Causes of pain in the region of the heart
Last reviewed: 23.04.2024
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There are 2 types of pain in the heart that are caused by heart disease:
- anginal pain associated with myocardial ischemia resulting from coronary artery insufficiency;
- non-angiogenic pain, or cardialgia, which are based on other mechanisms than those that cause myocardial ischemia.
The lack of coronary circulation, which causes the appearance of pain in the heart, may be a consequence:
- anatomical lesions of the coronary arteries or their dysfunction (spasm or inability to adequately expand as myocardial oxygen demand increases) - the so-called coronary forms of myocardial ischemia. This mechanism is most vividly represented in atherosclerosis and coronary artery thrombosis - the substrate of various forms of ischemic heart disease (angina, acute infarction, intermediate forms), inflammatory changes in the arteries (coronaritis), spasm of unchanged or coronary arteries damaged by atherosclerosis;
- increase the need for myocardium in oxygen with unchanged coronary arteries - the so-called noncoronogenic forms of myocardial ischemia. This mechanism is presented in case of inadequate physical activity, atherosclerosis, myocardial hypertrophy due to valvular defects or hypertension of the large or small circle of blood circulation, and also with an increase in body temperature;
- decrease in oxygen capacity of blood in anemia of various origins, carbon monoxide poisoning, dissociation of oxyhemoglobin. This mechanism is observed in a combined defeat of organs (including the heart) with a number of internal diseases and acute poisoning.
Non-cardiac (non-religious) pain, the origin of which is not associated with myocardial ischemia, are observed with a large number of diseases of the cardiovascular system, for example, with neurocirculatory dystonia, myocarditis, pericarditis, accumulation diseases, etc.
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