In the traditional sense, such a common symptom as a burning sensation in the chest is a sign of heart disease. Angina pectoris or myocardial infarction are usually the first candidates for the cause of the burning sensation in the chest. However, such a symptom often speaks in favor of other diseases, the differential diagnosis of which requires clarification of the nature of the burning sensation, its localization and features of the appearance, identification of concomitant complaints and disorders.
Medical significance of the symptom
The symptom of burning in the chest is very heterogeneous and can be caused by diseases of the digestive, bronchopulmonary, cardiovascular, musculoskeletal systems. Less commonly, the source of burning in the chest are diseases of the skin, lymphatic vessels and systemic autoimmune pathologies. Even more rarely, the cause is damage to the peripheral nerves in the form of shingles, radiculopathy.
Primary care physicians (emergency and general practitioners), as well as general practitioners, cardiologists, surgeons, pulmonologists, neurologists, deal with this symptom more often than others. Complaints of burning sensation are extremely rare in the practice of hematologists and psychiatrists. For a specialist, the most obvious cause of a symptom is found out quite simply after a thorough questioning of the patient, performing an electrocardiogram, and interpreting the accompanying complaints.
Symptom of cardiac profile
According to the established beliefs of patients, burning in the chest is a symptom of only a cardiological disease. In fact, this is not true, although cardiologists consider this complaint as specific for ischemic lesions in combination with chest pain. In the event of an attack of angina pectoris or as a result of the development of myocardial infarction, it is precisely a bunch of these symptoms that appears. Only burning without pain and shortness of breath is not specific for acute coronary events.
When myocardial infarction or an attack of angina pectoris appears complex of complaints in the chest: on the left, there is a squeezing burning pain that develops as a result of physical activity. Only occasionally does a heart attack or anginal attack occur at rest. The nature of these pains and burning does not change depending on the position of the body, movement in the shoulder girdle and torso, the depth of inspiration. Then the burning sensation bothers precisely behind the sternum, while the pain of a pressing nature is localized both behind the sternum and in the projection of the heart. The pain may also radiate to the neck.and lower jaw, reflected into the interscapular space or directly under the left shoulder blade, a little less often - into the left shoulder.
The nature of pain in an acute coronary event depends on the location of ischemia or necrosis along the anterior, lateral or posterior wall of the ventricle, as well as on the extent of the lesion. In patients with concomitant peripheral neuropathies (alcoholic or diabetic), pain and burning are mildly developed. Therefore, angina pectoris or a heart attack can be accompanied either by the most severe symptoms characteristic of acute heart failure, or, with a small amount of damage, proceed without significant disturbances at all.
Heart attack and angina
Complaints of pain and burning in the chest in the region of the heart as a signal of heart damage occur during an attack of angina pectoris or a heart attack. In the second case, if the pain does not stop after 2-fold intake of short-acting nitrates, medical attention is required. And in the first, in the case of angina pectoris, when burning and pain are always provoked by the same or equivalent load, Nitroglycerin is required. It is the burning sensation in the chest when walking or climbing stairs, which is accompanied by shortness of breath and a feeling of severe pressure in the chest, is a symptom of angina pectoris.
This complaint occurs as a result of episodic coronary spasm, due to which, during exercise, energy consumption in the heart increases, and due to the narrowed lumen of the arteries, it is not possible to deliver the required amount of oxygen and energy substrate. Giventhe condition goes away on its own 3-15 minutes after the cessation of the load or 3-7 minutes after taking short-acting nitrates.
The appearance of a burning sensation in the left side of the chest or behind the sternum, along with pain, occurs with stereotypical loads, for example, when walking from 250 to 500 meters or climbing 2-3 flights of stairs. The resource of each patient depends on the functional class of angina pectoris, which is determined depending on the exercise tolerance. A little less often, anginal pain occurs with a hypertensive crisis and paroxysms of tachyarrhythmias.
Digestive system disorders
Burning in the chest is a symptom of diseases of the digestive system, although many patients are convinced that in diseases of the stomach, esophagus, liver and pancreas, pain always bothers the stomach. In fact, there is a group of gastric and esophageal disorders that are bothered by burning in the chest and pain in the chest. However, these symptoms are usually associated with either dyspepsia or bad taste in the mouth and bitterness in the morning, belching, nausea, or vomiting.
Burning in the epigastric region and in the heart, as well as in the projection of the sternum, is a specific general symptom of diseases of the esophagus: esophagitis, reflux disease, tumors. Then the burning sensation in the chest is constant or associated with eating. With esophageal lesions, complaints occur immediately at the time of swallowing food, and with gastric, for example, with a stomach ulcer, pain and burning in the epigastrium andchest pain occur 30 minutes or more after eating.
Verification of esophageal and gastric complaints
GERD, esophagitis, chronic gastritis or stomach ulcers are more likely to be found in patients presenting with these complaints. Less commonly, pyloric stenosis, stenosis of the esophagus, Mallory-Weiss syndrome, accompanied by frequent vomiting, is determined. At the same time, tumors of the esophagus are characterized by burning in the chest, and violations of swallowing food, and vomiting of unchanged (undigested and untreated gastric juice) food.
Esophageal vomiting may not be the first symptom of a tumor, as it occurs when the lumen of the esophagus is obstructed. Burning in oncological lesions of the esophagus appears even later, which requires an examination and a decision on the operation. Gastric and esophageal complaints can be verified by performing X-ray gastroscopy and fibrogastroscopy with a mandatory biopsy.
Respiratory system disorders
Burning in the chest when coughing or breathing is a symptom of damage to the lungs, bronchi or pleural membrane. Most often, such a complaint is caused by the presence of pleuropneumonia. In this case, inflammation develops in a small marginal area of the lung, which is accompanied by simultaneous damage to the pleura. This means that along with pneumonia, first dry pleurisy appears, and then exudative.
Burning and pain in the chest at the site of the lesion, which are aggravated by deep inspiration or coughing, are a sign of dry pleurisy or swelling of the pleura. In case of further developmentexudative pleurisy, the pain subsides, the patient seems to be improving. However, in reality, exudative effusion aggravates the state of he alth, although there are fewer complaints.
Cancer of the chest cavity
In such a symptom as a burning sensation in the chest, the causes can be very diverse, up to the development of a tumor of the pleura, bronchi, breast, esophagus or lung. Therefore, in the event of such a complaint, the patient requires a thorough study of the symptom and an appropriate examination. At the same time, there is an unspoken rule in medicine that says that in all unclear cases, cancer should be suspected.
Although this phrase sounds dramatic, however, at the stage of differential diagnosis, if no changes are detected in laboratory tests and on the electrocardiogram, one should be guided towards performing FEGDS and radiographs. The latter are necessary to exclude ulcers and pneumonia, and are also able to provide information about the presence of a tumor in the digestive or bronchopulmonary system.
Cancer alert
In the case of oncological diseases, there may be a burning sensation in the chest on the right or behind the sternum, often of a permanent nature, which has a clear dependence on the phases of breathing or food intake. Sometimes the burning sensation bothers you constantly and does not depend on movement. Very often, in oncological diseases, it appears at the moment when the tumor from the primary focus has metastasized and developed at the screening site, squeezing the surrounding tissues or forming a fistulousmove.
For example, tumors of the esophagus first appear not with a burning sensation in the chest, but with swallowing problems, belching, and sometimes minor heartburn. The burning sensation itself begins to disturb at the moment when, due to the constant obstruction of the lumen of the esophagus and food retention, its overlying areas expand. Also, the appearance of this symptom is observed in the case of the formation of a fistulous tract connecting the esophagus to the trachea.
Symptoms such as trouble swallowing and weight loss for no apparent reason are early warning signs of a tumor in the digestive system. Burning in the chest in this situation is not the primary symptom, because most often it appears quite late. However, the appearance of such a symptom requires examination and identification of the cause that caused it.
Burning in neurological diseases
In addition to oncological diseases, such a symptom as burning and tingling in the chest is also characteristic of neurological pathologies. For example, this is observed with herpes zoster, radiculopathy, lesions of the spinal column, intercostal neuralgia. As a rule, chest pain comes to the fore here, which is sharp, stabbing or cutting, depends on the position of the body, or increases with movement. Only occasionally the pain is permanent and can mimic an anginal attack, because it appears after exercise.
Burning in the chest on the right, as well as pain in the chest in the projection of the shoulder blades or along the spinal column -typical symptoms of lesions of the musculoskeletal system: osteochondrosis, deforming arthrosis, ankylosing spondylitis, spondylopathies. At the same time, the symptoms are simultaneously attributed to neurology, for the reason that as a result of these diseases, compression of the roots of the spinal nerves occurs.
The stabbing character of the pain with a clear association with movement is specific to radiculopathies. Other radicular symptoms can also be determined by neurologists, each of which is specific to a particular lesion site. Often there is no doubt whether pain and burning in the chest on the right or behind the sternum is a sign of a neurological disease, since the diagnosis is sometimes obvious. Regardless of this, the patient needs an ECG and laboratory tests.
This is necessary to exclude heart damage, as well as for non-specific diagnosis of infectious diseases, leukemia or hematosarcomas. Many of the patients suffering from hematological neoplastic diseases confirm that their disease was detected without complaints as a result of a complete blood count during a routine examination or medical examination.
Treatment of specialized diseases
After examining a patient with a complaint of burning in the chest, treatment is prescribed according to the violations found. If the symptoms are associated with myocardial infarction, preparations are made for interventional interventions, in the case of angina pectoris, the treatment regimen is adjusted. If tumors of the breast, lung, bronchus, pleura, pharynx, esophagus or stomach are detected,a comprehensive examination necessary for planning the scope of the operation.
In the case of pneumonia, when the question of the origin of the symptom is removed by performing X-rays and complete blood counts, antibiotic and physiotherapy treatment is prescribed. In case of neurological disease, physiotherapy and anesthesia are appropriate. Moreover, in everyday practice, the detailing of a symptom usually does not cause difficulties, since the accompanying complaints usually allow you to quickly and accurately make a diagnosis.
CV
The causes of such a symptom as a burning sensation in the chest are very diverse. Among them are diseases of the respiratory, cardiovascular and digestive systems. Occasionally, burning is a sign of oncological, neurological and skin diseases. At the same time, it is important to understand that in order to interpret the symptom, it is necessary to study the accompanying complaints, as well as the conditions and patterns of the occurrence of burning, its persistence or paroxysmal nature. An isolated chest burning symptom is exceptionally rare and is indicative of a skin lesion that is almost always easy to spot.
Burning is a symptom, and there can be no talk of any treatment without an adequate diagnosis. The correct tactic is to contact a specialist and examine in order to identify a specific cause. You can start treatment immediately if there is an obvious cause of the symptom. However, if there is no effect, diagnostic questions should be resolved until a specific diagnosis is made and the symptom completely disappears inresult of treatment.
