Aching pain in the heart (cardialgia) is a subjective sensation of pain localized in a given area: behind the sternum, in the periosternal region, in the back, left shoulder blade, epigastrium (“above the stomach”) and the entire left arm. Manifestations of cardialgia also include a number of subjective sensations described by different people due to different education, emotional perception and level of pain threshold with the following terms: discomfort in the heart, aching pain, heart aches, numbness, heaviness in the heart and other completely non-medical, but having great value in diagnostic search, terms.

Due to its localization - in the area of one of the most important organs of our body, as well as its fairly frequent occurrence this symptom, cardialgia causes reasonable concern when it appears, forcing people to seek medical help in hospitals, clinics and call ambulance.

Etiology of pain in the heart area

Despite the widespread and almost commonplace nature of this symptom, the etiology (cause) of aching pain in the heart area is quite serious diagnostic task and lies in the plane of such medical disciplines as cardiology, rheumatology, pulmonology, neurology, vertebrology, psychiatry, oncology, mammology and endocrinology.

According to clinical statistics, the reasons that caused aching chest pain, which led to a visit to a medical facility, were divided as follows:

36% – diseases of the musculoskeletal system;
19% – diseases of the gastrointestinal tract;
16% – other reasons;
14% – coronary heart disease;
8% – mental disorders;
7% – respiratory diseases.

Thus, only less than 6th part of all pain in chest are directly related to coronary heart disease, while the rest are not related to the heart.

Traditionally, chest pain is divided into two broad groups based on etiology:

Cardiogenic pain – caused by pathology of the heart.
Non-cardiogenic – caused by diseases not related to the heart;

Causes of pain related to the heart (cardiogenic)

The main causes of cardiogenic chest pain:

Ischemic pain is characterized by:

Localized behind the sternum or in the parasternal area;
Often aches and radiates to the left arm, neck, lower jaw, teeth, into the left shoulder blade;
The pain itself is characterized as aching, pressing, squeezing, and there is often a feeling of going numb left hand, heart, shoulder blade, rarely the pain is acute, burning in nature;
In the vast majority of cases, it is associated with physical or emotional stress;
Pain short-term– its duration is usually measured in several minutes;
The pain goes away after taking it.

Causes of pain not related to the heart (non-cardiogenic)

The main causes of non-cardiogenic chest pain:

Self-diagnosis and treatment at the pre-medical stage

Of course, if you have pain in the chest, you must contact a specialized medical institution, where the appropriate treatment will be carried out. differential diagnosis, a clinical diagnosis is made and treatment is prescribed, but situations are not uncommon when it is not possible to seek medical help, or you will have to wait too long for help. In such a situation, you can take some measures at home and take a number of harmless medications that will not harm, but may well alleviate the condition and subsequent diagnosis. Accept any medical supplies is possible only in the absence of contraindications and individual intolerance.

The pain arose some time after eating, especially fatty, fried or spicy food, localized in the epigastric region and behind the sternum, bursting or burning, does not radiate anywhere, there is no shortness of breath, weakness and sweating. It is advisable to drink a little milk, non-carbonated alkaline mineral water, antacid drugs (Almagel, Rennie, Gastal, Maalox and others).
Pain in the upper abdomen that occurs on an empty stomach, often at night. You can take the steps described above, and also eat a little non-spicy, boiled food.
Pain in the right or left hypochondrium is dull, aching or sharp, bursting, cramping, encircling with or without radiating. Associated with food intake, or not clearly associated. It is necessary to take antispasmodic drugs no-spa, papaverine, magnesium sulfate.
Chest pain due to high fever. It is advisable to take antipyretic drugs, which almost all have a certain analgesic effect: analgin, aspirin, paracetamol.
Chest pain has a clear location and intensifies when changing body posture, breathing and pressing on the area where it hurts. You can take anti-inflammatory drugs diclofenac, nimesulide, ibuprofen, indomethacin, and analgesics will also not harm.
Chest pain associated with psycho-emotional stress is often relieved by taking sedatives: preparations of motherwort, peony, valerian and even validol can be effective in this situation.
If the pain fits the description of ischemic pain, or clinically resembles myocardial infarction, you need to take a 500 mg aspirin tablet (the dosage is lower in soluble tablets), take a semi-recumbent position, eliminate physical and emotional-psychological stress (it is advisable not to even walk). You should immediately call an ambulance; it is strictly forbidden to go anywhere on your own, even to a clinic.

Diagnostic template

Once in a clinic or hospital, you can expect that the doctor will carry out a number of necessary diagnostic procedures, each of which has a certain value for confirming the diagnosis. Despite the apparent simplicity and clarity of pain, it is necessary to carefully consider the prescriptions, since pain in the heart area, especially when it first appears, requires a serious diagnostic search and a conscientious attitude of the patient.

Anamnesis collection. A detailed survey of the patient helps to establish the priority direction of the diagnostic search and the further range of laboratory and instrumental studies.
Physical examinations. Despite the achievements of modern diagnostic equipment in initial stage diagnostics, in order to quickly and accurately determine the diagnosis, it is necessary to carry out inspection, palpation, auscultation and, if necessary, percussion, which, if carried out correctly, will save precious time and, possibly, money.
Thermometry. Simple, cheap, but very important method examination, allowing to determine the global direction of the diagnostic search.
Definition . Allows you to evaluate the functioning of the cardiovascular system as a whole.
. Allows you to confirm arrhythmia and myocardial infarction, as well as thromboembolism, with a high degree of reliability pulmonary artery.
General blood test. Allows you to determine the presence of any inflammatory disease, which will indicate one of the above causes of chest pain (tracheitis, bronchitis, pleurisy, pneumonia, myocarditis and other causes associated with inflammation).
A general urine test gives an idea not only of the state of the urinary system, but also of the functioning of many organs and systems.
Biochemical blood test. It includes the determination of many indicators, the selection of the necessary ones is carried out by the doctor based on the above diagnostic actions in order to verify the diagnosis.
Ultrasound, X-ray, magnetic resonance, endoscopic and other visualization methods that allow you to confirm the presence of changes in the structure and arrangement of organs and tissues in order to confirm a diagnosis that has a morphological basis.

Video: specialist about heart pain

Many people often attribute it to heart problems, but this is not always the case. Often, some diseases of the digestive and respiratory systems, musculoskeletal system, various injuries and neurological disorders.

How to understand that it is the heart that hurts?

Heart pain comes in a wide variety of types, symptoms and causes. The chest can feel pressure, pricking, burning, aching, and so on - any such sensation can easily be attributed specifically to pain in the heart. Discomfort in the heart area can arise and cease spontaneously, its duration is quite uncertain - it all depends on the cause. The exact localization of this type of sensation can rarely be named. Understand that it is the heart that hurts, without going through special examinations, it won't work. Therefore, it is necessary to consult a doctor as soon as possible.

The most likely signs for pain in the heart are pain radiating to another part of the body and discomfort in the chest in the form of tightness.

If you experience pain in the chest area, you should remember your recent health - the first signs of disruption of the cardiovascular system usually appear much earlier before the first heart attack. By paying attention to them in time and accepting necessary measures The serious development of most heart diseases can be prevented.

TO early signs include:

Pain behind the ribs. This pain can radiate to the back, neck, arm, or lower jaw. In most cases, the left side of the body is affected. These sensations are often accompanied by shortness of breath, nausea, and excessive sweating.
Feeling of discomfort. Discomfort in this case disappears after have a good rest or taking nitroglycerin.
Shortness of breath appears. If you have heart problems, even minor physical activity can cause it. Such severe fatigue from everyday activities may appear much earlier than more serious symptoms.
Frequent pauses in breathing during sleep, loud snoring. Read more about heart pain at night.
Swelling. Initially, swelling is difficult to notice, but over time it increases. It becomes more difficult for a person to put on shoes and take off rings.

To determine the exact cause of the pain, you need to undergo an examination prescribed by a cardiologist or cardiac surgeon. In case of such problems, an electrocardiogram (ECG) will be mandatory, which can be carried out both at rest and with additional physical activity, and sometimes an ECG recording can be carried out throughout the whole day to monitor the readings. Heart murmurs are determined using phonocardiography. Echocardiography is used to study the condition of the valves, heart muscles and the speed of blood movement in it; it is carried out using ultrasonic waves. The coronary arteries are examined using coronary angiography, and insufficient blood supply to the heart is detected by myocardial scintigraphy.

Pain sensations not related to the heart are examined by radiography, and consultations with a neurologist and orthopedist are often resorted to. You may also need to visit other doctors depending on the identified cause of heart pain.

Symptoms of heart pain depending on the disease

Discomfort in the chest area associated with heart disease can appear at the most various reasons.

Depending on the nature of the pain, its prevalence, intensity, connection with external factors and characteristics of irradiation, we can more accurately talk about what disease it is caused by.

It is worth highlighting the main cardiac diseases and their characteristic symptoms:

Heart defect. It can be acquired or congenital. For a long time it may not manifest itself in any way. Sometimes there is pain in the heart, which has a cutting, stabbing or aching appearance. In this case, the patient often has .
Heart attack and... A heart attack is characterized by a sharp pressing pain that radiates to the left side of the back and chest. It is often accompanied by a fear of death in the patient. Breathing quickens. Conventional remedies for heart pain will not help here, and movement can increase the pain. Read more about how to recognize a heart attack by pain in the heart.
. It causes a fairly mild aching or stabbing pain, radiating to the left shoulder or neck. Physical activity will increase such pain; nitroglycerin is useless.
. Most people with this pathology experience pain that changes as the disease progresses. At first, the pain is prolonged, does not depend on physical activity, and nitroglycerin is not effective for it. Then pain syndrome begins to occur spontaneously or after physical effort, but here taking nitroglycerin already has an effect. The localization of pain varies, often the sensations spread over a large area.
Dissecting aortic aneurysm. It is characterized by sharp, extremely severe pain in the chest area. The degree of pain can be so severe that it leads to loss of consciousness. Emergency medical attention required.
. With this pathology, a dull pain is observed, the sternum is compressed and compressed. This pain usually radiates to the jaw, left arm, neck, and shoulder blades. It appears most often after emotional shocks, physical stress, or temperature changes. It can last a couple of seconds or a couple of tens of minutes. During an attack of angina, the patient experiences rapid heartbeat, shortness of breath, dizziness, weakness, and a feeling of fear. Taking nitroglycerin effectively stops the attack. The level and frequency of pain is not affected by body position.
Pulmonary embolism. Characterized by severe chest pain in the early stages. When inhaling, the pain intensifies, the pain is similar to angina pectoris, but without irradiation. Painkillers do not work. A person’s heart begins to beat faster, he suffocates, his blood pressure drops sharply, and his skin turns blue. Urgent medical attention is required.
. There are several types of this pathology, which are characterized by various changes heart rate. For most of them, the unifying symptom is.
. The most common symptom of this inflammatory process is considered to be a dull pain in the heart area. The central part of the chest is most often the site of localization of pain; sometimes the pain syndrome is also characteristic of the neck, arm, and back. Coughing and swallowing increase discomfort. In a supine position, the patient's condition worsens; the sitting position is considered the most optimal. There is a rapid heartbeat.
Ischemia. The most common manifestation coronary disease heart is an attack of angina. Physical overexertion often causes exacerbation of coronary artery disease; at rest, a person’s well-being improves.
Valve diseases. The main symptoms of such pathologies include: weakness, shortness of breath, chest discomfort, dizziness, and cardiac dysfunction. Asymptomatic development of these diseases is also possible. They often cause heart failure, which causes swelling in the legs, bloating, and obesity.

Not all pain in the heart area is associated with it; sometimes they can be a symptom of diseases and injuries completely independent of the functioning of the cardiovascular system. The most common of them include:

Intercostal neuralgia. Quite often mistaken for heart pain. Similar to the sensations of angina pectoris with some differences. Intercostal neuralgia is characterized by sharp pain, aggravated by various movements, including breathing, coughing, swallowing. It may last indefinitely. The localization is point-like, between the ribs, and often extends to the back area.
Osteochondrosis. Thoracic osteochondrosis is characterized by pain that radiates to the back and upper abdomen. Discomfort increases with any movement. Sometimes there is a feeling of numbness in the left arm and interscapular area. Like intercostal neuralgia, pain due to osteochondrosis is often attributed to angina pectoris. It is easy to distinguish them by taking nitroglycerin - it does not help with osteochondrosis and neuralgia. Learn more about how to recognize pain when thoracic osteochondrosis for pain due to angina pectoris – .
Diseases of the digestive system. Quite often the cause painful sensations in the chest there are muscle spasms of the stomach walls. They are characterized by heartburn, nausea, and vomiting. This condition usually lasts longer than standard heart pain. Here there is a direct dependence of pain on food intake; it can appear on an empty stomach and disappear after satiety. In the acute form of pancreatitis, quite severe pain, which are similar to pre-infarction condition. Sometimes people can mistake gallbladder spasm for pain in the heart - in this case, the pain is often radiated to the chest area where the heart is located. A hiatal hernia is also quite similar in pain to angina pectoris; most often it occurs during sleep. Changing the position of a person's body to a vertical one with such a hernia improves well-being.
Disorders of the central nervous system . Pathologies of this type are characterized by prolonged chest pain on the left. Symptoms in this condition are expressed in constant aching pain, which is periodically acute. Neuroses are characterized by sleep disturbances, increased anxiety, irritability and other vegetative problems. On an electrocardiogram, neuroses of this type are difficult to distinguish from coronary heart disease.

What to do?

If pain occurs in the heart area, it is necessary to consult a doctor as soon as possible, otherwise a possible disease may develop before serious complications arise. Immediately after heart pain occurs, several rules should be followed to improve the situation. These include:

Calm. Stress will make the situation worse anyway.
Changing position. If you feel relief due to a change in body position, you most likely should not look for the cause in the heart. If the pain only gets stronger, then there is a high probability that it is caused by an attack of angina pectoris.
Access to fresh air . Shortness of breath is common symptom various diseases that cause heart pain, so it is better to immediately increase the air flow into the room. It is also necessary to loosen clothing to reduce breathing difficulties.

The risk of cardiovascular diseases leading to heart pain increases due to many factors, such as increased level cholesterol, glucose and blood pressure. Smoking, excess weight, insufficient amounts of vitamins and physical activity. It is important to periodically go through medical examinations to identify dangerous diseases in advance and begin timely treatment.

Heart- the main organ of the human body. It, like a motor, supplies all organs and systems with nutrients and oxygen, which is necessary for the functioning of cells.

But, as you know, nothing lasts forever, and the human engine can malfunction. We’ll talk about them, because if there is pain in the heart, then the hemodynamics of the body are unstable.

What does the heart hurt about: the causes and origin of heart pain

Chest pain is one of the the most important indicators disturbances in the functioning of the body. Such pain occurs when various pathologies hearts. It is impossible to say unequivocally “what the heart aches about,” but, according to medical indications, pain in the heart area may appear due to the following reasons, which are divided into two large groups:
1. Impaired functioning of the organ itself:

insufficient nutrition of the heart muscles themselves;
inflammatory process in organ tissues;
metabolic disorders in the coronary arteries;
a large load that causes changes in the organ itself (enlargement of the ventricles, loose closure of the valves).

2. Diseases not directly related to the heart, but radiating pain to this area:

gastrointestinal pathologies (gastritis, ulcer);
neuralgia – clamping of nerve endings in the spinal column, ribs;
pathologies of the lungs and bronchi;
consequence of injury.

How to understand that your heart hurts?

As we have already found out, pain in the chest area can be caused not only by cardiac pathology. This happens because everything internal organs connected by nerve endings. To make sure that it is the heart that hurts, you need to go to a medical institution for examination and confirmation or refutation of the diagnosis.

The manifestation of heart pain directly depends on the reasons that provoked it; we will talk about the characteristics of pain later. Such pain may be:

pulling;
tingling;
aching;
squeezing;
cutting;
with impact in the hand, under the shoulder blade.

How does the heart hurt: main types of pain and symptoms

With angina pectoris, the patient complains of pain, as if someone had stepped on his chest. Chest discomfort is described as a tight feeling that interferes with breathing. It was this feeling that prompted in ancient times to call this disease angina pectoris.

It can be localized not only near the heart, but also radiate to the left arm, shoulder, neck, jaw. Basically, the pain syndrome appears suddenly, and it can be provoked by strong physical, emotional stress, eating, taking a deep breath. The duration of such pain is up to 15 minutes.

Heart pain during myocardial infarction

Myocardial infarction is ischemic necrosis of heart tissue:

during the process (during an attack), necrotic areas appear on the myocardium, a sudden sharp pain appears, radiating to the left arm and back;
there is numbness in the limb;
with a small area of necrosis, the patient feels a burning sensation and compression in the sternum, but can stand on his feet.

The insidiousness of the pathology lies in the fact that symptoms may be completely absent. The patient may only occasionally complain of chest discomfort.

With extensive tissue damage, a person loses consciousness and requires immediate resuscitation followed by hospitalization.

Heart pain due to pericarditis

Do not try to diagnose yourself, much less prescribe treatment for yourself. This should be done by a competent specialist, a cardiologist or cardiac surgeon.

The symptoms of heart diseases are similar to each other, so before making a diagnosis, you should undergo a thorough diagnosis.

One of the most important diagnostic methods is electrocardiogram. It can be carried out not only in an office with a special device; if necessary, an electrocardiogram is done:

during physical activity - treadmill test;
indicators are written throughout the day - Holter monitoring.

There are other ways to study the heart:

echocardiography method- are checked muscle tissue heart, its valves;
phonocardiography method– heart murmurs are recorded;
ultrasound method– blood circulation in various cavities of the heart is examined;
coronagraphy method– the coronary arteries themselves and their functioning are examined;
myocardial scintigraphy method– determines the degree of narrowing of the lumen of blood vessels;
radiography method(computer tomography or magnetic resonance imaging) – makes it possible to confirm heart pathologies or identify “non-cardiac” causes of pain.

Cardiologists have noted: with a broad description of the pain syndrome, most likely the cause is not heart disease. Such diseases are characterized by recurring pain of the same type.

How to distinguish pain in the heart from pain of non-cardiac origin?

Any tingling, pain, or compression in the left side of the chest suggests heart problems. Is this true? It should be noted that the nature of heart pain differs from non-cardiogenic manifestations.
1. Pain not related to the heart characterized by:

tingling;
shooting;
acute pain in the chest, left arm when coughing or sudden movement;
do not disappear after taking nitroglycerin;
constant presence (not paroxysmal).

2. Regarding heart pain, then they differ:

heaviness;
burning;
compression;
spontaneous appearance, come in attacks;
disappearance (subsidence) after taking nitroglycerin;
radiating to the left side of the body.

What to do if your heart hurts?

Initially, you should contact a specialist who will make a diagnosis and prescribe adequate treatment, which will be aimed at eliminating the pathology that causes pain. If you have heart pain, you should not take unfamiliar medications, as they may not be suitable for you specifically.

Unfamiliar remedies can cause the condition to worsen or cause even more harm.

If you know that you have hypertension, then you need to take quick-acting medications recommended by your doctor to avoid an attack.

First measures for heart pain

In cases where a person does not know about possible heart pathologies, and pain in the heart area appears for the first time, the following must be done:

Take a sedative. This could be Corvalol, tincture of valerian or motherwort.
Lie down or sit down to be comfortable.
If the chest pain is severe, you can take an analgesic drug.
If after taking sedatives or painkillers the pain does not go away in the first half hour, call an ambulance.

Do not take medications that help friends and family on their advice. A cardiologist should prescribe “your” drug after carefully studying the diagnostic data.

Pain in the heart

Pain in the heart area can occur at any age – even in a child. However, you shouldn’t scream out loud in horror that you’ve had a heart attack. First, myocardial infarction is only one of the possible reasons pain in the heart area, and not the most common one. And secondly, such pain may not be associated with the heart at all, have a functional (transient) nature and be a symptom of problems in the spine, lungs, stomach, ribs or muscles.

Causes of pain in the heart area

To help yourself or someone else to a loved one effective assistance, first you need to understand the reason that caused the pain in the heart area. So what can cause this kind of pain?

Pathology associated with disruption of the heart: deficiency of blood supply, inflammation of the muscle or lining of the heart, metabolic disorders, overload.
Diseases of other organs and systems of the body.

Thus, we have two large groups of states, each of which consists of a huge number individual diseases. Let's look at the most common of them.

Coronary heart disease – angina and myocardial infarction

The essence of IHD (coronary heart disease) is a lack of oxygen supply to the heart muscle. The cause of this deficiency is usually a spasm of the coronary vessel in combination with the presence of an atherosclerotic plaque. If, as a result of vascular spasm, the tissues of the heart lack oxygen, lactic acid is formed in them, which causes sharp, severe pain.

Features of pain in ischemic heart disease:

localization - behind the sternum; but there may be another location - shoulder, back, even stomach;
the nature of the pain is pressing, burning; with myocardial infarction, the intensity of pain can be extremely pronounced;
associated complaints: difficulty breathing, fear, sticky sweat, dizziness;
an attack of pain usually occurs after physical activity or due to stress;
An attack of angina, as a rule, is quickly stopped by taking a nitroglycerin tablet (under the tongue).

Of course, IHD can also occur atypically - for example, without pain or with the development of attacks at night, during sleep. However, most often, ischemic pain makes itself felt by the symptoms described above.

Help: nitroglycerin in any available form (preferably tablets or capsules).

Arterial hypertension

With arterial hypertension, pain in the heart area is usually a sign of a sharp increase in pressure: the load on the heart muscle increases, the heart cannot cope with its work - pain occurs.

Features of pain in the heart area with increased blood pressure:

often combined with headache;
associated complaints: dizziness, lightheadedness, nausea, drowsiness, feeling of heat;
a previously established diagnosis of arterial hypertension or recorded attacks of high blood pressure.

Help: To find out the cause of the pain, you should measure your blood pressure. If your blood pressure is high, you need to take a fast-acting antihypertensive drug (lowering blood pressure) - corinfar (it can be placed under the tongue to speed up the onset of the effect), furosemide (a diuretic) or any other drug that your doctor recommends.

Arrhythmias

Some types of heart rhythm disturbances can also lead to oxygen starvation cardiac muscle and heart pain.

Features of pain during arrhythmia:

irregular pulse, which can be detected in the classical way (on the wrist) or when measuring blood pressure with a modern device;
unpleasant, frightening sensations of freezing and interruptions in the heart;
dizziness, weakness, sometimes loss of consciousness;
Pain in the heart due to cardiac arrhythmia usually occurs against the background of a severe attack of arrhythmia, when the heart ceases to cope with its function, therefore, after the attack of arrhythmia is relieved, the pain also disappears.

Myocarditis

Myocarditis is an inflammatory process in the heart muscle. Inflammation can be caused by viruses, fungi or pathogenic bacteria and is often a complication of any infectious-inflammatory disease (acute respiratory infections, tonsillitis, etc.).

Features of heart pain with myocarditis:

pain is not associated with physical activity and stress;
the pain is almost constant;
the nature of the pain is stabbing, cutting;
nitroglycerin does not relieve pain;
signs of the inflammatory process - increased general body temperature, chills, weakness, lethargy, drowsiness.

Pericarditis

Pericarditis too inflammatory disease, however, inflammation in in this case affects the pericardium, the lining of the heart.

Features of pain with pericarditis:

usually there is no referred pain felt in the left arm, left shoulder, back, etc.;
pain may intensify in a certain position of the body, but it is not associated with exercise;
the pain often intensifies with inspiration;
general body temperature may increase;
most often it is a complication of an infectious-inflammatory disease (for example, acute respiratory infection).

Cardiomyopathy

Cardiomyopathy is characterized by metabolic disorders in the heart muscle with a gradual pathological change in tissue structure. Cardiomyopathy may be caused by prolonged arterial hypertension, arrhythmia, chronic intoxication (alcohol, drugs, occupational), diabetes mellitus, hormonal disorders.

Heart pain with cardiomyopathy is usually associated with a lack of oxygen supply to the myocardium. Some characteristic features there is no pain - it can be constant or periodic, pressing and cutting, localized in almost any part of the chest.

Heart defects

A heart defect is a change in the normal structure of the heart structures (usually the valves that provide physiological blood flow). Pain due to heart defects is explained by overload and increased myocardial demand for oxygen.

Features of pain with heart defects:

the pain is often constant;
additional symptoms: swelling, shortness of breath, increased blood pressure, etc.

It should be taken into account that heart disease can be acquired - for example, due to complicated angina. Therefore, the appearance of pain in the heart and other suspicious symptoms after a sore throat or other inflammatory diseases may indicate heart damage. This condition requires consultation with a doctor and examination.

Vegetovascular dystonia

Vegetovascular dystonia (VSD, neurocirculatory dystonia, cardioneurosis) is a functional disorder associated with a violation of the nervous regulation of the heart. The occurrence of VSD is usually associated with stress or an age-related crisis.

Features of heart pain with VSD:

the patient’s young age is characteristic (often adolescence or youth);
the pain is often aching, stabbing;
localization - in the left half of the chest;
pain occurs in attacks that usually go away on their own or after taking sedatives;
Most often, attacks of pain occur in connection with psychological experiences;
associated symptoms: weakness, fluctuations in blood pressure, feelings of fear, neurotic manifestations (obsessiveness, tearfulness, sleep disturbance, irritability), feeling of lack of air.

Stomach pathology

Pain in the heart area can be caused by gastritis or stomach ulcers. The typical localization of pain due to inflammation or ulcerative defect of the gastric mucosa is the upper abdomen, but pain can also be reflected in the chest, resembling cardiac pathology.

Features of pain with gastritis and stomach ulcers:

the occurrence of pain is associated with food intake (on an empty stomach or, conversely, after eating);
additional manifestations: nausea, vomiting, abnormal stool, feeling of heaviness in the abdomen, belching, heartburn;
pain is not relieved by taking nitroglycerin, but antacids (those that reduce acidity) may be effective gastric juice) or the usual intake of soft food (milk, weak broth, etc.).

Esophagitis

Esophagitis is inflammation of the mucous membrane of the esophagus. As a rule, such inflammation occurs as a result of gastroesophageal reflux - the reflux of gastric juice into the esophagus. The classic symptom of the disease is heartburn, which in some cases may be accompanied by chest pain.

Features of pain with esophagitis:

pain is often combined with heartburn;
pain is associated with eating;
additional symptoms: sensation foreign body in the esophagus, difficulty swallowing, nausea, vomiting.

Pneumonia and pleurisy

Pneumonia is an inflammatory disease of the lungs, which, when the pleura (the lining of the lung) is involved in the inflammatory process, is accompanied by pain in the heart area (with left-sided inflammation).

Features of pain in pneumonia and pleurisy:

usually high temperature(38 degrees and above);
combination of pain with severe weakness, cough, sweating;
dependence of pain on coughing and the act of breathing (increased with inspiration).

Osteochondrosis

Osteochondrosis is expressed in pathological change intervertebral cartilage, leading to a number of unpleasant manifestations - impaired movement, stiffness, pain. Pain due to osteochondrosis thoracic spine can simulate pain in the heart.

Features of pain in the heart area with osteochondrosis:

usually pain in the heart area is combined with pain or discomfort in the back;
the pain can be very intense – shooting;
the occurrence of pain is associated with unsuccessful or sudden movement, overload of the spine (lifting heavy objects, working in an uncomfortable bent position, etc.);
pain increases or decreases depending on body position, depth of breathing, sneezing, coughing;
associated symptoms: numbness, decreased sensitivity, sensation of “pins and needles” in separate parts body (arms, legs).

Intercostal neuralgia

Intercostal neuralgia is manifested by attacks of severe but short-lived pain in the chest. The reason for this condition may be osteochondrosis, hypothermia, prolonged work in an uncomfortable position, or sudden unsuccessful movement in the spine.

Features of pain with intercostal neuralgia:

the pain is sharp, preventing the person from taking a full breath;
an attack of pain suddenly begins and ends just as suddenly;
Usually in one of the intercostal spaces you can find an area that is painful to the touch.

Pain in the heart area: what to do?

Treatment for heart pain depends on its cause. For selection correct tactics behavior when such pain occurs, below we provide general recommendations that will help you avoid serious complications.

If the pain occurs against the background of an exacerbation of your long-standing chronic disease(osteochondrosis, gastritis, peptic ulcer), use medications prescribed by your doctor to treat the underlying disease.
Try to find a certain body position that relieves the pain. If such a position is found, maintain it for a while - perhaps the pain is associated with a temporary disorder in the spine or muscles, then it will soon disappear.
If the pain is accompanied by worsening general condition(sharp rise in temperature, cold clammy sweat, pallor skin, loss of consciousness), urgent consultation with a doctor is necessary - call an ambulance.
If you suffer from angina pectoris, but the attack of pain has become particularly severe and cannot be relieved by your usual means, call an ambulance.
Measure your blood pressure: if the numbers are high, take an antihypertensive drug or call an ambulance.
If you independently cope with periodic pain in the heart area, but it recurs regularly, take the time to visit a doctor and undergo the minimum necessary examination.

The article was prepared by doctor Ekaterina Vladimirovna Kartashova

Heart pain is always considered (and quite rightly) one of the most dangerous manifestations of pain. And the point here is not at all that there is nothing to replace this organ in the event of its stoppage or “final breakdown”. In the same way, for example, it is not yet possible to replace the pancreas, and therefore acute pancreatitis and pancreatic necrosis are considered diseases that seriously threaten life.

What are the dangers of heart pain?

The danger of heart pain - why shouldn’t you endure it?

The fact is that in the event of a cardiac catastrophe (for example, sudden coronary death), for a person, as an individual, to return to life, there is no more than 5 minutes of time at room temperature.

In the event that cardiopulmonary resuscitation is performed, indirect massage heart disease, defibrillation and other techniques will begin 6 - 7 minutes or more after breathing and circulation have stopped - we will get a person with serious manifestations of hypoxic encephalopathy. He will have serious problem with memory, performance, character will change. Most likely, he will have to leave his job of an intellectual nature, or register for disability.

Resuscitation after 10 minutes can lead to a “vegetable” being brought back to life, that is, a person with a dead cerebral cortex.

Of course, these are the most extreme and gloomy forecasts. Much more often, pain does not indicate sudden death and loss of consciousness, but a variety of different processes that can occur not only in the heart, but also in other organs. How to recognize that it is pain in the heart?

How and where does a person’s heart hurt?

Location of the heart in the chest

As a rule, pain in the heart occurs in the area of its projection to the anterior chest wall. This is the area of the sternum, the area of the fifth intercostal space on the left, where the apex of the heart is located - the area of the left ventricle where the apex beat is felt. But sometimes cardiac pathology manifests itself in pain, which can radiate to the back, jaw, or teeth. In some cases, with acute myocardial infarction, there is even a suspicion of perforation of a gastric ulcer - the abdominal pain can be so severe.

It must be remembered that the heart receives autonomic innervation, not at all the same as muscles and skin. Therefore, the heart will hurt differently: not like a wound on the arm, a burn or a bruise. All of us have had a stomach ache at some point. Now try to transfer this particular feeling of pain to the area of the heart - and you will get an idea of the nature of the pain. This pain is difficult to define: it is diffused over a certain area, can come from “the very middle of the body” and have a “deep” character.

Most often, the heart “aches.” The aching pain can last for a long time - from several minutes to hours, or even days and months. This may indicate indolent processes, for example, endocarditis or pericarditis. The heart can also “whin” when there is high blood pressure or an overload of the organ’s chambers with blood volume.

Sometimes my heart hurts. This can happen chaotically, and often does not coincide with the heart rhythm. Most often, people get scared when they feel a “strong stabbing” in their chest and go away. In fact, this is just one of the most harmless options for episodic pain.

Older people often experience pressing and squeezing pain, not in the heart, but in the sternum, where the projection of large vessels is located. This dangerous pain associated with exercise is called angina, or an attack of coronary artery disease.

This variety of locations and nature indicates that you need to pay attention not only to pain and its nature, but also to special signs. Let's list the symptoms that make it more likely to say that the cause of the pain was the heart.

First of all, you need to grab your wrist with four fingers of your left hand and feel your own pulse. Find out if there are any interruptions, tachycardia, rapid and thready pulse, as well as “dips” in the chest. If there are rhythm disturbances, then with a high probability the pain syndrome can be provoked by them, especially in old age, as well as while taking all kinds of medications, especially diuretics.

Then you need to assess the relationship between pain and physical activity. Load refers to various types of physical stress that cause increased breathing and increased heart rate. This includes fast walking, climbing stairs, and physical labor. The appearance of intense, compressive pain in the chest that occurs after physical activity (or during it) and requires its cessation is a sure sign of circulatory failure in the heart itself.

After assessing the rhythm and the relationship with the load, it is necessary to evaluate the relationship of pain with a certain posture and movement. If pain occurs during a certain movement, then most likely the source of pain is the musculoskeletal system (for example, intercostal neuralgia).

Of course, there is another situation - if it is difficult to breathe while lying on your back and there is severe, pressing pain in the heart area, which intensifies every day, then this may be a symptom of fluid accumulation in the cavity of the heart sac - the pericardium. Then the pain is relieved if you take a position with your chest tilted forward (or get on all fours).

In addition to the relationship between pain and these important factors, other circumstances need to be assessed. Thus, with pronounced redness of the face, sweating, excitement, headache, against the background of emotional stress or physical activity, aching pain may indicate a rise in blood pressure, or a hypertensive crisis, especially in people with excess body weight.

In the same case, if pain in the heart area is combined with severe weakness, the appearance of cold sticky sweat, fainting, pallor, and the appearance of a rapid and thread-like pulse, then this indicates the development of vascular collapse. This can be a serious symptom of myocardial infarction, especially if a person has a strong fear of death, a sallow complexion appears, and the tips of the fingers, nose and ears turn blue. This indicates a decrease in perfusion pressure in the capillaries and the onset of tissue hypoxia. In this case, you need to urgently call an ambulance.

Note: even if collapse occurs without any pain, you should urgently call an ambulance. This condition can be caused, for example, by internal bleeding - you must not hesitate, otherwise hemorrhagic shock will develop.

Why can your heart hurt?

Let's consider the main causes of pain in the heart - acute or chronic. It will be much easier to understand the reason if we remember what our muscle pump consists of and where the pain can come from?

The internal lining of the cavities of the heart, forming the valve apparatus - endocardium. Its smooth and slippery shell ensures smooth blood flow through the chambers;
The myocardium is a powerful muscle that provides all the blood circulation in the body;
The pericardium is the outer layer of the heart, consisting of two layers. The outer layer anchors the organ in the chest with the help of ligaments, and the inner layer of the pericardium is tightly connected to the heart. Between the sheets there is a little fluid, which allows the heart to glide during contractions without loss due to friction;
Large great vessels and nerves of the heart;
Coronary vessels supplying the myocardium.

From this scheme, the following sources of pain can be identified:

Acute and chronic endocarditis. It manifests itself as prolonged and mild pain in the heart, most often of a bacterial nature. Accompanied by a rise in temperature, prolonged fever, general deterioration well-being. The danger of endocarditis is the destruction of valve leaflets and the occurrence of progressive heart failure.

We also must not forget that various valve defects, especially those with significant volume overload of the atria and ventricles, can cause pain in the heart area associated with physical activity and at rest.

Myocarditis. Also occur due to infectious, toxic, autoimmune causes. Signs are constant, aching pain in the heart, decreased myocardial contractility. This is manifested by shortness of breath and decreased tolerance to physical activity.
Pericarditis. They manifest themselves with different symptoms. We described the signs of effusion pericarditis above. Sometimes dry pericarditis occurs when fibrin strands fall out between the sheets. Then you experience quite severe and constant pain. If the accumulation of effusion begins, the pericardial layers are separated, and the pain disappears, but then returns in the form of heaviness and pressure.

There are armored or constrictive pericarditis, as well as adhesive pericarditis. In both cases, constant pain of varying intensity occurs, with the addition of symptoms of heart failure: edema, shortness of breath, enlarged liver, pulmonary edema.

Coronary vessels. When they spasm, a typical attack of angina occurs, usually due to physical exertion, stress, or inhalation of frosty air. Substernal pain occurs, sometimes the heart and left arm hurt, the pain radiates to the hand, the left half of the neck, and jaw. Sometimes dangerous painless forms of ischemia occur, which are noticeable only on an ECG.

Finally, nerves may be the cause of pain. This is nothing more than autonomic neuralgia. It can occur when various diseases And functional states, and, as a rule, it does not have a significant effect on changes in cardiac function.

There is such a diagnosis as myocardial dystrophy. This is a non-inflammatory lesion of the heart muscle caused by metabolic disorders, for example, in chronic alcoholism. If your heart hurts after drinking alcohol, then most likely the patient already has a long history of alcohol abuse.

Let's look at the questions that patients most often ask.

Can the heart hurt with normal blood pressure?

Of course it can. Indeed, as discussed above, pain may not be associated with hemodynamics, but may occur as a result of organic damage, for example, the occurrence of adhesions in the pericardial cavity, with inflammatory changes in the heart muscle, or with vasospasm.

You need to remember that although a hypertensive crisis increases the chances of heart pain, the heart can hurt at any pressure.

Can your heart hurt all the time?

The heart can hurt for a long time, but in each case there is a specific reason. Can your heart hurt all your life? Of course not. Usually people think that they have constant pain if their heart has been bothering them for several months. The cause must be sought among organic diseases that occur with an inflammatory component (pericarditis, myocarditis, endocarditis).

If there are signs of heart failure, then the presence of a defect can be highly likely. With myocardial dystrophy, there may also be long-term pain, for example, with hyperthyroidism or hypothyroidism.

Can the heart hurt with osteochondrosis?

Of course it can. There are zones of Zakharyin-Ged reflected pain, and in the presence of pathology of the intervertebral discs of the lower cervical and thoracic spine, cardialgia and signs of neurological symptoms may occur, for example, if the heart hurts and the arm goes numb, there is a feeling of “crawling goosebumps.”

In this case, you first need to exclude cardiac causes of pain, as the most important, and only then proceed with routine diagnosis of complicated osteochondrosis.

Which doctor should you go to for pain in the heart?

You need to start with a general practitioner. He will be able to quickly diagnose major disorders, for example, the presence of coronary heart disease or make a diagnosis of myocarditis. One day is enough for this. It is worth recording an ECG and doing an ultrasound of the heart, listening to its sounds, assessing the presence of signs of heart failure, and much will become clear, albeit at a superficial level. You can also consult a cardiologist.

What to do if your heart hurts badly? If this happens to a young and healthy person, then you need to lie down, relax, take Valocordin, and ventilate the room. Sometimes your heart can hurt even after training, so you need to wait a little. If the pain continues and other symptoms appear, then you need to call a doctor.

You need to behave completely differently during an attack of angina. What to do at home if your heart hurts and compresses? First of all, the patient also needs to be laid down, his head raised higher, air flow ensured, and all belts, ties, and shoes removed. If this is not possible, then you need to sit down and stop all physical activity. You need to calm down: panic increases oxygen consumption by tissues and increases the work of the heart, which in conditions of myocardial ischemia can lead to a heart attack.

A nitroglycerin tablet must be given under the tongue for resorption, and after that an aspirin tablet. If the pain has not stopped, then after 10 minutes you can repeat the appointment and call the cardiology ambulance team.

General principles of treatment of heart pain

The most important thing is to identify the source of pain in the heart. A correct diagnosis is the key successful treatment. It is important not to take painkillers; you need to cope with cardialgia in other ways:

For inflammatory lesions - anti-inflammatory drugs, hormones, autoimmune diseases– with the help of cytostatics, basic drugs and monoclonal antibodies;
In case of infection - rational antibacterial therapy, increasing immunity, sanitizing foci of infection;
If a diagnosis of myocardial dystrophy is made, then long-term treatment is necessary, with the elimination of the cause, the prescription of vitamins, enzymes, and energy drugs;
With effusion of pericarditis, pericardial puncture will bring relief;
If an attack of angina occurs, the main task is to prevent the occurrence of myocardial infarction. Nitrates, beta blockers, calcium antagonists, and ACE inhibitors are used.

In conclusion, it must be said that the presence of pain in the heart is always a reason to visit a cardiologist and undergo an examination. And, even if everything is in order, and the episode of pain is isolated and not dangerous, this visit will be a reason to start treating healthy image life and give up bad habits.