Discomfort in the middle of the sternum may be caused by problems with different organs located in this part of the body. Only a doctor can make an accurate diagnosis by comprehensively analyzing complaints and symptoms, as well as the results of tests and hardware studies.
However, just by the nature of the pain: pressing, stabbing, pinching, burning, pulsating, shooting - one can make a preliminary conclusion and understand in which direction to “move in search of the culprit” when a person complains that he has pressure in the middle of the sternum.
A variety of pain sensations in the chest, also called thoracalgia, can also be superficial or deep, anterior or posterior, associated or not with breathing, physical activity or changes in the position of the body. The information and video in this article will help you first understand why the sternum hurts in the middle.
Is this caused by psychogenic reasons, harmless musculoskeletal phenomena, or the matter is much more serious, and the presence of a disease of an internal organ or musculoskeletal system should be suspected.
If there is pressure on the chest at rest or when walking, then the heart is most likely to blame. Especially when it not only feels tight in the sternum, but also makes it difficult to breathe.
What causes such a symptom: atherosclerosis, ischemic heart disease, chronic heart failure or another cardiovascular disease, for example, a “regular” resting ECG and stress tests will help you figure it out.
To differentiate cardiac pathology from problems with the spine or lungs, one of three functional stress tests can be used (pictured above):
- Test on a treadmill (treadmill, treadmill).
- Study on a bicycle ergometer (VEM).
- Cardiopulmonary exercise test (CPET).
Many people do not know, and cardiologists sometimes forget to warn, about the need to prepare for stress testing.
The instructions are:
- in 24 hours– should be avoided stressful situations and heavy physical activity, do not drink strong tea, coffee, alcoholic or other strong tonic drinks;
- in 3 hours– do not smoke, drink or eat;
- in the morning, on the day of the test, breakfast should be light - biscuits, a glass of juice or fermented milk drink;
- come to the office 30 minutes before before the start of the study.
The final and most accurate answer is whether the myocardium has enough blood and oxygen during physical activity, can be given using coronagraphy with a contrast agent.
Advice. If possible, it is better to do MSCT angiography. Although its price is higher than that of a classic interventional examination, it allows you to examine vessels much safer and faster.
Symptoms characteristic of diseases with cardiac etiology
Some heart diseases occur without any symptoms.
However, you should remember the signs that are characteristic of angina attacks and pre-infarction conditions:
- The attack always begins suddenly, without any “preliminary” symptoms. This can happen both at rest, including during sleep, and after physical or emotional stress. Quite often it can be caused by changes in ambient temperatures, for example, when leaving a warm room into frost.
- Painful sensations - compresses or presses in the middle of the sternum. It becomes difficult to breathe. Sometimes you can come across such a description of pain - something is pressing, as if a stake has been driven between the breasts, which burns strongly. Many people compare the sensations not with pain itself, but with pressure. It seems as if a heavy stone or concrete slab was placed on the chest. It is no coincidence that the popular name for angina pectoris is “angina pectoris.” During an attack, a person does not have enough air, he instinctively begins to grab it with his mouth and, sometimes, makes croaking sounds.
- Possible, but not required:
- irradiation of pain to the left (right) shoulder, collarbone, scapula, elbow;
- pain below chest in the middle - in the area of the solar plexus or stomach;
- darkening of the eyes;
- profuse cold sweating;
- tingling and coldness in the hands and feet;
- pre-fainting state.
On a note. An attack of angina lasts from 1 to 15 minutes. If sudden pain in the chest in the middle lasts longer, then there are 2 options - myocardial infarction or pain syndrome has nothing to do with the heart.
Urgent Care
What to do if you have chest pain and difficulty breathing?
When such symptoms are caused by changes in the cardiovascular system, then the person already has a sufficient arsenal of medications in home medicine cabinet, among which there is nitroglycerin. It must be taken while sitting or lying down, as it causes a sharp spasm of the blood vessels in the head.
After taking the first nitroglycerin tablet (drops or spray), according to the instructions, you must wait 3-5 minutes, restoring the rhythm of your breathing, keeping calm and motionless.
If there is no positive effect - there is pressure on the sternum and breathing has not become easier - you should take the medicine again. Sensitive people, especially women, may be advised to take additional Corvalol or a sedative.
For your information. Taking analgin or another drug against the inevitable headache caused by nitroglycerin is absolutely pointless. By the time they begin to act, the brain vessels will return to normal on their own.
If after 15 minutes, during which 2 doses of nitroglycerin were taken, the chest pain and difficulty breathing does not disappear, it is better to play it safe and call an ambulance. The cost of delay in myocardial infarction is death.
Chest pain not associated with cardiac dysfunction
However, there is no need to panic ahead of time. If the chest hurts in the middle, then the reasons may be completely unrelated to the cardiovascular system.
The cause of nausea, pressing pain in the left hypochondrium and its irradiation into the sternum, occurring half an hour after eating or drinking alcohol, may be a hernia of the diaphragm or acute cholecystopancreatitis. Well, the culprit behind the burning and pressing sensation under the chest in the middle or a little higher after eating is “banal” reflux or heartburn.
The condition when there is a tickling in the middle of the sternum is most likely due to bronchitis, but if such a “tickling” does not go away for a long time, it is necessary to mandatory go for an examination to a pulmonologist. Should be excluded malignancy in the lungs, bronchi, trachea or esophagus. In other cases, when it becomes constantly difficult to breathe and pain appears in the sternal area, probable cause there may be pleurisy or another disease that has affected the pulmonary membrane.
Many people begin to worry about discovering that it hurts to press on the middle of the chest. There's no need to be nervous. In almost everyone, increased palpation of the lower part of the sternal bone causes pain.
Pain, discomfort or unpleasant sensations - torcalgia - are very often the result of neurological or muscular problems, or a disorder of the skeletal system. Let's list the most common ones.
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It is the neurological manifestation of this pathology that is most often confused with an attack of angina. At the same time, they drink nitroglycerin endlessly, wondering why the pain in the left elbow and shoulder does not go away, and the pain in the middle of the sternum. By the way, it can last from 10 minutes to 10 hours, and its distinctive feature– weakness and inability to fully lift left hand upward due to increased pain in the heart area. |
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Usually intercostal neuralgia“hurts” on the side of the chest and closer to the back. However, if the process involves the costal cartilages, in the places where they connect with the sternum, which are shown in the photo, then it will really hurt to breathe full breasts. Occurring when inhaling, when coughing, sneezing or during awkward movements, stabbing lumbago can easily be mistaken for heart pain. |
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Excessive mobility of the cartilaginous endings of 7-10 ribs or microtrauma in this area can cause pain in the chest when moving, sneezing and coughing. In fact, it stings or presses under the left sternum inflammatory process in sympathetic anastomoses of intercostal nerves. The pain is quite easily relieved and cured with the help of ointments containing anti-inflammatory non-steroidal substances. |
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Aching pain in the center of the chest may be a symptom of xiphoid process syndrome. A pathology called xyphoidalgia is an inflammation of the nerve endings in this area. In addition to the xiphoid process, they innervate the diaphragm, part of the stomach and duodenum. Along with prolonged pain in the atrium, a feeling of constriction in the throat very often occurs. |
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If discomfort and dull, prolonged pain spread in a semicircle as in the photo, and the area of the shoulder and shoulder blade remains painless, you can suspect the presence of pectalgia or large pectoral muscle. Such manifestations require establishing a clear cause of origin, since they may indicate a “missed” myocardial infarction. |
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In the case when the pain is localized in the place indicated in the figure, from there it radiates to the area of the heart, scapula and shoulder joint, and intensifies during arm movement, a clear differentiation of pectoralis minor syndrome is necessary. The same symptomatic manifestations possible with heart and/or lung problems, especially in people who abuse tobacco and alcohol. |
And in conclusion of the article, we would like to remind you once again that “joking with your heart” is life-threatening. If unpleasant or uncomfortable sensations arise in the chest area, the best decision is to go to an appointment with a family doctor or local physician, who, if necessary, will issue a referral for further examination by the necessary specialist.
A common reason for visits to the doctor is a dull pain in the middle of the sternum. The reasons for this anxiety state there are quite a few in this area. These symptoms may indicate the most various diseases.
Therefore, it is important to pay attention to both painful sensations in the chest and their accompanying signs, so that during a visit to the doctor you can most accurately describe your condition in order to make the correct diagnosis.
They often lead to stupid people pathological conditions organs located in the chest:
- sympathetic, autonomic nerves;
- lymphatic system;
- trachea, lungs, bronchi;
- liver;
- thoracic aorta, heart;
- central esophagus;
- thymus gland.
The chest protects these organs from exposure external factors. They are exposed to a variety of diseases, accompanied by dull, painful sensations in the center of the chest.
Anatomy of the chest organs
Causes of dull pain in the sternum
Diseases of the heart and blood vessels
A dull pain in the middle of the chest indicates heart or vascular disease. If the attacks are short, the nature of the pain is compressive, they occur:
- in the sternum;
- cover the scapula;
- felt in the left hand.
Perhaps this: sensations appear during movement, exercise physical work, subside after a short rest.
Dull pain indicates a serious condition that needs to be eliminated through urgent hospitalization.
A heart attack is similar in its symptoms to an angina attack, but the pain during a heart attack is more severe and lasts longer. It appears not only during physical activity, but also in calm state.
In addition to chest pain, a patient who has had a myocardial infarction feels intense fear, for which he cannot explain the reasons. This is one of obvious signs heart attack.
Dull pain in the middle of the chest occurs with illness circulatory system and may be related to: 
- pulmonary vascular thrombosis;
- embolism;
- neuroses of the heart muscle;
- illness coronary vessels and etc.
Stomach or esophagus problems
Dull pain in the sternum is possible when pathology of the stomach or intestines occurs. It is most likely that there are problems with the stomach, manifested by pain when:
- peptic ulcer of the stomach, duodenum;
- acute pancreatitis;
- abscess of the diaphragm;
- reflux esophagitis;
- acute cholecystitis.
If there is pain behind the sternum in the middle and there is a suspicion of one of these diseases, you need to pay attention to associated symptoms: belching, nausea, increased formation of gases, heartburn.
Reason painful sensations If one of the gastrointestinal pathologies is detected, spasms of the esophagus or stomach are present. Pain occurs on an empty stomach after eating food. It subsides if the patient takes an antispasmodic drug.
Diseases of the respiratory system
A dull pain behind the sternum in the middle, the causes of which are hidden in the respiratory organs, is accompanied by a cough. It can be sharp, persistent, strong. Perhaps this condition is caused by developing diseases:
- tracheitis;
- pleurisy;
- pneumonia;
- bronchitis.
Spinal problems
The sternum hurts in the middle if there are problems with the spine, often osteochondrosis. Dull pain in the middle of the chest can be constant or paroxysmal, depending on the location of the body.
If a person moves, the pain may intensify, less intense - in a calm state of the body. This is often signaled by radiculopathy, localized in the spine, in its thoracic region. It often develops with progressive osteochondrosis.
Pain in the middle of the sternum may be due to congenital pathologies, features of the spine.
Complications of osteochondrosis are expressed by compression of the nerve roots. Pain localized in the middle behind the sternum is neurological in nature, thus intercostal neuralgia manifests itself. It is slightly weaker in strength than hepatic colic. Its focus is located near the heart and in the left shoulder blade. The sensations are similar to those that occur during angina pectoris.
A distinctive feature of intercostal neuralgia is the lack of a positive effect when taking nitroglycerin, a medicine that reduces heart pain.
How to determine what pain behind the sternum indicates?
To understand why there is a dull pain between the chest in the middle, it is necessary to analyze the accompanying symptoms. It must be remembered that it occurs with very different diseases of organs located at the chest level.
It is important to correctly assess your condition and understand what caused the dull pain in the middle behind the sternum. It is often associated with heart disease. But there are different reasons.
Possible as deadly dangerous conditions, requiring urgent medical intervention, and functional disorders that do not require urgent hospitalization.
When detailing the signs that manifest dull chest pain, it is necessary to take into account its characteristics, which differ:
- by type (sharp, blunt);
- by nature (burning, stabbing);
- by additional localization (left, right, center);
- irradiation (where it is felt - in the left hand, the little finger on the left hand);
- the time when the pain appears (at night, during the day, in the evening or in the morning);
- how it is alleviated (ensure a state of rest, a certain posture, a sip of water, nitroglycerin);
- what affects its strengthening (movements, swallowing, breathing, coughing).
Often during diagnosis, information about family history (illnesses of relatives), gender, age of the patient, work performed (harm factors), and addictions play a significant role.
It is important to pay attention to the events that preceded the appearance of a dull pain in the middle of the chest:
- possible injuries;
- infections;
- wrong diet;
- overwork, etc.
It is necessary to find out whether similar attacks have happened before and what was their cause.
Useful video
How to distinguish cardiac chest pain from another disease - watch the following video:
Conclusion
- Detailed collection of all symptoms and signs, analysis pain will allow preliminary diagnosis of the patient's condition.
- The picture will become clearer more accurately upon examination by a doctor, as well as with the help of laboratory tests.
- Pain behind the sternum in the middle cannot be ignored; it is important to see a specialist in a timely manner to avoid serious health consequences.
One of the most common complaints when applying for medical care is “chest discomfort.” This does not only mean pain. Patients may complain of or suddenly appear. What can cause these symptoms?
The difficulty of diagnosing the causes of the complaints described above is based on the fact that pathological processes occurring in various organs can give a similar picture.
Heart
Diseases of the heart and blood vessels are often accompanied by pain symptoms that vary in nature and area of irradiation:
- angina pectoris is characterized by attacks of minor pain. The patient describes his sensations as follows: “I feel squeezing.” In addition, the patient may experience nausea and weakness. This symptomatology is possible both after exercise - angina pectoris, and without it - angina at rest. The attack can be quickly stopped by taking medications, such as nitroglycerin. Cardiologists emphasize the low intensity of pain in women;
- a heart attack is accompanied by more intense pain. In addition, there is irradiation of pain into the arm on the left, as well as the thoracic spine. You may feel nauseous, weak and dizzy. Rest and the use of heart medications do not have the desired effect;
- The clinical picture of thrombosis of the artery draining blood from the lungs is often similar to a heart attack. The pain appears behind the sternum suddenly, sharply. The difference from a heart attack is shortness of breath of varying severity. At a later stage, a cough occurs. When coughing up, the mucus is streaked with blood. The appearance of such a symptom indicates the onset of a pulmonary tissue infarction;
- with aortic dissection, pain discomfort in the middle of the chest is quite intense. The patient does not always accurately indicate the location of its location. Initially, the pain may cover the area of the shoulder blade (pain under the shoulder blades). Then it gradually fills the entire chest on the left with irradiation into the arm and.
Respiratory system
Pathology of the respiratory system can be either acute or chronic. These are inflammations of the lungs, pleura, and bronchi. This kind of pain is not constant. It may get worse when you cough or sneeze. Diseases are most often accompanied by fever and other signs of general intoxication.
Gastrointestinal tract
If a patient complains of pain in the middle of the chest on an “empty stomach,” then this is a reason to suspect a disease of the gastrointestinal tract (for example, gastric ulceration). Algia covers the epigastric region, retrosternal space and. In addition to pain, there is heartburn and nausea. However, this symptomatology is easily relieved with antispasmodics and proper nutrition.
Spine
Pathological processes involving the chest can also cause discomfort in the thoracic region. The reason is the infringement of the nerve roots that extend from. This symptom is possible when intervertebral hernia or at late stages osteochondrosis. In these pathological processes, anatomical structural disorders will be visually determined spinal column and chest.
What to do to get rid of the problem
If you experience pain in the chest area, you should immediately contact medical institution. For example, to a local therapist. He will be able to make an initial diagnosis.
At the appointment, the doctor will collect anamnesis, perform an examination, palpation and percussion examination. In addition, there will be appointed lab tests, ECG. To clarify the diagnosis, consultation with a specialized specialist is necessary. Only after this is treatment prescribed. It is often difficult to make a diagnosis right away, and to clarify it, the patient is recommended to undergo inpatient treatment.
When to call an ambulance
Sometimes the patient's condition is so serious that it is necessary to immediately call ambulance. This must be done if the following symptoms appear:
- Severe sudden pain, especially if it appears at night.
- Blurred consciousness.
- A gradual increase in pain accompanied by weakness and the inability to take a breath.
- Difficulty breathing, sore throat. Inhalation and exhalation are accompanied by strange sounds.
- Angina pectoris is not controlled by conventional medications.
Chest pain (thoracalgia) is an unpleasant sensation that occurs during pathological processes in internal organs, chest or spine injuries. This condition leads to difficulty breathing, stiffness of movement and a significant deterioration in a person’s quality of life. To eliminate the manifestation, you should contact a medical institution.
Etiology
Pain in the chest in the middle, on the right or left side is provoked pathological changes from the outside of cardio-vascular system or upper respiratory tract. Pathologies associated with the spine are also not an exception. In general, chest pain can be caused by the following etiological factors:
- post-traumatic syndrome;
- neurological diseases;
- coronary heart lesions;
- cardiovascular pathologies;
- aortic dissection;
- injuries to the back, sternum and spine;
- respiratory diseases;
- organ pathologies abdominal cavity;
- psychosomatics.
The pattern of chest pain may indicate a possible underlying factor. Pressing pain in the chest may indicate a pre-infarction condition, so you should urgently call an ambulance.
Symptoms
Chest pain may be accompanied by the following: additional signs clinical picture:
- , for no apparent reason;
Depending on the etiology, the overall clinical picture may be supplemented specific signs, which helps differentiate them:
- sharp, strong pain in the middle or left side of the chest, radiating to the arm or neck may be a sign acute ischemia or myocardial infarction;
- pain in the chest on the right or left, which occurs during physical activity and completely disappears at rest, may indicate angina pectoris;
- sharp pain on the left side of the chest, radiating to the back, may be a symptom of aortic dissection;
- Chest pain when coughing or taking a deep breath may indicate the development of an upper respiratory tract disease.
Also, pain in the chest when inhaling can be a sign of and. In this case, the general clinical picture may be supplemented by the following manifestations:
- and fever;
- cough;
- labored breathing.
The cause of pain in the chest in the middle may be .. In this case, the clinical picture may have the following signs:
- when trying to take a deep breath or exhale, the pain intensifies sharply and has a stabbing character;
- discomfort is felt in the area of the right or left hypochondrium;
- pain radiates to the stomach, liver, and in some cases to the heart;
- attacks of pain occur periodically or only when physical activity;
- pallor skin;
- impaired skin sensitivity;
- decreased tone of the chest muscles.
If such a clinical picture is present, you should urgently seek medical help. Otherwise, serious complications and even death may develop if the pain is caused.
Diagnostics
Why the chest hurts, only a doctor can say after examination and diagnosis accurate diagnosis. If the patient's condition allows, the attending physician conducts a detailed physical examination to determine the general medical history. The medical history must be taken into account. To make an accurate diagnosis, the following laboratory and diagnostic measures are used:
- general and biochemical analysis blood;
- sputum analysis (if observed) coughing);
- pulse oximetry;
- chest x-ray;
- blood for markers of myocardial infarction;
- diagnostic appointment medicines;
If osteochondrosis is suspected, as the root cause of pain in the chest on the right or left, general program diagnostics may include such additional methods examinations:
- computed tomography of the cervical and thoracic spine;
- contrasting discography;
- myelography - study spinal cord using a contrast agent.
Additional research methods may be prescribed at the discretion of the doctor, depending on the current clinical picture, anamnesis and medical history. Treatment can only be prescribed after an accurate diagnosis.
Treatment
Treatment directly depends on the etiology pathological process, which provoked the development of such a symptom. Sometimes, the addition of such symptoms requires urgent hospitalization of the patient.
All in all, drug therapy for pain in the chest on the right or left, may involve taking medications of this type:
- painkillers;
- vasodilators;
- chondroprotectors.
However, treatment with drugs comes entirely from etiological factor, which provoked pain in the chest area.
How adjuvant therapy, to eliminate pain in the left side of the chest or with another localization of the symptom, the doctor prescribes the following physiotherapeutic procedures:
- shock wave therapy;
- mud therapy.
Depending on the etiology of pain, manual therapy may be prescribed.
In any case, therapy should only be prescribed by a competent medical specialist. Pain on the left side of the chest, on the right or in the middle, may indicate the development of a serious pathological process, so self-medication is fraught with serious consequences.
Prevention
There are no specific preventive methods in this case. This is due to the fact that pain in the chest area is a symptom, and not a separate nosological unit. Should stick to the general healthy image life and nutrition, doing exercises or walking sport sections, do not overcool, seek medical help in a timely manner, do not neglect preventive examination medical specialists, and also undergo fluorography every year without fail.
Discomfort in the chest area can be quite serious symptom. There are many vital organs located here, for the normal functioning of which the causes can become a serious obstacle. They can hide in a wide variety of pathologies: from intestinal problems to aortic diseases. How to understand what exactly is wrong in the body?
Pain caused by vascular diseases
One of the common diseases is It is distinguished by constant, never-ending cells or in its upper part. Discomfort increases during physical activity. If the discomfort does not go away for more than a day, you should immediately consult a doctor; hospitalization with surgical intervention may be required.
Other severe cardiovascular disease, in which pain appears in the chest area, which extends from the right ventricle. The sensations may resemble angina pectoris, the discomfort worsens with inspiration. Even after taking painkillers, it does not go away for hours. Patients with thromboembolism have a bluish tint to the skin, decreased arterial pressure, palpitations and shortness of breath. The patient needs prompt medical intervention.
Pain caused by gastrointestinal diseases
As a result muscle spasm stomach
may occur Understand that the source of the problem is precisely gastrointestinal tract, it is possible in cases where chest pain in the middle of the chest occurs some time after eating or simultaneously with a feeling of hunger. In such a situation, an ulcer is often diagnosed. The disease is also accompanied by nausea or vomiting, heartburn. You can get rid of muscle spasms, which cause discomfort, with the help of antispasmodics, but the problem can only be completely eliminated by treating the ulcer itself.
A similar situation occurs with gallbladder diseases. Pain under the chest in the middle occurs when affected bile ducts, also similar sensations can be caused by pancreatitis. For many patients, the discomfort is simply unbearable and can easily be mistaken for a heart attack. In such cases it is necessary intensive therapy in the hospital. Finally, another reason may be. It can be determined by the aggravation of unpleasant sensations when bending over or in horizontal position bodies.
Pain caused by spinal problems
Deformations in the thoracic region soon lead to discomfort. Chest pain in the middle of the chest can be constant or occur periodically. As a rule, it worsens when the corresponding muscles are activated. Osteochondrosis or hernia can cause such deformation intervertebral discs. You can get rid of the unpleasant sensation with the help of acupuncture and therapeutic massages Alternatively, you can use novocaine infiltration to relieve pain. If severe chest pain in the middle of the chest is not relieved by anything and continues to cause inconvenience, the patient is recommended to take painkillers.
