Aching pain in the chest. Why does sharp pain in the sternum occur, and how to stop it? How does chest pain manifest?

Pain in the chest indicates a problem in the body; such a signal cannot be ignored. To prevent possible future problems, it is important to identify and eliminate the cause of the failure in a timely manner.

What does chest pain mean?

This condition is called thoracalgia in medical practice. The term is created on the basis of the Latin word “thorax”, which translated into Russian means chest, as the upper part of the skeleton of the body, or the thoracic spine. Doctors hear complaints about pain in this area not only from the elderly, but also from people in the prime of life. This is the second reason for seeking medical help after abdominal pain. The first thing that comes to a person’s mind when obvious chest pain appears is dysfunction of the cardiovascular system.

But in reality, there are many reasons why the chest may hurt. There can be several of them, intertwined at the same time. Any type of chest pain, regardless of the cause of its occurrence, has a negative impact on the quality of life. Some of them are short-term pain, they do not pose a danger, and are not a cause for concern. Some species can signal the development of conditions that threaten the health and life of the patient. Thus, severe and sharp pain in the chest, reminiscent of an attack, requires emergency medical attention.

To differentiate dangerous pain that cannot be postponed from the physiological norm, you should answer a number of questions:

in what exact place (or area) is pain or discomfort felt in the chest area;
what type of pain, its distribution;
how long does the chest hurt;
what serves as a provoking factor;
what symptoms accompany the painful condition.

What can hurt your chest?

The variety of reasons why the chest hurts and the complexity of the solution is explained by anatomy coupled with physiology. This osteochondral formation, an important element of the body’s defense, has the structure of a closed hollow space.

Her skeleton is formed:

ribs connected to the spinal column (12 thoracic vertebrae);
the sternum, which protects vulnerable lungs, heart, liver, esophagus, and important arteries from injury and damage;
muscular frame;
the diaphragm, which plays a major role in the respiratory process;
ligamentous apparatus.

Potentially, all of these organs and areas can be a source of pain. When analyzing what else can cause chest pain, you should remember the anatomical features of the female body and her reproductive system.

In women, the cause of pain in the sternum may additionally be:

physiological pain that occurs as a reaction of the nervous system in response to various stimuli that damage or destroy the glandular and connective tissue of the female breast. The mammary glands of a woman are abundantly penetrated with nerve fibers;
breast diseases - oncology, infectious inflammation, fibrocystic diseases;
cyclical changes in hormonal levels - during menopause or associated with the menstrual cycle (changes in the neurohumoral regulatory system, in the ovaries, uterus, and other internal genital organs);
the onset of pregnancy;
chest injuries, surgical interventions.

The term “mastalgia” is used to refer to a feeling of discomfort or pain localized in any part of the mammary gland. This collective concept is not a diagnosis, but a clinically significant symptom complex. Another reason why chest pain in men is gynecomastia - a benign enlargement of the mammary gland. It is often observed in former athletes who abruptly stopped training, men with tumor diseases, and disorders of the endocrine glands. The risk group also includes men who use hormonal, antipsychotic drugs, and tranquilizers for a long time.

Etiology of chest pain

Chest pain is accompanied by many diseases and disorders.

Depending on the causes of discomfort, it is customary to distinguish 2 types of pain syndrome:

Vertebrogenic – caused by pathology of the spine or surrounding tissues. Occurs as a result of compression, irritation of the nerve roots of the branches of the thoracic spinal nerves or due to excessive muscle tone. Most often it is provoked by osteochondrosis or herniated intervertebral disc. The reason that the chest hurts can also be instability or fracture of the vertebrae, thoracic or cervical spondylosis, radiculitis, tumors, ankylosing spondylitis, spinal stenosis, trauma, spondyloarthropathy, types of degenerative-dystrophic and infectious lesions.
Nonvertebrogenic – associated with diseases of internal organs, blood vessels, or is psychogenic in nature. The main cause of pain in the sternum or heart area is deterioration of coronary circulation, angina pectoris, myocarditis. Thoracalgia is accompanied by cardiac ischemia, rheumatism, pericarditis, and myocardial necrosis. Non-vertebral syndrome is caused by aortic aneurysm, pulmonary artery blockage, neuroses, panic manifestations, respiratory diseases, inflammation of the gastrointestinal mucosa, pancreatitis, tumor diseases, hernia or spasm of the esophagus, and stomach ulcers.

How to recognize the cause of pain

To decide what to do if your chest hurts, whether to call an ambulance, you need to diagnose the condition of your body and try to independently determine the cause of the pain based on the symptoms. The origin of pain can be judged by its nature, intensity, localization and by what other symptoms predominate in the clinical picture.

First of all, you should pay attention to the time factor. What signs allow you to exclude cardiology and suspect neuralgia:

constant pain that persists day and night, may subside in the morning and intensify when walking;
the place where discomfort is felt usually exactly corresponds to the localization of the pathological process. The phenomenon of irradiation may be observed, when the process of excitation spreads to other nerve centers and responds in the lower back and shoulder girdle. In such cases, there is a characteristic increase in pain during physical activity, laughing, sneezing, deep breaths, coughing;
when pressing on points located along the spine, pain begins to be felt or its intensity increases;
local increase in temperature, hyperemia;
muscle pain that increases when bending the body forward, lifting or stretching the arms, turning the shoulders;
pinched nerve is accompanied by numbness of the area in which the compression occurred;
the painful condition is a one-time one, associated with a certain action or situation - excessive overload, hypothermia, a cold, as well as with an unsuccessful movement or a sharp bend, or injury.

With heart ailments, clear local pain is rarely observed; there is predominantly reflected periodic pain, which does not last constantly and often manifests itself in attacks. What symptoms should you pay attention to?

So, if:

the chest is burning, aching, there is a connection with food intake - gastritis, ulcers, colitis or pancreatitis are diagnosed. The violation is accompanied by heartburn, belching, and stool upset;
pain in the center of the chest or in the upper part - a cold, most likely bronchitis, or heart problems;
it hurts above the chest - it can be assumed that it is a consequence of drafts and heavy lifting;
aching chest, monotonous pain in the chest, breathing hard, perhaps increased sweating, dizziness, but no other obvious symptoms are detected - this is how stress, anxiety, negative emotions, neuroses usually manifest themselves;
constant pressing, sometimes piercing pain not associated with breathing (especially in the area of the mammary gland) - the situation should be alarming, because this may be a sign of the formation of a malignant tumor;
paroxysmal pain that occurs behind the chest, lasting 3-5 minutes, a feeling of pressure, burning, compression in the cardiac region or more widely on the left - probably angina pectoris, often against the background of emotional stress or physical overload.

How to treat and what to do for chest pain

Only a qualified physician can accurately determine the root cause of the pain syndrome by conducting a survey, an initial examination, and laboratory and diagnostic tests. Each specific situation requires the use of its own specially selected treatment regimen. Which doctor to contact: patients with complaints of chest pain are helped by a therapist, a neurologist, a cardiologist, and, if necessary, a specialized doctor - a pulmonologist, gastroenterologist, oncologist.

As first aid, the patient should stop, calm down, provide fresh air, take validol, nitroglycerin, or other medicine prescribed by the doctor. You should know that for neuralgia, vasodilators do not work; analgesics (usually in the form of ointments, suppositories, patches) are used to alleviate the condition.

What to do with chest pain: if this is not a manifestation of scoliosis, but the result of the influence of psychological factors, sedatives and psychotropic drugs can help.

Conditions requiring emergency response:

dull, prolonged pain lasting from half an hour to a day or more, when the entire front part of the chest hurts, while taking nitroglycerin preparations does not lead to regression - myocardial infarction;
irradiation to the left hypochondrium, shoulder, armpit, neck, jaw;
unbearable cutting pain in any area;
severe bursting pain (often swelling of the upper limbs, neck), wandering along the spine, indicates a thoracic aortic aneurysm. If a slow pulse, cyanosis, or fainting are observed, this indicates aortic dissection, a process that is fatal;
sudden acute pain when breathing, coupled with cough, fever, coughing up sputum with blood - pulmonary embolism, life-threatening. May lead to pulmonary infarction, persistent hypotension, shock;
additional manifestations - lack of air, lump in the throat, impaired consciousness, palpitations, persistent increase or decrease in blood pressure, vomiting.

In any case, you should not postpone visiting a doctor; treatment should be timely and comprehensive.

Chest pain is an unpleasant phenomenon that can occur due to many reasons. To get rid of pain of such localization, you need to know what caused it. Some conditions may require emergency treatment. When exactly to “sound the alarm” and when can you deal with the problem yourself? We'll talk about this and more further.

General concepts

Chest pain is a common symptom that can affect anyone. It is an unpleasant painful sensation in the area where the ribs attach to the chest. Most often, pain in this part of the body occurs during movements - when walking, breathing, turning and bending, coughing, etc. More rarely - at rest.

Most patients believe that chest pain is a sign of heart disease. Official statistics show that only in 40-50% of cases, heart disease is the culprit of pain in the sternum.

In 90% of cases, pain appears due to problems with organs located directly in the chest. Only in 10% of cases are they an echo of disturbances in the functioning of organs located in the abdominal cavity.

A similar illness can be caused by:

diseases of the cardiovascular system;
lung pathologies;
diseases of osteochondral structures;
diseases of the gastrointestinal tract or diaphragm;
injuries;
psychogenic factors.

Reasons

Most often, pain in this localization occurs due to injuries and various diseases. Which ones exactly? Let's take a closer look.

Diseases of the cardiovascular system

The most common culprits of pain in the sternum are heart disease. We are talking about diseases such as:

. A pathology in which blockages occur in the vessels supplying blood to the heart. This leads to oxygen starvation of the organ, as well as a decrease in blood flow, which causes pain in the sternum. Unpleasant symptoms appear not only in the chest, but also radiate to the arm, back and even jaw. It seems to a person that the entire chest is compressed. As a rule, such sensations occur during times of severe stress or emotional tension.
. A pathology in which blood through the artery stops flowing to the heart, not partially, but completely. Blockage of the vessel leads to such a dangerous condition that is fraught with the death of heart muscle cells. In this case, the patient experiences more severe pain in the left side of the sternum (than with angina), which spreads throughout the chest and also radiates to the arm, persisting for a long time (30 minutes or more). The pain is of a pronounced burning nature.
. A disease characterized not only by pressing pain in the center of the sternum, but also by respiratory dysfunction and increased body temperature. Arterial blockage does not occur with myocarditis. Despite this, the general symptoms of the pathology are very similar to those of a heart attack.
. When the pericardium (one of the linings of the heart) becomes inflamed, this disease is diagnosed. The pain associated with the pathology is very similar to that which worries patients with angina pectoris. We are talking about acute pain in the entire sternum of a compressive nature, which radiates to the shoulder and arm. With pericarditis, pain can spread not only to the sternum, but also to the neck muscles. Most often, the pain intensifies with deep breathing, eating, or lying on your back.
. Hardening of the heart muscle, causing heart failure. This condition interferes with the normal functioning of the heart. As a result, the patient experiences left-sided sternal pain of a burning nature, as well as accompanying pathological symptoms - fatigue, breathing problems, insomnia, dizziness.
Mitral heart disease. A disorder in which the heart valve does not close completely. With this diagnosis, a person suffers from aching pain in the central and left part of the sternum, rapid heartbeat, and dizziness.
Atherosclerosis of the coronary vessels. A dangerous condition associated with blockage of the coronary artery by cholesterol plaques. If blood stops flowing completely through a vessel, a coronary artery may rupture. Against the background of the pathology, the patient experiences unbearable pain in the sternum or a sensation of rupture in the chest. The pain can radiate to the abdomen, back and neck.

Lung diseases are often the cause of chest pain. Most often, pain syndrome is provoked by banal viral infections, as well as bacterial lesions. Less commonly, the cause of discomfort in the chest area is more serious illnesses, such as cancer.

Let's look at the most common ones:

Pleurisy. Inflammatory damage to the mucous membrane of the lungs, which is characterized by acute pain in the sternum during inhalation and exhalation. In addition to pain, a person is bothered by an intense cough, as well as frequent sneezing.
Pneumonia. A common cause of sudden pain throughout the sternum, occurring against the background of an infectious process in the lungs. The pathology is accompanied not only by pain, but also by other symptoms - intense cough, increased body temperature, and copious sputum discharge.
Pneumothorax. Damage to the lungs, in which the integrity of the organ is disrupted and air escapes into the chest cavity. This process is accompanied by severe pain in the left and right parts of the sternum, which intensifies with deep breaths.
. A disease in which the patient has high blood pressure in the lungs and nearby large vessels. In this regard, the right side of the heart muscle begins to work more intensely, which causes pain in a characteristic localization - on the right side of the sternum. With pulmonary hypertension, the pain syndrome is very similar to the pain that appears during an attack of angina.
Asthma. An inflammatory disease of the respiratory tract. The patient suffers from a severe cough, shortness of breath, whistling breathing, and sometimes pressing pain in the central part of the sternum and trachea.

Diseases of the gastrointestinal tract

When pain occurs in the sternum, patients rarely attribute it to problems and malfunctions in the gastrointestinal tract. As practice shows, it is in vain. They are the ones that often lead to painful sensations. The most common diseases:

Gastroesophageal reflux disease. Manifested by heartburn and pain in the central upper part of the sternum. It occurs due to the reflux of stomach contents into the esophagus. Very often, this disease can be confused with heart ailments, since the patient thinks that the heart, which is located in close proximity to the esophagus and is connected to it by nerve endings, is hurting. In this case, the person complains of burning and pressing pain that occurs after eating or intense physical activity.

In addition to gastroesophageal reflux disease, other pathologies of the esophagus, for example, its hypersensitivity, can cause chest pain.

Stomach ulcer. May cause constant pain in the lower part of the sternum and throat. The main problem with this pathology lies in the presence of ulcers on the gastric mucosa. In this case, eating a light meal, regular baking soda, or tablets used to treat the stomach can help cope with the pain.

In 90% of cases, ulcers and chest pain occur in people who frequently drink alcohol and are “experienced” smokers.

Pancreatitis. Inflammation of the pancreas usually causes pain in the lower part of the chest. In this case, the patient’s condition worsens with sharp bends forward or in a lying position.
Diseases of the gallbladder and biliary tract. Pain in the sternum due to gall pathologies appears after eating fatty foods. A person complains of heaviness in the stomach area, as well as unpleasant painful sensations in the lower right part of the chest.

Injuries

The main cause of pain in the middle of the sternum is injury. They can be very diverse - from a banal fall from a height to a blow to the chest on the steering wheel during an accident. If after the incident there is pain in the sternum, you need to see a doctor. The specialist will determine whether the pain is a consequence of serious damage to internal organs. If the injury is minor, the pain will go away within a few days after proper treatment.

A common cause of chest pain is a fracture of a rib or several ribs. In this case, the pain is concentrated at the site of the fracture and intensifies when pressing on the problem area, taking a deep breath and coughing.

Other causes and diseases

In addition to the above diseases, chest pain can be caused by:

Stress. Cause pain in the chest, the so-called psychogenic nature. They appear during strong emotional stress and experiences against the background of spasm of the pectoral muscles.
Sedentary lifestyle. Leads to constriction of the chest muscles, which are compressed even more with reduced physical activity.
Any type of cough. Cause irritation of tendons and intercostal muscles. Excessive muscle tension provokes pain in the sternum of characteristic localization.
Enlarged thyroid gland.
Diaphragmatic hernia.
Osteochondrosis.
Intercostal neuralgia.
Congenital pathologies of the spinal column.

Without consulting a specialist, it is very problematic to establish the true causes of pain in the sternum. That is why, when they appear, it is worth making an appointment with a doctor.

What to do?

When chest pain occurs, you should act based on assumptions about what could cause it.

If chest pain occurs for the first time and is not too severe, you can try taking any painkiller. For example, paracetamol. The drug will help relieve muscle spasms and quickly alleviate the condition.

If you suspect spasmodic pain, doctors recommend taking a warm bath or applying heat to your chest (for example, a warm, but not hot, heating pad). This technique will help the muscles quickly relax, and as a result, the pain will subside.

Patients suffering from diseases of the gastrointestinal tract who are aware of their problem should focus on fractional meals. If pain appears after eating, you can drink enzyme-containing preparations (for example, Festal or Creon) or a small amount of mineral water.

If you suspect a “cardiac” origin of the pain, it is important to immediately call an ambulance and provide the person with complete rest until the doctors arrive.

In most cases, in the presence of the above-described serious diseases of the heart, gastrointestinal tract or lungs, it is almost impossible to relieve chest pain with lightning speed.

When should you call a doctor immediately?

For some types of chest pain and accompanying symptoms, there is no way to delay calling an ambulance. You should call emergency services immediately in the following situations:

chest pain appeared after intense physical activity;
pain syndrome is accompanied by severe coughing (including blood) or loss of consciousness;
the pain is burning and spreads not only to the sternum, but also to the shoulders, arms, neck, and lower jaw;
the attack does not go away within 10-15 minutes, including after rest and taking nitroglycerin;
pain is accompanied by tachycardia, dizziness, nausea or vomiting, increased sweating, fainting;
Pain in the sternum feels like heartburn, but the usual heartburn pills do not relieve it.

Urgent Care

The sudden appearance of severe pain in the sternum of any location can pose a threat not only to the health, but also to the life of the patient, as it is most often caused by a dangerous disease or pathology.

put the person in a comfortable position, ensure a flow of fresh air into the room;
give an age-appropriate dose of nitroglycerin;
take an analgesic orally;
Apply a pepper patch or mustard plaster to the site of pain for 5-7 minutes.

Diagnostics

To cope with chest pain and forget about it for a long time, you should undergo a comprehensive examination.

Minimum diagnostics for patients with chest pain include:

consultation with a doctor and collection of anamnesis (the specialist asks the patient about diseases of the heart, stomach, lungs, symptoms of pathology, medications taken, etc.);
ECG (if necessary, an additional stress test is performed);
radiography;
gastroscopy (comprehensive examination of the stomach);
angiography of the coronary vessels (a series of images of the vessels of the heart muscle).

Additionally, auxiliary research methods may be prescribed - a blood test for markers of myocardial damage, CT, MRI, ultrasound of the abdominal organs and blood vessels.

It is much easier to treat any diseases and pathologies at the initial stage than in an advanced form. Therefore, if pain in the sternum appears, you should immediately start diagnosing it and, after making a diagnosis, proceed to treatment.

Most often, for pain in the sternum, the patient is advised to:

drug treatment;
physiotherapeutic methods of influence.

Any therapy is prescribed only in accordance with a previously established diagnosis, depending on the reasons that caused them.

If during the examination it was not possible to determine the exact cause of the pain, the person is admitted to a hospital for a more thorough comprehensive diagnosis. During the examination, the patient can only be prescribed painkillers.

Possible complications

Even infrequent and not too intense pain in the sternum can lead to very sad consequences and complications. The latter depend on the reason for the chest pain.

The result of ignoring pain attacks in the sternum area can be:

chronic pain in the chest area, a feeling of stiffness between the ribs;
oxygen starvation of the body;
disruption of normal mobility of the arms and shoulders;
pneumonia;
neuralgia of various origins;
respiratory failure, up to respiratory arrest.

The most serious complications of chest pain are associated with heart disease. We are talking about heart attacks, which can lead to death.

Forecast

Depends on the root causes of pain in the sternum, as well as the correctness and timeliness of providing assistance to the patient.

Are we talking about a short-term malfunction of the heart or gastrointestinal tract, not severe pathologies of the bronchopulmonary system? Adequate drug therapy can help solve the problem and get rid of it completely.

In 50% of cases, the prognosis for patients with chest pain is favorable.

In case of serious cardiac pathology, the prognosis is less favorable - the patient may face disability or even death.

Prevention

give up bad habits that increase the load on the heart, increase blood pressure, and also negatively affect the condition of the lungs, gastrointestinal tract, and other organs and systems of the body;
exercise regularly, following a training regimen adequate to your level of physical fitness;
alternate any types of physical and mental activity with proper rest;
promptly seek medical help for any infectious diseases of the bronchopulmonary system;
when working sedentarily at a computer, create comfortable working conditions, regularly perform special exercises to get rid of unpleasant sensations in the sternum and between the shoulder blades;
focus on proper nutrition - abandon unhealthy foods in favor of healthy foods that provide the body with all the necessary vitamins, micro and macroelements.

As you can see, chest pain is a common phenomenon that can occur with various diseases and pathologies. The main thing is to make a timely diagnosis, accurately determine the causes of the pain symptom and begin treatment. In this case, the risk of encountering complications will be minimal.

Chest pain is a very alarming symptom. The chest is a part of the human torso, consisting of the chest cavity, in which the organs of the cardiovascular system, breathing, and bone tissue are located - the sternum, ribs, spine, and muscle fibers. That is why, if a person has chest pain, this symptom cannot be associated solely with heart disease. The reason may be the pathology of any of the above organs.

Why does my chest hurt?

Chest pain can occur for a variety of reasons. First of all, you need to understand the main symptoms, only then can you correctly determine the main cause and carry out the necessary treatment.

The reasons when a person has pain under the chest can be very diverse. It all depends on what is causing the pain. So, for example, angina pectoris can cause pain in the left chest. In this case, the sensations may have a paroxysmal character.

Also, heart pain can be aching. For this reason, pain syndromes are quickly relieved by validol and nitroglycerin, and short-term physical activity also helps. The cause of pain in the right chest may be intercostal neuralgia. In this case, symptoms persist for a very long time. This disease can appear as a result of pinched nerve roots near the intercostal nerves. Muscle spasms may also appear, which become unbearable for a person.

Pain in the middle of the chest most often occurs with lung diseases.

Main symptoms of chest pain

If the chest hurts in the middle in women or men, as well as on other sides, it is important to understand the main symptoms. Most often, pain is accompanied by additional signs that help identify pathology:

cough for no reason;
dyspnea;
headache;
fog of consciousness;
severe fatigue.

The clinical picture can be supplemented by secondary signs - sharp pain appears during certain actions. The sensitivity of the skin may also be impaired, the skin may become pale, and the tone of the chest muscles may decrease.

How to quickly relieve chest pain with folk remedies?

Treatment methods with folk remedies can be used for relatively safe problems. Properly organized treatment with these drugs gives quite good results. Excellent for mild pain and a clearly known cause.

Recipes for chest pain perfectly complement pain therapy:

Recipe - Soda. It is considered one of the most popular remedies for chest pain. If the cause of pain is stomach pain, then baking soda diluted in warm or cool water will help cope with this problem.
Recipe - Garlic. This is an excellent remedy for preventing cardiovascular diseases. It is recommended to chew a clove of garlic at night to get maximum benefit. A crushed clove of garlic diluted in milk also helps relieve pain.
Recipe - Milk with turmeric. It has been proven that consuming turmeric can prevent the development of cardiovascular diseases. A teaspoon should be diluted in hot milk. It is best to use the resulting mixture before bedtime.

How to diagnose (search for) the cause of chest pain

To diagnose the cause of chest pain, a general examination of the patient is performed, while clarifying the general history. In addition, special laboratory and diagnostic measures are carried out:

pulse oximetry;
general blood test;
biochemical blood test;
radiography;
blood for markers of heart attack.

What causes chest pain when inhaling?

Pain when inhaling in the chest can be caused by serious pathologies in the human body. To establish the exact cause, you will need to undergo the necessary diagnostics and laboratory tests.

What to do if it’s hard to breathe and your chest hurts

If you experience such symptoms, you should immediately consult a doctor.

Attention! When a person is intoxicated when injured, it is necessary to remember that pain can occur after a certain time. In such cases, pain receptors are blocked; alcohol in this case plays the role of a synthetic analgesic.

Main types of treatment for chest pain

Treatment primarily depends on the disease that is causing the pain.

Angina pectoris is treated with nitroglycerin tablets. In this case, the pain should disappear no later than five minutes.
For inflammatory diseases of the respiratory system, take anti-inflammatory drugs and cough suppressants.
For pain caused by thoracic osteochondrosis, measures are taken to restore normal mobility of the intervertebral discs. For this, a specific set of exercises is selected.
Pain due to cardioneurosis is treated by strengthening the body and increasing immunity.
Pain due to intercostal neuralgia is relieved by the administration of painkillers and B vitamins in combination.

In what cases is it necessary to urgently consult a doctor?

In some cases, when your back and chest hurt, you need to immediately consult a doctor. This is required for the following symptoms:

with a feeling of fullness inside, burning pain radiating to the left shoulder, jaw or neck;
with very severe pain that is accompanied by fainting;
for pain with severe coughing attacks;
in cases where the pain does not stop within 15 minutes;
with shortness of breath and the appearance of blood when coughing.

The main causes of pain in the chest in the middle are angina pectoris and myocardial infarction. Extremely dangerous include pulmonary thromboembolism and dissection of the aortic wall. The symptoms of diseases of the digestive system are similar, but they are associated with food, and pulmonary pathology is associated with breathing. In case of osteochondrosis, trauma, joint diseases, the pain is increased by turns and movements, and in case of neurocirculatory dystonia, physical activity relieves it.

If there is discomfort in the chest, contact a therapist, and if there is acute pain that is not relieved by Nitroglycerin, an ambulance must be called.

In most cases there may be pain in the middle of the chest in the sternum area:

heart;
lungs;
large vessels (aorta, pulmonary artery);
the bone itself, its connection zones with the ribs;
muscles of the intercostal spaces;
stomach, esophagus;
mediastinum (space between the lungs, heart, large vessels)

When the layers of the pericardial sac (pericardium) or pleura (surrounding the lungs) are stretched, pain occurs in the center of the chest. The reason why pain appears in the middle of the chest is also its spread from the spine, gall bladder, duodenum, pancreas, diaphragm, intestines.

Why does pain occur in the middle of the sternum?

Pain in the middle of the sternum is associated with heart disease in approximately 75% of cases. It is caused by angina pectoris, myocardial infarction and, less commonly, inflammation (pericarditis, myocarditis), defects (), metabolic disorders (myocardial dystrophy, cardiomyopathy).

Aching, dull

Monotonous, dull and aching pain is characteristic of:

Dull pain in the sternum and heart can be a complication of diabetes mellitus and hypertension, heart disease, and circulatory failure. It occurs with increased thyroid function and renal failure.

Strong, sharp

An attack of sharp and severe pain occurs with angina pectoris. If it progresses, it develops into. The main signs of a lack of blood flow to the heart (coronary artery disease):

pain when walking, climbing uphill, emotional stress;
at rest, after taking Nitroglycerin it weakens;
lasts 3-15 minutes;
spreads upward (neck, jaw) and left (arm, shoulder blade);
character – burning, pressure, heaviness, squeezing (when describing the patient shows a clenched fist);
There are risk factors - age over 40 years, more often men, smoking, diabetes, obesity, gout, low physical activity, high blood cholesterol, similar diseases in blood relatives.

Symptoms of a heart attack:

angina attack lasting more than 15 minutes;
Nitroglycerin does not completely relieve pain;
cold clammy sweat;
shortness of breath, inability to lie down (indicates a complicated course);
redness or sharp pallor of the upper half of the chest, neck, blue lips, fingertips, nose;
drop in pressure, weak pulse, interruptions in rhythm.

Causes of chest pain in the middle that are not related to the heart in men and women

Pain in the middle of the chest also occurs for reasons that do not relate to the heart - diseases of the digestive system, lungs, large vessels.

Gastrointestinal problems

Painful sensations are associated with food - eating spicy, fatty foods, alcohol, overeating. Associated symptoms:

abdominal pain;
nausea, vomiting;
aversion to food;
there is an increase in temperature;
tense, swollen abdomen, painful when palpated;
spasms, increased gas formation, rumbling.

The reflux of stomach contents into the esophagus (reflux disease) is similar to an attack of angina. The pain also spreads upward and is relieved by Nitroglycerin. Belching and relief after drinking water or drugs to reduce acidity (antacids) help to distinguish it.

Features of pain in diseases:

Diseases of the gastrointestinal tract	Symptoms
Peptic ulcer	Pain at night, when hungry, an hour after eating, relieves with milk, soda solution
Gallbladder	Provokes fatty, spicy foods, an attack after 1.5-2 hours
Pancreas	Weakness, nausea, girdle pain, mainly in the epigastric region
Inflammation of the esophagus (esophagitis)	Caused by sour, spicy foods, alcohol, antacids relieve
Spasm at the junction of the esophagus and stomach	Difficulty swallowing, pain immediately after eating, belching, hiccups, throwing up food while lying down

Diseases of the respiratory system

The main sign of pain is its connection with breathing, coughing, and movements. Additional symptoms:

increased body temperature;
difficulty breathing;
wheezing in the chest;
pain when palpating the chest;
cough with sputum or dry, hacking cough.

Suddenly air enters the chest (spontaneous pneumothorax). It happens with bronchial asthma, emphysema, and sometimes for no reason in men of thin build.

At first, the pain is associated with breathing, then it develops into a constant pain in the neck and sternum. Signs:

heavy breathing;
dry cough;
pale face, cyanosis of the body;
weak pulse;
pressure drop;
intercostal spaces are smoothed;
one half of the chest lags behind when breathing.

An extremely dangerous condition is dissection of the aortic walls. The pain is unbearable, surpasses all other types, spreads to the back, head, legs, and stomach. An important symptom is that the pulse is different in the carotid and radial arteries, the pressure is different in the arms. There is deterioration of vision and difficulty swallowing. Patients are usually elderly, have long-term hypertension, or have (connective tissue weakness).

When the branches of the pulmonary artery are blocked, pain appears behind the sternum, but does not spread throughout the chest. They are combined with:

bluish skin tone;
severe shortness of breath;
discharge of pink sputum.

Usually, before this, the patient suffered thrombosis of the veins of the leg, surgery, and was on bed rest for a long time. If detected untimely, death may occur due to respiratory and heart failure.

Osteochondrosis and other spinal problems

The pain syndrome changes intensity when:

turning the body;
raising your arms, moving them back;
head tilts.

When palpating the spine, there are pain points. When lying on your back, it is difficult to lift a straight leg due to increased pain, and when it is bent, the sensations decrease. The attack appears after heavy lifting, hypothermia, sudden movements.

Mediastinal diseases

Pain caused by inflammation in the mediastinum (mediastinitis) is characterized by the following properties:

dull, prolonged;
spread to the back, neck;
worsens when swallowing and throwing back the head;
there is bulging of the veins of the neck, chest, cyanosis of the skin, its swelling;
accompanied by hoarseness, fever, heart rhythm disturbances, attacks of suffocation, and cough.

Mediastinitis is a complication of inflammation of the lungs, trachea, heart and pericardial sac, esophagus, and also occurs due to injury.

It is a consequence of a blow to the steering wheel during an accident, compression of the chest, a fall from a height. Symptoms of a fracture:

severe pain when breathing, moving;
swelling of the skin, hemorrhages, bleeding;
When the lungs are damaged, air enters the chest cavity (pneumothorax), and blood accumulates (hemothorax).

The diaphragm is located between the chest and abdominal cavity. And where the esophagus passes through there is a hole. When it expands, part of the intestine may protrude into the chest cavity. The pain radiates to the back, encircles, and appears after eating. It is strengthened by:

cough,
forward bend,
bloating,
increased gas formation,
straining,
lifting weights.

Relieves the attack by vomiting, burping, taking a deep breath, and moving to a standing position.

Autonomic dysfunction

Most often it is necessary to distinguish between pain in the sternum and heart with angina pectoris and neurocirculatory dystonia. Typically for the latter disease:

happens more often in women;
colorful description of symptoms;
pain syndrome changes location and character;
physical activity makes it easier, and intense frequent breathing strengthens;
lasts more than 30 minutes;
the intensity of pain changes in waves;
accompanied by severe anxiety, fear of death, rapid pulse, trembling hands, lack of air.

Watch the video about the symptoms of vegetative-vascular dystonia:

Excessive sports training

Too much muscle tension in athletes, especially during strength training, can cause tearing and stretching of the muscles near the sternum. This causes long-term pain that increases with movement. There is also danger in contact sports - wrestling, boxing, hitting the chest with a ball.

Such injuries may go unnoticed at first, but over time lead to a constant and dull pain in the center of the sternum. Teenagers with fragile skeletal and muscular systems are at particular risk.

Neurological and joint causes of recurrent chest pain

Periodic pain in the chest area can be caused by damage to the rib joints with the sternum. There is local swelling, pain in individual points, and redness of the skin. External changes are often absent, and pain occurs with movements of the torso, shoulders, arms, and intensifies when pressure is applied to the place where the ribs are attached. This disease is called Tietze syndrome.

The pain can be short-lived or last for hours, days, or even years. Patients are unsuccessfully treated for heart disease, since the symptoms are similar to an attack of angina pectoris, with the exception of the main symptom - there is no clear connection between physical activity and pain.

What can cause pain in the middle of the sternum when moving?

The main reasons that provoke pain when moving in the sternum in the middle:

Disease	Symptoms
	Physical activity is characterized by consistency, that is, an attack always appears after going up, for example, to the second floor, after a distance of 500 meters; with rest, the pain subsides and is relieved by Nitroglycerin.
Osteochondrosis	Pain is caused by turning, bending, raising the arms, and is relieved by anti-inflammatory drugs (Ibuprofen).
Previous injuries and surgeries on the chest	Deterioration occurs with changes in weather, physical activity, and heavy lifting.
Pleurisy, pleuropneumonia	Inflammation of the lungs, complicated by effusion into the pleural cavity, is accompanied by cough, high fever, pain associated with breathing, and shortness of breath.

What to do if there is discomfort in the chest in the middle

If discomfort appears in the middle of the chest and there is no pain attack, you can go to the clinic at your place of residence; in case of acute pain, you need to urgently call a doctor.

Which doctors should I start with for examination?

If the patient has not previously contacted specialists, then the examination should begin with a therapist. He will be able to make a preliminary diagnosis, give directions for an ECG, chest x-ray and blood tests. Based on their results, it will be clear in which direction to carry out additional diagnostics.

What to do in case of severe pain

When the first attack of pain occurs, you should sit in a chair, provide fresh air and take a Validol tablet or 20 drops of one of the sedatives - Valocordin, valerian tincture. For signs of angina pectoris, an Acetylsalicylic acid tablet is needed under the tongue.

Expert opinion

Alena Ariko

Expert in Cardiology

If the condition has not changed, and the attack lasts more than 15 minutes, an ambulance must be called. Such symptoms do not exclude the presence of myocardial infarction, and the sooner it is detected and treatment begins, the smaller the area of the heart it will cover. If there is pain that cannot be tolerated, covering most of the chest, or a drop in pressure, you should immediately call a doctor without waiting for the effect of the medications.

Prevention measures

In order to prevent heart disease as the most serious and common cause of chest pain, it is necessary:

stop smoking;
control blood pressure, cholesterol and blood glucose levels;
reduce the risks of stressful situations, learn to relax (breathing exercises, meditation, yoga), take natural-based sedatives (Novo-Passit, Persen, Sedafiton);
reduce body weight in case of obesity;
set aside time every day for physical exercise and walks in the fresh air;
change your diet - give up fatty and fried foods, limit meat, replacing it with fish, legumes, reduce the proportion of sweets, flour, eat more fresh and boiled vegetables, whole grain cereals, berries, fruits, herbs, nuts, fermented milk drinks.

Pain in the middle of the sternum is most often associated with heart disease - angina pectoris, myocardial infarction. The attack causes inflammation (myocarditis, pericarditis), aortic dissection, pulmonary embolism. All of these conditions are extremely dangerous. Diseases of the digestive and respiratory system, osteochondrosis, and vegetative-vascular dystonia are similar in their manifestations.

With injuries and physical strain, there is also pain in the chest. When an attack occurs for the first time, sedatives, Aspirin, Nitroglycerin are used, if they do not produce an effect, an ambulance must be called.

Useful video

Watch the video about possible causes of pain in the sternum in the middle:

Heart pathologies are a dangerous cause of chest pain

In women after menopause heart and vascular diseases occur with the same frequency as in the stronger sex. Before menopause, the female body is protected from them by the hormones estrogen. Heart disease usually causes pain on the left side of the body, but it is also very common in the mid-chest area.

Pain due to angina pectoris is the most common. They appear during movement, after walking, or physical activity: the more the coronary vessels are affected, the less stress can provoke discomfort. If pain occurs at rest, this reflects an advanced stage of the disease. During an attack of angina, pain can radiate to the back and shoulder blades, arm, shoulder, neck and even jaw. Symptoms of angina pectoris include:

A much more dangerous condition - myocardial infarction. Pain during a heart attack is very pronounced and cannot be relieved by taking pills. The pain can spread to any area of the chest, stomach and back, accompanied by a burning sensation, pressure on the chest, fear of death, and fainting. During such an attack, the important task is to call an ambulance in time and begin treatment. Also in women, chest pain occurs due to heart defects, thrombosis, pericarditis, but such causes are less common.

Gastrointestinal diseases and chest pain

If the chest hurts in the middle, the causes in women may also relate to pathologies of the gastrointestinal tract. Most often, pain in the center of the chest is caused by chronic gastritis and reflux esophagitis in the acute stage. The causes are inflammation of the stomach walls and reflux of gastric contents into the esophagus. Such conditions can be provoked by stress, alcohol consumption, smoking, consumption of spicy and hot foods, and treatment with certain drugs. The symptoms are as follows:

Acute chest pain is often perceived as cardiac pain, but in fact it is a sign of a gastric ulcer or duodenal ulcer. But it appears against the background of gastrointestinal pathologies in direct connection with food intake - on an empty stomach with an ulcer, immediately after a meal - with gastritis, an hour after a meal - from duodenal problems.

During pregnancy, pain from gastrointestinal problems is accompanied by heaviness in the stomach and is almost always combined with severe heartburn.

Chest pain - pulmonary pathologies are to blame

Since most of the chest is occupied by the lungs, their diseases may well cause discomfort. In women, chronic lung pathologies are more common with a long history of smoking, with autoimmune and allergic diseases, as well as with untreated inflammatory processes. Lung pathologies, each of which can cause pain in the middle of the chest, are as follows:

Almost any pulmonary disease has a lot of other, more characteristic signs, and pain syndrome only accompanies them. The main component of the clinical picture is cough - dry, wet, with or without sputum production. Often there is an increase in body temperature, shortness of breath, wheezing in the lungs, and symptoms of general intoxication - if we are talking about an acute infectious disease. The pain in this case is associated with spasms that strain the intercostal muscles and the diaphragm.

Lung tumors cause pain inside the chest only in the later stages and are often accompanied by hemoptysis.

Acute heart-type pain can be characteristic of pleurisy, aching - for pneumonia, pain during exercise and on inspiration - for tracheitis.

Diseases of the spine and nervous system as a cause of pain

Cervical and thoracic osteochondrosis is a very “popular” cause of pain in women, which is localized in the chest. Why does discomfort appear in the chest area when the spine is damaged?

The fact is that pinched nerves lead to the development of intercostal neuralgia, which can cause pain in any part of the chest. Often such sensations even resemble a heart attack, or pain due to inflammation of the stomach.

Unpleasant signs may appear after sleep if a person with osteochondrosis sleeps in the wrong position and does not use orthopedic products. The pain may intensify when bending forward while inhaling. Osteochondrosis is accompanied by other symptoms:

Often scoliosis of the spine - its curvature in the thoracic region - also leads to intercostal neuralgia.

For women, such pathologies as cardiac neurosis and vegetative-vascular dystonia are very common, and they also cause pain in the chest in the middle.

Other causes of chest pain in women

Having discovered pain in the chest, many women suspect problems with the mammary glands, in particular breast cancer. This disease, indeed, occurs frequently, but it causes pain only in the later stages, when there are a number of other signs (a formation noticeable when pressed and palpated, discharge from the nipples, etc.). Pain is more typical for mastopathy, although it is localized not in the center of the chest, but directly in the mammary gland.

Thyroid diseases are much more common in women. Hyperthyroidism, nodular goiter, diffuse goiter - all these diseases can cause pain radiating to the chest, as well as the following symptoms:

If you overuse training or undergo physical overexertion, pain in the chest muscles is also possible. This symptom is typical in women under stress, depression, nervous exhaustion, as well as bruise, blow, or any injury to this area.

Diagnosis and treatment of chest pain

The diagnostic algorithm will depend on the nature of the discomfort, its severity and other symptoms. Thus, in case of acute heart pain or serious injuries, diagnosis and treatment are carried out after hospitalization. For chronic pathologies with subacute symptoms, diagnostic methods may be as follows:

Treatment will depend on the problem found. So, for neuralgia, you need to do massage, physiotherapy, and take painkillers. For angina pectoris, take a number of heart medications and follow a diet. Antibiotics and cough suppressants help treat lung diseases. For gastrointestinal pathologies, special medications and special nutrition are prescribed. It is not recommended to delay treatment - this is the only way to avoid complications.