Vaginal pain

Vaginal pain is a complaint that doctors often hear, especially ambulance doctors. Diagnosis of these pains is quite complicated, because it can be either direct pains or irradiating ones - giving to the chest from other organs.

Why is the chest pain difficult to diagnose?

• If the chest pains are localized at the top of the chest or abdomen, then this can be a cardiovascular disease
• If the pain behind the breastbone is connected with the internal organs, it can give in both the chest and the abdominal cavity
• A person can describe the pain in his own way, that is, perceive it individually, and by these signs it is very difficult to recognize the real cause of pain
• Great importance in determining the cause of retrosternal pain has an anamnesis - and for its thorough conduct, you need maximum interaction between the doctor and the patient, as well as the high qualification of the doctor
• The patient's physical data are very important for determining the causes of chest pain, but this will also require additional tests

What causes chest pain?

With the chest pain of acute origin, the doctor can assume the following causes that threaten human life. Among the most common diseases that cause chest pain, there may be the following:

1. acute myocardial infarction
2. unstable angina
3. pulmonary embolism
4. esophagus
5. aortic dissection
6. spontaneous pneumothorax

If all these diseases are excluded (and they all threaten life), then a person needs additional diagnostic tests. They are conducted in the clinic, and with acute pain - observation in the hospital.

What kind of retrosternal pain?

Pain can be sharp, sharp, piercing - such pain can be muscular-skeletal in origin. In 74% of patients, doctors can diagnose pleurisy. Of all the patients, 14% of the chest pains may be non-pleural.

Symptoms of pain in different diseases are difficult to diagnose even because they may not be completely characteristic of a particular disease. For example, retrosternal pain in patients with a heart attack can be perceived as burning, although sometimes manifested as a pressure. Conversely, with a stomach illness, the pain can be burning, but it is perceived as a pain due to a heart attack.

Where can the chest pain give?

Pain with angina pectoris is almost always supplemented with a retro-intestinal component, as with other causes of pain caused by diseases of the internal organs. Such pains can be delivered to completely different places, not those from where the source of pain comes from. Angina usually gives pain to the shoulder, neck, the inside of the hands (or just the left arm).

Patients who complain of aortic dissection, give to the upper abdomen and back. It depends on how far the aorta has become.

When a patient has gastro reflux disease, in other words, esophageal reflux, pain rarely renders to another area, but still such cases happen. In 20% of the pain can give back, sometimes in the arms and shoulders (when the pain is particularly pronounced and the disease is in an acute stage).

When do the chest pain begin and how long does it last?

The chest pains, which are due to the angina pectoris (angina pectoris), last much less than the pain in case of a heart attack. Their duration is from 5 to 15 minutes, and with the infarction of pain this time is not limited. Pain with angina go away after taking nitroglycerin and it is very important to lie still, do not move and do not act.

If the angina is unstable, the chest pain may not pass for 15 minutes. Pain behind the sternum can continue even at rest and after nitroglycerin do not pass.

And with variant angina pectoris pain may occur even at night, not to mention the state of rest. Nitroglycerin can help this pain to subside. Those who have variant angina may even engage in moderate physical activity.

Pain with a heart attack increases and does not pass after half an hour. Vaginal pain with ischemia of the heart can gradually increase, then reach a peak, and then the person does not stand up and causes an "ambulance". Pain in the chest due to aortic dissection or pulmonary thrombophlebitis may first be intense, and then gradually subside.

Pain with foodborne illnesses can manifest as burning, or it hurts in the throat when swallowing, or spasms. Heartburn most often manifests itself in a quarter of an hour after eating, especially if it was a plentiful dish and fatty besides. Heartburn can become active in certain poses. For example, when a person bends down or lies down on the left side or back.

Chest pain in the esophagus is called loneliness, if this pain occurs during passage of a lump of food through the esophagus. The nature of this pain can be burning, because food irritates the mucosa of the esophagus. The pain may be short-lived, but rather acute, especially if the food passes through the narrowest place of the esophagus.

If the esophagus spasms, the pain can be blunt and localized in the center of the chest. The duration of this pain can vary from a couple of excruciating seconds to 10 minutes.

Because of similar symptoms, the pain in the esophagus and the pain in the heart are very difficult to distinguish. In addition, diseases can be combined. Statistics argue that almost a third of patients with myocardial infarction or unstable angina may complain of pain due to heartburn. Such a retrosternal pain can cut a person for several hours, although the minimum duration is a few seconds. In addition, retrosternal pain manifests itself when palpation of different parts of the chest.

What prevents accurate diagnosis of chest pain?

Special schemes for determining the causes of retrosternal pain have long been developed. But there are additional circumstances that can interfere with accurate diagnosis.

Diagnosis, which concerns the examination of patients with acute myocardial infarction, is complicated because doctors do not take into account other causes of chest pain, except for myocardial infarction. But the cause may be pain in the gastrointestinal tract, which remain unrecognized.

The probability of diagnosing a particular disease is very difficult to apply to a patient with these or other characteristics.

Not every diagnosis can reveal all the symptoms of diseases, because each patient is different

Diagnosis of chest pain

In the emergency department, a typical approach to chest pain involves diagnosing the most dangerous causes: heart attack, pulmonary embolism, aortic dissection, esophagus rupture, pneumothorax and cardiac tamponade. Often the real cause of retrosternal pain is not so easy to detect.

If a person has a presumably acute coronary syndrome ("unstable angina"), many doctors take an anamnesis, then an ECG, then diagnose heart enzymes. In some cases only complex diagnostics can determine the cause.

As with all diseases, in which the main symptom is chest pain, a thorough medical history and physical examination will help. Express diagnostics can save a person's life and can often be done without the help of an X-ray or a blood test (for example, with aortic dissection). But in general, more research is often needed to establish a diagnosis.

The physician pays attention to the last changes in the state of health, family history (with premature atherosclerosis, increased cholesterol), smoking, diabetes and other risk factors in determining the causes of retrosternal pain.

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When determining the chest pain, the following diagnostic methods are used:

• X-ray examination of the chest and / or abdominal cavity
• CT scan can be very good, but not always available (for example, in the district clinic).
• Electrocardiogram (ECG)
• CT angiography of pulmonary (with suspected embolism of the pulmonary artery)
• Blood tests:
• Clinical blood test
• Analysis for electrolytes and renal function (creatinine)
• Hepatic enzymes
• Serum lipase, to eliminate acute pancreatitis

Recurrent pain can be a sign of serious diseases that require careful examination and treatment, so you can not ignore this symptom.