Unpleasant symptoms that occur in the heart area always cause discomfort to people and scare. Intercostal neuralgia, symptoms on the left, in the area of the heart, in which appear in 100% of cases, indicates some problems in the body.
However, pathology is rarely associated directly with diseases of the cardiovascular system. If neuralgia has long become a chronic disease that occurs regularly, each patient should know how to distinguish its symptoms from true heart pathologies.
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- Symptoms of Neuralgia
- Signs in children
- Causes of Neuralgia
- Characterization of Neurological Pain
- How to distinguish heart pain from neuralgic syndrome
- Drug therapy
- Characterization of Neurological Pain
- Discomfort differentiation
- How heart pains manifest
- How heart pains manifest
- Heart pain therapy
Symptoms of Neuralgia
The most common symptom of neuralgia is pain in the left or right intercostal region, as well as in the area of the heart. In 1-5% of cases, bilateral pathology occurs. The pain can pass from front to back, giving back to the shoulder blade, located above or below the area of the heart. Also, pathology is characterized by signs:
- tingling from the sore side on the left, as well as directly in the area of the heart, less often on the right side;
- numbness of the skin, or increased sensitivity;
- the skin turns red, there is a feeling of heat or cold;
- it is difficult for the patient to breathe, with coughing, symptoms intensify.
You can confuse the signs of intercostal neuralgia with serious illnesses, so for a differential diagnosis it is better to consult a doctor.
The body of a pregnant woman does not work at all as usual, and many symptoms of diseases are blurry, incorrectly interpreted.
Intercostal neuralgia in this condition may result from compression of the nerve roots by organs. Because of this, symptoms occur not only in the area of the heart:
- acute pain can be in any zone on the left, less often on the right;
- symptoms are often given to the stomach and heart, scapula;
- the longer the term, the stronger the signs appear, after delivery they almost completely disappear.
Sometimes inactive viruses wake up during pregnancy. Herpes zoster caused by herpes is one of them. It is characterized by the presence of vesicles on the skin with subsequent formation of ulcers.
Signs in children
Intercostal neuralgia develops in childhood, especially when the baby is improperly carried in her arms. However, up to 3 years, the child cannot correctly identify the symptoms. Parents can recognize them:
- the child complains of pain in the abdomen, sternum, or on the side of the shoulder blades;
- possibly stuttering and crying;
- sleep is disturbed;
- perspiration intensifies.
It should be remembered that with intercostal neuralgia, the pain is especially severe during movement, and when at rest it quickly subsides.
There are many ways to distinguish the pain on the left from a heart attack.
|If symptoms occur on the left, then the pain will intensify with inhalation and exhalation, as well as when trying to change the pose. It hurts a lot if they start to feel the ribs.||With heart lesions, symptoms persist constantly: in a standing, lying position.|
|Pain sensations encircle the upper body: shoulders, chest, rib area, shoulder blades. The pain persists for a long time.||Heart pains are given in the left hand and persist in the sternum, in the center. Discomfort lasts no longer than 15-16 minutes.|
|Sedatives, painkillers, NSAIDs help.||The pain goes away from nitroglycerin.|
|The pulse remains in a normal state, pressure rarely changes.||The pulse can increase or decrease, the pressure rises or falls sharply, depending on the concomitant heart disease.|
But you can not ignore the characteristics of the body of individual patients. Some heart diseases are accompanied by increased pain on the left with movement or inhalation. To accurately determine the disease that causes the unpleasant symptoms, you must consult a doctor.
If symptoms are given under the ribs or lower back, it is necessary to separate from the intercostal neuralgia disorders in the digestive and urinary system. Also, pathology is sometimes confused with lung diseases – pneumonia and pleurisy.
To diagnose the disease, you can contact a therapist or a neurologist. If the doctor suspects the development of cardiovascular disease, he will be referred to a cardiologist. For diagnosis, methods such as MRI, ECG, X-ray, urine and blood tests are used.
Causes of Neuralgia
A symptom such as intercostal neuralgia accompanies various diseases. It is impossible to consider a violation as an independent pathology. The process develops under the influence of the following factors:
- Pinched spinal nerve in the sternum. The main causes of pathology are protrusion, osteochondrosis and intervertebral hernia.
- The nerve is in a constantly irritated state, muscles between the ribs become inflamed. Deviation may occur due to stress, trauma or increased physical exertion. Sometimes it causes a mechanism of hypothermia or infection.
- Hormonal changes that trigger pathological processes in cells. This is observed with menopause, during pregnancy.
- Immaturity of the ligamentous apparatus. This reason becomes a factor of unpleasant symptoms in the region of the heart with intercostal neuralgia only in children, when the bones are actively developing, but the ligaments behind them do not have time.
Such processes as tumors in the spinal cord, or the constant exposure of chemicals to the body can cause a deviation. Another reason is diseases of the muscular and skeletal system, including multiple sclerosis and destruction of the myelin sheaths of nerves.
Important! Diabetes mellitus is one of the common causes of intercostal neuralgia associated with metabolic disorders and endocrine changes.
They lead to a violation of the trauma of the spine, sternum, ribs. Symptoms may also appear with constant muscular tension.
In order for the treatment of intercostal neuralgia in the heart to be correct and effective, different methods must be used. An integrated approach to drug therapy is the basis of treatment. Here’s what you need to observe and take with a pathology located on the left or right side of the sternum:
- it is necessary to observe bed rest for 2-4 days, so as not to provoke inflammation;
- sleep on an orthopedic pillow and hard mattress so that there are no relapses;
- to eliminate pain, NSAIDs based on ibuprofen or diclofenac, Movalis, Meloxicam are taken, these drugs also eliminate inflammation;
- use muscle relaxants to eliminate pinched nerves – “Sirdalud” or “Midokalm”;
- B vitamins are needed to restore muscle activity, nerve endings and immunity.
In severe cases, injections are prescribed when the nerve is pinched in the heart. Most often they use painkillers: Movalis, Ketanol, Milgamma, Novocain, Analgin.
Advice! Warming ointments help in the treatment of neuralgia with nerve damage in the heart area or slightly lower on the left side.
Gels based on snake venom “Viprosal” and “Viratoks” work very well. In addition to drugs with poison, Voltaren, Dikloran, Ketanov, and Flexen are used to eliminate the symptoms.
If intercostal neuralgia gives in the heart, but its cause comes from disturbances in the structure and functioning of the spine, joints, then physiotherapeutic procedures are prescribed:
- therapeutic massage using ointments;
- osteopathy – effects on the skeleton to improve blood circulation, lymph outflow;
- Shiatsu – Japanese massage, which affects biological points;
- Exercise therapy and gymnastics on simulators with a trainer.
Be sure to use an orthopedic mattress for spinal damage.
To combat intercostal pathology, you can use traditional medicine. They are taken orally in the form of juices and decoctions, or compresses and ointments are made. It is necessary to discuss with the doctor the possibility of using prescriptions:
- black radish juice, salt solution from 0,5 l of water and 2 tbsp. l., juice of potatoes and onions 1 to 1 is used in the form of compresses;
- a decoction of chamomile is applied to the damaged area and taken orally by prescription;
- for grinding use tincture on birch buds (0,5 l of vodka per 200 g).
A sedentary lifestyle is one of the reasons for the development of diseases of the musculoskeletal system after 25 years in 45% of people. Therefore, the main way to prevent intercostal neuralgia and symptoms such as pain on the left or in the area of the heart during its development is moderate physical activity.
Advice! The patient should protect himself from hypothermia, treat hormonal and infectious diseases on time, and also prevent heavy lifting in jerks.
It is important to observe the regime of work and rest, a sufficient amount of time to sleep and eat right. Alcohol, smoking and other bad habits, including overeating, provoke the development of neuralgia. It is useful for prophylaxis to take multivitamin preparations.
Pain in the region of the heart and on the left side in the middle of the ribs is the primary symptom of intercostal neuralgia. It is easy to confuse it with diseases of the cardiovascular system, so you need to be able to conduct differential diagnosis. For an accurate diagnosis, a person needs to see a doctor.
Intercostal neuralgia (thoracalgia) provokes compression and inflammation of the intercostal nerves. It is accompanied by intense pain. This disease requires a correct diagnosis and treatment prescribed by a neurologist. Self-medication is highly undesirable, since neuralgia can give serious complications.
Very often, this disease occurs against the background of another ailment, due to inflammatory and degenerative transformations in the spine.
Due to pinched nerve with costal neuralgia, pain appears in the heart, shoulder blades, arms
The reasons that provoke neuralgia are as follows:
- mechanical damage to the sternum and back;
- low immunity;
- pathology of the nervous system;
- defects of the spine (hernias of the intervertebral discs, osteochondrosis, deforming spondylosis and others);
- lungs’ cancer;
- intoxication with damage to internal organs or after taking medication;
- bacterial diseases, for example, tuberculosis.
Intense pain directly in the chest is also an indicator of various cardiovascular diseases.
- Myocarditis is an inflammatory process in the heart muscle that appears as a complication against infections (flu, tonsillitis, diphtheria and others).
- Pericarditis is an inflammation of the outer wall of the heart, usually of a post-infarction, rheumatic, or infectious form. May be accompanied by severe shortness of breath.
- Injuries resulting in damage to the heart.
- Malignant and benign neoplasms that press on organs located directly in the chest.
- Endocarditis is a disease of the inner wall of an organ provoked by infection, intoxication or bruising.
- Coronary heart disease – characterized by impaired blood circulation and oxygen delivery to the heart muscle. It is formed against a background of various vascular diseases, bad habits, and obesity.
Characterization of Neurological Pain
When a person speaks of chest pain, then pointing to the place of localization, he touches it. By the way he does this, an assumption may arise what exactly caused this symptom. If the patient points his fingers aiming to where it hurts, then most likely the complaint does not apply to heart problems.
Doctors with sufficient experience, already during the preliminary examination of a sick person, are able to determine the cause of the disease. Experts have a clear idea of the difference in symptoms, giving rise to suspect pain in the heart or to diagnose neuralgia, knowing exactly how to distinguish them. When a person suffers from a heart, a preliminary diagnosis of this orientation will save time, which draws the line between life and death.
After describing the pain during myocardial problems, in order to understand how to distinguish heart pain from neuralgia, we will dwell on its characteristics. The chest area is innervated by many nerve trunks. This part of the human body, in addition to the musculoskeletal skeleton of the chest, contains vital organs – the heart, bronchi, lungs, large vascular trunks – the aorta, vena cava, their branches.
All of them have a complex system of innervation. Through the chest part of the body cavity, nerves pass to the organs of the abdominal cavity, branching to the heart, bronchi, and lungs. Therefore, what kind of neuralgia exists in the region of the heart depends on which nerve trunk has a problem.
In order to “unravel the web” of painful sensations of nerve weaves, you need to understand where which nerve passes, how its work is disturbed, what connection exists between the organs controlled by it.
An attack of biliary colic is manifested by severe chest pain, which is associated with irritation of the vagus nerve. This nerve branches to the heart and abdominal organs. Its irritation spreads from the gallbladder upward. The attack is accompanied by a strong heartbeat, sweating. Not only symptoms, but even an ECG often gives signs of a heart attack. An experienced doctor will pay attention to the localization of pain on the right, which is very rare for MI.
Neuropathy involving these trunks, sometimes referred to as “cardiac neuralgia,” can cause chest soreness. In total, people have 12 pairs of intercostal nerves, one of which actually lies under the last rib. Recognizing their soreness is not difficult to learn. It has characteristic features:
- It is not associated with a state of rest, physical activity, stress. It has a permanent character, targeted localization.
- Usually it is described as sharp, stitching, tearing, spasmodic, aching, gnawing, shooting.
- Often it is a girdle – passing on the same horizontal level, as if a belt encircling a body. The patient clearly defines the place of pain, their boundaries.
- Strengthens with coughing, sneezing, laughing, breathing (during inspiration).
- May be accompanied by symptoms of numbness, tingling, burning sensation.
Cardiac neuralgia has the following symptoms:
- Tension, tremor of the muscles of the back.
- Numbness, tingling of the skin of the intercostal spaces.
- Redness or pallor of the skin, rash along the affected nerve.
The causes of intercostal neuralgia can be different. They are associated with damage, compression or inflammation of these nerves.
The main causes of intercostal neuralgia
- compression of the nerve trunks – a hernia of the intervertebral disc, osteochondrosis;
- chest injuries (non-medical), back;
- viral infections – a consequence of the reactivation of chickenpox virus in people who once had chickenpox (herpes or shingles);
- injuries caused by earlier surgical intervention (opening the chest for access to the heart, lungs, diaphragm);
- sharp physical exertion;
- being in an uncomfortable position for a long time;
- exposure to draft, leading to inflammation of the roots of the spinal nerves of the thoracic segment,
- violation of metabolic processes;
- the result of a deficiency of vitamins of group B;
- acute respiratory infections;
Women have an increased risk of problems in the intercostal area from the end of the second to the end of the third trimester. But the reasons that can affect the pregnant body, causing pathological phenomena that complicate the work of the nervous system, are not completely clarified.
A change in the hormonal background during pregnancy leads to relaxation of the ligaments and joint capsules of the whole organism. Rib joints are no exception. The condition is also associated with the pressure of the growing uterus on the surrounding organs, tissues, partial violation of blood circulation and fluid circulation there, and biochemical imbalance.
These processes affect the areas of distribution of nerve trunks, neuropathy occurs, and cardiac neuralgia develops. Violations of the sympathetic nervous system increase sweating, change the pulse of the expectant mother. The condition is very similar to a heart attack. Moreover, during physical exertion, painful sensations also sharply increase.
In addition, there is a direct impact mechanism. When the child continues to grow, he presses with his body on everything around him, leads to the formation of subluxations of the ribs, irritation of the intercostal nerves. The lower back, back, diaphragm, nerves passing through them also suffer.
The pregnant uterus presses on the sciatic, lateral, femoral, cutaneous and other nerve trunks, on the hip joint, sacroiliac joint, and provokes subluxations of the vertebrae. This causes pain in the back, cramps, muscle cramps, numbness of the lower limbs and skin of those areas of the body where the fetus presses on the nerve trunks. When there is an increase in physical activity, the intensity of soreness can increase.
The taste sensitivity of the anterior 2/3 of the tongue is lost, there is a burning pain throughout the nerve, especially behind the ear. This condition is 3 times more common in pregnant women than in all other people. Neuropathologists still can not conclusively explain what this is connected with.
It is significant that pregnancy can be the favorable condition that contributes to the manifestation of nervous system failure. Indeed, in pregnant women, shoulder and sciatic neuralgia, carpal tunnel syndrome, headaches, paresthetics meralgia are just as common.
In the case of development of pathologies of the cardiovascular system, painful sensations are accompanied by burning, tingling, and strong pressure in the chest area. Such symptoms appear as a result of the development of angina pectoris, myocardial infarction, pericarditis or inflammation of the heart bag accompanied by shortness of breath, fatigue, swelling, coughing attacks, changes in blood pressure and heart rate.
Myocardial infarction appears as a result of blockage of arteries, problems with the transportation of blood through the vascular system. Such pathological phenomena cause short, sharp, pressing pains in the chest. Determining the exact place of their localization is difficult. Painful sensations cover not only the chest, but also the esophagus, cervical and lumbar. The development of myocardial infarction is accompanied by the appearance of cold sweat, nausea, vomiting.
When closing the walls of blood vessels with atherosclerotic plaques, cardiologists diagnose angina pectoris. This type of pathology determines the restriction of blood access to the heart muscle in full. Angina pectoris appears with increased physical exertion, which cause overstrain of the human body, as well as after stressful situations that cause strong negative emotions.
Timely treatment of pathologies of the cardiovascular system eliminates the risk of irreversible processes in the human body, the death of the patient. Knowing how to distinguish heart pain from neuralgia, you can save the life of a loved one, a loved one, by providing him with effective first aid.
Many patients who experience discomfort in the chest area want to know what causes them: heart pain or neuralgia. A definite answer can be obtained after consulting a specialized specialist who, according to the results of diagnostic measures, will clarify the diagnosis and prescribe adequate treatment. Its main goal is to relieve pain and relapse.
Neurological pains in the chest appear as a result of the development of a number of diseases. These include:
- osteochondrosis of the thoracic vertebrae;
- the state of protrusion or the appearance of a hernia of the intervertebral discs;
- injury to the upper part of the spinal column;
- diagnosis of neoplasms;
- damage to the chest of the spine due to the development of tuberculosis or syphilis;
- spondylosis against the background of grown osteophytes;
- untimely treatment of colds and infectious diseases;
- high frequency of hypothermia, nervous shocks, stressful situations.
How to distinguish heart pain from neuralgic syndrome
Discomfort in the sternum can be a symptom of fatal pathologies, therefore, when diagnosing, it is important to differentiate as soon as possible: the heart hurts, or neuralgia makes itself felt. The etiology of the disease can be suggested by eliminating the signs of angina pectoris. An accurate diagnosis, however, is only possible after examination of the heart and spine.
|Intensity of discomfort||Strong, compressive.|
Burning, similar to heartburn – for a heart attack, dull and aching – for non-coronary origin.
|There are aching, pulling, burning, stitching pains that occur for a short time or torment both day and night.|
|Characteristic of pain||Zagrudnaya||Tinea, aggravated by irritation of individual points and a sharp movement (“backache”).|
|Duration of manifestation||5-20 minutes, longer with a heart attack.||It has no characteristic duration.|
|Active drugs||“Nitroglycerine”||Ibuprofen and other NSAIDs, lidocaine patches, muscle relaxants|
|Condition of occurrence||Stress, physical activity. With angina pectoris, a manifestation during sleep is characteristic.||Sharp movements of the upper limbs and body, laughter, cough, deep breaths and exhalations, uncomfortable body position, prolonged stay in one position. For reasons, it is mainly recorded in adults.|
|Other signs||Change in heart rate and blood pressure, arrhythmia, shortness of breath.||A characteristic posture with a bend towards the affected area, burning, tingling, discoloration and sensitivity of the skin.|
It is rarely possible to unequivocally recognize how the pathology manifests, and to distinguish neuralgia from heart pain on the basis of only complaints. This is due to the fact that intercostal neuritis does not have a single typical clinical picture.
If pain in the heart is not an isolated case, and lasts longer than 15 minutes, you should immediately consult a doctor.
|number||Difference criteria||Heart pain characteristic||Characterization of Neurological Pain|
|1.||Pain intensity||Strong, oppressive, aching, short-acting and quickly disappearing after taking the medicine||Very strong, intensifying when performing movements, the duration of which can be calculated in days|
|2.||Location||Behind the sternum or at the level of the 5th intercostal space||In the direction of the location of the intercostal nerve|
|3.||Additional symptoms||Pallor of the skin, cold sweat, lack of air, swelling||Strengthening pain with sudden movements|
|4.||Factors provoking pain||Emotional or physical stress||Sharpness of movement|
|5.||Pain Relief Medications||Nitroglycerine||Nonsteroidal anti-inflammatory drugs: Diclofenac, Nimesil, Nurofen, etc.|
The appearance of any kind of pain in the chest area signals the need to seek qualified medical help. Timely treatment eliminates the aggravation of any type of disease and the risk of serious complications.
It is quite difficult to distinguish whether the heart is disturbed or neuralgia by external signs, since both conditions are characterized by discomfort in the chest area. Manifestations of pain are different. If men are more likely to experience discomfort in the lower chest, then women – in the upper.
A preliminary diagnosis can be made if you pay attention to the features of the symptom:
- Firstly, neuralgia occurs due to compression of nerve endings, so pain spreads along their entire length; the patient experiences discomfort not only in the chest, but also in the area of the shoulder blade or back.
- The second diagnostic criterion is the duration of the pain syndrome. With cardiac pathologies, discomfort is disturbed for several minutes. Neuralgia provokes aching or stitching pains that do not go away for more than 20 minutes.
- The third feature is the effect of a provoking factor. On this basis, it is easier to distinguish intercostal neuralgia and osteochondrosis from heart pain. The latter occurs against a background of severe stress, after physical exertion, emotional experiences. But you need to understand that neuralgia often develops as a result of cardiovascular pathologies. With osteochondrosis, the intensity of pain increases with movement, while with cardiac pathologies such changes are not observed.
- The last diagnostic criterion is the effect of drugs on the patient’s condition. With pains in the heart, the patient feels relief after taking Nitroglycerin, while the drug does not help with pinched nerve fibers. With heart pathology, a decrease in physical activity also helps, which does not give results with neuralgia.
To distinguish heart disease from neuralgia, it is necessary to pay attention to the nature of the accompanying phenomena. With signs of heart disease, blood pressure often rises. Organ dysfunction leads to a violation of the heart rhythm. To stop such symptoms, appropriate drugs help. The pressure after taking “Valocordin” is normalized, and “Nitroglycerin” eliminates arrhythmia.
If we look at the causes of these disorders, we can understand the differences in pain of the heart muscle and neuralgia in adults. Pain in the heart develops due to myocardial infarction, pulmonary embolism, myocarditis, pericarditis, aortic aneurysm, hypertension, angina pectoris. Each of these factors leads to various symptoms.
With angina pectoris, the pain radiates to the left arm, neck or under the shoulder blade.
The intensity of the syndrome is diverse. The pain bothers for several seconds or minutes (sometimes up to 20). At the end of an attack of angina pectoris, the patient feels a lack of air. There may be a fear of death.
With a heart attack, there are:
- blanching of the skin;
- profuse sweating;
- increased breathing and increased intensity of pain during movement;
- fear of death.
In inflammatory heart diseases (pericarditis, myocarditis), the pain syndrome usually acquires a pulling character, and its intensity enhances physical overstrain. At the same time shortness of breath, arrhythmia and an increase in body temperature are noted.
Aortic aneurysm is indicated by prolonged painful sensations that worry for several days. Thromboembolism is indicated by signs characteristic of the first disease. But unlike angina pectoris, the pain does not spread to other departments and is localized in the chest. The following symptoms are also possible:
- blue lips and skin;
- a sharp drop in blood pressure;
- heart palpitations;
With hypertension, the pain syndrome occurs sharply, which is caused by an increase in blood pressure. This heart disease is characterized by the following symptoms:
- blind spots before the eyes;
- gait disturbance.
In addition to these reasons, the heart often hurts from nerves. In this case, the symptom ceases to bother as soon as the patient’s mental state is restored.
Neuralgia, like a heart disease, occurs against a background of muscular and emotional stress. The provoking factors that cause compression of nerve fibers include:
- injuries or other damage to the chest;
- hernias and other pathologies affecting the musculoskeletal system;
- infectious and viral diseases;
- frequent hypothermia;
- salt deposits in the spine;
- deficiency of vitamins of group B.
Usually, with a lesion of the chest, the pain spreads along the rib (usually the lower one). This manifestation is not typical for a sick heart.
Since it is not always possible to determine the type of pain – a problem in the heart or is worried about neuralgia, it is necessary to pay attention to the nature of the symptom and the accompanying signs that help establish the type of violation. Compression of nerve fibers causes neuralgia, and pain is characterized by the following features:
- stitching, cutting, wavy;
- the intensity of the manifestation of the syndrome increases with inspiration, movement;
- pain can be disturbing for several days;
- the intensity of the symptom increases with palpation;
- the appearance of distant pains in the scapula, neck, chest and throughout the length of the nerve;
- decreased sensitivity in the problem area, which is not typical for heart disease;
- muscle cramps;
- blanching of the skin;
- local temperature drop.
In this regard, with symptoms of neuralgia in the heart, treatment is determined by the nature of the concomitant disorders. Simultaneously with the indicated phenomena, other signs arise that provoked neuralgia in the region of the heart. In particular, with intercostal neuralgia, the symptoms on the left are supplemented by vesicular rashes with exacerbation of shingles.
In heart diseases, the pain syndrome is mainly localized in the upper chest. Such pathologies provoke a sharp deterioration in the patient’s condition up to fainting.
Only clinical studies help to understand whether the heart hurts or the cause of discomfort in neuralgia. It is impossible to distinguish both states based only on the collection of information about the patient’s condition, because cardiac neuralgia is characterized by symptoms that occur with a variety of diseases, including respiratory pathologies.
If the electrocardiogram does not reveal deviations, apply:
- coronary angiography;
- Ultrasound of the heart;
- MRI (rarely used to detect degenerative changes in the heart).
Coronary angiography is a study that can help distinguish a heart attack from neuralgia. During the procedure, a contrast agent is introduced into the vessels in order to determine the speed of passage of blood. The method allows to detect the presence of blockages or stenosis, as well as the localization of these disorders.
An echocardiogram provides information about the current state of the heart walls, organ defects, and the course of inflammatory processes. The latter are also diagnosed based on the results of a biochemical blood test.
If necessary, a tomography of the spine is prescribed. This procedure is performed if deviations in the condition or work of the heart are not detected.
Cardiac neuralgia is treated mainly with medications selected depending on the characteristics of the causative factor. The treatment regimen is individual for each patient, the duration of treatment is determined taking into account the severity of the case.
Characterization of Neurological Pain
It is almost impossible to independently understand what provoked the feeling of pain in the region of the heart, since it manifests itself equally in different health conditions. As soon as there is pain in the chest, it is recommended to seek the help of a doctor. Only a thorough diagnosis can identify the real cause of discomfort.
Under any assumptions about heart disease or neuralgia, seek medical attention. You do not need to engage in treatment on your own, as it is fraught with deterioration or death. After a detailed study, the specialist will determine the correct diagnosis and prescribe the appropriate treatment for him.
To determine what became the factor in the appearance of cramping in the chest, doctors use the following diagnostic methods:
- Electrocardiogram. It is carried out in two ways – in an inactive position and after a little physical exertion. Using an ECG, the heartbeat is checked and disturbances in the conductive system are detected. The method helps to detect ischemia and heart attack.
- Coronarography (study of the coronary bed). By introducing a contrast medium, it helps to determine the patency of the vessels and the aorta. During the study of the distribution of the substance, it is possible to identify problems of the walls of blood vessels.
- Echocardiography. This study uses ultrasound, with which you can determine the volume of the heart chamber and the thickness of the walls of the organ. The method allows you to find out if there are any inflammatory processes or heart defects.
If all of the above methods did not reveal heart disease, then it is necessary to continue the examination to establish problems with the peripheral nervous system.
Under these circumstances, the following diagnostic methods are used:
- clinical studies of blood and urine;
- blood by ELISA for antibodies to herpes simplex viruses;
- MRI of the spine, with suspected hernia or neoplasm;
- electroneurography, with bruises;
- radiography of the chest and spine.
Pain in the heart or neuralgia – distinguish a specialist after a full examination, based on which he will prescribe a course of treatment.
Cardiologists are involved in the detection of heart pain. Disease treatment provides for drug therapy after obtaining the results of diagnostic measures. The nature of pain in the chest area provides an opportunity to suggest the presence of heart disease, the vascular system. To clarify the diagnosis, the passage is assigned:
- electrocardiography, which refers to a diagnostic study designed to detect abnormalities in the rhythm of the heart and the function of its conducting system;
- coronarography, which provides the opportunity to identify localization sites and the degree of narrowing of the arteries;
- echocardiography, which involves ultrasound examination of the heart, the identification of its defects of a congenital or acquired nature, the determination of the thickness of the vascular walls, evaluation of the valve system.
With the exception of heart pathologies, a computer or magnetic resonance imaging of the thoracic spine is prescribed. The results obtained are the basis for identifying the causes of heart pain or neuralgia. The treatment prescribed by the cardiologist is supplemented by strict adherence to a dietary nutritional diet, and reduced physical activity.
It is also strictly forbidden to smoke tobacco products and drink alcohol, regardless of the concentration of ethanol contained in them. Only doctors are allowed to diagnose neuralgia or heart pain. Self-treatment of an unpleasant syndrome in the chest area can cause serious complications and death of the patient.
The acute form of intercostal neuralgia, which is associated with a knife stroke, subsides over time and passes into the stage of aching pain only after taking non-steroidal anti-inflammatory dosage forms in the form of tablets, gels, ointments, injections. The use of nitroglycerin or cardiac drugs will not help eliminate the symptoms of pathology.
There are also more accurate examination methods, these include examination on an ultrasound and MRI machine and electroneuromyography.
With the help of ultrasound and a tomograph, you can see the presence of compression of the nervous tissue from the outside. It can be a cyst, a tumor, inflammation. And also is there a local blood circulation disorder in the area of pain. This is a big plus when diagnosing, since you can see the focus, which can be eliminated with the help of surgical treatment.
Diagnosis of osteochondrosis has become much easier, thanks to the MRI device, since it allows you to see the cause of compression of the nerve roots that has arisen in the intervertebral discs, you can also see spondylolisthesis – displacement of the vertebrae or a violation in the spinal cord, such as stenosis – narrowing of the spinal canal.
Tomographs are of two types, which allow you to make out smaller parts, up to 1 mm in size and which can reveal details of 5 mm or more. It depends on the magnetic field, in the first case it is equal to 1,5 Tesla, and in the second, 0,4 Tesla is enough.
Also, the procedure on this device has contraindications, the most important of them is the presence of metal objects in the body. The magnetic field of the tomograph will not only attract the object to itself, but also warm it.
If neuralgia occurs due to hypothermia or awkward movement, an MRI scan will be useless.
Electroneuromyography examines the entire nervous system and determines the failure of the nerve impulse
Electroneuromyography or ENMG diagnoses a violation of the behavior of an uneven impulse along a selected nerve. This procedure begins with mild irritation of the nerve by electric current, in another way neurostimulation. If the nerve is motor, then muscle irritation occurs, and an analysis of the muscle response is done.
If a nerve with neuralgia is examined, then the reaction to irritation is evaluated. This procedure is painless. It happens that when conducting ENMG, needle electrons are introduced into the muscles, which can cause tingling and burning in the muscles. Needles are similar to those used for acupuncture.
A preliminary diagnosis is made depending on the medical history and complaints of the patient. Before you can surely distinguish intercostal neuralgia from heart pain, as a rule, general tests of the myocardial condition, structure and size of the organ and spine are performed.
Electrocardiography If cardiovascular (coronagenic) disease is suspected, the most informative and simple diagnostic method is ECG. It allows you to detect arrhythmia, examine the condition of the myocardial adrenal system and find out if the patient has abnormalities characteristic of ischemia and heart attack. To confirm the diagnosis of angina pectoris, an ECG can be performed at rest, with a load, and daily removal of a cardiogram by the Holter method.
Coronarography To determine the cause and degree of narrowing of the lumen of the coronary arteries, an X-ray examination with a contrast medium is performed. According to its distribution in the vessels of the heart, a conclusion is drawn about the need for surgical intervention (stenting or bypass surgery).
Echocardiography. If coronogenic pathology is excluded, and the clinical picture is characterized by aching pain and the absence of signs of vascular disorders (shortness of breath, blue lips, drug reactions), the structure of the heart is examined. EchoCG allows you to visualize the work of the body, measure the thickness of its walls, the volume of the chambers and valve parameters.
Spinal tomography. If heart disease is excluded, then neuralgia and spinal lesions are suggested, to which intercostal fibers are suitable. The main method for diagnosing pathologies of nerves and column is tomography (magnetic resonance or computed). With the help of numerous images, the diagnostic doctor evaluates the shape, volume, relative position of the vertebrae, the condition of the intervertebral discs, and possible destruction of bone tissue characteristic of cancerous tumors.
Sick in the sternum can with the following diseases of the musculoskeletal system:
- osteochondrosis (may differ by a blurred clinical picture);
- injuries with displacement of the vertebrae and ribs, pinched nerve fibers;
- malignant neoplasia of the spine;
- bone damage in some systemic diseases (syphilis, tuberculosis);
- hernia and bulging intervertebral disc;
- spondylosis (spine-shaped bone growths of the vertebrae).
Therefore, pain in the sternum is not always a heart problem. Disorders of a neuralgic nature, pathology of the musculoskeletal system, and even digestive dysfunctions can give such a clinical picture. Therefore, before starting treatment, you should undergo a full medical examination to identify the exact cause of chest pain. An ECG will help with 99% certainty to exclude or confirm a cardiogenic source of discomfort.
It is possible to distinguish intercostal neuralgia and cardiac pathologies, including by the localization of pain. With thoracalgia, the discomfort is girdling, but it is necessarily manifested by the sensitivity of several points at which the affected fibers are located. With the development of neuritis, the pain area can migrate from the sternum, capturing the spine and the area of the shoulder blades. The patient in this case is often not able to determine the starting point.
Discomfort spreads along the affected fiber. Reflected pain in neuritis can be felt in the scapula, lower back, subclavian region. In cardiac pathology, it is usually observed in the shoulder and left arm.
However, the more frequent case of the location of the pain point in neuralgia is the intercostal space. In the region of the heart, nerve roots are damaged, as a rule, in women. With left-sided thoracalgia in men, pain is most felt on the lower ribs, masking the pathology as a digestive tract disease.
How heart pains manifest
Pain in the heart or neuralgia – only a doctor can distinguish in accuracy according to the results of the examination. But for emergency care, you need to know what distinguishing features have ailments in heart attacks. With various lesions of the muscles of the heart, the localization, intensity and frequency of spasms will be different.
This pathology is characterized by cutting or squeezing pains directly in the heart, spreading throughout the sternum and extending under the left shoulder blade, neck and arm. The frequency of spasms can be from 2 to 20 minutes. A change in body position does not bring relief. Pain is accompanied by panic fear of death, oxygen starvation, asphyxia.
This condition is accompanied by acute compressive pain in the chest, radiating to the spine. Pallor of the skin, severe sweating, frequent breathing appear. There is a fear of death, a person cannot move, loss of consciousness is possible.
3. Pericarditis and myocarditis.
These diseases are characterized by moderate or acute pain. Drawing or cutting pain appears. With pericarditis, their localization in most cases in the upper section of the organ and the right hand. With myocarditis – under the ribs or under the left shoulder blade, slightly higher than the upper part of the heart. Both diseases are also accompanied by shortness of breath, fever, arrhythmia.
4. Aortic aneurysm.
This pathology may be accompanied by prolonged pain in the upper section of the chest. The strength of spasms increases with any attempt to move.
5. Thromboembolism of the pulmonary artery.
The pains with this disease are the same as with angina pectoris, the only difference is that they do not give off to other parts of the body. In addition, thromboembolism is characterized by:
- severe cyanosis of the lips and skin;
- a sharp decrease in pressure;
- shortness of breath.
Acute pressing pains in the region of the heart and in the head appear with a sudden increase in pressure, which is typical for hypertension. The accompanying symptoms will be redness of the face, the appearance of vision problems (“goosebumps” and spots in front of the eyes), dizziness.
How heart pains manifest
4. Aortic aneurysm.
Pain in the heart is triggered by neuralgia, because in most cases the nerves located in the chest area are affected. Despite the fact that the location of the cramps in both ailments is the same, the symptoms of neuralgia are significantly different from the symptoms of heart disease.
- Intense pain, aggravated by breathing, coughing, movement.
- Prolonged pain sensations of a burning or cutting nature.
- Inability to touch the intercostal region, as the pain intensifies with pressure. False sensations of spasm in the heart can be triggered by its spread to the chest, both arms, neck, and m />
- Sensitivity disappears in the area of the inflamed nerve, goosebumps appear.
- Convulsions, excessive sweating, pallor of the skin are observed.
- The area of the body on which the inflamed nerve is located begins to freeze. This is due to a decrease in temperature on it.
- Very rarely, neuralgia is accompanied by vomiting.
Heart pain therapy
Heart disease, like neuralgia, should be treated under the supervision of a specialist. You can only provide emergency assistance on your own.
With severe pain in the heart while waiting for a doctor should:
- help the patient take a half-sitting position;
- lay a capsule of Nitroglycerin under the tongue;
- make a weak heart massage lasting 5 minutes.
After the examination, therapy will depend on the diagnosis. There is a specific treatment regimen for every heart disease.
To eliminate the symptoms of ischemia, heart attack and heart failure, the following drugs are prescribed:
- Nitroglycerin and drugs based on it relieve a heart attack;
- Iso-Mac 20 eliminates the symptoms of the disease, relieves pain;
- Nitrosorbide increases the resistance of the heart muscle to physical activity;
- Olikard Retard reduces myocardial oxygen demand, has a coronary expansion effect;
- Efoks Long has the same effect as the olikard;
- Pectrol is an analogue of Olikard.
The following agents are used to improve blood composition and vascular patency, as well as relieve inflammation:
In the treatment of arrhythmias and hypertension, beta-blockers are prescribed that normalize heart rhythm.
This group includes:
Also, in combination with the above drugs or for emergency assistance, the doctor may recommend taking the following drugs:
- Lasix relieves spasm during an attack (taken in combination with magnesium, sodium, calcium);
- Chlortalidone reduces pressure and reduces pain;
- Verapamil has an antihypertensive, antiarrhythmic, antianginal effect;
- Gallopomil prevents recurrent myocardial infarction, helps to eliminate an attack of angina pectoris;
- Diltiazem increases coronary blood flow, normalizes heart rate, reduces the tone of smooth muscles of arteries;
- Calcium antagonists eliminate spasms of blood vessels;
- Digoxin and Strofantin instantly eliminate the cause and symptoms of a heart attack.
Also, during treatment, it will be necessary to observe the following conditions:
- limit physical activity;
- daily perform exercises from a specially selected complex of exercise therapy;
- adhere to bed rest.
Heart disease, like many others, is easier to prevent than to cure.
Preventive measures include:
- refusal of bad habits (smoking, alcohol);
- balanced diet that does not allow obesity;
- refusing too much salt;
- physical education;
- control of blood pressure;
- sleep at least 8 hours a day;
- annual consultation with a cardiologist.
Also, in order to prevent and in combination with taking medications for the treatment of heart pain, you can use traditional medicine recipes. Decoctions of medicinal herbs will help strengthen blood vessels, normalize blood pressure and heart function. Before starting treatment at home, you need to find out from your doctor if there are any contraindications.
Most diseases that cause heart pain or bouts of neuralgia are successfully treated. The main thing is to recognize the symptoms of the disease in time, and seek medical help.
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