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Symptoms of disease - pain in the heart

The pain of the heart is connected with the defeat of the internal organs, bone and cartilage structures of the chest, myofascial syndrome, diseases of the spine and peripheral nervous system or psychogenic diseases. Thoracalgia can be symptoms of angina, myocardial infarction, prolapse of the mitral valve, stratifying aneurysm of the aorta, pulmonary embolism, pleurisy, pneumonia, malignant neoplasms of the lung, diseases of the gastrointestinal tract (stomach and duodenal ulcer, pancreatitis or cancer of the pancreas, cholecystitis), phrenic abscess.

Between the severity of pain in the heart and the seriousness of the underlying causes of the marked only a weak dependence.

Coronary heart failure.

- Myocardial ischemia (angina pectoris). A feeling of pressure behind the breastbone with a typical radiating to the left arm, usually with physical strain, often after a meal or in connection with the emotional stress. Diagnostically significant effect of nitroglycerin and recreation.
- Acute myocardial infarction. Feeling close to the myocardium ischemia, but intense and prolonged (approximately 30 min), rest or nitroglycerin not relieve them. There are often III and IV heart tones.

Non-coronarogenic heart failure.

Myocarditis.
Pain in the heart occurs in 75-90% of patients with myocarditis. As a rule, it is a heavy, aching or stitching pain, often in the region of the heart. The relationship with physical activity is not observed, sometimes there is a growing pain in the years after load of days. Nitrates pain is not cropped. Clear the relation between the changes of ECG and pain syndrome no.

Pericarditis.
Pain in the heart when pericarditis is one of the leading signs of disease, but the pain syndrome has certain peculiarities. Most often pain in pericarditis occurs only at the beginning of the disease, when there is friction sheets of the pericardium. When a significant amount of fluid in the pericardium or adhesion cavity pain disappears, in connection with the pain syndrome short.

In acute dry pericarditis pain is most often localized in the apical shock, but may extend to the whole pericarditis region. Less pain it is noted in the epigastrium or upper quadrant. Irradiation of pain in the left arm, shoulder, shoulder blade little is typical for pericarditis. At the same time there are often irradiation on the right side of the chest and right shoulder. By the nature of the pain may be dull, aching, or, on the contrary, the sharp, cutting. A characteristic feature of pain when pericarditis is the dependence on the breath and body position. The breath is often superficial because of the increasing pain with deep breathing. Sometimes patients have to make a forced position (sitting, leaning forward).

Cardiomyopathy.
Pain syndrome occurs in all patients with cardiomyopathy, however, it is more typical to gipertroficescoy cardiomyopathy.

The nature of the pain when cardiomyopathy is undergoing as the course of the disease, certain changes. Most often initially arises atypical pain (not connected with physical activity, long-term, not relieves receiving nitroglycerin). The nature and location of the pain can widely vary. Typical of stenocardia attacks, as a rule, is not observed. Often there episodic pain attacks, triggered by the load (often - walking), in the same time the main background or the most typical is the spontaneous pain, in one way or another relieves nitroglycerine, but not as clearly as in a typical angina.

Acquired heart defects.
Expressed myocardial hypertrophy contributes to the development of the relative failure of the coronary circulation disorders and metabolic processes in myocardium. In connection with the fact that the acquired heart defects are the most common cause of thyroid diseases, pain in the precordium region is characteristic for this pathology.
Most often, the pain in the heart area, is marked on aortic vices.

Prolapse of the mitral valve.
The pain in his heart at this pathology long, dull, gloomy or poignant, did not respond to nitroglycerin.

Myocardial dystrophy.
Clinical manifestations of myocardiodystrophy few typical and at the same time is quite varied. Pain in precordium area frequently and is of a varied nature.

Arterial hypertension.
Hypertension, symptomatic arterial hypertension is quite often accompanied by various pain in precordium area. There are several variants of pain. First of all, it's a pain when raising HELL, caused by excessive tension of the walls of the aorta and stimulation mechanoreceptors the myocardium of the left ventricle. Usually this is a long nagging pain or a feeling of heaviness in the heart.

Neurocirculatory dystonia (NCD).
Pain in the heart, rather frequent symptom of the NDCs. Providing 4 type of pain:

1. Simple false angina - aching or aching pain in the apical or precordium area, a weak or moderate, lasting from several minutes till several hours, it is detected in 95% of patients. Angioneurotic false angina (in 25% of patients) - paroxysmal, is relatively brief, but the often-repeated during the day, rating or pressing the pain of different localization, running mostly on their own, but often relieved drops votchala test, validol, nitroglycerine. May be accompanied by anxiety, feeling short of breath, rapid heart rate. Is not accompanied by ischemic ECG changes. In the basis of it, probably, a disorder of the coronary arteries and hyperventilation.

2. Paroxysmal protracted false angina (false angina vegetative crisis) - intensive pressing or aching pain in the heart, not relieved reception of validol and nitroglycerin, accompanied by fear, trembling, palpitations, shortness of breath, increased AD. Terminated by a usual sedatives in combination with ß-blockers. It happens in 32% of patients with severe course of the NDC.

3. False angina - burning or stinging pain in precordium or parasternal area, are accompanied by almost always hyperalgesia at a palpation of intercostal spaces. The pain is not terminated by a reception nitroglycerin, validola and valokordin. The best results have mustard on the heart, irrigation hloretilom, acupuncture. Is 19% patients. The reason, probably, is the irritation of cardiac sympathetic plexuses.

4. Pseudo angina voltage (false angina) - a heavy, aching, squeezing pain in the heart or behind the breastbone, arising or growing in walking, physical strain. It is detected in 20% of patients. Probably, the reason for it is inadequate for the physical stress hyperventilation and the disorder of metabolism in the myocardium.

Which diseases there is pain in the heart

Pain in the heart, associated with neurological diseases.

Pain syndrome in the heart of the conditional variety of neurological diseases. First of all, it is the disease of the spine, the front of the chest wall and the muscles of the shoulder girdle (osteochondrosis of the spine and various muscular-fascial syndromes), in addition, there are cardialgia in the structure of psychovegetative syndrome.

Characteristics of the various pain syndromes in diseases of the spine and muscles:

Syndrome muscular-fascial or in costal-vertebral pain (not visceral):
1. A fairly constant localization of pain.
2. Unconditional communication pain with a voltage of appropriate muscle groups and the regulation of the body.
3. Low intensity of the pain, the lack of accompanying common symptoms in chronic course or a clear conditionality began in acute injury.
4. Clear data palpation, allowing the identification of pathology: local pain (limited) palpation of the appropriate muscle groups, muscle gipertonus, the presence of trigger zones.
5. Decrease or disappearance of pain in the various local impacts (mustard plaster, pepper plaster, electric or acupuncture, massage or electro physiotherapy, infiltration trigger zones novocaine or hydrocortisone).

Syndrome radicular pain (including intercostal neuralgia):
1. Acute onset of the disease or sharp aggravation of a chronic course.
2. The primary localization of pain in the area of the respective nerve root.
3. Clear relationship with the movements of the spine (the radicular pain) or body (in neuralgia).
4. Neurological symptoms of cervical or chest pain.
5. The sharp local pain in the ground out of intercostal nerves.

Osteochondrosis of the spine.
This is a degenerative-dystrophic lesion of the intervertebral disk, in which the process, starting more often in pulposus the kernel, progressively extend to all elements of the disc with a subsequent involvement of the whole segment (tel adjacent vertebrae and intervertebral joints, ligaments). Degenerative changes in the spine may lead to secondary defeat of the nerve roots, causing pain in the chest. The mechanism of pain associated with compression of the spine biased intervertebral disc with symptoms of the cervico-thoracic pain, inflammatory changes of the nerve roots, the irritation of the border of the sympathetic chain, followed by along with the pain of vegetative disorders.

The nature of the pain syndrome in osteochondrosis of the cervical spine can be different and depends on the localization of lesions, the degree of compression roots. Radicular pain may be cutting, sharp, shooting. It increases during straining, coughing, tilting and turning your head. Metastases in the spine C6 complains of pain in his hand, extending from girdle on the outer surface of the shoulder and arm to the I-II fingers, hyperesthesia in these areas, malnutrition and reduction in reflexes with the biceps. In case of compression of the spine C7 pain spreading to the outside and back of the shoulder and arm to the third finger. The spread of pain on the inner surface of the shoulder and arm to the IV-V fingers typical for the defeat of the spine C8. In osteochondrosis of thoracic spine pain, as a rule, the first is localized in the region of the spine and only then develop symptoms of chest pain. Pain syndrome is associated with the movement, provoked by turning torso.

Muscular-fascial syndrome occurs in 7-35% of cases. His appearance provoked by the injury of soft tissues with bleeding and sero-fibroid extravasatum, pathological impulses in visceral lesions, vertebrogenic factors. As a result of exposure to several of the ethiological factors develops the muscle-tonic reaction in the form of the hypertonicity of the affected muscles. The pain caused by muscle spasm and the violation of circulation in muscle. Characterized by the appearance of or pain increases with the reduction of muscle groups, the movement of the arms and trunk. The intensity of the pain syndrome can vary from discomfort to severe pain.

The syndrome of the front of the chest wall is observed in patients after myocardial infarction, and also in noncoronary defeat of the heart. Probably, it is connected with the flow of pathological impulses from the heart of a segment of the chain, leading to dystrophic changes in the respective municipalities. In some cases, the syndrome can be caused by a traumatic myositis. At a palpation revealed the taste of tenderness front of the chest wall, trigger points at the level of 2-5-th sternocostal joints. When scapulohumeral periarthritis pain is related to movements in the shoulder joint, marked trophic changes of the brush. Shoulder-rib syndrome is characterized by pain in the shoulder blade with the subsequent distribution of the girdle and neck, the side and the front of the chest. When interscapular pain syndrome of the pain is localized in the interscapular, it contributes to the emergence of static and dynamic overload. The syndrome of the pectoralis minor muscle is characterized by pain in the region of the III-V ribs on sterno clavicular line with possible radiating to the shoulder.

When Tietze's syndrome noted a sharp pain in the place of connection of the sternum with cartilages II-IV of the ribs. The Genesis of the syndrome, possibly associated with aseptic inflammation of the rib cartilage. Xiphoidia is manifested sharp pain in the lower part of the sternum, increasing the pressure on xiphoid process. When manubriosternal syndrome reveals a sharp pain on the upper part of the sternum or lateral. Skalenus syndrome caused by compression of neuro-vascular beam of the upper extremity between the middle East and Central stair muscles, as well as normal I or additional edge. The pain in the front of the chest is combined with the pain in the neck, shoulder joints. At the same time can be a vegetative disorders in the form of fever and the paleness of the skin.

A psychogenic false angina is a common variant of a pain in the heart, which consists in the fact that the phenomenon of pain, while leading the clinical picture at some stage of the disease, is at the same time in the structure of various emotional and vegetative disorders, pathogenetically connected with the pain in the heart. The pain is most often localized in the zone of the apex of the heart, precordium region and the region of the left breast nipples. It is possible, the «migration» of pain. It is noted variability of the nature of the pain. Can be annoying, stitching, pressing, squeezing, burning, or throbbing pain, more often it undulating, not terminated by nitroglycerine, at the same time may decrease after validol and sedation. The pain, as a rule, long-lasting, however, is possible and short-term pain, which requires the exclusion of angina.

Which doctor should I contact if there is a pain in the heart

• Cardiologist
• Pulmonologist
• Traumatologist
• Neuropathologist
• Resuscitator
• The emergency doctor
• Oncologist

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Map of the symptoms and the types of pain is intended solely for educational purposes. We strongly recommend do NOT self-medicate; on all matters relating to the definition of the disease and ways of its treatment, contact your doctor. Md-tips is not responsible for the consequences of use information posted on the site.