Stinging pain occurs when:

Pressing character

Pressing pain can be a manifestation of:

angina;
myocarditis;
mitral valve prolapse;
pericarditis;
foreign body of the esophagus (in this case, the fact of swallowing some inedible object, for example, a fish bone is noted);
cardiomyopathy;
myocardial dystrophy;
heart tumors (eg, myxoma);
poisoning with drugs, alcohol, drugs, phosphorus-organic compounds, poisons. In this case, there is the fact of taking drugs, alcohol, treating plants from pests, and so on;
ulcers in the stomach at the junction with the esophagus.

If the nature of the pain is sharp

The word "sharp pain" is usually used only to describe myocardial infarction. In addition to cardialgia of a similar nature, there is a general deterioration in the condition, cold sweat, fainting, heart rhythm disturbance. Irradiation of cardialgia - in the left shoulder blade, arm.

If the pain feels like "severe"

Severe pain occurs when:

myocardial infarction;
osteochondrosis of the cervical and thoracic regions;
intercostal neuralgia, especially caused by herpes zoster;
thromboembolism of the pulmonary artery;
rupture of a dissecting aortic aneurysm;
myocarditis.

Pain is felt all the time or most of the time

Constant pain is characteristic of osteochondrosis. At the same time, there is no deterioration in the condition, but “goosebumps” and numbness in the left hand, a decrease in its strength, may be noted. A similar complaint is described and pericarditis - inflammation of the outer shell of the heart - the heart bag. It is also characterized by general malaise and fever. Pericarditis can also be a source of frequent pain that goes away from time to time. This is how you can describe the pain syndrome with menopause or anxiety disorders.

Pain syndrome of blunt character

If a dull pain is felt in the region of the heart, it may be:

anterior chest wall syndrome;
arterial hypertension (in this case, high blood pressure is recorded);
overload of the intercostal muscles, for example, during very active physical training or playing wind instruments for a long time.

Sharp pain in the region of the heart

Acute pain is observed with pleurisy or pericarditis. Both diseases are characterized by fever and weakness.

Nagging pain

It is typical for:

thrombosis;
neuro-circulatory dystonia;
angina;
osteochondrosis;
diseases of the gastrointestinal tract.

Pain syndrome of a burning character

Such a symptom is noted with myocardial infarction, in which case there will be a sharp deterioration in the condition, there may be clouding of consciousness due to pain shock. Pain in neurosis is described in the same way, when psycho-emotional disorders come to the fore.

Diagnosis depending on the conditions for the occurrence of pain syndrome and associated symptoms

Consider additional characteristics of the pain syndrome:

If the pain radiates to the shoulder blade, it can be: angina pectoris, spasm of the esophagus, myocardial infarction, cardioneurosis.
When the pain increases with inspiration, this indicates: intercostal neuralgia, pleurisy or myositis of the intercostal muscles. When the intensity of the pain syndrome increases with a deep breath, it can be: pneumonia or pulmonary embolism. In both cases, there is a deterioration in the general condition, but with inflammation of the lungs this happens gradually, and with PE, the count goes on for minutes.
If the pain syndrome increases with movement, this may be a sign of osteochondrosis of the cervical or thoracic region.
When arm radiating pain appears, a person may have one of the following conditions:
- osteochondrosis;
- myositis of the intercostal muscles on the left side;
- myocardial infarction;
- angina;
- interscapular pain syndrome;
- endocarditis;
- pneumothorax.
When the pain syndrome is accompanied by shortness of breath:
- myocardial infarction;
- pneumothorax;
- pulmonary embolism;
- pneumonia;
- ruptured aortic aneurysm.
If both weakness and pain in the region of the heart appear, it may be tuberculosis, pleurisy, pericarditis, dissecting aortic aneurysm, pneumonia.
The combination "pain + dizziness" is typical for:
- mitral valve prolapse;
- cardiomyopathy;
- cardioneurosis;
- osteochondrosis or hernia of the cervical region, accompanied by compression of the vertebral artery.

What to do with cardialgia

If you have pain in the heart area, what to do:

Stop performing any action, take a semi-lying position, put your legs just below the body (if there is dizziness - above the position of the body).
Unfasten all interfering clothes, ask to open the windows.
If the pain is similar to that described for angina pectoris, take "Nitroglycerin" under the tongue. If the syndrome is stopped by 1-2 tablets (they act within 1.5-3 minutes), on the same day or the next, contact a therapist to diagnose coronary heart disease and prescribe appropriate treatment. You can’t drink more pills - from them, among other things, pressure decreases (P.S. headache after taking nitroglycerin is a normal phenomenon, it is removed by Validol or Corvalment, which contain menthol).
If nitroglycerin did not help, and at the same time there is difficulty in breathing, weakness, fainting, severe pallor - call an ambulance, be sure to indicate that there is pain in the heart. You can first drink an anesthetic tablet: Diclofenac, Analgin, Nimesil or another.
If the pain in the region of the heart disappeared after you stopped, this condition requires an early diagnosis using an ECG and ultrasound of the heart. Not paying attention threatens to aggravate the situation with the development of heart failure.

Treatment is prescribed only by a doctor - based on the results of the examination. Self-medication is unacceptable, since the diseases manifested by this symptom are radically different. Self-medicating, for example, osteochondrosis, which actually turns out to be myocarditis, can lead to the development of heart failure, when any wrong movement will be accompanied by shortness of breath, a feeling of lack of air and swelling.

Thus, pain syndrome localized in the region of the heart can be caused not only by heart diseases. Much more often, its causes are pathologies of the ribs and intercostal muscles, spine, esophagus and stomach. In order to start moving towards a diagnosis, you need to state your complaints to the therapist. The doctor will either sort out the problem on his own, or refer you to the right specialist. This will be a better solution than to undergo examinations on your own, wasting time and money.

Chest pain usually depends on one of the organs of the chest (heart, lungs, esophagus) or components of the chest wall (skin, muscles or bones). Sometimes internal organs are located close to the chest, such as the gallbladder or stomach, and when they fail, it causes chest pain. Chest pain can also be the result of neck pain, this is the so-called referred pain.

Ischemia and angina pectoris

All organs and tissues of the body need oxygen and nutrients, which saturate them with blood. Blood travels through a huge network of arteries throughout the body, including the vessels that supply blood to the heart muscle. These vessels, called coronary arteries, are located directly on the surface of the heart muscle.

In people with coronary artery disease (CHD), the coronary arteries become clogged with fatty deposits, also called plaque. They can be the reasons for the narrowing of the coronary arteries, and then enough oxygen does not enter the blood, and the blood itself does not pass well through the vessels. The heart does not receive it and begins to work intermittently. This is called coronary heart disease.

Angina pectoris is also one of the types of chest pain, quite dangerous. This type of heart disease is especially common during physical activity, when the heart rate increases and blood pressure rises because the heart needs more oxygen. Angina develops when the need for oxygen exceeds the amount of oxygen that delivers blood to the heart muscle.

Heart attack (myocardial infarction)

A heart attack, or myocardial infarction (MI), happens when blood vessels stop flowing due to plaque buildup in them. Blood clots (thrombi) can partially or completely block an artery. This blood plug slows or completely blocks the flow of blood to the heart muscle area. And then the person has a chest pain. If the pain continues for more than 15 minutes, the muscles can be damaged and tissue death occurs - a heart attack. During a heart attack, the patient may feel discomfort and pain, which is similar to the pain of ischemia. A heart attack can happen after a long period of angina.

Other cardiovascular diseases

Some cardiovascular diseases that are not related to blood flow in the coronary arteries can cause chest pain.

Some people suffer from classic angina pain. This is called variant angina, which can be caused by temporary spasm of the coronary arteries. These arteries, as a rule, are not affected by cholesterol plaques, so they are not narrowed, and doctors also do not diagnose arterial obstruction. But with variant angina, a partial blockage of the artery due to spasm in one of its sections can occur.

Pericarditis, or inflammation of the membrane around the heart, can also cause chest pain that worsens with deep breathing. The pain may ease when the person sits or leans forward. When listening to the heart, the doctor hears unusual, uncharacteristic sounds of the heartbeat. This noise leaves the pericardium. Problems with the heart (pericardium) are confirmed by an electrocardiogram (ECG).

Inflammation of the heart muscle, called myocarditis, can also cause chest pain, which is similar to ischemic pain. Myocarditis is often caused by a viral infection.

Another cause of classic angina pain in people with normal coronary arteries is "syndrome X", which is more common in women. People with this condition may not know the cause of their chest pain at all.

Problems with the heart valves or heart muscle (called hypertrophic cardiomyopathy) can also sometimes cause typical chest pains, such as those associated with angina pectoris. People diagnosed with mitral valve prolapse and aortic stenosis, for example, may often complain of chest pain.

A rather rare but serious cause of chest pain is a dissection (rupture) of the aorta. The aorta is the main artery in the body. It consists of several layers of muscle cells, similar to the layers that surround the bulb. Sometimes these layers rupture and the person bleeds outside of the circulatory system, meaning the blood is distributed throughout the body. This is a very serious disease that can only be treated with vascular surgery. Chest pain due to aortic dissection is usually very severe, they occur very suddenly, they give to the back or between the shoulder blades.

Chest pain can also spread to the skin, muscles, bones, tendons, soft tissues and cartilage of the chest, so even with palpation, a person feels severe pain. Trauma, including recent surgery, can lead to severe chest pain (felt more in the chest wall).

Chest pain due to diseases of the esophagus

The esophagus is the tube that connects the mouth, throat, and stomach. Since the esophagus and the heart serve the same nerves, in some cases, chest pain due to the esophagus can be confused with cardiac ischemia. In some patients, chest pain due to diseases of the esophagus causes it to spasm and becomes weaker after taking nitroglycerin.

A number of medical conditions can cause pain in the esophagus, including gastroesophageal reflux disease, also known as heartburn, which is caused by acid leaking back up the esophagus from the stomach. This pain can be uncomfortable or very painful for the person.

Chest pain can cause spasms of the esophagus due to a disorder of its motility - the muscles around the esophagus do not move correctly, causing chest pain. Causes of chest pain can be esophagitis - inflammation of the esophagus, sometimes it occurs due to medications.

Gastrointestinal tract

Diseases of the gastrointestinal tract increase the number of problems associated with chest pain, which begins and then spreads throughout the chest. Diseases that cause chest pain include ulcers, gallbladder disease, pancreatitis, and irritable bowel syndrome.

Chest pain due to diseases of the respiratory system

The lungs provoke a number of problems that cause chest pain. Many diseases of the respiratory system cause pain that gets worse with deep breathing.

Pulmonary embolism - a blood clot in the vessels of the lungs. It almost always worries people at high risk for disorders due to recent surgery, those who stay in bed for a long time, pulmonary embolism can occur in pregnant women or patients after recent pelvic surgery. The chest pain associated with a pulmonary embolism comes on suddenly, is accompanied by shortness of breath, and may worsen with deep breaths.

Pneumonia - infections in the lungs and their inflammation can cause chest pain, cough and fever.

Pleurisy is inflammation of the tissues surrounding the lungs. Pleurisy can occur due to a viral disease or as a complication after an injury. Pleurisy can also provoke a disease such as pneumonia, pulmonary embolism. Pleurisy causes chest pain.

A pneumothorax is a collapsed lung that creates an air cushion in the space between the chest wall and the lungs. Pneumothorax causes chest pain, sometimes very strong and unbearable.

Psychological causes of chest pain

Panic disorder or depression can make a person feel chest pain. Severe chest pain associated with panic attacks of fear or anxiety can occur in a person with disorders of the unequal system. These changes can be diagnosed on an electrocardiogram (ECG).

Chest pain can occur when the nerves in the chest wall become inflamed. The pain may radiate to the tissues around the lungs, the diaphragm, or the abdominal mucosa. A herniated disc or arthritis of the cervical spine can lead to persistent complex chest pain.

Symptoms of chest pain in heart disease

Chest pain that is caused by angina pectoris or pain that is caused by a myocardial infarction can be similar. They differ in duration and sharpness. If the pain lasts no more than 15 minutes, it is angina pectoris, and if it lasts more than half an hour, it is a heart attack. With a heart attack, the pain is stronger and more acute. Depending on the cause, chest pain can be sharp, dull, burning, and may be localized in one or more areas (mid-chest, upper chest, back, arms, jaw, neck, or entire chest area). Heart pain may get better or worse after physical activity or even during rest. There may be other associated symptoms (sweating, nausea, palpitations, shortness of breath).

Ischemic chest pain, as a rule, is not localized in a specific place, but is felt throughout the chest. Heart pain is often located in the center of the chest or upper abdomen.

If the pain is felt only in the right or left side, and not in the center of the chest, it is unlikely to be caused by coronary heart disease.

Radiation chest pain is heart pain that radiates to other areas of the upper body, not just the chest. These areas are the neck, throat, lower jaw, teeth (chest pain may radiate to the teeth), as well as the shoulders and arms. Sometimes chest pain can be felt in the wrists, fingers, or between the shoulder blades.

Unlike non-cardiac pain, heart pain can start suddenly and get worse at the very beginning. This is often associated with physical activity. Non-cardiac pain, unlike cardiac pain, may last only a few seconds or persist for several hours. The pain may get better when the person takes nitroglycerin or it may not go away even after taking it. Then this is a very serious symptom. Pain that persists for days or weeks is more likely to indicate angina or a heart attack.

Muscle spasms or spasm of the esophagus that provoke chest pain may become weaker after taking nitroglycerin. If eating or taking antacids can relieve chest pain, then it is most likely caused by problems with the esophagus or stomach.

Pain during ischemia usually does not increase with a deep breath or pressure on the area where it hurts and where the person feels discomfort. Ischemic pain is usually independent of position, although some patients with ischemia feel relief when they sit down, especially when they lean forward.

Concomitant symptoms of cardiovascular diseases that cause chest pain

Dyspnea
Nausea, vomiting, belching
sweating
Cold, clammy goose bumps
Frequent and fast pulse
Cardiopalmus
Fatigue
Dizziness
fainting
Indigestion
Discomfort in the abdomen
Tingling in the arm or shoulder (often on the left)

Diagnosis of chest pain

Many circumstances and diseases can cause chest pain. And they are diagnosed differently.

Basically, in the diagnosis, the palpation method and a doctor's interview are first used. In some diseases that cause chest pain, palpation can clearly show the cause. For example, with angina pectoris, when pressing on the chest area, the chest hurts even more.

An electrocardiogram, or ECG, shows how electrical waves travel through different parts of the heart muscle. In people with ischemic chest pain, changes in the heart muscle are clearly visible on the ECG.

Blood tests - can be used to analyze heart muscle enzymes. During a heart attack, these enzymes can move from the heart into the blood. Tests of cardiac enzymes found in the blood may indicate the possibility of a myocardial infarction.

Stress test - the patient is observed while walking or running on the treadmill. This method is very indicative in the diagnosis of ischemia. During active running or walking, cardiac activity is monitored on the ECG. So the doctor can recognize the symptoms of ischemia. Echocardiography can also be used to diagnose cardiovascular disease.

Cardiac catheterization – also known as coronary angiography, this technique uses a small catheter inserted into the coronary arteries and uses a special dye to show the outline of the heart. Arteriography is recommended for people at high risk for coronary disease and blocked arteries. The results of the arteriography can help guide the best treatment.

Data interpretation - with this diagnostic method, the doctor will be able to synthesize all the factors described above in order to determine the cause of chest pain. Even if there is evidence of coronary heart disease, other diseases can also be the cause of the pain. Many of these can mimic ischemic chest pain. Statistics show that in most cases, chest pain, in which a person calls an ambulance, is not caused by angina pectoris or myocardial infarction.

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If chest pains are caused by diseases of the gastrointestinal tract, folk remedies are used, for example, fresh potato juice for ulcers or painkillers.

One of the ways to treat chest pain can also be a change in the daily regimen: increasing or, conversely, weakening physical activity.

Chest pain is a serious symptom, so you need to see a doctor if this pain does not go away for a long time.

Cardiovascular diseases today occupy a leading position among the dangerous and common diseases in the world.

At the heart of such diseases, a genetic predisposition is most often distinguished, as well as an incorrect lifestyle.

There are many cardiovascular diseases and they proceed differently: they can occur as a result of inflammatory processes in the body, intoxication, injuries, birth defects, metabolic disorders, etc.

However, the variety of reasons for the development of these diseases is connected by the fact that their symptoms can be common.

Chest pain as a harbinger of heart disease

A symptom such as an unpleasant feeling of discomfort and pain in the chest area may portend a violation of the heart and blood vessels.

If the pain is burning in nature, then this condition indicates a spasm of the coronary vessels, leading to malnutrition of the heart. This kind of pain in medicine is called angina pectoris.

There are such pains as a result of:

physical activity,
at low temperature,
often in stressful situations.

The phenomenon of angina pectoris occurs when the blood flow ceases to satisfy the needs of the heart muscle masses for oxygen supply. In people, angina pectoris is called "angina pectoris". The doctor recognizes such a disease literally at the first visit of the patient.

Diagnosis of abnormalities in this case is difficult, because to make the correct diagnosis, it is necessary to monitor the development of angina pectoris and additional examinations (for example, daily ECG monitoring). There is a difference between angina pectoris and angina at rest.

rest angina. Usually not associated with physical activity, shares characteristics with severe angina attacks, and may be accompanied by a feeling of shortness of breath. Often occurs at night.
angina pectoris. Attacks of such angina pectoris occur almost with a certain frequency, which is provoked by the load. When the load decreases, the seizures stop.

However, they also distinguish unstable angina, which is dangerous for the development of myocardial infarction. Patients with an unstable form of angina pectoris are necessarily hospitalized.

Heart disease causing chest pain

According to the patient's description of the sensations of pain in the chest area, an experienced doctor draws a conclusion about the nature of the disease. The cardiovisor device in such cases helps to determine whether this deviation is associated with a disease of the cardiovascular system.

Diagnosis of chest pain

Clarification of the duration, localization, intensity and nature of chest pain, as well as reducing and provoking factors is very important.

Previous abnormalities in the work of the heart, the use of potent drugs that can cause spasms of the coronary arteries (for example, cocaine or phosphodiesterase inhibitors), as well as the presence of a pulmonary embolism or a risk factor for coronary heart disease (travel, pregnancy, etc.) are of considerable importance.

A burdened family history increases the possibility of developing coronary artery disease, but it makes no sense to specify the causes of acute pain.

Additional research methods

The minimum examination of a patient with chest pain may consist of:

pulse oximetry,
chest x-ray.

For adults, screening for markers of myocardial tissue damage can be done. The effectiveness of such tests with anamnesis data, as well as an objective examination, make it possible to form a preliminary diagnosis.

At the initial examination, a blood test may not be available. If the indicators of the markers indicate damage to the myocardium, then they cannot ascertain about the damage to the heart.

Diagnostic sublingual nitroglycerin tablets or liquid antacids cannot reliably differentiate between gastritis, GERD, or myocardial ischemia. Each of these medical drugs is able to reduce the signs of disease.

Treating chest pain

Medical and therapeutic treatment of chest pain is carried out in accordance with the diagnosis.

If the causes of chest pain are not fully understood, the patient is taken to the hospital for an in-depth examination, to monitor heart conditions. Of the drugs, only opiates can be prescribed until a correct diagnosis is made.

Prevention of heart disease

To prevent the occurrence of heart ailments, doctors have developed several recommendations:

Walk more, regularly do feasible and simple physical exercises. It is not recommended to start physical exercises with the greatest loads, and before starting such training, it is imperative to consult with doctors so that the chosen program will only benefit the body.
Try to maintain an optimal body weight.
It is imperative to keep under control possible factors for the development of atherosclerosis, for example, high blood pressure, the amount of cholesterol, etc.
Nutrition should always be regular and complete, more protein food and vitamins with minerals should be in the diet.
It is recommended to visit a doctor regularly and carry out the necessary laboratory tests.
Remember the golden rule of health: it is always easier to prevent a disease than to treat it later.

Prognosis of symptom of chest pain

Predicting a symptom that subsequently develops into a cardiovascular disease is very difficult. The fact is that it all depends on the provision of first aid to the patient.

How do heart diseases manifest? Symptoms and signs

I began to think about what and how my chest could hurt many years ago, since the first panic attack happened to me. The first thing a person thinks about when he feels chest pain is his heart. Especially if these pains appeared for the first time or suddenly, without any apparent, at first glance, reasons. Indeed, quite often chest pains are associated precisely with cardiovascular diseases (CVD), but not always. But we will start with heart diseases, since they are the most dangerous and their symptoms begin to appear quite unexpectedly.

After the doctors first started talking about my possible diagnosis of coronary artery disease, I began to become intensely interested in the symptoms and manifestations of various heart diseases and try to compare them with my feelings. I am a suspicious person, I immediately “earned” cardioneurosis, which I later barely got rid of. Therefore, I do not recommend that you “deep into the topic” on your own, but it is better to discuss your problems with a cardiologist at an in-person appointment, where the doctor will answer all your questions.

But nevertheless, it still doesn’t hurt to know some information about pains in the heart, or rather, about diseases of the cardiovascular system, because it’s also not worth taking pains in the chest too lightly.

So, the most common heart diseases and their symptoms:

Ischemic heart disease (CHD)

The main symptom of coronary heart disease is angina pectoris, or an attack of chest pain. Pain is described as a feeling of discomfort, heaviness, pressure, burning, fullness in the chest. Sometimes this condition is associated with indigestion or heartburn. Typically, pain occurs in the chest and may radiate to the shoulders, arms, neck, throat, teeth, or back. Other symptoms of coronary heart disease include: shortness of breath, palpitations, irregular heartbeat, irregular heartbeat, weakness and dizziness, nausea and sweating.

If these symptoms are considered from the point of view of a person who has been suffering from VVD for a long time, then, in general, all these pains, palpitations and other manifestations of ischemia are no longer new to him and he encounters them almost daily. This I mean that it is likely that chest pain may not be related to CVD. But taking risks and leaving such symptoms unattended is very dangerous! If you have experienced these symptoms for the first time, then you need to urgently undergo a COMPLETE cardiac examination. Remember: making one cardiogram is not enough! An ECG shows the state of your heart at the moment, and the symptoms of coronary heart disease can appear suddenly and quickly disappear without a trace and you can only “catch” them on daily ECG monitoring (Holter examination).

myocardial infarction

The most common symptoms of myocardial infarction include:
Pressure, heaviness, pain in the chest, arm and behind the sternum. Pain radiates to the back, teeth, throat, or arm
Feeling of fullness, heaviness in the abdomen (sometimes symptoms resemble heartburn)
Sweating, nausea, vomiting, dizziness
Excessive weakness, anxiety, shortness of breath
Frequent and unstable pulse

During a myocardial infarction, the attack lasts an average of 30 minutes or longer and is not relieved by oral medications (nitroglycerin or other nitrates). At first, the symptoms may be mild, but gradually the pain intensifies and becomes intense. Some people have no pain during a heart attack (silent myocardial infarction). As a rule, such a course of a heart attack is typical for patients with diabetes mellitus.

Cardiomyopathy

Cardiomyopathy is a myocardial lesion of unknown origin with the development of an increase in the size of the heart, heart failure, and a violation of the heart rhythm and conduction. Among diseases of the cardiovascular system, it occupies a special place.

One of the first symptoms of dilated cardiomyopathy may be fatigue during exercise, weakness. Later, shortness of breath appears, at first during exercise, then it intensifies and, at the height of the disease, cardiac asthma and various rhythm disturbances appear. Very often there are pains in the heart of a different nature: aching, stabbing, squeezing.

Pericarditis

Symptoms of pericarditis include:

Chest pain other than angina (pain associated with coronary artery disease). It can be acute and localized in the central part of the chest. The pain may radiate to the neck and, in some cases, to the arms and back. Symptoms worsen when lying down, taking a deep breath, coughing, or swallowing. Relief comes from sitting upright
Slight rise in temperature
Fast heart rate (tachycardia)
And these are only the most common heart diseases! Even with a cursory reading, you can clearly see that most of the symptoms and manifestations of CVD are very similar to each other, so it is very important to see a cardiologist who can make the correct diagnosis.

As I mentioned earlier, not all chest pain is necessarily related to heart disease, there can be many reasons. More on this in the next article.

How to distinguish heart pain from others? What examination should be done? About all this edition of the News. Medicine toldneurologist, candidate of medical sciences, head of the hospital at the Yusupov Hospital Sergey Vladimirovich Petrov.

Sergei Vladimirovich Petrov

Pain is a kind of body signal that indicates a problem. There are several organs in the chest, and each can be a source of pain. When a person experiences chest pain, this may be due to the manifestation of an inflammatory process in the lungs, a disease of the esophagus, but it may also be heart pain.

Usually, any pain leads to a decrease in the quality of life, but not every pain is life threatening. Some types of pain indicate a serious problem in the body. And if you do not respond correctly to this pain, then not only the quality of life may suffer, but also great harm will be done to your own health, and even death is possible. One of these types of pain is heart pain.

Heart pain (in medicine called angina pectoris or "angina pectoris") occurs when there is insufficient oxygen supply to the heart muscle. Most often this is due to the narrowing of the lumen of the vessel that feeds one or another part of the heart muscle. In most cases, the patient's description of their pain is enough to diagnose angina.

What are the signs of a heart attack?

Photo: Kaspars Grinvalds/Shutterstock.com

First, this localization. Most often it is pain behind the sternum or in the left side of the chest. The pain may radiate to the left arm, between the shoulder blades or to the lower jaw. Secondly, characteristic. In the classic version, it is a pressing, squeezing, baking or dagger pain.

The next important point is that angina pectoris most often has provoking factors- physical or emotional stress. This means that there is no pain at rest, but they appear during physical or emotional stress. With a critical narrowing of the vessel that feeds the heart muscle, angina pectoris can appear with minimal stress at rest and even at night.

In assessing the origin of chest pain is always taken into account time factor. True heart pain is not of a long-term nature, the count goes on for minutes. In other words, the heart cannot “wine, pull, prick” for several hours, days, or day after day. Such pains are more often a manifestation of pathology from the musculoskeletal system. However, true heart pain lasting more than 20 minutes indicates the possible development of a formidable complication - myocardial infarction.

It is worth paying attention to the circumstances under which the pain goes away. Angina stops on its own within about a few minutes, for example, if the patient stops or calms down. Some patients are helped by nitroglycerin, which reduces or completely stops angina pain within 1-2 minutes. If a person has developed a myocardial infarction, then chest pains will not be stopped and after taking nitroglycerin they will not pass, in this case emergency help is needed.

With angina pectoris, there is a temporary disruption of blood flow in a coronary artery affected by an atherosclerotic plaque. Taking nitroglycerin allows you to expand the lumen of the vessel, improve blood flow and thus the pain will go away, which leads to a regression of pain. With a heart attack, the narrowing of the lumen is so pronounced that it leads to irreversible damage to the heart muscle. In this situation, the pain has a different cause and taking nitroglycerin will no longer give an effect.

In addition to the classic characteristics, angina pectoris can wear the so-called atypical forms, up to manifestations in the form of shortness of breath or abdominal pain.

Thus, we see that on the one hand, in most cases, heart pain can be easily recognized, but on the other hand, it is not always so easily recognizable. That is why it is important that if you have pain in the chest, you feel short of breath, you should immediately consult a doctor.

What can a doctor do when a patient comes to him with chest pain?

First of all, the doctor will carefully ask the patient to tell about all the symptoms. If, as a result of a survey, the doctor gets the impression that the pain may be angina pectoris, then it is necessary to conduct a diagnosis to confirm the patient's complaints.

Photo: Image Point Fr/Shutterstock.com

What tests are needed to confirm or refute the diagnosis?

When it comes to heart disease, an important study is the electrocardiogram (ECG) at rest. In many diseases, the ECG changes, but in the presence of angina in a patient at rest without pain, the ECG may be completely normal. This means that the ECG data will be within the normal range, and the patient will feel angina pectoris. Thus, if angina pectoris is suspected, one cannot limit oneself to conducting an ECG at rest.

An important stage of the examination in determining the genesis of chest pain is a stress test. The most commonly used combination of load (track or bike) in combination with ECG registration. Changes in the ECG during exercise and complaints from the patient with a high degree of probability allow us to judge the presence or absence of angina pectoris. If there are concomitant complaints, for example, interruptions in the work of the heart, the doctor may prescribe a daily ECG monitoring. It will allow you to fix rhythm disturbances, if any. And in some cases, heart rhythm disturbances can indicate a problem in the blood supply to the heart muscle.

In addition, cardiovascular risk factors are assessed: age, gender of the patient, heredity, blood pressure, the presence of certain diseases, as well as a number of blood parameters, the increase of which is associated with an increased risk of angina pectoris (blood lipids, glucose, creatinine).

There are typical manifestations of heart pain, but the disease can also be atypical. That is why doctors do not recommend self-medication, but trust qualified specialists. If you're experiencing chest pains that you haven't experienced before, make an appointment and discuss them with your doctor. It is quite possible that already at the initial consultation, the doctor will tell you that there is no threat from the heart. But it is possible that a more complete examination may be required. It is important to consult a doctor in a timely manner. And the doctor will assess the symptoms, risks, conduct the necessary examinations and, if necessary, develop a treatment plan or a plan of preventive measures together with the patient, so that the patient lives as long as possible and the quality of life is not affected.