Chest pain what to do. Causes of chest pain in the middle, how to distinguish between cardiac discomfort and what to do. Neurological and articular causes of recurrent chest pain

Chest pain is a sign of several pathological conditions, some of which pose a direct threat to life. Diseases that are not vitally dangerous also lead to the onset of a symptom. An important skill for people who are far from medicine is the ability to distinguish between vital and relatively harmless pain, provide first aid, and stop a heart attack.

What can hurt in the sternum in the middle

There are 6 main causes of discomfort in the chest area.

Angina pectoris, heart attack

It develops suddenly, more often after exercise, due to spasm of the coronary arteries and oxygen starvation of the myocardium. Sensations arise directly in the center of the sternum or radiate to any point of the body on the left side. There are cases when heart pains were accompanied by tingling in the heel, dental phenomena, numbness and soreness in the hand or stomach area. The nature of the pain is compressive, pressing, often pulsating.

Neuralgia, osteochondrosis

The result of inflammation of large nerve trunks (and intercostal ones too). Unpleasant sensations occur against the background of hypothermia, intensify gradually, reach a maximum on the 2nd-3rd day of illness. In some cases, the onset is abrupt, the pain is stabbing in nature. Backaches debut at the time of physical exertion, with body tilts. May occur in the sternum on the right and left.

Respiratory diseases, colds, bronchitis, tracheitis

Feelings are weak or moderate, worse with coughing. Physical activity does not affect the severity of the symptom. There are other signs of URT infection: shortness of breath, fever, general toxic syndrome, sputum.

Injuries of the sternum, esophagus, respiratory tract

The patient's history has a damaging effect: blows, foreign body stuck, falling from a height onto the chest, medical manipulations (bronchoscopy). The pain is moderate, often dull in nature. There are concomitant signs: hemoptysis, vomiting of "coffee grounds", uncontrollable cough, acrocyanosis in case of damage to the upper respiratory tract.

Hypertension

The development of an attack leads to stress, refusal to take medication prescribed by a doctor, physical activity. Chest pain is localized behind the sternum, to the left and right of it. The nature of the sensations is similar to a heart attack, the pain can be partially stopped with nitrates. The patient may experience nausea. Pathology is accompanied by aching headache in the back of the head. Sometimes a flush develops, a feeling of heat.

Heartburn

Reflux of gastric juice into the esophagus, irritation of the mucous membranes. Accompanied by belching, burning behind the sternum, difficulty swallowing. The attack occurs after eating or when the patient is lying down.

It is not always possible to make an accurate diagnosis without appropriate examinations. In some cases, the symptoms are blurred or resemble another disease. If a person has pressing pain in the sternum in the middle, changes in the cardiovascular system should be suspected first of all.

A differential test to rule out a heart attack is a drug test. A Nitroglycerin tablet is placed under the patient's tongue or Nitrospray (Isoket) is sprayed. If within 1-2 minutes the patient's condition has improved markedly, then there is a coronary pathology. The lack of effect indicates a different origin of pain.

Note: the reaction to nitrates is absent in acute myocardial infarction. There are a number of other signs that make it possible to suspect this disease. Diagnostic difficulties arise with an erased and asymptomatic course.

Another sign that allows you to suspect a coronary attack is the persistence of pain at rest. With neuralgia and injuries, the symptom intensifies during movement, however, it partially subsides when the patient is in a supine position. In infectious diseases, pain occurs mainly during coughing.

A characteristic sign of neuralgia is an increase in discomfort when tapping with fingers on the edge of the costal arch. In addition, the intensity of pain increases when trying to stand up, sit down. Sometimes there is irradiation to the area of the shoulder blades. Neuralgia does not radiate to other parts of the body.

When to Call for Emergency Help

Emergency measures are required for patients with intractable heart attack and suspected myocardial infarction. If there is a history of ischemic disease, and the pain is compressive, it is necessary to call the SMP team, regardless of the severity of the accompanying symptoms. The classic signs of AMI include:

A sharp decrease in blood pressure to shock numbers (70/40).
Constrictive or dagger pain behind the sternum.
Pallor.
Violation of consciousness up to its loss.
Cold sweat.
Lack of effect from taking nitroglycerin.
Swelling of the jugular veins.
Tachycardia more than 100 beats per minute.

25% of AMI are asymptomatic or have an indistinct clinical picture. There are gastralgic (pain in the stomach), asthmatic (shortness of breath), anginal (resembling an infection of the upper respiratory tract) variant of the course.

The help of the SMP is required for patients with injuries of the esophagus, respiratory tract. A sign of a severe injury is:

Black or brown vomit.
Cough with much red blood.
Intense pain in the esophagus.
Decrease in blood pressure by 10–20 mm Hg. Art. relative to the usual values.
Open wounds in the sternum.
Crepitation of bone fragments.
Strong blows to the problem area in the recent past.
Shortness of breath, increased breathing by 20% of the norm and above.
Blue shade of earlobes, lips.

In the absence of the described signs, emergency medical attention is not required. The patient is recommended as soon as possible a visit to the clinic to the local doctor.

Diseases according to accompanying symptoms

In the absence of characteristic signs, the diagnosis is carried out according to the phenomena that are observed in the patient.

Difficulty breathing when inhaling

It occurs due to a mechanical obstruction in the airways. If a symptom is detected against the background of complete health, the presence of a foreign body is first suspected. The gradual development of the "clinic" gives grounds for oncological alertness. In some cases, the phenomenon occurs against the background of paralysis of the diaphragm, however, there is no pain in the sternum.

Lump, gives in the throat

An extremely non-specific sign is noted in patients with angina pectoris, inflammatory diseases of the upper respiratory tract, tantrums, with a dry cough (as well as in people suffering from vegetovascular dystonia). In combination with squeezing pain, it is an indirect sign of a heart attack, if there is a cough - infectious processes.

Gives in the back between the shoulder blades

It occurs mainly in neuralgia and osteochondrosis. Backaches indicate compression of the nerve trunks by an intervertebral hernia or spasmodic muscle layers.

Dry cough

In 90% of cases, it is evidence of infectious diseases, including acute respiratory infections, acute respiratory viral infections, whooping cough. Occurs when the airways are not completely blocked by a foreign body or tumor. It occurs in 0.5–1% of people with a heart attack.

Pain in the middle of the sternum when moving

It is a sign of stable angina (attacks only during exercise) or neuralgia. The symptom should be evaluated as part of the overall clinical picture. If sensations occur during physical exertion, there is a history of coronary artery disease, the phenomenon is stopped by nitrates, then a conclusion is made about cardiac origin. Lack of effect from nitroglycerin, irradiation to the shoulder blades, connection with physical activity, recent hypothermia - evidence of inflammation of the nerve trunks.

Diagnostic methods based on external signs do not accurately determine the disease. The patient needs an objective examination, including taking an electrocardiogram at rest and under stress, sputum analysis, chest x-ray.

First aid what to do

Events are fundamentally different for each of the considered states. If it was not possible to accurately determine the disease, it is recommended to provide the patient with rest, an influx of fresh air. With low blood pressure, lay the person so that the legs are above the level of the head. If breathing problems are present, the front end of the bed should be raised. A semi-sitting position is recommended. After that, you need to call the doctors.

Heart attack

The basis of emergency measures is the use of fast-acting nitrates. If the paroxysm has developed at the time of physical activity, it is stopped. The patient is placed in bed, the position of the body is free. A quick way to introduce nitrates is to spray Isoket spray. One press releases 1.25 mg of Isosorbide dinitrate. It is better to apply the solution to the sublingual space (from 1 to 3 doses of the drug).

It is permissible to use tablet forms of drugs, nitroglycerin. Assigned to 0.5-1 mg under the tongue. Before the doctor arrives, do not exceed the minimum dosage. If after 5 minutes after taking the improvement has not come, the introduction is repeated. The lack of effect from 3 doses of Nitroglycerin indicates the development of AMI.

With a pronounced decrease in blood pressure, nitroglycerin is not used. The drug dramatically expands the blood vessels, leading to increased hypotension and the development of the steal syndrome. In 1/3 of patients with intact consciousness, a severe short-term headache occurs.

Acute myocardial infarction

With AMI, help lies in the speedy hospitalization in the ICU. At the prehospital stage, the patient should be allowed to chew ½ tablet (150–200 mg) of acetylsalicylic acid. If the SBP is kept above 90 mm Hg. Art., and the pulse is more than 50 beats per minute, it is permissible to give 1 tablet of Nitroglycerin under the tongue (ACC / ANA recommendations from 2002). With tachycardia, Propranolol is indicated at a dose of 0.5-1 mg / kg of body weight. All but ASA should be used only if it is not possible to immediately hospitalize a person for one reason or another.

Neuralgia, osteochondrosis

With severe pain, the patient should take any non-steroidal anti-inflammatory drug (Analgin, Ibuprofen, Paracetamol). Therapy can be supplemented with muscle relaxants (Mydocalm, Tolperison). Rest, dry heat on the affected area, temporary restriction of physical activity are recommended. In the presence of an intervertebral hernia, the patient should consult with a neurologist to assess the possibility of surgical treatment of the disease.

Foreign bodies of the upper respiratory tract and esophagus

Removing a foreign object should be done as quickly as possible. Waiting for the arrival of doctors in this situation is impractical. To remove a foreign object from the respiratory tract, the patient should be laid so that the head and chest are below the level of the pelvis, then a strong pat on the back in the area of the shoulder blades. If consciousness is preserved, assistance is provided in the patient's standing position. The victim should be clasped with his hands from behind so that the palms close in the epigastric region. When a person tries to cough, it is necessary to increase the expiratory pressure with a sharp push upwards. Often this method allows you to remove the item in 1-2 attempts.

In the presence of foreign bodies in the esophagus, emergency measures for their extraction are not taken. There is no threat to life. You should wait for the SMP car, transport the person to the health facility, where the object will be removed using special endoscopic equipment.

Injuries of the respiratory tract, esophagus, accompanied by bleeding

Before the arrival of doctors, the victim should be given a semi-sitting position. Ice wrapped in a soft cloth is placed on the projection area of the sternum. The use of tableted hemostatic agents is acceptable, but in case of massive bleeding it is not advisable. Moderate hemorrhages are an indication for taking Etamzilat at a dose of 20 mg / kg of body weight. It is necessary to ensure the patency of the respiratory tract and prevent their obstruction by blood clots. To do this, the patient's mouth is periodically cleaned with a twist of the bandage (without unfolding) or with a gauze swab wound around the index and middle fingers.

In case of injuries of the sternum, the patient should be given a supine position without a pillow, ensure peace. With severe pain syndrome, analgesics are prescribed. If open wounds are present, a gauze dressing should be applied to stop bleeding and prevent infection. Treatment with antiseptic compounds is carried out only along the edges of the damage. It is strictly forbidden to pour solutions into the wound.

ARI, ARVI, bronchitis

The patient should be kept calm. If the body temperature exceeds 38 ° C, give an antipyretic (Paracetamol, Aspirin). The patient should not be covered with a warm blanket even if he complains of chills. Let's just allow a light blanket. To facilitate breathing and reduce soreness, inhalations with anti-inflammatory drugs are carried out. With bronchospasm, hormonal drugs (Pulmicort) are used. The general toxic syndrome is stopped with the help of complex compounds (Coldrex, Rinza, Theraflu).

Hypertension

Elevations of blood pressure by 20 units and above require medical correction. The first aid drug is Captopril. Take the drug at 25 mg, under the tongue. The medicine begins to act within 20-25 minutes. Do not try to relieve pressure quickly. Normalization of indicators should occur over several hours. Otherwise, there is a risk of vascular collapse. In the absence of Captopril, it is allowed to use Dibazol (0.02 mg) in combination with Papaverine (40 mg). Hospitalization is required when blood pressure rises by more than 30–40 units from normal, in the presence of a hypertensive crisis clinic (a sharp deterioration in well-being, severe headache, impaired vision, coordination, neurological failures).

Heartburn

For a one-time elimination of unpleasant symptoms, you can use enveloping agents (Maalox, 1-2 sachets per appointment). In addition, systemic antacids (Famotidine tablets 20-40 mg) are effective. It is not recommended to use baking soda to reduce acidity, since the neutralization reaction that occurs in the stomach leads to the release of gases and overstretching of the walls of the organ. A similar method can be used once if there are no other means of combating heartburn.

Doctor's conclusion

Soreness in the chest area is a serious symptom that requires careful differential diagnosis. It should be borne in mind that some deadly diseases appear outwardly harmless. Therefore, self-medication is not worth it. The patient should be given first aid, then consult a doctor. Only a specialist with diagnostic equipment at hand will be able to accurately determine the causes of pain and prescribe treatment.

Any pain syndrome signals a malfunction in the body. If pain occurs in the region of the chest, including in its central region, there is a high probability of pathology of the organs located in it. Timely diagnostics, which allows to determine the disease at an early stage of its development, and the accuracy of the medical report are very important for a successful cure.

Unpleasant sensations can be the result of both diseases of the organs in the area of pain concentration, and be an echo of neighboring ailments (radiating pain).

The thorax, consisting of the sternum, spine, ribs and muscles, is a protective structure for the organs located in the chest cavity.

They belong to several important systems:

respiratory;
digestive;
nervous;
lymphatic.

Causes of discomfort in the center of the chest: diseases of its bone and soft tissues, diseases of the organs that are located inside it.

Why can the chest hurt

There are several factors that cause pain syndromes. Diagnosis is often complicated due to the irradiation of pain and the similarity of the symptoms of some diseases.

Pathologies of the respiratory system

Inflammation of the lower respiratory system, consisting of the larynx, trachea, bronchi and lungs, is often accompanied by spasm-related pain in the chest during inhalation or coughing.

Tuberculosis affecting the lungs (sometimes other areas) is characterized by coughing up blood and sputum, swollen lymph nodes, tachycardia, pulmonary rales, shortness of breath, pyrexia, loss of appetite, and chest pain.
During pneumonia, in which inflammation affects the lung tissue, patients are not uncommon: fever, wet cough, myalgia, shortness of breath, cyanosis, aching chest pains that become stronger when a person coughs.
With tracheitis, the temperature rises, wheezing, coughing, chest pain when inhaling are noted.
A significant concentration of pleural effusion (sometimes the concentration of fluid in a limited area is diagnosed) leads to compression of the diaphragm and muscles, which causes pain. Pleurisy is often accompanied by acute pain, which can be confused with heart.
Inflammation of the mucous membranes, and sometimes the layers of the bronchial wall, with bronchitis is characterized by: passing from dry to wet cough, mild fever, lethargy, apathy and pain radiating to the back and other areas.
Neoplasms in the respiratory system lead to constant pain when inhaling, coughing up blood, tachycardia, shortness of breath, and sometimes to fever.

Important! Constriction and pain in the chest can also be the result of atopic asthma, pneumothorax, hydrothorax, pulmonary embolism, inflammation of the bronchi from descending purulent discharge in sinusitis.

Osteochondrosis

A common source of chest pain is osteochondrosis. In cartilage, which is an integral part of the joints, degenerative-dystrophic deformations are observed. They usually affect the discs between the vertebrae.

This disease, which manifests itself in the thoracic, cervical, lumbar and sacrococcygeal sections of the spine, develops with age-related changes, a sedentary lifestyle, and dynamic overloads. It is also associated with chronic ailments, metabolic disorders, excess weight, hypertension. Osteochondrosis of the thoracic region is accompanied by pain of varying intensity in the chest and back.

Important! Often, malaise is mistakenly attributed to heart disease, and the wrong treatment is started.

Diseases of the cardiovascular system

With heart disease, pain is usually felt in the left side of the chest, but can radiate to other departments, felt in the middle of the chest cavity.

Pain is caused by angina pectoris, cardiac neurosis, myocardial infarction, coronary artery disease, aortic aneurysm. Aching, prolonged painful sensations, a feeling of constriction and burning combined with shootings.

Diseases of the digestive system

Digestive ailments often lead to discomfort in the center of the chest.

An ulcer of the stomach and / or 12 duodenal ulcer during an exacerbation can lead to pain in the sternum, often perceived as heart attacks. The difference lies in the dependence of pain in stomach ailments on eating food.
Pain in the chest is also caused by gastroesophageal reflux disease, when the contents of the duodenum or stomach are thrown into the esophagus. It affects itself (its mucosa), and sometimes the higher organs.
Pain behind the sternum is felt with a hernia of the diaphragm. Symptoms often resemble an angina attack. But the discomfort caused by a hernia usually manifests itself when lying down and disappears after getting up. It does not depend on physical activity, reminds of itself after eating.
Chest pain occurs due to the formation of gallstones or inflammation of the pancreas.

Injuries

Painful sensations of varying intensity can be caused by a fall or a blow. Bruises leading to damage to muscles, blood vessels or skin, resulting in hemorrhage, are manifested in the appearance of edema and swelling. Pain is caused by movement or touching the affected area. In the case of more serious injuries that a person receives in a fall, accident or strong blow, there may be a violation of the integrity of the soft tissues, fractures or cracks in the skeleton of the chest.

Incorrectly organized physical activity

After active sports or physical work, the chest often hurts. The malaise is called krepatura. It is associated with the release of lactic acid by muscle tissues, which irritates receptors, microfractures of muscle fibers. This syndrome is not dangerous, it passes in a few days. You can avoid the onset of the disease by properly organizing a workout or work and providing the body with a sufficient amount of vitamins A, E and C.

In addition to the indicated ailments, pain in the center of the chest leads to:

Chest diagnostic methods

When conducting a diagnosis, it is necessary to take into account many characteristics of discomfort:

concentration and type of pain;
its duration and depth;
circumstances that provoke the occurrence of pain;
conditions for relief of pain.

The diagnosis is made by means of physical, laboratory and instrumental methods.

Respiratory examination

During the first examination, pulmonologists perform:

Instrumental methods allow for more informative diagnostics.

X-ray in several projections helps to determine the localization of inflammation.
Bronchoscopy is necessary for examination and assessment of the condition of the mucous membrane of the trachea and bronchi.
Thoracoscopy is prescribed to examine the pleural cavity.
Spirography allows you to determine the efficiency of the lungs.

Identification of diseases of the cardiovascular system

Failures in the work of the CCC can be detected even when visiting a therapist through physical methods. With the help of palpation, the strength and height of the heart beat are determined. Percussion of the heart helps to establish its position, size and configuration.

Auscultation using a stethophonendoscope determines the noise, characteristics of heart sounds.

The use of a tonometer (pressure and pulse are measured several times a day) allows you to establish the presence of hypertension or hypotension, to identify tachycardia and arrhythmia.

If any deviations are found, further examination is carried out.

Examination of the digestive system

During the initial examination, physical methods are used to obtain an approximate assessment of the patient's condition. In the future, it is required to pass a general analysis of urine and blood, as well as conduct a biochemical blood test. More accurate data will help to obtain additional instrumental examination.

Probing is prescribed to study the gastric juice, its indicators, it allows you to find out the balance of acidity.
Endoscopy is performed to examine the condition of the small and large intestines.
Radiography is aimed at determining the contours of different parts of the digestive system, defects in their walls.
Ultrasound is usually used to examine the condition of the pancreas and gallbladder.
MRI and CT scans are done when pancreatitis, gallstones, or tumors are suspected.
Impedancemetry of the esophagus is necessary to study the peristalsis of this organ.

Diagnosis of osteochondrosis

The neurologist examines the spine in various positions. As a result, the nature and localization of the problem is determined.

An accurate diagnosis with the identification of possible hidden pathologies can be made after instrumental examination methods: radiography, MRI and computed tomography.

How to relieve pain

If the causes of pain in the middle of the chest are known, it is necessary to take a prescribed medicine to stop them. Nitroglycerin helps to stop heart pain. Attacks of osteochondrosis are relieved by painkillers.

"Nitroglycerine"

Discomfort associated with muscle problems is relieved by physiotherapy and massage.

Table. Treatment regimens for individual organs

Disease	Treatment method
	In case of illness, antibacterial, antiviral, anti-inflammatory, antihistamines, cough medicines are prescribed. The diet, plentiful drink is shown.
	The pain is relieved with analgesics. The temperature is normalized with antipyretic compounds. Drugs are prescribed to relieve inflammation, increase immunity. The exudate is removed. Physiotherapy, exercise therapy, diet are shown.
	A special diet is needed: hot and fatty foods, citrus fruits are prohibited. Portion sizes should be limited. You can not sharply lean forward after eating, wear squeezing clothes. Drug treatment consists of taking antacids and prokinetics.
	Cytoprotectors, antacids, calcium channel blockers, antibiotics, probiotics, agents to suppress excessive production of acid and enzymes, prokinetics, drugs that calm the central nervous system are prescribed.
	Beta-blockers, calcium channel blockers, nitrates, ACE inhibitors are prescribed.

When the pain is sharp, the patient weakens and loses consciousness, it gets dark in his eyes, nitroglycerin does not help - it is urgent to call the doctors.

The appearance of pain in the middle of the chest can signal the presence of a serious illness. Its relief with painkillers will not lead to the elimination of pathology. The only sure way to solve the problem will be to seek help from a medical institution.

Video - Medical treatment of osteochondrosis

Osteochondrosis of the thoracic spine is a slowly progressive disease. Degeneration of intervertebral disc tissue does not occur overnight. And not even in one month. And it is very difficult to notice the development of the disease at an early stage due to the fuzzy symptoms. However, treatment should be started as soon as the diagnosis is made in order to exclude the possibility of protrusions and hernias, as well as the complications associated with them. On our website you will find

A feeling of discomfort or pain of a different nature in the chest in the middle was experienced by many people. Such pain rarely appears by chance and most often its appearance is promoted by physical overstrain or a serious illness in a person. First of all, pain when inhaling in the sternum in the middle is associated with cardiac pathologies. However, there can be many other reasons for this, including spinal diseases, pulmonary and neurological diseases, and rib injuries.

Regardless of the cause of such a symptom, its manifestation cannot be ignored. In any case, it is necessary to urgently consult a doctor in order to identify the source of pain and exclude causes that are dangerous to human life.

Feeling of pressure in the chest

Dull pain in the sternum in the middle, of a pressing nature, occurs in 95% of cases and more. This is its main type for heart problems.

The main reason is a long-term ischemic process. There are two types: heart attack and angina pectoris. At their core, both are varieties of coronary insufficiency. The second proceeds more gently, over a long period of time.

Attention:

The duration of the pain episode is not more than 30 minutes. Anything above that could indicate a heart attack.

Hospitalization is required for urgent care and clarification of the cause of discomfort. The pain radiates to the left arm, between the shoulder blades, to the neck.

The essence of the process lies in the gradual destruction, death of the myocardium. In contrast to the avalanche destruction on the background of a heart attack.

Sooner or later, an emergency will occur, if angina pectoris is not treated, acute necrosis will occur in the future of 3-5 years.

Recovery is required on an ongoing basis. The disease is divided into 4 functional classes (abbreviated as FC), in fact, this is a distinction in severity.

The first FC gives a complete cure. The duration of therapy is about six months. Starting from the second, the probability of a total recovery is zero. But survival is good.

Each case is considered individually, there are no universal recipes and forecasts. Sharp pain in the sternum, unbearable in intensity, can also indicate a heart attack.

Treatment Methods

Depending on the disease that provokes pain, treatment is prescribed. Medicines are used, as well as folk remedies and alternative therapies.

Medications

Pain in the sternum in the middle will help eliminate medications from different groups, which are selected depending on the underlying disease.

The most effective means:

Nitroglycerine- the most popular drug that is prescribed for an attack of heart disease. It helps to normalize the functioning of the organ and eliminate heaviness, pain in the sternum. When a symptom occurs, put 1 tablet under the tongue. If there is no effect, it is allowed to take the medicine again after 40 minutes. The drug is not used for course treatment. Cost - from 50 rubles.
Barboval- a remedy in the form of drops, used for pain in the sternum, provoked by angina pectoris or other pathology of the heart. If discomfort occurs, it is necessary to take 25 drops of the medicine, it is allowed to repeat it 2 times a day for 7-10 days. The tool has a sedative property and eliminates pain. Price - from 120 rubles.
Validol- the most popular medication used for chest pain, as well as heart rhythm disturbance and tachycardia. Helps to quickly eliminate the manifestation, not used in courses. If pain occurs, put 1 tablet under the tongue, if necessary, repeat after 2 hours. The cost of the medicine starts from 20 rubles. for 10 tablets.
Atenolol- a drug from the group of beta-blockers, which is prescribed to eliminate pain in the sternum, provoked by heart disease. The drug reduces the heart rate by reducing myocardial oxygen demand, this allows you to reduce the load on the muscle, slightly lower blood pressure. It is necessary to take tablets in courses of 2-3 weeks. The patient should take 1 tablet in the morning and evening. The price of the product is approximately 80 rubles.
Spazmalgon- antispasmodic, used for pain that is provoked by muscle spasm or intercostal neuralgia, osteochondrosis. The patient is prescribed tablets, which he must take 2 pieces per day. The duration of the course should not exceed 10 days. The price of the drug starts from 60 rubles.
Rennie- a means to reduce the acidity of gastric juice, which is used in the case when the pain is associated with an exacerbation of gastritis or peptic ulcer. Helps to quickly eliminate heartburn and discomfort, improves the functioning of the body. The patient is prescribed chewable tablets, which he takes 1 piece 3-4 times a day for 3-5 days. Price - from 150 rubles.
Omez- a medicine that blocks the production of hydrochloric acid and protects the walls of the stomach from its negative effects. The patient is advised to take it in case of pain in the sternum associated with pathologies of the stomach. The course lasts 3 weeks, should be taken 1 tablet 3 times a day. The price of the product is from 100 rubles.
Ketorol- non-steroidal anti-inflammatory drug with analgesic properties. Helps eliminate pain caused by osteochondrosis, additionally eliminates discomfort in the thoracic spine. It is allowed to use tablets no longer than 7 days in a row, 2 pieces per day. The cost of the medicine is approximately 130 rubles.

The patient may be prescribed one or more drugs, depending on the severity of the underlying disease.

Folk methods

The pain in the sternum in the middle can be eliminated with the help of alternative medicine recipes that have sedative properties. Typically, prescriptions are used for suspected pathologies of the heart and digestive organs.

Alternative medicine prescriptions can only be used if there are no contraindications, and also after consulting a doctor.

Other methods

Among the alternative methods of treatment, diet therapy and relaxation therapy can be distinguished. These methods have a beneficial effect on the whole body, improve well-being, facilitate the work of the heart and reduce the frequency of symptoms. The main advantage of the methods is that they are effective for pain of any origin.

Diet therapy involves the exclusion from the menu of the following products:

Canned food.
Marinades.
Smoked products.
Confectionery.
Fat meat.
Fatty dairy products.
Alcoholic drinks.
Carbonated drinks.
Fast food.

In addition, do not abuse caffeinated drinks. The diet should consist of a small amount of boiled or stewed meat, fish, fresh and stewed vegetables. It is useful to include cereals, boiled potatoes, greens in it. Among dairy products, preference should be given to those that contain a minimum amount of fat. Such a diet is recommended to be followed constantly.

Relaxotherapy involves daily relaxation with the use of suitable music. After a hard day, the patient is advised to take a comfortable position, turn on the sounds of nature and breathe deeply for 20-30 minutes, feel how the tension leaves the body, and the brain is released.

After 2-3 sessions, relaxation will come faster, and overall well-being will improve significantly. The minimum course consists of 20 daily sessions, but it is better to use the technique constantly.

Backache

Periodic, short-term tingling rarely accompanies cardiovascular disease. The approximate frequency is 20-25%. If there is a connection with cardiac pathologies, then they talk about such conditions:

Prolapse, stenosis or infection of the mitral valve. This anatomical structure closes the gap between the left atrium and ventricle, preventing blood from moving in the opposite direction. With malformations, MK regurgitation occurs - a reverse flow of liquid connective tissue.

As a result, the contractility of the myocardium decreases, dilatation (stretching) of the chambers is formed, the amount of blood ejected into the large circle is significantly reduced. Gradually, the process leads to violations of the anatomical development of cardiac structures.

Recovery involves surgery at an early stage. The sooner it is done, the higher the chances of a complete cure.

Pain episodes are short. Often, patients do not pay attention to such a manifestation at all.

Stenosis of the aortic valve. This structure is located at the level of transition of the left ventricle into the main artery of the body. The role is identical: the movement of liquid connective tissue is strictly in one direction. Into a big circle.

Treatment is also surgical. Intense stabbing pains in the sternum are uncharacteristic, since the basis of the symptomatic complex is other manifestations: shortness of breath, weakness, drop or increase in blood pressure, and others.

Aortic aneurysm in progress. It is a special formation, wall protrusion of the artery. At the stage of formation, the pathological process makes itself felt with minimal discomfort.

Often there are no unpleasant sensations at all, the diagnosis is made on the basis of data from an objective assessment of the state of the vessels. Recovery is surgical, it consists in excising the changed area, but with great care.

Heart neurosis with cardialgia. Why exactly heart pain occurs is not fully understood. It is assumed that we are talking about the work of the central nervous system, insufficient braking speed.

The development of discomfort is directly caused by stress, mental overload. Typically, a symptomatic complex appears in patients with a special personality: vulnerability, impressionability, emotional lability as components.

A typical feature of pain of neurotic origin is the absence of evidence for organic pathology. Objective diagnostics does not show deviations.

No special treatment is required. Despite this, the intensity of lumbago is significant. Hypochondriacal patients may mistake an episode of neuralgia for a heart attack.

Vegetative-vascular dystonia. It is a non-specific syndrome. It develops as a result of diseases of the brain, hypothalamus, endocrine system.

Contrary to the beliefs of a significant part of the population and even the medical community, this is not a diagnosis, but a manifestation of a certain condition. You need to treat the underlying disease, but not the symptom.

Recovery is carried out under the supervision of a team of specialists. Heart pains are relatively short in duration and do not cause real danger to life.

Myocarditis. Or inflammation of the muscular layer of the heart. It is an infectious (viral, bacterial, fungal), less often an autoimmune process. Requires urgent treatment in a hospital. The phenomenon quickly leads to tissue destruction. This is a direct indication for prosthetics.

In rare cases, the pathological manifestation is caused by a change in the innervation of the heart.

Stitching pain almost never indicates cardiac problems. The probability is 20% or so.

Attention:

It is not worth completely excluding the cardiac nature of the manifestation. If there are complaints, it is recommended to urgently diagnose using ECHO, ECG, and at least measure blood pressure and heart rate.

Respiratory diseases

The organs of the entire respiratory system are located in the chest cavity, and their diseases can be accompanied by pain in the middle of the sternum. The most important of them are the bronchi, lungs and pleura.

Bronchitis, bronchial asthma and other bronchial diseases

With various infections, prolonged smoking, work with harmful substances, damage to the tissues of the bronchi occurs and bronchitis occurs. This often causes pain in the middle of the sternum, associated with muscle tension during coughing, which can be dry or wet. The bronchi themselves cannot hurt - they have pain receptors.

Pain, as a rule, is located in the middle, or on the side where the inflammation is more. It is aggravated by inhalation and by coughing.

Bronchial asthma is a chronic, allergic-induced disease of the bronchi. It is manifested by periodic attacks of suffocation, with difficulty exhaling. To diagnose bronchitis, a doctor listens to the lungs with a stethoscope. Bronchial lesions are visible on fluorography, CT, MRI. In uncertain cases, bronchoscopy is performed - the camera is inserted directly into the bronchi and examined from the inside. Bronchial asthma is established using special respiratory tests. Depending on the cause of bronchitis, antibiotics, expectorants (if the cough is dry), anticholinergics are prescribed to expand the lumen of the bronchi. About treatment regimens for acute Napsiano bronchitis here. What to do for the treatment of bronchial asthma, the doctor will say. He selects a special treatment, including a combination of drugs.

Pneumonia and pneumonitis

When bacteria, viruses, or chronic inhalation of small dust particles enter, inflammation occurs in the lung tissue. The lungs themselves do not hurt. They have pain receptors. The pleura can hurt when the inflammatory process spreads further. If the inflammation is caused by an infection, fever, coughing, and feeling unwell, such as with the flu, occur. With chronic damage to the lungs by a dispersion suspension in the air, an unproductive cough and discomfort in the sternum come to the fore. A mild respiratory tract infection can be treated at home: bed rest, hot tea with herbal infusions, expectorants, vitamins. In case of a serious illness, accompanied by high fever, severe weakness and pain, it is necessary to call a doctor who will give recommendations on what to do.

Doctor's advice

There are more than 50 diseases and conditions that are united by one syndrome - cardialgia, i.e. pain in the region of the heart, incl. - in the region of the sternum. By themselves, they are in no way connected with the work of the heart, but require the exclusion, first of all, of heart problems. Therefore, you should not try to diagnose your condition on your own - you need to consult a therapist. After the examination, the doctor will decide on further tactics - he will refer you for an examination or to another specialist (neurologist, gastroenterologist, cardiologist, etc.).

Victoria Druzhykina Neurologist, Therapist

Pleurisy

Pleurisy is the involvement in the infectious process of the lining of the lungs - the pleura. Fluid (exudate) can accumulate in it, which prevents the lungs from expanding - this causes pain in the chest. Characterized by a deep breath, lying on its side. More often pleurisy develops after or during pneumonia. Read more about pleurisy treatment here.

It is not difficult to make a diagnosis - pleurisy is visible on fluorography. But for treatment, a procedure is necessary to remove fluid from the pleural cavity, it can only be carried out by a qualified specialist.

Tumors of the respiratory system

Unfortunately, lung cancer comes out on top among other tumor diseases and has a high mortality rate. In the early stages, the tumor is very small and may not manifest itself. Pain in the sternum is a variant of the first symptoms that requires diagnosis. Sometimes a chronic dry cough without progression joins. What to do if a cough persists for a long time is to carry out a fluorography. In addition, you need to take blood tests, sometimes a bronchoscopy is prescribed.

If you have similar symptoms, you can consult a general practitioner and pulmonologist.

Feeling of heat in the chest

The burning nature of discomfort, on the contrary, often indicates an acute process, an emergency.

Typical reasons for the development of the manifestation are:

Heart attack. It is a pronounced malnutrition of the muscle layer of the organ. Dying away (necrosis) occurs, the intensity of blood circulation and the supply of tissues with oxygen and nutrients decreases.

Recovery is carried out urgently, in intensive care. Indicative is the ECG with typical features of the process.

After stabilization, heart failure of varying severity develops. This condition is corrected for the rest of his life with the help of drugs. They are taken constantly, some courses.

The result is post-infarction cardiosclerosis, that is, the replacement of dead tissues with scar tissue.

During the rehabilitation period and for some time after it, aching pain in the middle of the chest is possible. This is a bad prognostic sign. Indicates tissue ischemia (poor circulation).

Blockage of the pulmonary artery. It occurs as a result of the separation of a blood clot from the main site of development. A blood clot can be located anywhere, usually in the lower extremities.

Far from always, the formation closes the lumen of the vessel completely (otherwise death occurs, the last thing the patient has time to feel is a sharp, severe pain in the chest, then unconsciousness comes).

In such a situation, a burning sensation is possible, it is felt as an increase in temperature at a local level. Without competent urgent assistance, everything ends in death. Possible heart attack and other emergencies.

Burning pain occurs when an aortic aneurysm ruptures. It develops with the formed pathology. When the formation is destroyed, an intense outflow of blood is observed. Death occurs in a matter of minutes, if you do not provide urgent assistance. This is usually beyond the power of even professional doctors, not to mention people without training.

A rupture can be caused by trauma, a blow to the sternum, an increase in blood pressure, an infectious disease, and other factors. The only way to prevent is to detect and surgically eliminate the aneurysm in a timely manner.

Burning chest pain occurs not only in these conditions. It can also indicate acute ischemia (coronary insufficiency).

What to do if the sternum hurts

The cause of pain in the chest area can be not only somatic pathology, but also trauma. This is a very dangerous condition that requires rapid correction, as damage to vital organs is possible. After an injury, you must:

loosen tight clothing;
ensure maximum peace;
rub whiskey with ammonia;
give sedative and vasodilating drops (Corvalol, Motherwort, Valocordin) - this will improve myocardial function;
with severe pain - a couple of painkillers for the prevention of shock (Ketorol, Ketanov, Analgin);
cold on the chest;
if a fracture is visualized, immobilize;
warm the victim
be there until the ambulance arrives.

If the injury is caused by a wound, it is necessary to treat the surrounding tissues with an antiseptic (Miramistin, hydrogen peroxide, iodine, brilliant green), apply a sterile bandage, and cold on the wound.

The tactics of treating somatic pathology is complex. The main purpose of therapy is to relieve pain. For this, different groups of drugs are used in accordance with the cause of the pathology.

Pathology	Preparations
Vessels, heart	Appoint: Potassium-magnesium preparations (Asparkam, Panangin). Nitrates (Nitroglycerin, Nitrong). Cardiac glycosides (Celanide, Digoxin) With angina pectoris, a Nitroglycerin tablet under the tongue is enough, if after 5 minutes there is no result, you need to call an ambulance, since the patient's life (AMI) depends on it.
Respiratory system	Apply: Antibacterial (Levofloxacin, Amoxiclav, Ceftriaxone). Antiviral (Tamiflu, Cycloferon, Arbidol). Anti-inflammatory (Nurofen, Nise. Ibuprofen). Expectorants (Codelac, Ascoril, Lazolvan) In the future, a course of breathing exercises is required.
Digestive system	Use: Means that facilitate the passage of the food bolus (Ganaton, Motilium). Antiemetics (Zofran, Lotan, Avomit). Proton pump blockers for GU (Pantoprazole, Omez, Ultera). If Helicobacter pylori is detected, a course of antibiotic therapy (Clarithromycin, Flemoxin, Metronidazole). Severe pains stop - Maalox, Phosphalugel, Almagel. Drugs are used that lower the acidity of gastric juice and restore the integrity of the gastric mucosa (Polysorb, Helicol, Nolpazu). The entire period of treatment requires exclusion from the diet of fried, spicy foods, freshly squeezed juices, sweets.
Spine	Recommend: Antiarthralgics (Diclofenac, Voltaren, Nimesulide). B vitamins Thoracic osteochondrosis involves a set of special exercises. Intercostal neuralgia involves an injection course.
Nervous system	Cardioneurosis requires a special daily routine, elimination of stressful situations, diet therapy with a predominance of vitamins C, A, PP and group B, relaxing massage, acupuncture and vacuum therapy, herbal remedies: hawthorn, valerian, watch, veronica, sweet clover, oregano, St. John's wort, strawberries , hyssop, calendula, nettle.

With chest pain, men and women are equally common, so the approximate treatment regimen for its relief is common.

Ripple

It is found in developing myocardial infarction or an attack of hypertension.

The first state has already been described. As for GB, usually we are talking about a significant increase in the tonometer. This is the so-called crisis state. It is characterized by intensification, overload of cardiac activity.

It is possible to take the patient out of this situation only in a hospital. The longer the experience of hypertension, the higher the risk of an emergency.

Throbbing pain accompanies every heartbeat. Indicates insufficient efficiency in supplying the muscular organ itself with oxygen and nutrients.

Neuropsychiatric diseases

Sometimes a person goes to the doctor with a disturbing pain in the sternum, but after conducting research, it turns out that the person is absolutely healthy. In this case, the pain is psychogenic in nature, this condition is also called cardioneurosis. The patient himself describes his painful sensations, as if a lump or stone behind the sternum. There may also be a complaint about palpitations, interruptions in ri. As a rule, all these phenomena occur after emotional experiences. A person is very worried about retrosternal pain, suspects that he has a dangerous disease. In general, a person with cardioneurosis is characterized by anxiety, anxiety, multiple fears, insomnia and other manifestations of a suspicious nature.

Summing up all of the above, it should be emphasized the importance of a timely detailed diagnosis of pain in the sternum. It is very important to consider, after which the pain intensifies or vice versa decreases, where it radiates. In a situation with retrosternal pain, the first step is to exclude life-threatening diseases, such as myocardial infarction, aortic aneurysm dissection.

Grigorova Valeria, medical commentator

Liver intoxication: symptoms and treatment
Pancreatitis: symptoms and treatment

Aching discomfort

Occurs against the background of cardiac pathologies of a sluggish type and often as a result of non-cardiac conditions.

This may be hypertrophic or other cardiomyopathy, proliferation of organ tissues, acquired and congenital malformations of structures without critical impairment of functional activity, and others.

When complaining of aching pain in the chest in the middle, the measurement of blood pressure, heart rate, listening to the heart sound, evaluation of ECHO and ECG data are shown.

If necessary, MRI diagnostics is prescribed. Tumors of cardiac structures are possible, although such formations are rare and account for no more than 1.5-2% of all primary neoplasias.

Psychological illness due to stress

What to do with back pain between the shoulder blades? Or how to calm the muscles of the ribs if the back and chest hurt? Finding answers to these questions on your own is very problematic, especially if they appear against the backdrop of stressful situations.

You will be surprised, but problems with the chest, stomach and abdominal pain are closely related to psychological pathologies, and are accompanied by so-called psychogenic pains.

Such diseases can form if people are very worried. In the process, squeezing of the muscles is observed, as spasms occur in the chest.

If, in the presence of such disorders, people limit physical activity, for various reasons, then it is very difficult to eliminate pain in the lower chest or in its upper part. The fact is that it is impossible to get rid of muscle blocks while in a constant sitting position.

Other development factors

Not always discomfort, especially pulling pain in the sternum, is the result of cardiac pathologies. In 40-50% of situations, the cause is not related to the muscular organ at all.

Gastritis and stomach ulcer. In the first case, we are talking about inflammation, in the second - about the formation of erosions on the mucous membrane. Both conditions can give reflected discomfort. The chest is the main target.
Reflux esophagitis. Escaping acid back into the esophagus. With a long course of the pathological process, there are persistent aching pains in the epigastric region, the acute nature of the discomfort is atypical.
Chest injury. Fractures give the most sharp, pronounced sensations.
Inflammation of the lungs or pneumonia. infectious origin. From the left side. It is characterized by severe, pressing pains. Nitroglycerin has no effect.
Osteochondrosis. Degenerative-destructive disease of the spinal column.
Herniated discs (extrusions).
Myositis or inflammation of the skeletal muscles.
Intercostal neuralgia. Common cause of discomfort.

Chest pain above the solar plexus

In the role of the causes are inflammatory processes that affected the walls of the stomach. This leads to the release of the contents of the organ directly into the esophagus. These conditions can lead to:

stressful situations.
Abuse of alcohol-containing drinks.
Smoking, as well as addiction to spicy food.

It's a dull pain

If the pathology of the gastrointestinal tract became the cause of the pain, then the following symptoms may be observed:

aching compression in the left and central region;
uncomfortable aching sensations in the upper abdomen;
the appearance of heartburn and constant heat in the larynx;
nausea with pain in the middle of the chest, in some cases, vomiting.

Pain and lump in throat

Such symptoms also appear with the development of diseases that affect the gastrointestinal tract. Problems during swallowing (feeling of a lump in the throat), if there is a serious violation inside, can only be eliminated by complex treatment, revealing the type of developing disease.

Diseases of the esophagus

Malfunctions in the functioning of the gastrointestinal tract are accompanied by soreness in the central part of the chest. Unpleasant sensations arise due to spasms of the esophagus, as well as the stomach and even the gallbladder. In this case, there will be no burning behind the sternum, as with osteochondrosis.

The patient will experience dull, aching pain, which will intensify its manifestation with pressure on the epigastric zone. Often, discomfort is given to the back.

If the esophagus hurts, and other organs mentioned, you should not start self-treatment, it is better to immediately consult a doctor and undergo the necessary examinations.

Subdiaphragmatic abscess

When the bone in the middle of the chest hurts, we can almost always determine the probable causes of such sensations. But when the disease affects the lower part of the diaphragm (the muscular tube located between the abdominal and chest cavities), it is difficult to find intelligible answers.

This pathology is called "subdiaphragmatic abscess", during which purulent formations appear in the cavity. The fight against such a disease is often carried out by a surgical method.

If there is a need to immediately eliminate pain, you should give preference to a medication of the NSAID category (Ketanov, Ibufen, etc.). To prevent infection of nearby healthy tissues, Tsiprolet is most often used.

Pathologies affecting the bronchopulmonary system

Dull pain "bells" that appear in the chest area may indicate the presence of diseases that affect the respiratory system. This symptom often appears with the development of:

tracheitis;
pneumonia;
pleurisy, and bronchitis.

If pain is observed on the left side in the upper part of the chest or on the right side, you should also be alert.

The most commonly mentioned diseases are accompanied by difficulty in taking a deep breath.

It is very easy to explain the occurrence of these pathologies. Inflammatory processes occurring in the lungs can affect the intercostal muscles, as well as the diaphragm area. That is why the patient notices that the chest can hurt on the left side. Moreover, pain can appear in other areas, and they occur with any muscle contraction.

Additional symptoms include fever. In addition, there is often a prolonged cough.

How to make a delimitation

Discomfort of cardiac origin has a number of distinctive features:

Localized strictly in the center. Perhaps a slight shift to the left side, closer to the shoulder.
Gives to the shoulder blade, arm up to the hand, cervical spine.
The nature of the unpleasant sensation, as already mentioned, is pressure, burning, tingling (extremely rare).
When changing the position of the body, breathing, the strength of the pain does not change. This indicates a lack of communication with the musculoskeletal system, the lungs. Most likely it is the heart that is to blame. At the same time, walking and even more intense physical activity will lead to increased discomfort.
It is possible to stop with Nitroglycerin (1 tablet). This is a typical feature of cardiac pain. But with a heart attack, the action may be incomplete.
Pressure on the back or chest does not change the strength of the discomfort.
At rest, pain is relieved.

Attention:
These moments are not considered reliable diagnostic criteria. The share of subjectivity is great, at the same time, there are exceptions to every rule.

With the development of discomfort in the chest, if it lasts more than 10-20 minutes, it is recommended to call an ambulance to resolve the issue of transportation to the hospital.

Women's chest pain

The chest in women most often hurts exactly in the middle due to stress, emotions, experiences. In addition, discomfort can be provoked by:

mastopathy with irradiation of pain in the sternum;
goiter with pressure drops and intermittent pain syndrome;
obesity with excessive load on the spine;
tight underwear that compresses the nerve endings;
bad habits;
PMS with engorgement of the mammary glands before menstruation;
swelling of the chest with burning sensation around the glands and referred pain behind the sternum.

Sometimes it is quite difficult to figure out why it hurts here, a mandatory consultation of a specialist is required.

Reasons to call an ambulance

Among the signs that require a call to the ambulance:

Discomfort that lasts more than 30 minutes. Regardless of the degree of intensity. Likely to develop a heart attack. Better to be safe.
Severe, unbearable pain syndrome, not relieved by nitroglycerin.
Dyspnea. Eliminating even minimal physical activity. Occurs not only with dangerous phenomena, but also at the time of an attack of angina pectoris. Transformation into acute necrosis (heart attack) is possible. You don't have to wait for the transition.
Cephalgia (headache), dizziness. Especially if they are accompanied by the inability to navigate in space.
Paralysis, paresis.
Feeling of goosebumps all over the body or in certain areas.
Distortions of the face. Inability to control facial muscles.
Fainting, syncope. Especially repeated ones. Along with previous neurological symptoms, they indicate ischemia of cerebral structures and a possible stroke.
Slurring of speech. Fog in the field of vision, hearing loss.
Confusion of consciousness.
Paleness of the skin.
Cyanosis of the nasolabial triangle.

These signs do not 100% indicate not a heart attack, stroke or other emergency conditions, but they are very common with them. This arouses suspicion. Therefore, a thorough diagnosis is required in a short time.

Symptoms for which you should call an ambulance

If one or more of the above symptoms are present, the patient will not be able to identify the cause of the discomfort without the help of a doctor. An experienced specialist will help to correctly relieve pain in osteochondrosis of the spine, which has overcome the thoracic region or eliminate other pathologies.

There are a number of cases when you should consult a doctor without delay. Be sure to call an ambulance if:

there is a piercing pain, causing a feeling of loss of consciousness;
discomfort from the chest area is given to the shoulder or jaw area;
there was a feeling of compression of the chest, while there is an instability of the pulse, vomiting, and dizziness;
the pain does not disappear, and lasts more than 15 minutes;
discomfort in the cartilaginous tissue is complemented by high temperature and unstable breathing;
there is a bloody cough, and discomfort in the chest.

When should you go to see a doctor

There are also cases when the patient will be able to visit a specialist on his own, but without unnecessary delay. You need to make an appointment with a doctor if:

after a meal there is a burning sensation;
when inhaling and coughing, pain appears;
when changing the position of the body, discomfort is exacerbated;
in the process of taking the medication, the manifestations of the disease intensify.

List of required examinations

If it hurts in the middle of the sternum, the patient's condition is assessed on an outpatient or inpatient basis. Depending on the expected event. The minimum program is required against the backdrop of a likely urgent process.

It includes:

Measurement of blood pressure and heart rate.
Electrocardiography. It is used to assess the functional position of cardiac structures. Shows arrhythmias and typical features of a heart attack.
Echocardiography. Study of the anatomical state of the heart and surrounding tissues. The method involves the visualization of areas. It is possible to identify the degree of violation.

In particularly difficult situations, the results are not expected, the condition is stabilized, and only then they think about long-term therapy. In other cases, there is time for a thorough examination.

Additional measures: ambulatory monitoring, cardiac MRI, stress tests (with caution), coronography and blood tests.

Also, chest x-ray, FGDS (endoscopic method for assessing the condition of the gastric mucosa and esophagus), visualization of vertebral structures.

As needed, third-party specialists are involved, most often a neurologist. In the absence of data for organic defects, they speak of idiopathic cardialgia.

Literature

Galaktionova M.Yu., Voronina N.V., Rakhimova A.L., Mironova O.I. Neuroprotective therapy in the treatment of autonomic dysfunction syndrome in children and adolescents. 2013. No. 1.
Yakhno N.N., Parfenov V.A., Reichart D.V. Multicenter non-interventional prospective observational program to study the practice of prescribing the drug teraligen in patients with a diagnosis of autonomic disorder (START-2: Russian experience with the Russian-language validated version of the 4DSQ questionnaire. Interim analysis) // Journal of Neurology and Psychiatry. S.S. Korsakov. 2015.
Frese T., Mahlmeister J., Heitzer M, Sandholzer H. Chest pain in general practice: frequency, management, and results of encounter // J Family Med Prim Care. 2019.
Mourad G., Alwin J., Strömberg A., Jaarsma T. Societal costs of non-cardiac chest pain compared with ischemic heart disease-a longitudinal study // BMC Health Serv Res. 2013/
Ortiz-Garrido O., Ortiz-Olvera N.X., Gonzalez-Martinez M. et al. Clinical assessment and health-related quality of life in patients with non-cardiac chest pain // Rev Gastroenterol Mex. 2015.

Ludmila Zhavoronkova

Higher medical education. 30 years of work experience in practical medicine. More about the author

Possible causes of pain

In adolescence, under the influence of hormones, the development of glandular tissue begins, and girls develop breasts. In young men, the mammary glands normally remain unchanged. In rare cases, there may be a slight increase, itching or increased sensitivity of the nipples, which pass on their own. Noticeable breast growth in a man (gynecomastia), pain and internal hardening can be caused by the following reasons:

hormonal disbalance;
fat necrosis;
Mondor's disease;
cysts (including sebaceous glands);
inflammation;
mastopathy;
adenoma and fibroadenoma;
mammary cancer.

For the correct diagnosis, laboratory tests and ultrasound diagnostics are necessary. But predisposing factors are usually either local injuries or complications of gynecomastia.

Diseases according to accompanying symptoms

With the above diseases, soreness, usually localized in the middle of the chest, sometimes spreads to the left side of the body (less often the right or to the back). Only a doctor can make a diagnosis, therefore, except in cases of emergency hospitalization, it is unreasonable to postpone a visit to a specialist. It is important to monitor and inform the therapist about the accompanying symptoms: shortness of breath, sweating, swelling, high fever, cough, the nature of pain during exercise / rest, eating, different body positions.

There are 6 main causes of discomfort in the chest area.

The patient's history has a damaging effect: blows, foreign body stuck, falling from a height onto the chest, medical manipulations (bronchoscopy). The pain is moderate, often dull in nature. There are concomitant signs: hemoptysis, vomiting of "coffee grounds", uncontrollable cough, acrocyanosis in case of damage to the upper respiratory tract.

Hypertension

Heartburn

In the absence of characteristic signs, the diagnosis is carried out according to the phenomena that are observed in the patient.

It occurs mainly in neuralgia and osteochondrosis. Backaches indicate compression of the nerve trunks by an intervertebral hernia or spasmodic muscle layers.

Dry cough

Osteochondrosis of the thoracic region is a complex of degenerative-dystrophic disorders in the intervertebral discs. A vivid symptom is pain in the chest area, aggravated by movement, trying to take a deep breath, coughing, sneezing. There is numbness in the limbs, neck, shoulders. Compression of nerve endings leads to an increase in autonomic symptoms - headaches, dizziness, a feeling of lack of oxygen.

Scoliosis is a steady curvature of the spinal column relative to its axis. Strengthening the physiological curves involves the internal organs in the pathological process, changing their size and location. Among the clinical manifestations are pains in the chest area, which are similar to heart problems and respiratory diseases.

Traumatic injuries combine into one group different types of mechanical injuries affecting the frame base of the chest and the organs located behind it. If only the bones are affected, the pain symptom is localized at the site of the bruise, soft tissue edema and hematoma are also formed there. In the sternum it hurts when pressed and motor activity.

A bruise, compression, concussion of the internal organs is accompanied by a violation of consciousness, an accelerated weakened pulse, a drop in blood pressure, swelling and blueness of the upper body in the decollete area. When inhaling, it is difficult to breathe, the limbs become cold, short-term loss of hearing and vision is recorded.

Pleurisy is an inflammation of the serous membrane that covers the lungs. The main manifestations are pain in the sternum and cough, which does not relieve the feeling of tightness in the chest and shortness of breath. Dry pleurisy is characterized by stabbing pain, aggravated by movement and breathing, weakening when lying on a sore side.

Similar symptoms have pneumonia and bronchitis. Due to the accumulated pathological fluid, breathing becomes difficult, a painful cough appears. Forced expiration through the mouth leads to an overstrain of the respiratory tract and muscle tissue. Therefore, pain that originated in the chest is given to the interscapular space.

Inflammatory processes in the lower parts of the lungs and their pleural membrane provoke the innervation of the phrenic nerve. This explains what can hurt in the diaphragm when inhaling.

Problems with the liver and biliary tract (pancreatitis, cholecystitis) are detected by dull, undulating pain on the right side of the chest, which radiates to the back between the shoulder blades. Unpleasant feeling intensifies after eating, especially fatty or fried foods. A plaque appears on the tongue, bitterness is felt in the mouth.

Esophageal dyskinesia is a violation of the movement of semi-liquid and fiber-rich food from the pharynx into the stomach. Characteristic signs of the disease are pressing pain in the sternum in the middle, spreading over the surface of the chest, to the diaphragm, shoulders, feeling of a lump in the throat. Pain is relieved with a sip of water. Often the attack ends with regurgitation of the contents of the stomach.

It may be useful: how to identify a bruised spine and help the victim.

Severe and sudden chest pain in women and men is a serious cause for concern!

The task of doctors is to find out its cause and exclude serious diseases.

Having determined the localization and intensity of pain sensations, their frequency and duration, the doctor makes a preliminary diagnosis, which is then confirmed by instrumental and laboratory studies.

stupid
aching,
sharp
squeezing,
burning.

Injuries of various origins, received in a traffic accident, in a friendly fight or a drunken fight, can cause chest pain.

As a rule, the victims complain that the chest and back hurt.

As a result of an injury, rupture of muscles and blood vessels occurs, which is always accompanied by pain, which increases with inhalation, turns and tilts of the torso.
Injury to the periosteum when struck in the chest leads to prolonged pain, which passes very slowly.
With cracks and fractures of the sternum, pain is accompanied by general malaise and is aggravated by palpating it with your hands.

Thoracalgia

This is a diagnosis that determines the symptoms of chest pain. Vertebrogenic pathology associated with damage to the intervertebral discs is very common. It occurs under the following conditions:

osteochondrosis;
scoliosis;
kyphoscoliosis;
diseases of the cardiovascular system;
disruption of the digestive tract;
xyphoidalgia.

These pathologies are caused by a violation of the structure of the vertebrae, which compress, irritate or infringe on the nerves and provoke pain in the thoracic spine. They are localized in the chest, increase with bending, turning, raising arms, physical exertion, inhaling, exhaling and walking. They are sharp, encircling or squeezing.

The pain syndrome is localized under the left or right shoulder blade, depending on the side of the nerve infringement, and is directed along the nerve endings. Often it appears at night, and when placed on the left, it is accompanied by bouts of fear and is regarded as cardiac. It is pressing (the left side, the heart hurts), occurs after physical exertion, burning, accompanied by numbness of the hand.

Thoracalgia can occur with myocardial infarction, ischemia, angina pectoris and disorders of the gastrointestinal tract (ulcer, gastritis, GERD reflux disease), pulmonary diseases (bronchitis, emphysema).

Diseases of the heart, respiratory organs, gastrointestinal tract, musculoskeletal system and nervous system - all this can act as factors provoking pain in the middle of the chest.

In order not to start your own condition, allowing the development of a dangerous disease or a significant deterioration in well-being, you should take the following steps in time:

Seek advice from a therapist who will prescribe the necessary set of studies and tests to exclude a number of pathological conditions.
Change eating habits by eliminating fatty, salty, spicy foods from the diet. At the same time, you should eat fresh fruits and vegetables, dairy products, cereals, and drink more fluids more often.
Introduce moderate physical activity into your lifestyle. It can be expressed in physical therapy classes, visits to the pool or yoga courses, leisurely walks in the park or jogging in the morning.
Give up bad habits (frequent drinking of coffee-containing drinks, smoking, drinking alcohol or drugs). The organs of the respiratory and nervous systems, the heart and blood vessels will certainly appreciate such care and respond with full-fledged work for many years of life.
Eliminate stressful situations from your own life: to do this, you should change an overly nervous place of work or your own attitude towards such situations. For self-soothing, it does not hurt to master breathing techniques, meditation and relaxation techniques.

Anatomical description of the sternum

The sternum or sternum (sternum) is a long flat bone located in the central part of the chest. It connects to the clavicles and 2-7 pairs of ribs through cartilage and forms the anterior part of the chest.

The word "sternum" comes from the Greek στέρνον, which means "chest". (According to wikipedia.org)

The main function of the sternum is to protect the heart, lungs, and major blood vessels from traumatic injury. It resembles a tie in its shape, and among all the flat bones of the human body, it is the largest and longest.

The sternum consists of three parts:

handles
The xiphoid process.

Two clavicles (clavicles) are attached to the upper part of the sternum, and the costal cartilages of the first seven pairs of ribs are connected to its edge. The sternopericardial ligaments are attached to the inner surface of the sternum. The top of the sternum is also associated with the sternoclaidomastoid muscle.

The anatomical position of the sternum is defined as tilted, down and forward. The sternum is slightly convex anteriorly and concave posteriorly. It resembles the letter “T” in shape, since it narrows at the point of transition of the handle into the body, after which it again slightly expands to the middle of the body, and then narrows to the lower part, that is, the xiphoid process.

In adults, the sternum averages about 17 cm, while it is larger in men than in women.

It hurts, but there is no cause for alarm

Often pain is provoked by not too terrible factors, namely:

heartburn. The pain becomes more pronounced if the person is in a horizontal position;
physical fatigue. It is not difficult to determine the cause of discomfort in this case, since its appearance is preceded by intensive training, hard physical labor and other stresses;
a state of heightened anxiety. Stress can not only cause pain, but also provoke shortness of breath, heart palpitations;
muscle stretch. Its symptoms are pain and hypersensitivity without swelling.

Prevention of myocardial infarction

We will not be mistaken if we say that of all the listed diseases, the most dangerous is myocardial infarction. Without the timely help of doctors, an attack that has occurred can cause severe disability, or even lead to death. That is why an attack of a heart attack should be tried to prevent.

To prevent a heart attack, it is important to move more. In this regard, it is worth making it a rule to walk more often or at least once a day to take a short walk. If possible, you need to play sports, starting with small loads and constantly listening to your own well-being. Overloading the body to persons with a predisposition to a heart attack is strictly prohibited. Morning exercises can be an alternative to sports.

It is important to monitor your own weight, because with a sedentary lifestyle and malnutrition, a person is exposed to obesity, and this factor greatly increases the risk of cardiovascular pathologies. In this regard, review your own diet by reducing the amount of animal fats consumed and increasing the intake of plant foods. Also, keep your blood pressure and cholesterol levels under control. In case of violation of indicators, it is important to take preventive measures to prevent the development of hypertension and cholesterolemia.

Finally, I would like to say that attacks of serious illnesses, which manifest themselves as severe pain in the chest in the middle, are allowed by us. Most of us do not want to respond to the signals that the body sends. When pain occurs, we simply drink an anesthetic drug and wait for the unpleasant symptom to pass. Over time, taking pills becomes more frequent, and we do not even notice the moment when a severe attack requires an ambulance call and emergency hospitalization. This does not mean that at the first pain sensations it is worth calling an "ambulance", but a specialist's consultation in such cases is simply necessary.

Why does the chest hurt on the right side in men

If there is chest pain on the right in men, doctors, first of all, suspect spinal problems. Scoliosis, osteochondrosis, salt deposition - all these pathologies cause severe pain that occurs during physical exertion or during prolonged stay in an uncomfortable position.

Such a fairly rare disease, like herpes zoster, can cause pain when it is localized on the right side. Despite the fact that the disease belongs to skin pathologies, for some time before the formation of rashes on the skin, it manifests itself in the form of neuralgic pains, which causes pain in the right sternum in men.

With an injury in the right side of the chest, pain often does not appear immediately, but several days after the injury. Unpleasant feelings increase with inhalation, localization of pain is clearly felt.

First aid for chest pain

If necessary, the doctor will prescribe an additional examination:

chest radiograph,
heart ultrasound,
Exercise tests (treadmill test, bicycle ergometry - if stable angina is suspected),
Biochemical blood test,
Daily monitoring of blood pressure and ECG.

In case of acute severe cardiac pathology, as well as a serious condition of the patient (PE, myocardial infarction, pulmonary edema), the patient must unbutton the collar, open the window, sit in a reclining position or with legs down (to reduce blood filling of the lungs) and urgently call an ambulance, describing the severity of the condition to the dispatcher.

If the patient has an injury, you should give him a comfortable position and immediately call an ambulance. If a person is not in a serious condition, you can give him an anesthetic pill to drink (paracetamol, ketorol, nise, etc.).

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Chronic diseases of the respiratory and digestive organs in the acute stage do not require emergency assistance by the patient himself or those around him, if he is not in serious condition. It is enough to wait for the arrival of an ambulance or the appointment of your local doctor.

After suffering severe cardiac diseases (heart attack, pulmonary embolism, aneurysm dissection, pulmonary edema), treated in a cardiological or cardiac surgery hospital, regular constant monitoring by a doctor in a polyclinic at the place of residence is required. Treatment is selected strictly individually.

Inflammatory diseases of the trachea and lungs are treated with antibacterial drugs. Thoracalgia is treated by rubbing with anti-inflammatory ointments and drugs from the NSAID group (nise, ketorol, diclofenac, etc.).

ischemia and myocardial infarction and the prerequisites for their development

If we talk about the pathology of other organs, then the consequences may also not be the most pleasant - starting from the chronization of the process (with pathology of the stomach or lungs), and ending with malignant tumors in the mediastinal organs that were not diagnosed in time.

Therefore, for any acute, rather intense, or chronic retrosternal pain, it is necessary to obtain qualified medical care.

Give the patient a sitting or semi-sitting position;

If you have tight outerwear, unfasten it;

Give the victim a sniff of ammonia or wipe the skin around the temples with it;

Provide the patient with maximum peace of mind;

Give the patient to drink 15-20 drops of Corvalol or another vasodilator;

Give the victim 2 tablets of an anesthetic (ketanov, analgin);

Put something cold on the chest;

If there are visible fractures of the ribs, immobilize them;

Warm up the patient

Monitor the condition until the ambulance arrives.

In case of injury, in addition to the above measures, it is necessary to treat the skin around the wound with an antiseptic solution (hydrogen peroxide, iodine, brilliant green), apply a sterile bandage to the wound and apply cold.

Pain in the sternum in the middle does not always indicate cardiac pathology. According to statistics, discomfort of cardiac origin accounts for no more than 60% of all clinically recorded cases. Perhaps less, the information differs by region of the planet.

Difficulties in determining the cause prevent the patient from responding in time. For example, a heart attack can be falsely mistaken for an exacerbation of gastritis. What such fatal errors lead to is clear without words.

Therefore, the main action for pain in the middle of the chest is to call an ambulance. Transportation to a cardiology hospital is the next step. Further, specialist doctors understand by means of ECG, ECHO, assessment of heart sound.

The only reliable method for determining the source is a thorough diagnosis using instrumental methods. By eye, one can only estimate the approximate factors of the formation of the problem.

Development factors are multiple. In more than half of the cases, cardiac pathologies are to blame. An approximate diagnosis can be determined by the nature of the pain.

Feeling of pressure in the chest

Dull pain in the sternum in the middle, of a pressing nature, occurs in 95% of cases and more. This is its main type for heart problems.

Attention:

The duration of the pain episode is not more than 30 minutes. Anything above that could indicate a heart attack.

Hospitalization is required for urgent care and clarification of the cause of discomfort. The pain radiates to the left arm, between the shoulder blades, to the neck.

The essence of the process lies in the gradual destruction, death of the myocardium. In contrast to the avalanche destruction on the background of a heart attack.

Sooner or later, an emergency will occur, if angina pectoris is not treated, acute necrosis will occur in the future of 3-5 years.

Recovery is required on an ongoing basis. The disease is divided into 4 functional classes (abbreviated as FC), in fact, this is a distinction in severity.

The first FC gives a complete cure. The duration of therapy is about six months. Starting from , the probability of total recovery is zero. But survival is good.

Each case is considered individually, there are no universal recipes and forecasts. Sharp pain in the sternum, unbearable in intensity, can also indicate a heart attack.

Backache

Periodic, short-term tingling rarely accompanies cardiovascular disease. The approximate frequency is 20-25%. If there is a connection with cardiac pathologies, then they talk about such conditions:

, or occlusion of the mitral valve. This anatomical structure closes the gap between the left atrium and ventricle, preventing blood from moving in the opposite direction. With malformations, there is a reverse flow of liquid connective tissue.

Recovery involves surgery at an early stage. The sooner it is done, the higher the chances of a complete cure.

Pain episodes are short. Often, patients do not pay attention to such a manifestation at all.

. This structure is located at the level of transition of the left ventricle into the main artery of the body. The role is identical: the movement of liquid connective tissue is strictly in one direction. Into a big circle.

Aortic aneurysm in progress. It is a special formation, wall protrusion of the artery. At the stage of formation, the pathological process makes itself felt with minimal discomfort.

with cardialgia. Why exactly heart pain occurs is not fully understood. It is assumed that we are talking about the work of the central nervous system, insufficient braking speed.

A typical feature of pain of neurotic origin is the absence of evidence for organic pathology. Objective diagnostics does not show deviations.

No special treatment is required. Despite this, the intensity of lumbago is significant. Hypochondriacal patients may mistake an episode of neuralgia for a heart attack.

Vegetative-vascular dystonia. It is a non-specific syndrome. It develops as a result of diseases of the brain, hypothalamus, endocrine system.

Recovery is carried out under the supervision of a team of specialists. Heart pains are relatively short in duration and do not cause real danger to life.

Myocarditis. Or inflammation of the muscular layer of the heart. It is an infectious (viral, bacterial, fungal), less often an autoimmune process. Requires urgent treatment in a hospital. The phenomenon quickly leads to tissue destruction. This is a direct indication for prosthetics.

In rare cases, the pathological manifestation is caused by a change in the innervation of the heart.

Stitching pain almost never indicates cardiac problems. The probability is 20% or so.

Attention:

Feeling of heat in the chest

The burning nature of discomfort, on the contrary, often indicates an acute process, an emergency.

Typical reasons for the development of the manifestation are:

Heart attack. It is a pronounced malnutrition of the muscle layer of the organ. Dying away (necrosis) occurs, the intensity of blood circulation and the supply of tissues with oxygen and nutrients decreases.

Recovery is carried out urgently, in intensive care. Indicative is the ECG with typical features of the process.

After stabilization, heart failure of varying severity develops. This condition is corrected for the rest of his life with the help of drugs. They are taken constantly, some courses.

Ripple

It is found in developing myocardial infarction or an attack of hypertension.

The first state has already been described. As for GB, usually we are talking about a significant increase in the tonometer. This is the so-called. It is characterized by intensification, overload of cardiac activity.

It is possible to take the patient out of this situation only in a hospital. The longer the experience of hypertension, the higher the risk of an emergency.

Throbbing pain accompanies every heartbeat. Indicates insufficient efficiency in supplying the muscular organ itself with oxygen and nutrients.

Aching discomfort

Occurs against the background of cardiac pathologies of a sluggish type and often as a result of non-cardiac conditions.

This may be another, proliferation of organ tissues, acquired and congenital malformations of structures without critical impairment of functional activity, and others.

When complaining of aching pain in the chest in the middle, the measurement of blood pressure, heart rate, listening to the heart sound, evaluation of ECHO and ECG data are shown.

If necessary, MRI diagnostics is prescribed. Tumors of cardiac structures are possible, although such formations are rare and account for no more than 1.5-2% of all primary neoplasias.

Other development factors

Not always discomfort, especially pulling pain in the sternum, is the result of cardiac pathologies. In 40-50% of situations, the cause is not related to the muscular organ at all.

Gastritis and stomach ulcer. In the first case, we are talking about inflammation, in the second - about the formation of erosions on the mucous membrane. Both conditions can give reflected discomfort. The chest is the main target.
Reflux esophagitis. Escaping acid back into the esophagus. With a long course of the pathological process, there are persistent aching pains in the epigastric region, the acute nature of the discomfort is atypical.
Chest injury. Fractures give the most sharp, pronounced sensations.
Inflammation of the lungs or pneumonia. infectious origin. From the left side. It is characterized by severe, pressing pains. Nitroglycerin has no effect.
Osteochondrosis. Degenerative-destructive disease of the spinal column.
Herniated discs (extrusions).
Myositis or inflammation of the skeletal muscles.
Intercostal neuralgia. Common cause of discomfort.

How to make a delimitation

Discomfort of cardiac origin has a number of distinctive features:

Localized strictly in the center. Perhaps a slight shift to the left side, closer to the shoulder.
Gives to the shoulder blade, arm up to the hand, cervical spine.
The nature of the unpleasant sensation, as already mentioned, is pressure, burning, tingling (extremely rare).
When changing the position of the body, breathing, the strength of the pain does not change. This indicates a lack of communication with the musculoskeletal system, the lungs. Most likely it is the heart that is to blame. At the same time, walking and even more intense physical activity will lead to increased discomfort.
It is possible to stop with Nitroglycerin (1 tablet). This is a typical feature of cardiac pain. But with a heart attack, the action may be incomplete.
Pressure on the back or chest does not change the strength of the discomfort.
At rest, pain is relieved.

Attention:

These moments are not considered reliable diagnostic criteria. The share of subjectivity is great, at the same time, there are exceptions to every rule.

With the development of discomfort in the chest, if it lasts more than 10-20 minutes, it is recommended to call an ambulance to resolve the issue of transportation to the hospital.

Reasons to call an ambulance

Among the signs that require a call to the ambulance:

Discomfort that lasts more than 30 minutes. Regardless of the degree of intensity. Likely to develop a heart attack. Better to be safe.
Severe, unbearable pain syndrome, not relieved by nitroglycerin.
Dyspnea. Eliminating even minimal physical activity. Occurs not only during dangerous phenomena, but also at the moment. Transformation into acute necrosis (heart attack) is possible. You don't have to wait for the transition.
Cephalgia (headache), dizziness. Especially if they are accompanied by the inability to navigate in space.
Paralysis, paresis.
Feeling of goosebumps all over the body or in certain areas.
Distortions of the face. Inability to control facial muscles.
Fainting, syncope. Especially repeated ones. Along with previous neurological symptoms, they indicate ischemia of cerebral structures and a possible stroke.
Slurring of speech. Fog in the field of vision, hearing loss.
Confusion of consciousness.
Paleness of the skin.
Cyanosis of the nasolabial triangle.

List of required examinations

It includes:

Measurement of blood pressure and heart rate.
Electrocardiography. It is used to assess the functional position of cardiac structures. Shows arrhythmias and typical features of a heart attack.
Echocardiography. Study of the anatomical state of the heart and surrounding tissues. The method involves the visualization of areas. It is possible to identify the degree of violation.

Additional measures: ambulatory monitoring, MRI of the heart, stress tests (with caution), coronography and blood tests.

Also, chest x-ray, FGDS (endoscopic method for assessing the condition of the gastric mucosa and esophagus), visualization of vertebral structures.

As needed, third-party specialists are involved, most often a neurologist. In the absence of data for organic defects, they speak of idiopathic cardialgia.

Finally

Pain in the center of the sternum indicates cardiac (60% of cases) and non-cardiac factors (other situations). Diagnostics is shown in a short time.

There can be many reasons. Including from the lungs, the spinal column of the gastrointestinal tract.

A thorough examination allows you to develop the right treatment strategy. Removing the pain itself is not enough. You need to eliminate the root cause. Tasks are solved in parallel with the prevention of emergency conditions.

Pain in the sternum in the middle - all ages are “obedient” to it. This is one of the most common patient complaints found in medical practice worldwide. What causes these unpleasant manifestations? What serious diseases can hide such an alarming symptom? Medical experts have identified four main categories that combine certain negative factors, the presence of which can provoke pain of a different nature in the chest area. Here is a list of these categories:

Chest injuries and spinal problems.
Heart diseases.
Pathology of the lungs.
Diseases of the digestive system.

Any ailment that causes discomfort has its own characteristic signs. To better understand what kind of health hazard such manifestations can pose, let's take a closer look at the causes of their occurrence.

Why does it hurt in the middle of the sternum

The most common causes of pain in the sternum in the middle include:

osteochondrosis;
ischemic heart disease;
aortic aneurysm;
gastroesophageal reflux disease.

Thoracic osteochondrosis

The disease is a destructive process that affects the intervertebral discs, which are located in the thoracic spine. Its progression triggers dystrophic reactions in the tissues of the discs, leading to violations of their shock-absorbing functions, and also causes a change in the bone structures of the vertebrae themselves and leads to their pathological convergence with each other.

The result of such destructive reactions is a violation of the mobility of the spine and compression of the nerve roots located in the immediate vicinity of the spinal column. As a result, the resulting pain in the sternum in the middle radiates to the back and intensifies with physical exertion, sudden movements, weight lifting, and even when sneezing or coughing.

Factors predisposing to the development of osteochondrosis are:

Heredity.
Age changes.
Traumatic injuries.
Increased physical activity.
Circulatory disorders.
Hormonal imbalance.
Harmful working conditions.
Congenital morphological anomalies of the spine.
infectious processes.
chronic stress.

The lack of adequate treatment leads to the destruction of the fibrous ring and the release of fragments of the intervertebral disc into the spinal canal (hernia), which leads to an increase in compression myelopathy and a multiple increase in pain manifestations.

Cardiac ischemia

Another common cause is coronary artery disease (CHD). Pathology is an organic lesion of the myocardium caused by a lack of coronary circulation in the heart muscle. It can have acute manifestations (myocardial infarction, cardiac arrest) or take a chronic, protracted course (angina pectoris, cardiosclerosis). Factors contributing to the appearance of IHD are:

Hyperlipidemia.
arterial hypertension.
Drinking alcohol, smoking.
Overweight.
Metabolic disease.

The disease has an undulating nature of the course with a slow development of pathological manifestations and a gradual increase in negative symptoms. Its main features include:

Dizziness.
Pressing pain in the sternum in the middle (often -).
Increased sweating.
Clouding of consciousness.
Nausea.
Edema of the lower extremities.
Dyspnea.
Increased heartbeat.

IHD is irreversible. Adequate therapeutic measures can greatly slow down its progression and prevent the most negative development scenarios. In the absence of therapy, the likelihood of premature death (sudden coronary death) is high.

aortic aneurysm

Pathology implies a local expansion of a certain section of the aorta, caused by a violation of the tissue structure of its walls. Common causes of an aneurysm include:

Arterial hypertension.
Atherosclerosis.
Morfan syndrome.
syphilitic infection.
Traumatic lesions of the chest.
fibrous dysplasia.
Erdheim syndrome.
Age changes.
Alcohol abuse.

When an ailment appears in a person, not only does it hurt in the sternum in the middle, but additional symptoms also appear:

Tachycardia.
Pain in the region of the heart.
Dizziness.
Bradycardia.
Dysphonia.
Dry cough.
Dysphagia.
Increased salivation.

The lack of therapeutic measures can lead to the development of various complications. The most serious of them are stroke, acute renal failure, pulmonary hemorrhage. In critical cases, urgent surgical intervention is indicated. Prevention of the disease, first of all, is aimed at lowering the level of cholesterol in the blood.

Gastroesophageal reflux disease (GERD)

A similar pathology is characterized by a systematic reflux of the contents of the stomach back into the esophagus. This causes an inflammatory reaction in the tissues lining the walls of the esophagus, which leads to various negative symptoms and causes regular pain manifestations throughout the entire esophageal muscular tube. The main factors provoking the development of GERD are called:

Gross power errors.
Overweight.
Pregnancy.
Diaphragmatic hernia.
Uncontrolled intake of certain drugs.
Smoking.
Alcohol consumption.
Flatulence.

In the absence of treatment and ignoring the symptoms, the disease can cause various severe complications, the most dangerous of which are esophageal ulcer, aspiration pneumonia, malignant neoplasm.

The main symptoms of GERD:

Heartburn.
Belching sour.
Burning sensation in the chest.
Odynophagy.
Dysphagia.
Coronary pain in the chest.

Why there is pain in the sternum in the middle when inhaling

Most often, pain in the sternum in the middle when inhaling is associated with pulmonary diseases. When the lungs are affected, discomfort is usually associated with a violation of their pleural membrane, which contains many nerve endings and, when ruptured, inflamed or irritated, causes discomfort in the chest, as well as. As a rule, such manifestations occur with pneumonia, tuberculosis, bronchitis, pleurisy.

In second place are chest injuries. When falling from a height or an accident, a fracture of the ribs occurs, which provokes pain when breathing, and especially when taking a deep breath. The third most common are intercostal neuralgia, vascular and heart pathologies.

In addition to all the listed ailments, with pain in the sternum in the middle, the causes of discomfort can also be:

stomach ulcer;
vegetovascular dystonia;
thyroid pathology;
pregnancy;
foreign body in the esophagus.

In all cases, the causes of such sensations require medical clarification.

Diagnostics

The first step in the diagnostic procedures is making an appointment with a qualified medical specialist. Depending on the nature of the pathological process, the attending physician may be:

Gastroenterologist.
Vascular surgeon.
Cardiologist.
Neurologist.

If you are not completely sure of the cause that caused the pain syndrome, then you should seek the advice of a local therapist. Based on the results of a preliminary conversation, the following diagnostic measures can be assigned to the patient:

X-ray examination of the chest.
Gastroendoscopy.
Chromoendoscopy of the esophagus.
Ultrasound examination of the heart and abdomen.

Depending on the nature of the pain and the accompanying additional symptoms, additional diagnostic methods may be applied to the patient.

First aid

If there is pain behind the sternum in the middle, what to do in such a situation? In the vast majority of cases, the causes of the problem are traumatic lesions and paroxysmal heart pain. In case of injuries and bruises of the chest, it is necessary:

Place the injured person in a sitting or semi-sitting position.
Loosen tight outerwear that impedes breathing.
Give the patient a sniff of cotton wool soaked in ammonia.
Put ice or some cold object in the chest area.
If there are rib fractures, fix them.
With a strong pain syndrome, you can give the victim 1-2 tablets of an anesthetic drug.

If a person has a sudden heart attack, you must:

Lay the patient on his back, lifting his lower limbs slightly.
Release the chest from tight clothing.
Put a tablet of nitroglycerin or validol under the tongue of the patient.
Monitor the patient's condition until the ambulance arrives.

In all cases, it should be remembered that pain in the middle of the chest can be a manifestation of a dangerous pathological process. Any delay in seeking medical help can lead to death. To avoid such a negative scenario, it is necessary to contact a medical institution in time.