Pain in the region of the heart is always considered by the patient as an immediate threat to life. The subsequent development of vegetative reactions as a result of fear, increased heart rate and the appearance of a feeling of dissatisfaction with the breath reinforce such fears. Meanwhile, there are more than 100 causes of chest pain, and only 6 of them require emergency assistance and directly threaten he alth. Therefore, you need to correctly figure out how to distinguish heart pain from osteochondrosis or fibromyalgia, how to suspect an emergency pathology and what symptoms can be neglected.
Self-diagnosis problems
Due to the need to relieve pain, medication is required, for which you need to clearly understand the cause of these sensations. Misinterpretation of the source and cause of a symptom leads toto the fact that after taking the drug they do not subside and disturb further. Many types of chest pain cannot be completely eliminated with a single dose of medicines, and therefore almost every episode of their occurrence requires a visit to a doctor.
Stereotypical anginal pains of cardiac localization or previously unfamiliar and sharply occurring severe chest pains require emergency treatment, and skeletal or vertebrogenic low-intensity sensations require routine examination and treatment. Every patient should understand this simple thesis in order to exclude inappropriate behavior and attitude towards their he alth.
Self-diagnosis has two manifestations: the first is an underestimation of the severity of the condition, and the second is a panicky (sometimes intentional) exaggeration and distortion of the nature of heart pain. The latter occurs with the development of mild but unfamiliar or unpleasant symptoms. At the same time, thoughts are imposed on oneself and others about the incredible severity of the symptoms that have arisen, the inevitability of a formidable pathology, and the need for emergency access to an ambulance.
Reasons for overdiagnosis
This happens because of ignorance of the differences between heart pain and other variants of pain in the chest, and, succumbing to incredible fear and panic, the patient imposes on others the need to provide him with urgent medical care. It is important that the materials, diagnostic criteria, and symptom descriptions used in this publication be used by an adequate, self-disciplined patient.
Will beit is wrong to take any part of the publication out of context and interpret the severity of your condition only on the basis of individual phrases and sentences. The material on how to distinguish heart pain from osteochondrosis should be mastered in its entirety. It is necessary to clearly distinguish between pressing, stabbing, cutting and other types of discomfort, to highlight the accompanying symptoms, not to exaggerate or underestimate the significance of each manifestation.
Osteochondrosis of the spinal column
With a disease such as osteochondrosis of the thoracic spine, the symptoms and treatment of which will be discussed below, differential diagnosis is required so as not to confuse it with injuries of the ribs or spinal column, myocardial infarction, pulmonary embolism, dissecting aortic aneurysm, acute surgical diseases belly. At the same time, the concept of osteochondrosis is rather collective and simplified for understanding the patient.
In fact, the term refers to a group of degenerative diseases of the spine and intervertebral discs, the defeat or gradual destruction of which with age leads to compression of the spinal nerve roots. From exposure to them, as well as due to venous edema of the nerve roots, painful sensations develop. Their nature and patterns of appearance clearly demonstrate how to distinguish heart pain from osteochondrosis.
When the cervical spine is affected, dizziness, numbness and parasthesia in the shoulder girdle area, sharp pains of a stabbing and cutting nature in the chest and heart when the neck movesor upper limbs, on inhalation and exhalation. Pain with osteochondrosis of the thoracic spine is approximately the same as with lesions of the cervical region due to the fact that the disease rarely affects only one area.
Treatment tactics
With a disease such as osteochondrosis of the thoracic spine, the symptoms and treatment are not directly related to each other. That is, often the number of symptoms and the intensity of discomfort do not depend on the quality and duration of treatment. Low-intensity pains can even disturb for a long time or constantly. But this is observed in a situation of insufficient diagnosis (or non-fulfillment of recommendations by the patient), when a more severe disease of the musculoskeletal system occurs under the guise of osteochondrosis. In particular, the presence of herniated intervertebral discs, which is characterized by prolonged pain.
If all available methods of treatment have failed, it makes sense to perform an MRI of the spinal column and identify violations in the structure of the intervertebral discs. Thoracalgia, intercostal neuralgia and dorsalgia, myofascial syndromes and fibromyalgia, that is, all those diseases that are called osteochondrosis, are treated with NSAIDs (painkillers "Nimesulide", "Aceclofenac", "Ibuprofen", "Ketoprofen"), muscle relaxants ("Tolperizon"), B vitamins, physiotherapy.
Sources of pain in the heart
There are about 100 private causes of chest pain, therefore it is not possible to describe each of them within the framework of this publicationpossible. Therefore, it is reasonable to indicate all the sources of the occurrence of such sensations, which will be considered as their significance decreases. More often than others, the above pains of a skeletal nature are observed, grouped under the general concept of fibromyalgia. Vertebral and neurological disorders occur less frequently, and even more rarely, unpleasant sensations in the structures of the digestive system.
The most rare, but the most significant, are anginal pain in the heart, pain in pulmonary embolism, similar sensations occur with dissecting aortic aneurysm. Each of these states will be considered individually below. The severity of diseases associated with them will decrease from top to bottom (higher will be severe pathologies that threaten life and require emergency medical attention).
Anginal pains
Chest pain often comes not from muscles, bones and nerves, but from the heart, where they arise as a result of insufficient blood supply to the organ. And the most severe pathology is myocardial infarction, the complexity of the treatment of which patients most often underestimate. The main danger of a heart attack is cardiogenic shock, the development of which cannot be predicted at the stage of pain. This is probabilistic and requires an emergency call for help.
and burning), whether there is an improvement in the condition after taking short-acting nitrates. Additionally, the following indicators are evaluated: whether the level of blood pressure has changed, whether shortness of breath or a feeling of dissatisfaction with the breath has appeared.
You need to remember if you have experienced similar symptoms before and what was their previous cause. When anginal pain occurs in myocardial infarction, some stereotype is observed. That is, these are pressing constant pains without connection with the phases of breathing and movement in the chest, slightly decrease after taking nitroglycerin or subside for a short time, may be accompanied by shortness of breath and a feeling of dissatisfaction with the breath.
Treatment for anginal pain
Myocardial infarction is not the only pathology that can cause anginal pain. With angina pectoris, including its progression, the symptoms are similar. However, in this case, after taking nitrates, the heart pain is relieved. Unlike angina pectoris, this is rarely seen with a heart attack. If, after taking nitroglycerin after 5-7 minutes, the condition has not changed and re-taking the pill did not work after another 5-7 minutes, then it is reasonable to seek emergency medical help for a heart attack.
It can be caused by myocardial infarction, progressive or unstable angina pectoris, as well as prolonged angina pectoris on the background of a hypertensive crisis. Each of these conditions requires medical attention, sometimes hospitalization in a cardiologicalhospital. All cardiac pains, the symptoms and treatment of which are indicated above, require attention due to the risk of developing cardiogenic shock or left ventricular failure. And when such sensations appear in the chest, it should be remembered that anginal pain is stereotypical and manifests itself as a feeling of severe compression and burning behind the sternum, accompanied by shortness of breath or a feeling of dissatisfaction with inhalation, squeezing in the neck, sometimes in the interscapular space, accompanied by heat in the face, tachycardia.
Combined pain
It is important that heart pains are not excluded when confirming osteochondrosis, thoracalgia or neuralgia of the intercostal nerves. Since several organs and systems can be affected simultaneously, anginal pain often occurs along with skeletal pain. They are more difficult to distinguish from each other due to the simultaneous presence of pressing burning sensations in the heart, and stabbing pains along with parasthesias or “shots” in the back or intercostal spaces.
In such situations, a careful separation of symptoms is required, each type of which, together with the patterns of their occurrence, should be described to the doctor. It is necessary to perform an ECG and compare it in dynamics. The appearance of new changes on the ECG or a clear picture of acute coronary syndrome indicates heart disease. Then, regardless of the severity of skeletal pathology (osteochondrosis, thoracalgia, trauma), priority in treatment should be given to heart disease.
What to drink with heart pain and how to stop it in this casethoroughly explained by the attending physician before discharge from the hospital. It is not recommended to make changes to his prescription regimen on your own due to the fact that new drugs can affect the likelihood of recurrent coronary artery thrombosis.
Emergency Vascular Pathologies
In this group, there are two diseases that are manifested by pain in the chest and often pain in the heart. These are pulmonary embolism and dissecting aortic aneurysm. The intensity of pain varies from discomfort to the strongest unbearable, accompanied by tachycardia and shortness of breath at high or low blood pressure. The prognosis mainly depends on the extent of the lesion (total or subtotal PE), the speed of treatment and treatment.
With a dissecting aortic aneurysm, pain of a constant nature is strong and localized behind the sternum, in the interscapular region and sometimes slightly to the right of the sternum. The pain is stronger, the higher the blood pressure, and as it decreases, it weakens. The urgency of the pathology is due to the risk of rupture of a dissecting aneurysm, which will immediately cause symptoms of shock: sharp pallor and moisture of the skin, lethargy, lethargy, tachycardia, and rare breathing.
Pulmonary embolism
In pulmonary embolism, the clinical manifestations depend on the extent of the lesion. With total PE, the patient feels a sharp pain in the chest and heart, after which he almost instantly loses consciousness due to developing shock and arrhythmia. With subtotal PE, the sensations are less intense, accompanied by severe shortness of breath, tachycardia. Riskdevelopment of shock is also great, requiring emergency medical attention.
In this case, it is not necessary to think about how to distinguish heart pain from osteochondrosis, since the nature of sensations in both the first and second cases is fundamentally different. They cannot be confused with vertebrogenic pain, if only because they do not depend on movement and are accompanied by other severe symptoms (shortness of breath, loss of consciousness, tachycardia) and are accompanied by shock.
Surgical Abdominal Diseases
This group of diseases should include esophageal rupture, esophageal ulcer, gastric and duodenal ulcer, gastrointestinal bleeding, pancreatitis, cholecystitis. In the vast majority of cases, these pains are similar to cardiac pain, although they rarely mimic vertebrogenic pain or fibromyalgia. However, they differ in that they require emergency care, and patients almost always confuse them with pain in the heart and pain in osteochondrosis.
All diseases of the abdominal cavity are accompanied by dyspepsia in 90% of cases (vomiting, belching or nausea develops), and in 75-90% of cases, aggravation of pain can be associated with eating. So, if the patient is concerned about chest pain, nausea and vomiting (sometimes with blood or fetid discharge), then the likelihood of heart disease (as well as osteochondrosis, fibromyalgia or thoracology) becomes minimal. In 3-5% of cases of myocardial infarction, posterior localization is noted, which can sometimes be characterized by clinical signs of acute abdominal disease, mimic pancreatitis,cholecystitis, renal colic, appendicitis and others.
