Tingling In The Chest : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 08/09/2022

Tingling in the chest is mainly caused by neurological (cardioneurosis, masked depression, intercostal neuralgia) and cardiac factors (arrhythmias, ischemic and inflammatory processes in the heart). Less commonly, a symptom is provoked by pathologies of the bronchopulmonary and digestive systems. In women, tingling is possible with diseases of the mammary glands. The diagnostic complex includes ultrasonic, X-ray and electrophysiological methods, laboratory tests. For the relief of stabbing pains, medications and physiotherapeutic agents are used, less often minimally invasive and surgical interventions are used.

Why is it prickly in the chest

Cardioneurosis

Tingling in the left half of the chest, especially in the projection of the heart, is most often found in neuroses. Discomfort in the chest is provoked by mental fatigue, stress, and is occasionally noted during physical exertion. Patients tend to talk in detail about their condition: they pick up a lot of words to describe the pain (pricks, aches, squeezes). Simultaneously with the tingling, there is a sinking heart, chills or hot flashes.

As a rule, a person takes the symptoms of cardioneurosis for signs of a severe cardiac disease. There is increased anxiety, fear of death, which aggravate the course of the disease. Stitching sensations disturb the patient several times a day, last no more than 1 hour, have a mild or moderate intensity. The tingling attacks may disappear as suddenly as they begin.

Somatized depression

For mental disorders, tingling, cardialgia with a pinching feeling in the chest ("precordial anguish") are pathognomonic. Symptoms often appear in the morning, immediately after waking up, but as the depression progresses, the daily periodicity is lost. The tingling is complemented by autonomic changes: hyperhidrosis, bradycardia or tachycardia. Psycho-emotional state is characterized by irritability, fatigue, apathy.

Cardiovascular diseases

Tingling on the left side of the chest is observed in organic and functional cardiac diseases. Usually it is the first symptom of pathology. The intensity of sensations varies depending on the cause. With an organic lesion, there are strong “backaches” that force a person to freeze and put a hand to the precordial region. Typical cardiac factors for tingling in the chest:

  • Arrhythmias. Rhythm interruptions are manifested by mild and short-term stabbing sensations that are clearly localized in the chest. Against their background, the patient experiences fading or, conversely, too fast heartbeat. Symptoms do not have clear provoking factors, can appear at any time of the day.
  • Cardiac ischemia. IHD is characterized by intense stabbing pains that are felt behind the sternum or in the entire left half of the chest, radiate to the shoulder blade and arm. The attack lasts 5-1 minutes, quickly stopped by taking nitrates. If the symptoms are replaced by excruciating burning or pressing pain, there is a risk of unstable angina, turning into a myocardial infarction.
  • inflammatory processes. Pricking in the chest of moderate strength, which does not have a clear localization, is typical for myocarditis, endocarditis, pericarditis. It is possible that the symptom is related to a bacterial or viral infection that was transferred a couple of weeks ago. Patients also complain of shortness of breath, fatigue, fever.
  • Cardiomyopathy. Non-inflammatory myocardial injuries are characterized by a long, asymptomatic course. A person occasionally notices tingling in the precordial region, shortness of breath during physical exertion, interruptions in the work of the heart. Stitching sensations do not radiate, are mild or moderate.
  • Heart defects. Tingling in the chest occurs in pathologies with unchanged or partially altered blood circulation, which is not critical for the condition. In addition, shortness of breath, attacks of tachycardia or heart failure, cyanosis of the nasolabial triangle and fingertips are noted.

Tingling in the chest

 

Anemia

A stabbing sensation in the chest on the left is one of the components of an anemic syndrome caused by a lack of hemoglobin and insufficient saturation of tissues with oxygen. Discomfort is most pronounced during physical activity, and with moderate and severe anemia, it also occurs at rest. In addition to tingling, there is pallor of the skin, frequent bouts of dizziness and tinnitus, fatigue.

Respiratory diseases

Strong stabbing sensations are typical for pleural pains that develop against the background of dry pleurisy, pneumothorax, carcinomatosis. The tingling is unilateral, sometimes radiating to the interscapular region. The pain is aggravated by coughing, laughing. Therefore, the patient lies on his side on the affected side, trying not to move longer. The symptom is accompanied by shortness of breath, lagging behind half of the chest in breathing.

Tuberculosis

In the presence of a primary tuberculosis complex, involvement of the intrathoracic lymph nodes, patients feel a slight tingling on the side of the active process or in the center of the chest. The symptom is complemented by night sweats, cough with scanty sputum. When tuberculosis is complicated by pleurisy, sharp stabbing pains occur on one side of the chest. Soreness is aggravated with a deep breath, torso tilts in the opposite direction.

Intercostal neuralgia

With damage to the intercostal nerves, a person experiences a sharp tingling and shooting pain, which are localized in one place of the chest or spread along the ribs. Stitching sensations sharply increase when feeling the intercostal spaces, with deep breaths and turning the torso. The attack lasts a couple of minutes, at which time the patient freezes and tries not to breathe for fear of aggravating the pain.

The clinical picture of intercostal neuralgia is complemented by paresthesias (“crawling”) and numbness on the affected side of the chest. Rarely observed hyperemia of the skin, local hyperhidrosis. Attacks of tingling, arising on the left side of the chest, resemble cardiac pains. Middle-aged and elderly patients often try to relieve discomfort with nitroglycerin, but it does not give any effect.

fibromyalgia

This disease is characterized by tingling of varying intensity throughout the chest. Soreness is also felt in the abdomen, arms and legs - patients complain that "it hurts everywhere." Symptoms appear for no apparent reason, lasting several weeks or even months. On the skin of the chest, a feeling of "crawling", numbness, burning sensation is possible. With fibromyalgia, pain is complemented by fatigue and malaise, insomnia, and depression.

Inflammatory diseases of the ribs

Tingling may be one of the manifestations of Tietze's syndrome. Stitching sensations occur near the sternum, often on one side. They start suddenly, become stronger with awkward movements, coughing and sneezing. Symptoms persist for several years with alternating periods of exacerbations and remissions. Tingling in the chest also occurs with aseptic periostitis, osteomyelitis of the ribs.

Pathologies of the gastrointestinal tract

With lesions of organs located in the upper abdomen, tingling is often disturbed in the lower, less often in the middle sections of the chest, which is due to the peculiarities of innervation. Stitching sensations in the middle of the chest, above the epigastrium, are characteristic of hyperacid gastritis, gastric ulcer. With cholecystitis, hepatitis, tingling is observed in the chest on the right. There is a clear connection of discomfort with food intake, errors in the diet.

Diseases of the mammary glands

With mastopathy, a woman complains of soreness and tingling in one or both mammary glands. Unpleasant sensations intensify before menstruation, during this period the breast becomes very sensitive. Sometimes the stabbing pain has a clear localization, which is typical for the focal form of the disease. Similar symptoms occur with a cyst, fibroadenoma of the mammary gland.

Diagnostics

Tingling in the chest has dozens of etiological factors, so a detailed examination is necessary to clarify them. Several specialists are involved in the diagnostic search: a neurologist, a cardiologist, a therapist, etc. To determine the cause of stabbing pains in various parts of the chest, a set of laboratory and instrumental methods is selected, which includes:

  • Electrocardiography. ECG is used to diagnose rhythm disturbances: extrasystoles, blockades. The cardiogram also shows signs of coronary artery disease, myocarditis, hypertrophic cardiomyopathy. To assess the functional class of angina pectoris, specialists in the field of cardiology prescribe a stress test (ECG with a dosed load).
  • Ultrasound procedure. If abnormalities are detected during electrocardiography, echocardiography is performed. Ultrasound of the pleural cavity is informative for the detection of pleurisy. With unclear tingling in the lower chest, sonography of the abdominal organs is performed to identify an inflammatory process or signs of an ulcer. Ultrasound screening is the first stage in the diagnosis of breast diseases.
  • X-ray methods . Chest X-ray is a standard method that visualizes pathological changes in the lung parenchyma, pathognomonic changes in the configuration of the heart. If joint damage is suspected, an x-ray of the ribs is shown. To clarify the diagnosis, CT or MRI of the chest is done.
  • Blood tests. In the hemogram, anemia, nonspecific signs of inflammation can be detected. A biochemical blood test helps to diagnose coronary diseases (by a specific change in the lipid spectrum). With strong stabbing sensations in the region of the heart, it is advisable to investigate myocardial markers.

Considering that CNS disorders are a common cause of chest tingling, a complete neurological examination with a check of vegetative status is recommended for the patient. In rare cases, electrophysiological methods are prescribed: EEG, electroneuromyography (ENMG). According to indications, a psychiatrist is connected to the diagnostic search, who can identify signs of masked depression.

Consultation of a therapist for tingling in the chest

 

Treatment

Help before diagnosis

To eliminate tingling in the chest, you need to know its cause. Only non-drug methods can be used independently. A stabbing sensation of discomfort in the chest is often provoked by stress, overwork, so a person should avoid these factors as much as possible. Physical activity is needed, but they need to be dosed so as not to stretch the muscles and cause pain. Stitching pains in the chest - a reason to go to the doctor.

Conservative therapy

The tingling in the chest is predominantly mild to moderate in intensity, and therefore does not require the use of analgesics. With painful symptoms, painkillers are used to temporarily alleviate the condition. The basis of treatment is etiotropic therapy, which eliminates the cause of tingling. Drugs are selected based on the type of pathology. The following medicines are used:

  • Anti-inflammatory drugs . Essential for a wide range of conditions, from myocarditis and pericarditis to costal cartilage inflammation. Representatives of the group of non-steroidal anti-inflammatory drugs have an additional analgesic effect, quickly relieve unpleasant symptoms. In serious illnesses, therapy is enhanced with corticosteroids.
  • Drugs that affect the central nervous system . Recommended for cardioneurosis, depression, intercostal neuralgia. Treatment begins with mild sedatives, which, if necessary, are supplemented with antidepressants, tranquilizers.
  • Antiarrhythmic drugs . They normalize the heart rhythm, so the tingling in the chest, the feeling of a sinking heart disappear. Cardiologists select medicines of several classes, taking into account the type of arrhythmia and its severity, the presence or absence of other lesions of the cardiovascular system.
  • Antibiotics . Used for bronchopulmonary diseases that are caused by infections. For the treatment of confirmed tuberculosis, special antibiotics are needed, taken for long courses. The inclusion of antimicrobial agents in the treatment regimen is justified in rheumatic heart disease, acute cholecystitis, gastritis provoked by H. pylori.
  • Iron preparations . They are prescribed for anemia to increase the level of hemoglobin, eliminate symptoms (stabbing sensations in the chest, dizziness, weakness). With low levels of red blood, blood transfusions are indicated, which quickly normalize well-being.

As an addition to pharmacological treatment, physiotherapy methods are effective that successfully relieve discomfort. With stabbing pains, hydrotherapy, laser therapy, magnetotherapy are used. Methods of cognitive-behavioral psychotherapy help to eliminate the emotional and neurological causes of tingling in the chest. Biofeedback therapy is useful to enhance stress resistance.

Surgery

With congenital and acquired heart defects, the help of a cardiac surgeon is needed to correct anatomical anomalies and improve the prognosis for the patient. With pleurisy, a puncture is performed to evacuate exudate and locally administer antibacterial drugs. Some forms of benign breast neoplasia, which have a high risk of malignancy, must be removed.