Pain in the sternum

People most often associate chest pain with heart disease. Of course: from childhood we form a clear association: the heart is in the chest. But statistics show: chest pain can be associated with cardiovascular disease only in 2% of cases up to 18 years old, in 10% of cases up to 30 years old, and only with age - 50-60 years - these numbers gradually increase. What are the causes of chest pain?

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Main Causes of Chest Pain

Most often, chest pain is associated with problems in the functioning of internal organs. This disrupts the work of:

• Cardiovascular system
• Respiratory system
• Digestive system
• Musculoskeletal system
• Central nervous system
• Immune system

The most common conditions that can cause chest pain are:

• Angina pectoris
• Myocardial infarction
• Psychogenic diseases
• Mitral valve prolapse
• Aortic aneurysm (dissecting) or in other words - aortic rupture
• Pneumonia
• Pleurisy
• Lung cancer
• Stomach ulcer
• Duodenal ulcer
• Pneumonia
• Pulmonary embolism
• Diaphragmatic abscess

Depending on the cause, chest pain can be:

• Sharp
• Dumb
• Burning
• Aching
• Piercing
• Compressive
• Shooting

Here are some of the most common conditions that cause chest pain.

Chest pain associated with the cardiovascular system

Although this is far from the only cause of chest pain, heart and vascular problems are the most common causes of chest pain.

Angina pectoris

This is a disease in which blockages form in the vessels that carry blood to the heart. This reduces the flow of blood and oxygen to the heart, causing chest pain in the heart area. However, angina, unlike a heart attack, does not cause irreversible damage to the heart. Chest pain can radiate to the arm, shoulder, jaw, or back. A person may feel as if their chest is being pressed and squeezed. Anxiety or emotional stress can cause chest pain due to angina, so be careful, do not worry, protect yourself from excessive emotional expressions.

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Myocardial infarction (heart attack)

A heart attack occurs when blood from an artery to the heart not only flows weakly, but is completely blocked. This happens due to a complete blockage of the heart artery. Complete cessation of blood flow in the vessels of the heart causes the death of heart muscle cells. The pain is similar to the pain of angina, but it is much stronger and does not go away for a long time. And here is another difference between a heart attack and angina: excessive sweating, nausea, and severe weakness can accompany this pain, but it does not go away within 15-30 minutes, as happens with angina.

Myocarditis

In addition to chest pain, inflammation of the heart muscle, called myocarditis, can cause fever, fatigue, and breathing problems. Although there is no blockage of the arteries in this condition, the symptoms of myocarditis can resemble those of a heart attack (infarction).

Pericarditis

This is an inflammation or infection of the thin tissue sac that covers the heart, called the pericardium. Pericarditis can cause pain similar to angina. This is a sharp pain in the breastbone, a feeling of tightness in the chest, and the pain of pericarditis radiates to the arm, shoulder. This condition also often causes sharp, persistent pain along the upper neck and shoulder muscles. Sometimes the person feels worse when breathing deeply, eating and drinking plain water, or lying on their back.

Hypertrophic cardiomyopathy

When the heart muscle thickens, heart failure can occur. This condition prevents the heart from working as hard, and it pumps blood much harder. Along with chest pain, this type of cardiomyopathy can cause dizziness, shortness of breath, and other symptoms of poor heart function: increased fatigue, shortness of breath, poor sleep.

Mitral valve prolapse

Mitral valve prolapse is a condition in which the heart valve does not close properly. This causes chest pain, palpitations, and dizziness.

Atherosclerosis of the coronary arteries

A number of factors, such as smoking, poor diet, lack of exercise, and heredity, can cause a condition in which cholesterol plaques develop in the coronary artery. When a coronary artery becomes too narrow and the blood flow through it is blocked, a coronary artery rupture can occur. This can cause sudden, severe pain in the breastbone or a feeling of a tear in the chest, with the pain radiating to the neck, back, or abdomen.

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Chest pain related to lungs

Lung problems can cause different types of chest pain. The most common causes of chest pain include bacterial or viral infections, pulmonary embolism, and pneumothorax. Other less common causes related to respiratory diseases include rheumatoid arthritis, lupus, and cancer.

Pleurisy

This is an inflammation or irritation of the mucous membrane of the lungs and chest. The patient feels a sharp pain in the sternum when inhaling or exhaling deeply, and is also bothered by coughing or sneezing.

Pneumonia or lung abscess

Infections that enter the lungs through the respiratory tract can cause pleural pain and other types of chest pain, such as deep, severe pain. Pneumonia often comes on suddenly, causing fever, chills, cough, and mucus that is coughed up from the respiratory tract.

Pulmonary embolism

When a blood clot passes through the lobes of the lung, it can cause acute pleurisy, breathing problems, and a rapid heartbeat. This condition is also accompanied by chills and shock. Pulmonary embolism most often occurs after deep vein thrombosis or after a person has been lying motionless for several days.

Pneumothorax

This condition is often caused by chest trauma. Pneumothorax occurs when part of the lung collapses and air leaks into the chest cavity. Pneumothorax can also cause severe chest pain that gets worse when a person takes a deep breath, accompanied by other symptoms such as low blood pressure, dizziness, weakness.

Pulmonary hypertension

This disease is accompanied by chest pain, reminiscent of angina. Pulmonary hypertension is characterized by abnormally high blood pressure in the lungs, as well as in the arteries. Because of this, the right side of the heart works too hard, so the pain occurs mainly on the right side.

Asthma

Asthma is an inflammatory disease of the airways. This disease causes severe shortness of breath, wheezing, coughing, and sometimes chest pain.

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Chest pain associated with gastrointestinal diseases

Heartburn is a very common cause of chest pain that is not related to heart problems. Heart pain, such as angina, and heartburn pain are somewhat similar because the heart and esophagus are located close to each other and are connected by nerve endings. Other gastrointestinal diseases, in addition to gas reflux disease, can also cause chest pain. These include gastritis, ulcers, inflammation of the stomach walls, and so on.

Gastroesophageal reflux disease (GERD)

Also known as acid reflux, GERD occurs when stomach contents flow back up into the esophagus, causing acute esophagitis. This can lead to a sour taste in the mouth and a burning sensation in the chest or throat, commonly known as heartburn. Factors that can cause heartburn include obesity, smoking, pregnancy, and eating spicy or fatty foods.

Esophageal contraction disorders

Poor coordination of muscle contractions (spasms), high pressure on the walls of the esophagus during contractions, and other problems with the functioning of the esophagus can also cause chest pain.

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Esophageal hypersensitivity

Esophageal hypersensitivity occurs when the esophagus becomes extremely painful with the slightest change in pressure or exposure to acid. The cause of this sensitivity is unknown.

Esophageal rupture

Sudden, severe chest pain, vomiting, or a sharp rise in temperature may be a sign of a ruptured esophagus.

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Ulcer disease

A stomach or duodenal ulcer can cause recurring discomfort, a sore throat or chest pain. The cause is painful ulcers in the lining of the stomach or the beginning of the small intestine. This condition is more common in people who smoke or drink a lot of alcohol. The pain is often relieved by eating something or taking antacids (stomach medications), and sometimes baking soda can help.

Hiatal hernia

The diaphragm is a partition that separates the abdominal cavity and the sternum.

A problem with the diaphragm occurs when the upper abdomen bulges into the lower chest due to a diaphragmatic hernia. This usually occurs after eating. The chest pain tends to get worse when a person lies down (lying down triggers chest pain with a diaphragmatic hernia).

Pancreatitis

With pancreatitis, you may often experience pain in the lower chest, which gets worse when you lie down and gets better when you lean forward.

Gallbladder diseases

Problems with the gallbladder when it is diseased most often occur after eating fatty foods. A person usually experiences a feeling of fullness in the stomach or pain in the lower right part of the sternum or upper right part of the abdomen. Then it is necessary to examine the condition of the gallbladder.

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Chest pain associated with trauma

Sometimes chest pain can occur as a result of excessive pressure on muscles, ligaments or injury in the chest area during a fall or accident. Stress can also cause nerve pain in the chest area. They are also called psychogenic pain. These pains occur when a person is very worried about something, then spasms appear in the chest, the muscles are pinched. If a person leads a sedentary lifestyle, then it is much more difficult to cope with chest pain, because muscle blocks are not eliminated when sitting on the couch.

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Pain due to rib fractures

Chest pain from a broken rib may be worsened by deep breathing or coughing. This type of pain is often limited to one area. A person may feel pain when someone or themselves presses on the area of the sore rib. The area where the ribs join the breastbone may also become inflamed and painful.

Muscle tension

Even a simple cough can irritate the muscles and tendons between the ribs and cause chest pain when the muscles are overextended. Chest pain from muscle strain tends to get worse when the person strains even more by doing any kind of physical exercise.

Shingles

Caused by the chickenpox virus, shingles can cause sharp pain in the chest, and this can be a precursor to a rash that appears much later - a few days later.

Other Possible Causes of Chest Pain

Other causes of chest pain include anxiety or panic attacks. Symptoms that accompany this condition may include dizziness, shortness of breath, rapid heartbeat, tingling and trembling in the fingers.

When to see a doctor if you have chest pain?

If you're unsure about your symptoms, call your doctor for any chest pain, especially sudden pain that doesn't go away. Call your doctor if you have any of these symptoms along with chest pain.

• A sudden feeling of pressure or squeezing under the breastbone, especially if the pain does not go away after rest.
• Chest pain that radiates to the jaw area, left arm or back.
• Sudden, sharp chest pain that is accompanied by shortness of breath, especially after a long period of rest.
• Nausea, dizziness, rapid heartbeat or rapid breathing, confusion, weakness, excessive sweating.
• Very low blood pressure or very low heart rate.
• Fever, chills, cough, or yellow-green mucus that comes up when you cough.
• Problems swallowing - shortness of breath, sore throat
• Severe pain in the sternum that does not go away for a long time.

Which doctors should I see if I have chest pain?

• Pulmonologist
• Hematologist
• Gastroenterologist
• Traumatologist
• Therapist
• Cardiologist
• Psychiatrist
• Phthisiatrician