Aching pain in the heart: causes and treatment, possible diseases. How to distinguish heart pain from non-heart pain? Heart aches

One of the most common reasons for admitting patients to emergency departments is constant pain in the heart. With these symptoms, only immediate medical attention is often life-saving.

Difficulties in cardiac diagnosis

People experiencing constant pain in the heart, their causes are often seen in a heart attack, although this is not always the case. It is not at all easy to establish what causes pain in the heart area. For this, not only X-rays and blood tests can be used, but also computed tomography and others. instrumental methods research. However, there are many cases where it is enough for the doctor to carefully examine the patient's history.

Cardialgia (heart pain) occurs not only in pathological conditions, but also in clinical syndromes. Naturally, it is not always true to assess aching pain in the heart, the causes of which are heart disease, since sometimes they are not their main root cause.

Therefore, it is important to exclude the influence of cardiac disorders during examination, since a belated correct diagnosis can seriously aggravate the severity of the patient's condition.

Sources of chest pain

With a high degree of probability chest pain means a violation of cardiac activity, but this cannot be stated with 100% certainty. Under heart pains, symptoms of heart disease, other problems are sometimes disguised that completely different organs can suffer:

• The chest wall along with ribs, skin and muscles.
• Spine, muscles and nerves of the back.
• Trachea, pleura, or lungs.
• Aorta.
• Heart and sac (pericardium).
• The diaphragm and the flat muscle separating the chest from the abdominal cavity.
• Esophagus.

Heart pain associated with cardiovascular disease

Angina pectoris

This disease most often presents with heart pain, symptoms in this case can be supplemented by nausea and excessive sweating... The cause of angina pectoris is atherosclerosis - the deposition of fatty plaques on the walls of the coronary vessels, which leads to a gradual narrowing of their lumens and obstruction of blood flow, which provides the heart with oxygen and nutrition. If the myocardium receives an insufficient amount of oxygen for its activity, it begins to weaken. The heart pumps blood less intensively, and its owner experiences a dull aching pain in the heart. Moreover, if the pain intensifies during exertion and is localized in the left side of the chest, then this is a sign of stable angina pectoris. In contrast, unstable angina pectoris is characterized by sudden attacks of severe heart pain, which can appear even in a state of complete rest. In these cases, urgent medical attention is needed.

People who have constant pain in the region of the heart caused by angina pectoris should adhere to healthy way life, especially in terms of nutrition - avoid consumption of foods rich in cholesterol. They should always have nitroglycerin on hand, which is used immediately when pain intensifies. If the nitro drug does not help, then an ambulance should be called.

Ischemic disease

Insufficient blood supply to the myocardium leads to coronary heart disease. Pathology develops against the background of atherosclerotic changes in the coronary vessels. IHD can be acute and chronic, or combine several clinical pictures.

Typically, patients with coronary heart disease experience paroxysmal heart pain. But when there is a constant aching pain in the heart, then the doctor should be alerted, since it indicates a serious complication. When a dull aching pain occurs in the heart, this can mean the progression of cardiosclerosis and even the first manifestations of the development of myocardial infarction. When the nature of pain changes with angina pectoris, a control study of the patient is necessary. The electrocardiogram allows you to identify the pathological dynamics of changes in a timely manner, so it must be used in clinical diagnosis.

Myocarditis and pericarditis

Very often we carry a cold or infection on our feet, not considering it necessary qualified assistance... But this can sometimes lead to very unpleasant consequences, since at the time of the blossoming of the infection or immediately after it, an inflammatory process or infectious-allergic myocarditis develops in the heart muscle.

At first, the course of the disease is latent, however, the doctor may suspect it on the following grounds:

• Aching pain in the region of the heart.
• Malaise, weakness.
• Dyspnea.
• An increase in temperature to subfebrile values.
• Interruptions in cardiac activity (palpitations, abnormal heart rhythms).

In diffuse forms of myocarditis, when it spreads, clinical symptoms may become more pronounced. The picture of the onset of the development of pathology is of particular importance, since the acute phase will be more severe clinically.

Constant aching pain in the heart with myocarditis is often combined with heart rhythm disturbances. While not permanent and mandatory, this feature is nevertheless considered important when assessed clinical picture when conducting differential diagnosis... Myocarditis of idiopathic origin has the most severe course. It can even be malignant and cause severe rhythm disturbances and heart failure. The condition is aggravated by an increase in the size of the heart, the so-called pronounced dilatation of the heart.

When the myocardium is exposed viral infection, then pericarditis often occurs.

Pericarditis is an inflammatory heart disease caused by fungi, bacteria and other factors. It is accompanied by mild or moderate persistent heart pain. These problems are not as dangerous as angina pectoris, but they may well cause severe complicationsso their symptoms cannot be ignored.

The clinical signs of this disease must be compared with the changes shown on the electrocardiogram. This is especially important when elderly patients complain of constant pain near the heart. ECG data can confirm the presence of ischemic changes in the heart.

Heart pain not associated with diseases of other organs

Severe pain syndrome can be a consequence of dyshormonal conditions and endocrine diseases. Pathology caused by thyroid, especially thyrotoxicosis, since cardialgia is considered a clinical manifestation for thyroid pathology.

With menopausal female syndrome, a dyshormonal state is the basis of cardiac abnormalities. In patients, pain in the heart with menopause can last for months, until an accurate diagnosis is made and begins replacement therapy... This pain can appear during sleep and at rest, so it should be differentiated from rest angina. Various vegetative manifestations here can become concomitant symptoms, they can significantly complicate the correct diagnosis.

Sometimes for heart pains are such constant chest pains that are caused by lung diseases, rib injury, and digestive system disorders.

Some mental disorders may also manifest: panic attacks or anxiety disorders. The latter cases, with inappropriate treatment, can themselves lead to somatic disorders, among which may be heart disease.

Heartache. It is this complaint that most often sounds from patients who come to see a therapist. This syndrome makes you worry and worry from the first seconds - according to statistics, heart pains force a person to seek help from medical professionals from the first attack, and not start self-medication.

Heart pain: symptoms and diagnoses

According to the patient's complaints, doctors can make a preliminary diagnosis - for various disorders in the work of the main organ, pain can be differentiated.

Ischemic heart disease

This definition combines two types of cardiac pathologies - angina pectoris and myocardial infarction. Both are characterized by pain in the region of the heart, but there are differences both in the nature of the pain syndrome and in the general clinical picture.

Learn more about ischemic disease hearts - in the video review:

Angina pectoris

In this state, pain appears due to a significant narrowing of the blood vessels of the heart (due to atherosclerosis or a large number of cholesterol plaques), as a result of which an insufficient amount of oxygen enters the main organ. An accumulation of lactic acid forms in the vessels, which causes pain. According to statistics, angina pectoris is often diagnosed at the age of 40 and older, and the pain becomes most intense during physical exertion.

The disease under consideration is characterized by acute attacks, burning pain, "spread" throughout the chest, quickly passing after taking certain medicines (for example, nitroglycerin).

note: an attack of pain with angina pectoris can pass in waves - unpleasant sensations either intensify or subside, the pain radiates to the scapula or arm, neck and interscapular space.

Cardiologists distinguish two types of pain during angina pectoris:

• with stress - this is considered a milder degree of development of pathology, because pain syndrome occurs only during physical exertion, increased blood pressure, stress, nervous breakdowns;
• at rest - uncomfortable sensations arise even during sleep, are in no way connected with stress and mean that angina pectoris acquires a health-threatening character.

Myocardial infarction

This pathology is considered a "logical" continuation of developed angina pectoris. The essence of a heart attack is that the coronary vessels are narrowed so much that the flow of blood to the tissues of the heart completely stops - some of the cells die. For myocardial infarction, the following symptoms will be characteristic:

• burning, sharp pain behind the sternum, which does not stop within 5 minutes and does not change towards improvement even after taking the usual medicines;
• falls sharply blood pressure - in some cases, the patient loses consciousness (fainting);
• the skin becomes pale, the appearance of cold clammy sweat is noted;
• the patient experiences a strong sense of fear of death and may panic.

The causes of a heart attack are described in this review:

Important: pain in the heart, characteristic of myocardial infarction, requires immediate intervention of medical workers - the condition threatens the patient's life.

Arterial hypertension

A significant increase in blood pressure indicators is classified in medicine as it is characterized by burning, aching pain in the chest area.

Pain syndrome due to increased blood pressure is easy enough to differentiate, because it is accompanied by the following symptoms:

• noise in ears;
• "flies" appear before the eyes;
• a severe headache attack, which is more often localized in the temporal region;
• uncritical dizziness;
• heat is felt in the body, the face is hyperemic (has pronounced redness).

Pain in the heart in this condition most often occurs with the development of a hypertensive crisis - blood pressure rises suddenly and immediately to critical levels.

Cardiomyopathy

Any pain in the heart that is not associated with a violation of oxygen supply, inflammatory or infectious processes in the main organ is called cardiomyopathy. In this pathological condition, the pain is variable in nature - aching or sharp, paroxysmal or constant, burning or stabbing. Pain syndrome can occur both with excessive physical exertion and at rest. Most often, cardiomyopathy is caused by a violation of metabolic processes in the body.

note: pain in the heart with the pathology under consideration is in some cases relieved by the use of nitroglycerin.

Myocarditis

The inflammatory process that develops in the tissues of the heart muscle is classified as myocarditis and is always accompanied by pain in the region of the heart. The inflammatory process can be caused by viruses, pathogenic bacteria and other pathogenic microorganisms.

The characteristic of heart pain in myocarditis is as follows:

• pain can be aching or cutting;
• after taking nitroglycerin under the tongue, there is no relief;
• the syndrome is not associated with excessive physical exertion or a nervous / psycho-emotional state.

Pain in the heart with myocarditis is joined by:

• general deterioration of health - drowsiness, weakness, fatigue;
• hyperthermia (increased body temperature) to subfebrile levels;
• the heartbeat becomes more frequent, but it can freeze for a few seconds at any moment.

note: myocarditis can be absolutely asymptomatic, but this is extremely rare in medical practice.

Pericarditis

The outer shell of the heart is called the pericardium and it is the inflammation of this tissue that provokes the development of pericarditis. With such a pathology, the pain syndrome has a very specific character:

1. Never radiates to the left arm or neck.
2. The most severe pain sensations are localized - the patient notes them at the bottom and left of the chest.
3. Pericarditis is the only heart pathology in which pain can "give" to right side chest, right arm.
4. The pain is cutting, sharp.
5. A patient with pericarditis will look for a position in which the intensity of pain decreases - usually a person sits with a low bowed head.

Vegeto-vascular dystonia

This disease is characterized by a systemic nature, in which the nervous regulation of the functional processes of the heart is disrupted. note: pain in the heart against the background of vegetative-vascular dystonia most often occurs in adolescence.

Doctors distinguish between several types of pain in the heart area against the background of vegetative-vascular dystonia:

1. Simple cardialgia. The pain in this case will be aching (very rarely takes a nagging character), short-lived and does not require taking any specific medications.
2. Cardialgia crisis of the vegetative type. The pain syndrome has a long duration, but there are no acute attacks. With cardialgia of a vegetative crisis, in addition to pain, the following symptoms will be present:
   • dyspnea;
   • heart palpitations;
   • feeling that there is not enough air;
   • a distinct sense of fear of death.
3. Sympathetic cardialgia. The pain is burning in nature, localized in the retrosternal region. A distinctive feature of sympathetic cardialgia is that when feeling the ribs, the pain syndrome becomes more intense.

A specialist tells in more detail about vegetative-vascular dystonia:

Arrhythmia

This is a disease that provokes a disturbance in the rhythm of the heart. Arrhythmia is easy to diagnose on your own, because the uneven work of the main organ is always pronounced:

• the heart beats either too often, or literally freezes for a few seconds;
• pain in the chest area is not intense;
• there is sudden general weakness and severe dizziness.

With arrhythmias, pain radiates to the left arm, left side neck and interscapular space.

Heart pains not related to organ problems

Pain in the heart may indicate pathologies of completely different systems and organs. It is interesting that doctors listen carefully to the patient and note that if the patient talks in great detail about pain in the heart, characterizing them "hourly", then most likely we are talking about the irradiation of the pain syndrome to the heart from other organs:

1. Duodenal ulcer / stomach ulcer and gastritis. Problems in the work of the organs of the gastrointestinal tract are manifested by severe pain in the heart. To differentiate pain from the stomach with a real heart attack, it is worth knowing what symptoms accompany false pain in the heart with stomach pathologies:
   • nausea and vomiting;
   • severe bloating;
   • there is a sour taste in the mouth.
2. Gastroesophagenic syndrome. With such a disease, a portion of hydrochloric acid from the stomach is regularly released into the esophagus, which provokes a false heart attack. The pain syndrome is characterized by a stabbing character and burning sensation, it can be localized on the left in the chest.
3. ... With an inflammatory process in the lungs with localization on the left, rather strong, pronounced pains in the heart area can occur. They have an aching and stabbing character, they often panic the patient, especially if a fake heart attack occurs for the first time. To differentiate pulmonary pain from heart pain, the following symptoms should be noted or excluded:
   • dry cough;
   • increased body temperature;
   • pallor of the skin;
   • severe shortness of breath.

In general, doctors believe that any pathology can provoke a false heart attack. For example, in acute respiratory diseases and influenza, intercostal neuralgia and osteochondrosis, pain in the heart will be present, which only a specialist can differentiate.

Heart pain - treatment

When the first heart attack occurs, a person immediately turns to a cardiologist for help - heart pains really cause a strong feeling of fear of death. The doctor must conduct a full examination of the patient:

• questioning and examination of the patient;
• ultrasound examination of the chest organs;
• electrocardiogram;
• cT scan.

Only after an accurate diagnosis has been made, recommendations will be given on the treatment of heart pathologies that provoke the appearance of chest pain. If there is an inflammatory process in the tissues of the heart, then you will need to undergo a course of treatment with antibacterial drugs (antibiotics), with viral etiology of pain in the heart, antiviral drugs are required. For each disease that causes pain in the heart, an individual treatment regimen should be developed.

Tsygankova Yana Alexandrovna, medical commentator, therapist of the highest qualification category.

Thank you

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

common data

Pain in heart - The most common symptom, with which physicians most often have to admit older patients. Currently, cardiovascular pathologies are becoming more and more prevalent against the background of malnutrition, low physical activity of people, frequent stress, and overweight.

At the same time, a symptom that people refer to as pain in the heart, may not be at all associated with the pathology of the heart itself. For example, it can be caused by a pathological process from the stomach, spinal column, lungs, ribs and sternum.

Sometimes, only at the doctor's appointment and after the examination, it is possible to establish exactly what the pain in the heart area is associated with.

What are the causes of heart pain?

There are many reasons due to which pain in the region of the heart develops. They can be roughly divided into two large groups:
1. Associated directly with the defeat of the heart itself:

• violation of the flow of blood and oxygen to the heart muscle;
• inflammatory changes in the tissues of the heart;
• metabolic disorders in the tissues of the heart;
• too much stress on the heart muscle due to high blood pressure or heart disease.

2. Diseases of other organs, in which pain is reflected in the heart area:

• the most common situation is stomach diseases such as gastritis and peptic ulcer;
• pain syndrome can be caused by damage to the thoracic spine, ribs, intercostal nerves;
• diseases of the lungs and pleura;
• diseases of the esophagus.

Coronary heart disease

Ischemic heart disease is a whole group of diseases and pathological conditions, the main symptom of which is heart pain. The most common types of coronary heart disease are angina pectoris and myocardial infarction.

Angina pectoris

Angina pectoris is a very common disease and the main cause of acute pain in the region of the heart in patients over 40 years of age.

The mechanism of occurrence of pain in the heart with angina pectoris is quite simple. The blood supply to the heart muscle is carried out through the coronary (coronary) arteries that braid the organ. When their lumen narrows (most often cholesterol plaques with atherosclerosis), an insufficient amount of oxygen is supplied to the myocardium. As a result, a large amount of lactic acid is formed in the muscle cells, which leads to pain. This violation is paroxysmal. Most often, attacks occur in stressful situations, with an increase in blood pressure, during intense physical exertion - that is, when the heart requires an increased amount of oxygen.

Angina pectoris is characterized by severe acute pain in the region of the heart behind the breastbone, most often stitching and burning. They come on very quickly and get worse, but usually go away within five minutes. The pain syndrome is quickly relieved by taking pills or a nitroglycerin spray under the tongue. During an attack, pain can be given to the left arm, shoulder, under the scapula, to the left half of the neck and jaw.

Pain in the heart with angina pectoris can occur when different conditions, depending on the course of the disease:
1. Exertional angina pectoris can be considered a more favorable variant of the pathology. In this case, pain occurs only at the moment of stress or intense physical exertion. The heart begins to contract faster and stronger, it needs more oxygen, but a sufficient amount of it is not supplied through the narrowed vessels.
2. With angina pectoris, pain occurs at any time, maybe even in a dream. This variant of the course of the disease is considered less favorable.

A painful attack with angina pectoris is relieved by taking nitroglycerin. A pill or spray is placed under the tongue, where the drug is very quickly absorbed into the bloodstream. If the pain persists, then it is necessary to call the ambulance team. Such patients are monitored by a local therapist and undergo periodic treatment.

The most reliable research method for establishing the narrowing of the coronary arteries of the heart is coronary angiography, when a radiopaque substance is injected into the vessels and an X-ray is taken.

Myocardial infarction

Myocardial infarction in most cases develops against the background of angina pectoris, and is, as it were, a more severe stage. In this case, the appearance of pain behind the sternum is due to the fact that at a certain point in time the coronary arteries narrow so much that the blood flow to the heart muscle completely stops, and its area dies. In this case, pain in the heart and other characteristic symptoms appear:
1. Very severe stabbing and burning pain behind the sternum in the region of the heart, which for a long time (more than 5 minutes) does not go away, does not come off after taking nitroglycerin.
2. At the same time, there is a drop in blood pressure, sometimes to such an extent that the patient faints.
3. The patient's skin turns pale, he becomes covered with a sticky cold sweat.
4. A strong sense of fear of death appears.
5. In this case, the patient's body temperature may rise.

The pain in the heart during myocardial infarction is so strong that it has to be relieved with narcotic drugs. When such pains appear, you need to immediately call the ambulance team. After performing an ECG, the cause of the pain immediately becomes clear: myocardial infarction manifests itself very clearly.

The patient is admitted to the intensive care unit. Myocardial infarction is a direct threat to life, therefore, much depends on the quality and timely treatment carried out.

Arterial hypertension

Arterial hypertension is an increase in blood pressure above normal values \u200b\u200b(more than 120 and 80 mm Hg). At the same time, increased loads are placed on the heart, its muscles have to work harder and with greater frequency. In addition, atherosclerosis, which in most cases is the cause of hypertension, also affects the heart vessels. Not only is the myocardium overloaded, it also receives less oxygen.

The most characteristic of high blood pressure in arterial hypertension is pain in the heart in combination with headaches. They can be pressing, stabbing, aching. At the same time, the following symptoms develop simultaneously:

• even more pronounced increase in blood pressure;
• tinnitus, "flies before the eyes";
• headache, dizziness;
• unsteadiness of gait, weakness, fatigue, drowsiness;
• redness of the skin of the face, a feeling of heat;
• swelling, mainly on the legs in the evening.

Especially often, pain in the heart area occurs during the so-called hypertensive crisis - a sharp increase in blood pressure to very high numbers.

To understand the origin of pain in the heart, it is enough to measure blood pressure. Most often, pain in the heart area occurs with the so-called hypertension stage 3, when an increase in blood pressure and impaired blood flow lead to severe disorders of the heart and other organs.

Myocarditis

Myocarditis is an inflammatory lesion of the myocardium - the heart muscle. The myocardium contains nerve receptors that respond to inflammation by causing pain. It can be caused by viruses, other microorganisms, and inflammation.
Pain in the heart and a feeling of chest discomfort are quite common in myocarditis (about 80% of patients with this pathology). In some patients, the disease progresses without any symptoms.

Pain in the heart with myocarditis is most often pressing or aching, sometimes it is stabbing. At the same time, it has practically nothing to do with stress and physical activity. Pain with myocarditis differs from angina pectoris in that there is no relief from taking nitroglycerin. Also, there are no pathological signs during the ECG.

With myocarditis, pressing pain in the heart is combined with other symptoms:

• weakness, lethargy, general fatigue;
• a slight increase in body temperature - no more than 37 o С;
• a feeling of an interruption in the work of the heart, a rapid heartbeat or fading.

If myocarditis proceeds without pain, then most often the patient does not consult a doctor, and the disease goes away on its own. If a therapist or cardiologist is involved in the treatment, then he can prescribe an ECG, ultrasound of the heart, chest x-ray. In the future, medications are prescribed, aimed at the main cause of the disease.

Pericarditis

It is also an inflammatory disease, but it does not affect the heart muscle, but the outer layer of the heart - the pericardium. It also has many nerve endings, the irritation of which leads to pain.

With pericarditis, pain in the region of the heart is characterized by the following features:
1. Pain sensations are noted at the bottom and on the left in chest - where the apex of the heart is. In some cases, they can cover the entire area of \u200b\u200bthe heart, or the entire left side of the chest.
2. With pericarditis, pain in the heart, reflected in the left arm, under the left shoulder blade, in the left half of the neck and jaws, is uncommon.
3. With this disease, pain syndrome often spreads to the right half of the chest and right arm.
4. With pericarditis, there is a sharp, aching, cutting pain in the heart.
5. Painful sensations do not increase during stress and intense physical exertion, but their intensity depends on the patient's body position. Often, in order to relieve pain, the person is sitting and leaning forward.
6. Pain in the heart during inhalation is characteristic.
7. The dynamics of pain in the heart over time is most interesting. They arise at the very beginning of the disease, with the so-called dry pericarditis, when during the contractions of the heart there is friction between the inflamed sheets of the pericardium. Then, with effusion pericarditis, fluid forms in the heart sac, friction ceases, and the pain subsides. But this does not mean that the disease has been cured.

If pain in the heart appears and pericarditis is suspected, the patient is examined, including ultrasound of the heart, ECG, chest x-ray. Treatment is prescribed against the main cause of the pathology: antiviral or antifungal drugs, antibiotics, anti-inflammatory drugs.

Cardiomyopathy

Cardiomyopathy is understood as all cardiac pathologies that are not associated with insufficient oxygen supply, inflammatory processes and valvular defects. For the most part, cardiomyopathy is based on metabolic disorders, which, one way or another, lead to pain in the heart.

With cardiomyopathy, pain in the region of the heart can be of the most varied nature. They can be localized only in a certain place, or occupy a large area. Pain syndrome can bother the patient constantly, and can also be associated with physical activity or stress. Sometimes it turns out to be removed with nitroglycerin, but not always.

For diagnosis and prescription correct treatment any patient with incomprehensible pain in the region of the heart must go to the doctor for examination and undergo an examination, which includes a chest x-ray, ECG, ultrasound of the heart, general and biochemical blood tests.

Heart defects

Heart defects can be congenital or acquired in nature, but in any case, they are accompanied by heart pain.

Pain in the heart with a malformation has the following development mechanism. If the structure of one of the valves is disturbed, certain chambers of the heart are forced to constantly pump a large amount of blood, while the filling of others remains rather weak. In this case, the overloaded heart muscle is forced to contract more often and harder. She experiences an increased need for oxygen, and besides, her resource is not endless - at a certain point in time she stops working adequately. All this manifests itself in the form of heart pain.

Pain in the heart with its defects are permanent. Most often they are pressing, stabbing, pinching. They can be accompanied by high blood pressure, swelling in the legs, and other symptoms.

Most often, pain in the heart area accompanies the following defects:
1. Aortic stenosis - narrowing of the aorta in the place where it departs from the left ventricle;
2. Mitral valve prolapse, which is located between the left ventricle and the atrium, is a very common congenital disorder that is detected in many children and can be expressed in varying degrees, often so weak that it is considered not a defect, but a small insignificant anomaly;
3. Acquired rheumatic heart defects arising from a prolonged course of rheumatism.

These pathologies are detected after chest x-ray, ultrasound of the heart, ECG. Depending on the type of defect, the severity of pain in the heart and other symptoms, surgical or conservative treatment is prescribed.

Cardiopsychoneurosis

Neurocirculatory dystonia (vegetative-vascular dystonia, vegetative dystonia) is a functional disease nervous system, in which the nervous regulation of many internal organs, including the heart, is disrupted. And this often causes pain in the heart. Most often, neurocirculatory dystonia develops in adolescents, which explains the high prevalence of such pain in adolescence.

Depending on the course of the disease, there are four types of heart pain in adolescence.

Simple cardialgia

This is a form of pain in the heart with neurocirculatory dystonia, which is observed in 95% of all patients. Most often it occurs spontaneously, lasts several minutes or hours, and then passes. Pain in the heart with simple cardialgia, aching or aching, occupies the entire region of the heart, or only its apex. Special help during the onset of such a pain syndrome is not required. Usually, a neurologist prescribes general therapy aimed at treating the underlying disease.

A separate subspecies of simple cardialgia is the so-called angioneurotic cardialgia. With her, pains in the heart - pressing or squeezing, are always paroxysmal in nature, are very short-term, but extremely strong. The pain can go away on its own, without any help, but most often patients use drops of validol or nitroglycerin to relieve it. If you have such seizures, you should visit a neurologist who will examine the patient, conduct an examination and prescribe an appropriate treatment.

Cardialgia of a vegetative crisis

It is also called paroxysmal lingering cardialgia. Heart pain occurs during the so-called vegetative crisis - an acute condition, when neurocirculatory dystonia manifests itself especially clearly.

Heart pain with cardialgia of the vegetative crisis continues very long time, it is pressing or aching, does not go away after taking validol and nitroglycerin. At the same time, other symptoms are observed:

• increased blood pressure, which is why this condition may resemble a hypertensive crisis;
• lethargy, weakness, a sense of fear;
• trembling all over the body;
• shortness of breath, feeling short of breath;
• feeling of rapid heartbeat.

Usually, an attack of such pain in the heart is relieved with drugs that lower blood pressure and sedatives.

Sympathetic cardialgia

With sympathetic cardialgia, pain in the heart is noted burning character, or just a burning sensation. The pain syndrome is located in the region of the heart or in the chest region. In this case, if you feel the gaps between the ribs, there will be an increase in the pain syndrome. Validol, valocordin and nitroglycerin do not help in this case, as is the case with other types of neurocirculatory dystonia.

For heart pains caused by sympathetic cardialgia, oddly enough, it is not medications that help, but thermal procedures, for example, mustard plasters or acupuncture.

The cause of pain in the heart in this case is excessive irritation and excitement. nerve plexusesresponsible for stress reactions in the body.

False angina

It turns out that in some cases vegetative-vascular dystonia can resemble angina pectoris. Although, in fact, these two diseases are very different.

With the so-called pseudo-angina pectoris, as with true angina pectoris, pain occurs in the region of the heart behind the sternum of a pressing, squeezing, aching character. They become stronger when the patient is in psycho-emotional stress or is experiencing increased stress.

In this case, the cause of pain in the heart is an inadequate response of the body and the heart muscle to physical activity. Often this condition is confused with angina pectoris. Therefore, it is very important to distinguish them from each other. The patient must definitely go to the doctor's office and undergo an examination (ECG, ultrasound of the heart, etc.) in order to accurately establish the diagnosis and receive adequate treatment.

Arrhythmia

Arrhythmia is a disorder characterized by an abnormal heart rhythm. There are many different types of arrhythmias, and often many of them can be accompanied by pain in the heart. Pain syndrome occurs directly during an attack, and is accompanied by the following symptoms:

• weakness, dizziness;
• a feeling of disturbances in the heart rhythm: interruptions in the heart, fading, rapid and strong heartbeat;
• sometimes the heart during an attack of arrhythmia ceases to cope with its function so much that the patient loses consciousness.

Pain in the heart with arrhythmia can be given to the left half of the chest, left arm and left armpit.

Often, the patient himself can distinguish arrhythmia pain from other diseases, since heart rhythm disturbances are felt quite well.

To clarify the origin of pain during an attack, an ECG is performed: the diagnosis of angina pectoris and its type are immediately clear.

If an arrhythmia attack is accompanied by acute pain in the region of the heart, then urgent medical attention is needed. It is necessary to call the ambulance team: the doctor will administer the appropriate antiarrhythmic drugs.

Pain in the heart reflected from other organs

In the immediate vicinity of the heart are many important organs: the stomach and esophagus, the lungs and the pleura covering them, the spinal column, ribs, sternum. Their diseases can create pain syndrome, which very much resembles heart pain.

Gastritis and stomach ulcer

Gastritis and peptic ulcer are diseases of the gastric mucosa, which differ from each other only in that gastritis is an inflammatory process, and an ulcer is inflammation in combination with a defect in the gastric wall.

With gastritis and peptic ulcer stomach reflected pain in the heart most often occurs after eating or, on the contrary, on an empty stomach (with damage to the lower stomach or duodenum). They are stabbing in nature, can last for a long time and do not go away after taking nitroglycerin and other drugs. The "gastric" origin of pain in the heart can be suspected by the following additional symptoms:

• a feeling of heaviness under the left rib, pain under the heart;
• heartburn, sour taste in the mouth;
• strong belching.

Most often, patients suffering from such "pain in the heart" are sent to see a cardiologist. Not finding signs of pathology from the outside of cardio-vascular system, the specialist will refer such a patient to a gastroenterologist.

Gastroesophageal reflux

Gastroesophageal reflux can confidently be called a disease of the 21st century. Almost 50% of all heart pains of extraneous origin are associated with it.

Usually, after the examination has been carried out and all "cardiac" causes of pain have been excluded, there is no doubt about the diagnosis. The patient is most often treated by a neurologist, and radiography and computed tomography of the spinal column are prescribed to confirm the diagnosis.

Intercostal neuralgia

For many people, it sometimes happened like this: it pricks for a short time in the side, presumably in the region of the heart, and then almost immediately "lets go." This is how intercostal neuralgia manifests itself, the symptoms of which are often confused with attacks of heart disease.

The causes of intercostal neuralgia are very diverse. It can be injuries, infections, and disorders of the spinal column.

If an attack of intercostal neuralgia was a single one, or it happens extremely rarely, then there is no particular reason for concern. If such pains recur regularly, you need to see a neurologist.

Psychogenic heart pain

Pain in the heart, which actually does not exist, can be felt by patients with neurasthenic neurosis, hysteria, obsessions, increased anxiety and suspicion, mental illness. Only a thorough examination and consultation with a psychiatrist will help to identify the true cause of heart pain in such a patient.

Heart pain treatment

As you can see from all of the above, heart pain is a symptom that can occur as a result of many different reasons. Accordingly, the treatment will be very different.

Usually, patients who have been suffering from a disease for a long time already have recommendations from their attending physician, and are well aware of how to act in such situations.

If severe pain have arisen in the heart for the first time in my life, then it is not worth the risk - it is better to call an ambulance.

Pain in the heart: first aid in road conditions - video

Before use, you must consult with a specialist.

Update: October 2018

A healthy heart is a prerequisite for a long and fulfilling life. Pain in the area of \u200b\u200bthe heart, at a minimum, requires careful attention to yourself. If they arise, then there is always alertness and anxiety. "Heart, heart, what happened, what confused your life?" Is cardiac pain always indicative of heart problems and how to distinguish them from other pains - in this article.

Where is the heart area?

The projection of the heart onto the anterior rib cage occupies the area from the upper edge of the cartilage of 3 ribs to the lower edge of the sternum body. The apex is projected in the 5th intercostal space 2 cm medially from the line crossing the middle of the clavicle. The right border goes from the cartilage of the 3rd rib to the 5th intercostal space on the right.

Usually any discomfort in the left side of the chest is taken for heart pain, regardless of its nature and intensity. But the typical location of heart pain is the area behind and to the left of the breastbone to the middle of the armpit.

Features of the spread of heart pains are the appearance of reflected pains (on the left in the scapula and under it, in the hand). Sometimes the reflection is isolated, for example with 4-5 fingers of the left hand, the left jaw. Rarely, the pain radiates to the right arm or left shoulder.

The nature of pain in the heart

The description of suffering by the patient himself is very important in the first stage of diagnosis. It is the detailed description of pain that allows the doctor to orient himself in the direction of the search and to reduce additional examination methods to the required minimum.

When questioning a patient, the following are taken into account:

• conditions for the occurrence of pain (during exertion or after, at rest, connection with food, at night or during the day)
• the nature of sensations (pricks, squeezes, whines, cuts, presses, constantly or periodically)
• duration of pain
• after which they stop.

Causes of pain in the heart area

Heart disease:	Diseases of the stomach and esophagus:	Toxic effects:
ischemic disease (angina pectoris, rhythm disturbances, myocardial infarction, postinfarction) endocarditis pericarditis myocardiopathy myocardial dystrophy secondary lesions in the background diabetes mellitus, uremia, hyperthyroidism heart injury tumors	esophagitis foreign bodies esophagus stomach ulcer tumors esophageal stenosis mallory-Weiss syndrome chemical burns of the esophagus and stomach gastric bleeding, ulcer perforation.	medicines alcohol heart poisons nicotine drugs
Heart overload:	Pulmonary pathologies:	Pathology of large vessels:
at arterial hypertension volume with thyrotoxicosis pressure with portal hypertension (for example, with)	pneumonia pleurisy tuberculosis silicosis tumors of the lungs or large bronchi	aortic aneurysm, including its dissection coarctation of the aorta pulmonary embolism
Mediastinal diseases:	Damage to the nerve trunks:	Bone lesions:
mediastinitis neoplasms	intercostal neuralgia herpes zoster	rib fractures and cracks pain with blood tumors
Muscle damage:	Skin lesions:	Breast pathologies:
stretching rhabdomyoma	boils carbuncles	mastopathy (gynecomastia in men) benign tumors

Gripping pain

This is a typical cardiac pain, informing about the oxygen deficiency of the heart muscle. It is characteristic of almost all forms of coronary heart disease. With angina pectoris, compressive pain in the chest in the region of the heart or behind the sternum gives typical reflections under the scapula and left arm. It occurs during exercise and passes on its own at rest or from taking nitroglycerin, which dilates blood vessels and redistributes blood between the layers of the myocardium.

Patients with various types of rhythm disturbances are also concerned about such pain:

• it is most common for atrial or ventricular fibrillation
• frequent extrasystoles
• paroxysmal tachycardia
• intracardiac blockade
• often pain is accompanied by fear of death and necessarily uneven pulse
• the equivalent of pain in some cases is shortness of breath, indicating circulatory failure.

Atypical compressive pain under the left shoulder blade, in the region of the heart, may occur at rest, in the early morning hours against the background of spasm of the coronary arteries (Prinzmetal's angina).

Sharp pain

This variant of pain always signals the need for emergency care, therefore, does not allow switching to anything else. The condition can be described as sharp pain, as it arises suddenly.

Angina pectoris

A protracted angina attack with a typical location and reflection of severe compressive pains is the result of incipient thrombosis, embolism or sharp stenosis of the coronary vessels. At this stage, nitroglycerin does not help well, but timely medication can prevent the death of the heart muscle. If, after taking nitroglycerne twice with an interval of five minutes, the pain does not go away. Must call ambulance.

Myocardial infarction

This is actually necrosis of the heart wall. Here, only treatment in a specialized hospital is able to save the patient's life and preserve its further quality. With myocardial infarction, the pain is very pronounced, protracted, uncontrollable with nitro drugs, accompanied by fear of death, a feeling of lack of air. sweating, hand tremors. It can also be atypical, such as giving to the stomach or imitating intestinal colic, accompanied by nausea and vomiting, cardiac arrhythmias, seizures, involuntary urination. Some heart attacks pass with a mild pain syndrome, which does not lose its sharpness, but the pain is more bearable. When pain is relieved only by neuroleptoanalgesia using powerful painkillers.

Diseases of the esophagus and stomach

The second variant of a dangerous sharp pain in the heart area is a catastrophe with the esophagus and the cardiac part of the stomach. Perforation of the cardiac ulcer will give dagger pain, which will lead to autonomic disorders in the form of lightheadedness. flashing flies before the eyes, dizziness or loss of consciousness.

For the esophagus, bleeding is more typical against a background of frequent vomiting (Mallory-Weiss syndrome) or from dilated esophageal veins with portal hypertension against a background of liver cirrhosis. The rate of loss of consciousness and the severity of circulatory disorders will depend on the amount of blood loss. In any case, ulcer perforation or bleeding is a reason for surgical treatment.

Pulmonary embolism

This is a blood clot that has come from the pelvic system or in the artery of the lung. The more branches of the pulmonary artery are thrombosed and the larger they are, the more pronounced and more intense the pain. In addition to it, coughing up blood, shortness of breath, palpitations, swelling of the cervical veins are observed. With thrombosis of large trunks, collapse and loss of consciousness develop. it's the same emergencyrequiring emergency assistance and hospitalization.

Aortic aneurysm dissection

More often occurs in older men against a background of prolonged unregulated arterial hypertension, atherosclerosis, or coarctation of the aorta. The provoking factor can be heart or aortic surgery. Most often, the ascending part of the vessel is stratified. In this case, the longitudinal rupture of the inner membrane leads to the accumulation of blood between the layers of the aorta. Suddenly there is a sharp tearing pain behind the sternum or in the region of the heart, radiating under the scapula. At the same time, the pressure rises first. and then falls sharply. There is an asymmetry of the pulse on the limbs, the skin turns blue. Sweating appears, fainting may develop. Disorders of motor activity become neurological manifestations. Hematoma can lead to oxygen starvation of the heart, shortness of breath, hoarseness. Patients often fall into a coma.

Broken ribs

Sharp pains are typical for. Subsequently, the nature of the pain changes to aching or gnawing.

Pressing pain

In cases of heart overload, pressure or dull pain may be felt.

• This type of pain can also occur in healthy people, for example, during excessive physical exertion, playing wind instruments that increase the pressure in the pulmonary circulation.
• With arterial hypertension, the heart has to pump blood against the pressure gradient, which impairs its blood supply and increases the load.
• Thyrotoxicosis leads to increased heart rate and overloads the heart with volume.
• Cardiac tamponade is a consequence of wounds and blood pressure of the heart. Also, the heart can squeeze the effusion with pericarditis of various origins (tuberculous, tumor).
• In case of myocarditis of an infectious or allergic nature, non-intense pressing pains are accompanied by shortness of breath, rhythm disturbances, and heart failure.
• Myocardiopathy, myocardial dystrophy, neoplasms of the heart also give pressing sensations without a clear connection with the load, prolonged or episodic.
• Pressing pains behind the sternum mimic esophageal foreign bodies or esophagitis.
• Intoxication of a different nature (medicinal, narcotic, alcoholic), as well as poisoning with organophosphate substances, ether, chloroform, neurotoxic plant poisons give severity pressure on the heart, combined with arrhythmias and heart failure, are fraught.
• Purulent pathologies of soft tissues, mastopathy. will also give excess pressure in the projection of the heart.
• High ones also lead to a situation where pressing pains mimic cardiac pathologies.

In order not to get into the situation of Tom Sawyer, who was not strong in anatomy and hid the donated flower closer either to the heart or to the stomach, you can use the comparative table to distinguish stomach pains from heart pains.

Stabbing pain

If the heart stabs occasionally, the pain is not accompanied by blood flow disorders (no fainting, dizziness, memory or speech disorders), as a rule, it is not dangerous.

• Most often, stabbing pain in the heart is caused by neurocirculatory dystonia, in which the vessels do not have time to adequately narrow or expand when the load changes.
• Rarely, stabbing pains are accompanied by infrequent extrasystole,),.

Strong pain

• Unbearable pain can be with a heart attack, pulmonary embolism, dissection of the aortic aneurysm. This is often 10 out of 10 points. Patients are agitated, rushing about. Have an intense fear of dying.
• 10-9 points on the scale of intensity gives mediastinitis - inflammation of the mediastinum. When a purulent process develops due to complications of surgical treatment, trauma to the esophagus, the collapse of tumors, the pain forces patients to take a forced position with their chin pressed to the chest. It is aggravated by swallowing and throwing the head back. There is also fever, sweating, agitation or confusion, and swelling of the upper body.
• Angina pectoris gives pain from 6 to 8 points.
• Myocarditis and pericarditis from 5 to 2.

Aching pain in the region of the heart

The more intense the rhythm of modern life becomes, the more patients complain of pain in the heart in the cardioneurosis program. There are absolutely no organic changes in the organ or the vessels feeding it in such patients, or they are insignificant.

• there is only a high degree of neurotization
• depression
• anxiety disorder
• often cardioneurosis develops in the framework of somatized depression.

Dissatisfaction with oneself and the world around us, which does not come out in behavioral characteristics, breaks out in the form of pain in the region of the heart. At the same time, patients are haunted by many unpleasant sensations: pressure on the heart, its fading with a sigh, aching pains and anxiety for their health.

Often, fixation on a non-existent cardiac pathology forces a person to be repeatedly examined, to change specialists and clinics, significantly poisoning his life. At the same time, an experienced psychotherapist or group correction could solve the problem in a short time.

Heart pain: what to do

If you suspect a heart problem, it is better to overestimate the risks and immediately consult a physician or cardiologist. After questioning and examination, the doctor will prescribe:

• urine and blood tests
• fluorography of the chest cavity
• if necessary, bicycle ergometry, treadmill and ECHO-cardioscopy.

This tactic will allow you to respond in time to real heart disease or make sure it is absent in a short time and save extra nerve cells. In addition, other serious and not very diseases are often masked under cardiac pathologies, which are also desirable to diagnose and treat in a timely manner.

From this article you will learn: what diseases can be accompanied by pain in the region of the heart, is it possible to find out by the characteristics of pain how the heart hurts, and how other organs hurt. Why it is imperative to pay attention to additional symptoms. What to do when heart pain occurs, and which specialist to contact.

Date of publication of the article: 08.02.2017

Date the article was updated: 05/25/2019

The heart is a vital organ connected with all organs and tissues through the vascular and nerve plexus system. Therefore, pain in the part of the chest where it is located is always perceived as a signal of cardiac pathology. But it is only 60–70% such a sign. About 30-40% of pains are of non-cardiac origin and are associated with pathology of other systems.

It is possible to completely stop (relieve) heart pains, but this is not enough to get rid of the causative disease of which they are a symptom. In order to solve this problem, you need to contact a specialist who has the most knowledge about the origin of heart pain. This can be a cardiologist, general practitioner, or family doctor.

Characteristics of pain in heart disease

The heart can ache in different ways - crushes, pricks, aches, burns, bakes; and with varying strength - from mild discomfort to intense, severe pain. Localization can also be different, but always corresponds to: the area of \u200b\u200bthe sternum, the left half of the chest and areas located next to it (left half of the neck, shoulder, scapula, paravertebral and interscapular region).

If it presses

The most common pain that occurs in cardiac pathology is pressing (in 95–99%). It indicates a circulatory disorder in coronary arteries, ischemic disease and angina pectoris.

Its typical characteristics are:

• It is provoked and intensified by any physical activity, experience or psycho-emotional stress.
• It is localized clearly behind the sternum or to the left of it.
• Can give to the left hand and shoulder blade.
• It is accompanied by a feeling of lack of air, shortness of breath and weakness.
• It passes at rest after the cessation of exertion or taking nitroglycerin.

Similar manifestations are possible with inflammatory myocardial damage - myocarditis. Additional criteria given in the table will help to distinguish angina pectoris from inflammation.

- a reliable sign of cardiac pathology.

If bakes

Pain behind the breastbone or in the left side of the chest can be sharp, burning. Patients say that their heart hurts, as if baking, burning in the chest. Such characteristics of the pain syndrome in 95–99% indicate a particularly dangerous cardiac pathology:

1. Myocardial infarction

• It bakes behind the breastbone and gives it to the left half of the neck, shoulder blade, shoulder.
• It occurs suddenly or after previous pressing pain more often during physical or psycho-emotional stress.
• It is accompanied by a drop in pressure, sweating, fear of death, severe shortness of breath.
• Symptoms are not relieved by taking painkillers or nitroglycerin.

2. Pulmonary embolism

This is a blockage of the blood vessels of the lungs with blood clots that enter them from the veins. lower limbs... According to the characteristics of pain and clinical manifestations, the disease is difficult to distinguish from myocardial infarction (they are almost identical).

3. Aortic dissecting aneurysm

With this pathology, a rupture of an abnormally expanded section of the largest vessel in the body occurs close to the exit site from the heart.

Burning pain is similar to a heart attack, but:

• rarely gives to the left half of the body;
• accompanied by pain between the shoulder blades in the spine;
• arises and intensifies after a previous episode of high blood pressure.

In case of acute burning pain in the heart, first of all, you need to think about the most serious diseases that can end in death if the patient is not provided with emergency care.

If pricks

Stitching pain is not specific for, but in 20-25% may indicate them. It can be:

1. Myocarditis.
2. Pericarditis.
3. Vegeto-vascular dystonia.
4. The reaction of the cardiovascular system to stress and neurosis.
5. Emerging aortic aneurysm.
6. Defects of the mitral and aortic valves.

If the stabbing sensations are associated with these diseases, they:

• constant and do not depend on the position of the body or certain movements (turning or tilting the body, raising the arm);
• may increase with walking or psycho-emotional stress;
• accompanied by general weakness or irritability;
• the heartbeat is rapid or the rhythm is disturbed;
• may increase at the height of a deep breath.

About 80% of stabbing pains in the region of the heart are a symptom of conditions not associated with cardiac pathology.

If it hurts or discomfort

Aching pain and discomfort in the heart are the most non-specific types of cardialgias, according to the characteristics of which it is impossible to find out what they are associated with and what to do with them. They equally often testify to both the fact that the heart hurts and diseases of other organs and systems (muscles and nerves, lungs and pleura, stomach and esophagus). Therefore, one cannot be guided by them alone. The main attention should be paid to the general condition, the patient's age, and other manifestations that are characteristic of cardiac pathology:

• acceleration, slowing down or interruptions of the rhythm;
• shortness of breath and feeling short of breath;
• swelling in the legs;
• pressure drops (increase or decrease).

All these symptoms, combined with aching pain or discomfort in the heart, can indicate any of its diseases: from harmless secondary cardialgias in healthy people against the background of overload of the body to a painless form of myocardial infarction, etc. To establish the true cause, you need to do examinations, the volume of which can only be decided by a specialist (cardiologist, therapist, family doctor).

If not the heart, then what?

In general, pains localized in the area of \u200b\u200bthe heart - behind the sternum and anterior surface of the left half of the chest, in 30% indicate the pathology of not this organ. They can be caused by the lesions described in the table.

Sick organs and tissues	Diseases and causes of pain in the heart	Features of pain syndrome: when it occurs and how it proceeds
Spine, ribs, intercostal muscles and nerves	Osteochondrosis	More often acute, stabbing, like a lumbago during turns of the torso, deep inhalation, or constant aching along the ribs to the left of the spine to the sternum.
	Hernia
	Myositis
	Intercostal neuralgia
Lungs and pleura	Left-sided pneumonia	More often aching, heaviness or discomfort is constant, but it can be severe acute during each inhalation, accompanied by shortness of breath, cough, high temperature body.
	Left-sided dry and exudative pleurisy
	Trauma
Esophagus and stomach	Hernia of the diaphragm	Aching pain and discomfort behind the breastbone, may be heartburn. It occurs after eating (especially overeating), accompanied by belching, heaviness, bloating.
	Peptic ulcer
	Reflux esophagitis, esophageal erosion and ulceration

Possible causes of heart pain

To understand exactly why pains in the heart have arisen, pay attention not only to their nature (acute, burning, aching, etc.), but also to other existing symptoms. But remember that they are not always interrelated, since they can be combined manifestations of different diseases in one person (for example, pathology of the esophagus and coronary artery disease or pleuropneumonia and intercostal neuralgia).

Diagnosis: the main signs of heart and non-heart pain

The table describes the most common criteria and signs by which you can determine what the pain in the heart area is associated with - whether it is damaged or not. This data will help you understand what to do with a sick person and whether he needs urgent help.

Heartache	Unhealthy pain
Behind the sternum or to the left of it along the front surface	Spot in one area of \u200b\u200bthe left half of the chest
Gives to the left hand, neck, shoulder blade	Gives along the ribs to the left, into the spine
Pressing, burning, stabbing	Stitching, aching, shooting
Provoked or aggravated by exertion (walking)	Provoked by sharp turns of the torso, deep breaths, food intake
More often paroxysmal	Paroxysmal or persistent
Decreases at rest	Decreases in a certain position of the body (motionless on the left side, half-sitting)
It is removed (stopped) with nitroglycerin	Does not decrease after nitroglycerin, relieves pain relievers
Pressure on the chest does not make the pain worse	Pressure on the painful point, near the spine and along the ribs is painful
It is accompanied by symptoms: shortness of breath or shortness of breath; palpitations or interruptions; high or low pressure; sweating and weakness; violation of the general condition.	Possible additional symptoms: curvature and crunch of the spine; cough and fever; heartburn, sour feeling in the mouth; belching, abdominal discomfort; the general condition is rarely violated.

What to do, how to help

If the cause of the pain is unknown to you

If you cannot determine what is associated with pain in the heart - regardless of the cause of their occurrence, do the following:

1. Don't panic, calm down, don't be nervous, breathe smoothly and shallowly.
2. Physical rest - it is better to lie down or sit down, so that the body is slightly raised, in last resort just stand up if you feel like you won't fall.
3. Fresh air - on the street, simply unfasten the top buttons or tie, which can squeeze the neck and chest, in the room, additionally open a window, window or door.
4. Measure your heart rate and blood pressure if possible. If the heart rate is above 90–95 or less than 55–60 per minute, and the pressure is above 140/90 mm Hg. Art. or below 100/60 (more or less than the numbers you are used to) - call an ambulance (phone 103), as there is a high probability of serious heart disease.
5. If after a few minutes the pain does not decrease, take an anesthetic drug (Ketanov, Panadol, Imet, Diclofenac) in combination with Aspirin or chew and place only Aspirin under the tongue.
6. If after 15–20 minutes the pain in the heart does not go away or intensifies, this may indicate a heart attack - call an ambulance. This can be done when it just arose, if the pain is burning, severe, accompanied by shortness of breath, pallor and sweating of the skin, a feeling of fear of death, high or low blood pressure.

For any heart or non-heart pain in the chest, do not take Citramon, Copacil, or other drugs containing caffeine!

If you know the cause of the pain

If you know the presumptive or exact cause of heart pain, in addition to the main measures, you need to do the following:

1. With angina pectoris:

• take nitroglycerin under the tongue;
• chew Cardiomagnyl or another drug containing acetylsalicylic acid;
• under normal or high blood pressure and the pulse can take beta-blockers (Metoprolol, Bisoprolol, Nebival);
• persisting pain for more than 30 minutes is a reason to call an ambulance;
• if pain goes away, see your cardiologist, general practitioner or family doctor.

1. With myocarditis and pericarditis, all that can be done at the first stage of help is to take pain relievers. Be sure to see a cardiologist and the sooner the better.
2. For intercostal neuralgia, osteochondrosis or other problems with the spine, take painkillers (Analgin, Diclofenac, Dolaren, Nimid) and consult a neurologist.
3. In case of problems with the stomach and esophagus - adhere to a dietary diet; in case of pain, you can take drugs Omez, Famotidine, Maalox, Motorix, Motilium. Per specialized assistance consult a gastroenterologist.

Heart pain is not just a symptom of heart disease. Whenever it appears, first of all, it is his pathology that must be excluded (this condition is most dangerous and more often than others requires urgent medical attention).