Chest pain is pain that is located in the middle of the chest. The symptom is accompanied by difficulty breathing, interruptions in the work of the heart. Soreness occurs in diseases of the respiratory and cardiovascular systems, hyperacid conditions, tumors of the mediastinum. To determine the cause of retrosternal pain, an ECG, ultrasound of the heart, radiography, and laboratory tests are performed. To stop unpleasant symptoms, prescribe antianginal drugs, antacids, anti-inflammatory drugs.
An attack of pain in angina pectoris begins suddenly during brisk walking, climbing stairs, or other physical activity. Severe pressing pain in the sternum in the middle makes a person stop and grab his heart. Often, unpleasant symptoms radiate to the left arm or collarbone area. Painful sensations squeeze the chest, prevent you from taking a deep breath. The skin turns pale, there is a sharp weakness.
The pain disappears after 5-2 minutes after rest or taking nitroglycerin tablets. The frequency of paroxysms ranges from a couple of times a month to several times a day, they are all similar in duration and nature of the pain syndrome. Acute penetrating pain behind the sternum, which is accompanied by cold sweat, fainting, are more characteristic of myocardial infarction. In such a situation, you need to call an ambulance.
The defeat of the heart muscle is manifested by a moderate pain syndrome, which is localized behind the sternum in the middle. The sensations are stabbing or squeezing in nature, occur at any time of the day, regardless of the level of physical activity. With endocarditis, the sternum hurts quite often. Soreness is combined with shortness of breath, palpitations. Increased pain occurs with an exacerbation of the inflammatory process, as evidenced by fever and chills.
For myocarditis, dull pains are typical in the center of the sternum and along the left surface of the chest. Also, patients complain of increased fatigue, a feeling of lack of air, dizziness. With pericarditis, severe pain and a feeling of fullness in the chest are disturbing, leading to difficulty breathing. Due to the inefficient work of the heart, the symptoms are aggravated with minimal physical activity.
When the sternum hurts in the center, this may indicate damage to the airways from the trachea to the middle bronchi. Viral and bacterial causes cause inflammation of the epithelial membranes, which is combined with irritation of the nerve endings and a feeling of discomfort. With tracheitis and laryngotracheitis, the pain in the chest is mild or moderate, scratching and sore throat are more concerned.
Bronchitis is characterized by pain in the middle of the chest, which occurs at the height of the disease. There is a dull pressing pain, which increases during bouts of coughing and greatly weakens at rest. The onset of discomfort is provoked by the inhalation of cold air, the ingress of dust into the respiratory tract. Soreness persists throughout the period of bronchitis - for 1-2 weeks.
There are also allergic causes of pain in the sternum. Most often, pain is caused by an attack of bronchial asthma, when, against the background of bronchospasm and suffocation, discomfort and a feeling of compression in the middle of the chest are felt. Pain of moderate intensity behind the sternum persists for several hours after suffering a paroxysm. Similar clinical manifestations also occur in chronic obstructive pulmonary disease.
With GERD, the sternum begins to hurt 15-2 minutes after eating, which is due to the reflux of hydrochloric acid into the esophagus. Soreness is aggravated by bending the torso forward, wearing tight belts that contribute to squeezing the stomach and reflex opening of the lower esophageal sphincter. Discomfort is localized exactly in the center of the chest, in addition to pain, intense retrosternal burning and heartburn in the throat are noted.
Painful sensations are provoked by errors in the diet - the abuse of carbonated drinks, fried foods, strong meat broths. For GERD, morning pain behind the sternum is typical immediately after waking up, since in a horizontal position, acid passively flows into the esophagus. If symptoms are accompanied by repeated vomiting of bile or blood, emergency medical attention is needed.
Constant intense pain in the center of the sternum is usually associated with esophageal causes. In acute and chronic esophagitis, there is a moderate cutting or burning pain in the middle part of the chest, which increases after eating. For dyskinesia of the esophagus and esophagus spasm, paroxysmal unbearable pains in the sternum exactly in the middle are typical, which usually last from 1 to 2 minutes.
A sharp dagger pain at one point occurs in the case of a formidable disease - a rupture of the esophagus. Against the background of an excruciating pain attack, vomiting opens with the contents of the stomach and blood, which does not bring relief. In the future, pain is localized not only behind the sternum, but throughout the chest, in the epigastrium. The patient is in a state of shock, cold sweat appears on his forehead, pressure drops sharply.
Several organs are located in the mediastinum: lymph nodes, thymus gland, thoracic duct, venous and arterial vessels. Most often, the sternum hurts with an increase in lymph nodes, which is caused by tumor causes - lymphogranulomatosis and non-Hodgkin's lymphomas. Disturbed by moderate dull soreness and a feeling of tightness in the chest, in the future, the symptoms intensify due to compression of the respiratory system.
Thymoma is initially manifested by discomfort in the chest area, periodic reflex cough. As the volumetric formation increases, the pain becomes stronger, radiating to the neck and shoulder blades. Patients also complain of sore throat and hoarseness caused by compression of the recurrent nerve. Similar symptoms occur in tuberculosis of the intrathoracic lymph nodes.
Chest pain is a common side effect of sodium bicarbonate and other absorbable antacids. Although these drugs are used to reduce acidity, after 10-2 minutes from their use, the stomach expands, a new portion of acid is thrown into the esophagus (“rebound effect”). Other reasons also lead to retrosternal pain: long-term use of NSAIDs, corticosteroids.
Complaints of pain in the sternum are the basis for visiting a general practitioner. The specialist is engaged in an initial examination to determine the cause of retrosternal pain: collecting data on the time of onset and the dynamics of the development of the disorder, conducting standard laboratory and clarifying instrumental methods. The most diagnostic value are:
Electrocardiography - a method of differential diagnosis of retrosternal pain
In the event of an attack of angina pectoris, a person must be seated, his collar unbuttoned and freed from clothing that squeezes the chest. It is important to provide fresh air. The sternum with IHD stops hurting after taking nitroglycerin, which patients should always carry with them. If the pain syndrome does not subside within half an hour, emergency care should be called.
To reduce the pain of GERD, it is recommended to eat often and in small portions, avoid strenuous exercise and bending over immediately after eating. It is advised to sleep on a high pillow. In case of respiratory diseases, it is undesirable to be in dusty rooms or rooms with low air humidity, so as not to provoke coughing and chest pain. With severe pain in the center of the chest, you should contact a specialist to find out and eliminate the cause.
Medical tactics depend on the pathology against which the pain syndrome arose. For pain behind the sternum, etiotropic drugs are mainly prescribed, specific analgesics are indicated for unbearable sensations with the threat of developing pain shock. To eliminate the etiological factor of unpleasant symptoms, the following medications are used:
Chest pain caused by a heart attack may require surgery to revascularize the heart muscle. Carry out balloon angioplasty and stenting of the area of the affected vessel. Large tumors of the mediastinum are an indication for thoracotomy and removal of pathologically altered tissue. In malignant tumors, the method is supplemented with radiation therapy and chemotherapy.