Система Orphus

Symptoms of disease - chest pain(right side)

Chest pain on the right side 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. Pain in the chest on the left 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 chest on the right and the seriousness of the underlying causes of the marked only a weak dependence.

Coronarogenic 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.



Which diseases there is chest pain(right side)

Common causes chest pains(right side)

Thromboembolism of the pulmonary artery.
Chest pain with PE is observed in 50-90% of cases, occurs sharply, according to its intensity and localization (behind the breastbone or parasternal) will remind you of the pain option of myocardial infarction. A very common symptom with PE is the shortness of breath that occurs as suddenly. Characterized by sudden weakness, and with massive PE possible loss of consciousness. In some patients there is coughing up blood. The objective examination: pallor, cyanosis, tachypnea, weak or thready pulse, falling AD, accent of II tone and systolic murmur of the pulmonary artery. Possible weakening of breath, moist rales and rubbing noise of the pleura.

For PE depends on the value of a blood clot and the level of destruction of the pulmonary arteries. When the lesion is the main trunk occur sudden expressed shortness of breath and cyanosis, very severe pain behind the breastbone, loss of consciousness, a decline AD. Possible fatal within a few minutes. When PE large branches are characterized by intense, bad docked chest pain, sudden sudden shortness of breath and intensive cyanosis of the upper half of the body, rhythm disturbances by type supraventricular reflex tachycardia, reduced blood pressure. In case of defeat of the smaller branches of the pulmonary artery appear or increasing shortness of breath, mild cyanosis, moderate pain in the chest, involved in the act of breathing, cough, which may be accompanied by hemoptysis, there may be moist rales and rubbing noise of the pleura in auscultation.

Flake aortic aneurysm.
Breaking down the aneurysm of the thoracic aorta is more likely to occur on the background of the permanently flowing arterial hypertension, expressed atherosclerosis of the aorta, syphilitic lesions of aorta, Marfan syndrome, as well as the heavy trauma of a thorax. Emit through proximal and distal blood splitting aneurism. Strain intima at the proximal exfoliating aortic aneurysm occurs most often at 2.5 cm from the aortic rings. Dissemination in the proximal direction leads to haemopericardium, a separation of the aortic valve, severe aortic insufficiency, occlusion of the coronary arteries (usually the right). In the distal exfoliating strain intima most often occurs immediately after a discharge of the left subclavian artery. The spread of delamination in the proximal direction uncharacteristically, haemopericardium and aortic insufficiency usually does not happen.

Pain in the chest, as a rule, intensive, refractory to nitrates and is not associated with physical activity. Typical localization in the area of the chest, it is possible irradiation in the neck, lower jaw, in both halves of the chest. Pain syndrome is very similar to that of myocardial infarction and severe attack of angina pectoris. The pain can last from hours to several days. Objectively observed expansion of the boundaries of vascular beam, cardiac dullness, expressed voiceless tones heart; may cyanosis of the face, swelling jugular veins. Forecast of the most unfavorable.

Diseases of the organs of respiration.

Pain syndrome in the lung diseases:
1. The emergence or strengthening of pain during deep breathing or coughing.
2. Acute short-term pain, usually limited, without tendency to irradiation.
3. The availability of other pulmonary symptoms (cough, production of phlegm and shortness of breath or dyspnoea of different kinds).
4. An acute or chronic lung disease in history, rubbing noise of the pleura, dry or moist rales, percussion evidence of emphysema, cavitary lesions or seal of the lung tissue.
It should be noted that the pain syndrome in the lung diseases although often found, however, is not usually a leading clinical syndrome. More specific cough, sputum production, shortness of breath, coughing up blood, zianoz, fever, signs of intoxication.


Spontaneous pneumothorax is an accumulation of air in the pleural cavity, not associated with traumatic injury of the thorax or curative effect. Can evolve with diseases that occur with the destruction of lung tissue (tuberculosis, abscess, bronchiectasis, swelling, bullous emphysema, hydatid cyst). Sometimes it can pneumothorax in practically healthy persons.
Clinically, the disease is characterized by sudden sharp pain in the chest. As a rule, there are shortness of breath, frequent shallow breathing, agitation, sweating. Shortness of breath inspiratory.

Pleurisy flows with the pain of different localization. When the lesion is parietal pleural pain, as a rule, is localized in the lower and side departments of the chest. Noting its strengthening at the deep breath and coughing. Pain in the blade and shoulder areas can be caused by a lesion of the wall of the pleura of the upper lobes of the lungs. When apical pleurisy possible pain in the arm due to irritation of the brachial plexus. Pain in the abdomen, sometimes vomiting and pain in swallowing are observed in the diaphragmatic dry pleurisy.

When lobar pneumonia chest pain often stitching, increasing when deep breath and coughing, in connection with than the patients try to repress it. Possible irradiation of pain in the abdominal cavity. Pain in lobar pneumonia is observed in 96% of cases, in case of intensified - in 88%. In chronic inflammatory diseases of lungs, pneumoconioses, tuberculosis is characterized by a long, whining, pressing the pain. When the abscess light pain is intense, there is the strengthening of when pressing on a rib or intercostal when the abscess close to cortical a layer of light. In addition, the pain intensified before the break of abscess in the bronchus.

The pain is often accompanied by tumor lung - from 50 % to 88 % of cases. The pain is quite different: a dull, aching, pressing, burning, twisting. It is possible irradiation in the shoulder, neck, stomach, head, increased cough, breathing deeply. Is she more often on the affected side, however, it can be irradiation in a healthy direction or girdle. The pain, as a rule, permanent, paroxysmal is uncommon.

Mediastinal emphysema. Acute severe pain behind the breastbone, often accompanied by a distinct crepitus.

Diseases of the organs of the abdominal cavity.

Pain syndrome is characteristic of many diseases of the abdominal cavity. When esophagitis there has been a constant burning sensation behind the breastbone, pain in the course of the esophagus, the increasing if swallowed, associated with the intake of cold or hot, solid foods. Diagnosis is based on a typical pain syndrome, symptoms of dysphagia. X-ray investigation reveals the violation of the motor, the unevenness of the contours of the esophagus, the presence of depo account of barium for erosions, phibroesaphoskopia - hyperemia of the mucous membranes and erosion.

When achalasia cardia (achalasia, idiopathic expansion of the esophagus), the pain is localized behind the breastbone, clearly associated with dysphagia and regurgitation of food. Pain episode can provoke reception of food. In addition to clinical manifestations important in the diagnosis of x-ray investigation, in which the observed delay barieva the suspensions, a significant expansion of the esophagus and fusiform narrowing it in distal.

Pain for hernia ulcers holes diaphragm most often localized in the lower part of the sternum. Characteristic of her appearance or strengthening after a meal, in a horizontal position, reduces pain in the quick change of position of a body. Is it diagnosed on the basis of x-ray and endoscopic studies.

Pain in stomach ulcer and duodenal ulcer, chronic cholecystitis can sometimes irradiate in the left half of the thorax, which creates certain diagnostic difficulties, especially if the diagnosis of the main disease is not installed. Fibrogastroduodenoscopy and ultrasound examination of abdominal cavity organs allow us to determine the true cause of the pain in his chest.

Chest pain on the right side associated with neurological diseases.

Pain in the chest conditioned by various 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 cardiodynia 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 breast 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 breast 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 sterna-clavicular line with possible radiating to the shoulder.

When Tietze syndrome noted a sharp pain in the place of connection of the sternum with cartilage II-IV of the ribs. The genesis of the syndrome, possibly associated with aseptic inflammation of the rib cartilage. Ksifoidiya is manifested sharp pain in the lower part of the sternum, increasing the pressure on xiphoid process. When Tietze syndrome reveals a sharp pain on the upper part of the sternum or lateral. Skalenus -a 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.



Which doctor should I contact if there is a chest pain(right side)

  • Cardiologist
  • Pulmonologist
  • Traumatologist
  • Neuropathologist
  • Resuscitator
  • Emergency doctor
  • Oncologist


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