Chest pain on the left is pain sensations of a compressive, stabbing, pressing nature, which are localized in the left half of the chest. Most often, the symptom is caused by coronary and non-coronary heart diseases, pain is observed with inflammation of the left lung and pleura, collagenosis, and gastrointestinal pathology. To establish the cause of the pain syndrome, an ECG, ultrasound of the heart, chest x-ray, clinical and bacteriological studies are performed, and invasive diagnostic methods are used. Nitroglycerin and NSAIDs are used to relieve pain, etiotropic drugs are selected after the underlying disease is identified.
Currently, coronary artery disease is a common cause of pain in this localization. With a stable form, the pain syndrome begins during physical activity, fast walking. According to the duration of the distance traveled, after which symptoms develop, the functional class of stable angina pectoris is determined. Unpleasant sensations are caused by insufficient blood supply to the myocardium. Pain in the left side of the chest has a compressive, pressing character, forcing the patient to stop walking or other physical work. The symptom is accompanied by tightness in the chest, the inability to take a deep breath. Characterized by irradiation of pain in the shoulder blade, left arm.
With a complicated course of coronary artery disease and unstable angina, attacks of pain on the left behind the sternum are noted more often, not always due to physical activity. In severe situations, the pain syndrome is observed at rest, it is accompanied by cyanosis, shortness of breath. Attacks of angina pectoris last from 5 to 3 minutes and are well stopped by taking nitroglycerin. The duration of chest pain for more than half an hour against the background of a rapidly deteriorating condition is a formidable symptom that requires immediate medical attention.
Soreness in the left side of the chest resembles a typical angina attack, but lasts 3 or more minutes. Pain in myocardial infarction is not stopped by nitroglycerin, the patient gets worse every minute. A sharp pallor of the skin and cyanosis of the nasolabial triangle are noticeable, cold sticky sweat appears on the forehead. The pain is so severe that it becomes difficult to breathe, often fainting develops. If a person remains conscious, he may experience a strong sense of fear and panic. With untimely assistance, the pathology can end fatally.
Non-coronary causes cause acute stabbing or constant pulling pains to the left of the sternum, the intensity of which depends on the extent of the inflammatory process. With infective endocarditis, pain develops against the background of general weakness and sweating, an increase in body temperature to febrile. The heart hurts constantly, discomfort increases with deep breaths, but does not change during physical exertion. In the elderly and patients with immunodeficiency, the symptoms are blurred, pain is accompanied by shortness of breath and heaviness in the chest.
A similar clinic occurs with myocarditis. With infectious-allergic inflammation of the heart muscle, symptoms appear 2-3 weeks after suffering tonsillitis or tonsillitis. Disturbed by moderate pain in the chest on the left, a feeling of palpitations and interruptions in the work of the heart. In acute myocarditis, pain occurs simultaneously with fever, weakness, nocturnal hyperhidrosis. The chronic process is characterized by moderate discomfort from the region of the heart, shortness of breath and increased fatigue.
The severity of the pain syndrome depends on the form of the disease. With hypertrophic cardiomyopathy, periodic stabbing or squeezing pains are observed near the sternum on the left, the appearance of which does not depend on external factors. With dilated cardiomyopathy, there is aching pain in the heart, which increases during habitual physical activity. A person periodically feels shortness of breath and lack of air, weakness and dizziness are disturbed in the morning. As the pain intensifies, signs of heart failure increase - edema on the legs, ascites.
Heart rhythm disturbances are manifested by periodic stabbing or squeezing pain in the chest on the left, which usually begin without precursors and exogenous influences. Pain during arrhythmia is sharp and strong, the patient freezes for a short time in one position, grabs the heart area with his hand. At the same time, tachycardia, palpitations are determined. As a result of the inefficiency of blood circulation, there is a sharp weakness and darkening in the eyes, pallor of the skin, and fainting. Often the symptoms disappear on their own after a few minutes.
Anatomical defects in the structure of the heart and efferent vessels cause anginal chest pain - compressive or pressing, with irradiation to the clavicle, poorly stopped by nitroglycerin. In addition to the pain syndrome, signs of circulatory insufficiency are revealed: shortness of breath during physical exertion, dry cough, swelling of the cervical veins. In children, chest pain on the left can be caused by congenital malformations that appear as the child grows. Causes of cardiac pain syndrome:
Chest pain develops in the later stages of hypertension, when degenerative changes occur in the heart muscle and coronary vessels. The pain syndrome is usually associated with spasm and obliteration of the arteries that feed the heart, and is manifested by compressive sensations that do not have a clear localization. With a hypertensive crisis, the pain intensifies, accompanied by a rapid heartbeat, flashing "flies" before the eyes. Frequent dull or pressing pains in the heart are often due to the secondary attachment of atherosclerosis.
The severity of symptoms in a dissecting aneurysm correlates with the degree of damage to the aorta. With a rupture of only the inner shell of the vessel, patients experience a sharp pain in the chest on the left and a fainting state. In the case of continued rupture and dissection of the aortic membranes, severe pains occur in the chest cavity, which radiate to the back, shoulder girdle area. The pain syndrome is so intense that the person often loses consciousness due to shock. Continued bleeding causes a drop in blood pressure, collapse and deep syncope.
With massive thromboembolism of large trunks of the pulmonary artery, a sharp stabbing pain in the chest suddenly appears without a clear localization. Pain syndrome in PE is accompanied by a feeling of lack of air, shortness of breath, skin cyanosis. If help is not provided, loss of consciousness and cardiac arrest occurs. Blockage of small vessels and focal pulmonary ischemia are the causes of moderate chest pain, which intensifies and reaches its maximum after a few days. Soreness in pulmonary infarction is combined with hemoptysis, severe cough, which indicates the development of a heart attack-pneumonia.
Many rheumatic processes occur with damage to the heart, which causes pain on the left side of the chest. Painful sensations with collagenoses occur periodically, have a pressing, stabbing or compressive character. Irradiation of the pain syndrome is uncharacteristic. The symptom is not related to stress or other external factors. Pain is accompanied by palpitations, shortness of breath, fatigue. Most often, a similar clinical picture occurs with rheumatism. Less commonly, similar symptoms are caused by systemic lupus erythematosus, dermatomyositis, and vasculitis.
Visceral pain is often associated with an inflammatory lesion of the left lung, pleura and bronchial tree. In this case, constant soreness is typical, which is aggravated during bouts of coughing, deep breathing. Other signs of an infectious process are also typical - sputum production, febrile body temperature. The most common causes that cause a feeling of pain in the chest on the left:
With a small size of the hernial protrusion, periodic discomfort occurs in the middle of the sternum and to the left of it. As the size of the hernia increases, sharp pains in the chest and epigastrium appear, which develop after eating, lifting weights, and against the background of stress. Symptoms last from minutes to several hours. Simultaneously with pain, dysphagia increases, even swallowing water is difficult. Constant intense pain on the left side is typical of a strangulated hernia, which requires emergency medical care.
The proximity of the nerve endings and segments of the spinal cord responsible for visceral innervation explains why it hurts in the chest area on the left when the digestive system is affected. Such pain can be disturbing in acute pancreatitis and splenitis, since these organs are located in the abdominal cavity on the left, directly below the diaphragm. Symptoms sometimes occur with hematomas and ruptures of the spleen. The pain syndrome is also caused by organic causes - the inflammatory process spreads from the abdominal organs to the chest through the diaphragm.
Heart pains are one of the "masks" of a depressive state, which is provoked by disorders of the autonomic innervation and the development of cardioneurosis. Symptoms appear for no apparent reason, are determined in people of any age, more often in women. Pain is variable, usually appearing in the early morning hours. Patients with depression tend to describe their discomfort at length and in detail. Pain is often preceded by a feeling of "fading heart", heaviness in the chest. The pain syndrome cannot be controlled with standard cardiotropic drugs.
If the patient begins to hurt in the chest on the left, he needs to consult a therapist. First of all, regardless of the age of the patient, the specialist excludes all cardiac causes of pain, after which instrumental studies of other organs of the chest cavity are performed. To clarify the etiological factor of the disease, extended laboratory tests are shown. In diagnostic terms, the most valuable are:
echocardiography
A person with a pain syndrome needs to be seated, freed from restrictive clothing, and fresh air should be provided. If the patient suffers from cardiovascular pathology, and he is prescribed treatment, in case of exacerbation, it is necessary to take nitroglycerin or other drugs as recommended by the doctor. In all situations, when it hurts on the left in the chest, a specialist consultation is required, who can exclude or confirm serious cardiac and respiratory diseases.
With severe pain caused by myocardial infarction or PE, narcotic analgesics are indicated, which help prevent the development of pain shock. Further therapy depends on the diagnosis. In cardiac pathology, the time to start treatment is important, a delay of several hours can cause serious complications. For etiotropic therapy of diseases that are manifested by pain in the left areas of the chest, drugs such as:
To restore arterial patency in coronary artery disease and myocardial infarction, endovascular technologies are used - angioplasty and stenting under the control of selective angiography. With extensive changes in the intima of the vascular wall, coronary artery bypass grafting is performed, which improves the blood supply to the heart. In case of diaphragmatic hernias, the following surgical interventions are used: suturing the hernial orifice and strengthening the ligamentous apparatus (cruroraphy), fixing the stomach in the abdominal cavity (gastropexy), and eliminating gastroesophageal reflux.