Why presses in the middle of the chest and breathing hard

According to statistics, more than half of chest pains associated with the heart

According to statistics, in 60% of cases, pressing pain in the sternum in the middle means heart problems. The remaining causes are associated with the musculoskeletal system, digestive system, various neurological disorders. Therefore, for middle-aged people with exacerbation of pain, it is recommended to immediately call an ambulance and exclude cardiac pathology.

Symptoms for cardiac abnormalities do not develop immediately – usually this occurs over several months or even years. A person knowing this does not go to the doctor, but continues to live in a normal rhythm. A little stress or nervous strain can provoke a pre-infarction condition, which a person will take for any other pathology. The consequences can be different: from a long stay in a hospital to a fatal outcome.

The type of pain in coronary heart disease is pulling dull. The reason is prolonged poor blood circulation in the tissues due to the deposition of cholesterol plaques on the inner walls of blood vessels. This happens with insufficient digestion of food, lack of enzymes, poor metabolism, and a sedentary lifestyle. Usually such people are overweight and overeating.

Aggravating factors for ischemia are:

  • Smoking, which reduces immunity and enhances the general intoxication of the body.
  • Hereditary predisposition when someone in the family has had cases of cardiovascular disease. A person could inherit the features of metabolism, under adverse conditions, the mechanism of the disease would start.
  • Blood pressure jumps.
  • Concomitant diseases, including severe endocrine disorders, such as diabetes mellitus.

To diagnose the condition of the heart, it is necessary to conduct 2 types of examinations – an electrocardiogram and angiography. It is important for the patient to know about his diagnosis, since for many, the protective mechanism is activated. Apply stress tests on an exercise bike or treadmill. It is necessary to properly prepare for the diagnosis:

  • The day before the test, a person should not drink alcohol, caffeinated drinks – tea, coffee, and physical and psychological stress should be avoided.
  • 3 hours before the diagnosis, you can not take food, water, or smoke. Breakfast should be light – juice, yogurt, yeast-free cookies.
  • You need to come to the diagnostic room half an hour before the examination in order to calm down and take the necessary position.

Angina pectoris or angina pectoris is caused by pathological narrowing of the coronary vessels and myocardial oxygen demand. An attack of pressing pain with shortness of breath occurs most often during experiences or emotional outbursts.

The causes of angina pectoris are vascular atherosclerosis, spasms of arteries, and thrombosis. When a blood clot occurs, an obstruction occurs along the artery and a heart attack develops. The cause of myocardial oxygen deficiency can be blood diseases – anemia, in which a small number of red blood cells are not able to satisfy the needs of tissues.

Angina attacks can be stable or unstable. In the first case, an increase in symptoms is almost always associated with increased physical activity or increased nervousness. In the second case, an attack of angina pectoris can develop at rest – physical and psychological. This should alert the person and force him to take any measures to stabilize the state.

Heaviness in the chest with difficulty breathing may indicate:

  • Angina pectoris – with minor changes in the heart, stagnant processes begin, because of which it is difficult to breathe and hurts in the chest.
  • Myocardial infarction – due to heart problems, severe chest pain appears, breathing is difficult, a feeling of fear appears.
  • Heart defects – formed in childhood, the patient is under the constant supervision of doctors.
  • Myocarditis is an inflammatory disease in which malfunctions of the heart muscle appear.

Heart diseases are treated by a cardiologist, neurologist and physiotherapist, a person who is diagnosed with one of the diseases of the cardiovascular system must monitor his health throughout his life.


Intercostal neuralgia develops due to inflammation of the intercostal nerves. Such a disease does not represent a life threat, but pressing pains are especially severe. With the disease, pressing chest pain appears suddenly and is particularly intense, which is why a myocardial infarction is often misdiagnosed, which is not confirmed by further examination.

The difference between heart pain and intercostal neuralgia

Neurological problems are characterized by the following symptoms:

  • Weakness in the left half of the body and inability to raise a hand.
  • Long-term pain – up to 10 hours.
  • Nitroglycerin does not help in this case.

Intercostal neuralgia is characterized by a symptom when it compresses the chest and it is not possible to take a full breath. This happens when the ribs are affected at the junction with the sternum. Shooting pain, aggravated by coughing, sneezing, awkward body movements. With the activation of the herpes virus, shingles can occur – a rash on the skin along the nerve extending from the spine. Nearby tissues become inflamed and intercostal neuralgia occurs.

The treatment of neuralgic pain is long. To do this, it is necessary to remove inflammation and eliminate the cause of intercostal neuralgia, which may consist in age-related damage to the vertebrae and cartilage.

Symptomatic pectalgia resembles heart pain

Pectoral syndrome of the pectoralis major muscle resembles heart pain in symptoms, but in fact it is not. Pain with damage to the anterior chest wall is dull, pressing. It is localized on the left in 80% of cases, on the right in 12% of patients, in 8% it has bilateral localization. Pain is constant, since it is associated with damage to the thoracic and cervical vertebrae and cartilaginous layers between them.

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The diagnosis is complicated by the presence of cardiac pathology in patients with damage to the pectoralis major muscle. In this case, examination by different specialists is necessary.

On palpation, painful zones are detected in the area of ​​the chest muscles, which clearly indicates myalgia and excludes cardiac pathologies. Seals of round or oval shape may form.

If the pain is localized to the left or right closer to the shoulder, it is necessary to differentiate the symptoms of the pectoralis major and minor. With myalgia of the minor muscle, the pain will give to the shoulder. The same symptoms are possible with problems in the lungs, especially if a person abuses smoking.

Violation of the gastrointestinal tract

A person who is in a nervous stress state for a long time receives not only psychological injuries, but also physical disorders.

At these moments, vasospasm can be observed, blood circulation is disturbed, as a result of which pain sensations appear in different parts of the body.

The causes of a neurological disorder can be cured only with the help of a psychotherapist and a neurologist.

Causes of gastritis

If you press in the sternum in the middle, the problem may be the increased acidity of the stomach with gastritis. The volume of digestive juices and the onset of inflammation of the walls of the stomach can cause a pressing sensation of overflow. Acute gastritis is characterized by the following symptoms:

  • Colic in the abdomen and worsening of general well-being.
  • Feeling of fullness inside.
  • It’s hard to take a breath.

Usually a person knows about his problems with digesting food, so he stops the pain himself. In some cases, gastritis can turn into peptic ulcer, which will require a serious approach to treatment, and sometimes surgery.

Acute pancreatitis causes severe pain and heaviness in the middle of the chest. In this case, the person begins excessive sweating, shortness of breath and other symptoms. Pancreatitis is a dangerous disease in which inflammation and obstruction of the pancreatic ducts is possible. In this situation, digestive enzymes can destroy part of the tissues of the body, which will cause bleeding and death for the patient. It is difficult to diagnose pancreatitis outside the hospital, according to the symptoms, it may resemble:

  • Poisoning, as there are abdominal pain, vomiting, diarrhea.
  • Cardiac pathology due to severe shortness of breath and pain in the sternum.
  • Appendicitis – due to the irradiation of pain in the lower abdomen.
  • Hepatic colic.

Provoking factors of pancreatitis is overeating

The provoking factors of acute or chronic pancreatitis are most often overeating and alcohol abuse. If the attack began after heavy intake of various foods, most likely the pain is associated with the gastrointestinal tract. It is recommended that you starve and drink plain non-carbonated water for 2 to 3 days, then start eating with porridge in the water in order to gradually put the organ into work.

Pancreatitis can be a complication of cholecystitis, an inflammatory process in the gallbladder. In this case, the pain will also be located in the chest area, but to the right of the center. It is necessary to check the body for stones, so that choleretic drugs do not provoke the movement of stones and do not clog the duct.

If this happens, urgent surgery is needed. In any case, it is important to know what size the stones formed in the cavity of the gallbladder and whether they can be removed using vasodilator drugs at home. If a large stone gets stuck in the duct, only a doctor can remove it with a laparoscope.

4. Pancreatitis

This is a disease in which acute or chronic inflammation of the pancreas develops and its cells die due to self-digestion. There is a pathology at any age. Pain in the disease initially occurs and presses in the stomach. Then it quickly spreads, acquiring a girdling character and surrendering to the chest.

Diseases of the respiratory system

Symptoms indicating problems with the respiratory system:

  • Presses in the chest during inspiration – pleurisy.
  • After smoking, discomfort is felt – bronchitis, asthma, malignant processes in the lung tissue.
  • Difficult to breathe – lack of oxygen in a poorly ventilated area.
  • Body temperature is elevated and chest pain is pneumonia. With pneumonia, cough and sputum discharge may not occur.
  • A person loses consciousness after a short-term sensation of chest pain – a blood clot in the pulmonary artery. This condition is extremely life-threatening and can lead to death within a few minutes without urgent medical attention.
  • Increased sweating and body temperature, weight loss, sputum and cough – tuberculosis.

Diagnosis requires fluorography, a stethoscope to listen to breathing, and blood and urine tests.

Diseases that can cause chest pain:

  • osteochondrosis;
  • scoliosis;
  • inflammatory processes in the costal cartilage;
  • rib fractures;
  • spinal hernia;
  • congenital deformities;
  • xiphoid process syndrome.

Osteochondrosis of the thoracic vertebrae causes pain in the chest area. The development of the disease is caused by age-related changes in bone and cartilage, trauma, prolonged physical activity, professional occupation in heavy sports, lack of enzymes and poor absorption of calcium, magnesium and phosphorus. You can make a diagnosis after an x-ray.

Scoliosis is a lateral curvature of the spine. It is characterized by an asymmetric arrangement of the shoulders, hip joints, uneven waist. With complications, compression of the lungs and heart is possible, which leads to shortness of breath. Injuries, muscle dystrophy, and congenital malformations lead to scoliosis.

Intervertebral disc hernia – the final stage of osteochondrosis

A hernia of the spinal column presses the chest in the middle and can lead to limited mobility and even disability. Rupture of the membrane of the intervertebral disc and protrusion of its inner part – this is hernia. In the thoracic region, hernial protrusion is rare due to less mobility and wear of the spinal discs.

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Chest pain usually causes damage to D3 – D8 discs. Symptoms may resemble angina pectoris, diseases of the digestive tract, girdle pain at the level of the solar plexus.

Signs of Marfan Syndrome

With genetic abnormalities, changes in the shape of the chest are possible. Such diseases include:

  • Marfan syndrome is a violation of the growth and formation of connective tissue. It manifests itself in a change in the proportions of the body.
  • Turner syndrome – chromosomal growth disorders, as well as cardiac pathologies.
  • Achondroplasia or dwarfism due to disorders in the brain tissue.

Deformations of the chest can be caused by severe infectious diseases – syphilis, tuberculosis, and also develop due to malnutrition, as in the case of rickets.

Chest pain with injuries

With a strong blow to the chest, pneumothorax can occur – the lung tissue subsides and the air concentration in the pleural cavity. At the same time, for some time it becomes difficult for a person to breathe, since gas exchange is disturbed, chest pain is felt. In some people, pneumothorax goes away without visible symptoms. In case of bilateral lung damage, it is necessary to insert a catheter and restore the lung from the side that is affected more.

In weightlifting athletes, when lifting weights, ruptures of muscle tissue occur – large or small pectoral muscles. This leads to acute pain and the inability to move a hand. The gap is treated by stitching the damaged muscle and restorative procedures.

6. Rib fracture

A fracture develops due to an external influence on the rib of a pressing force that exceeds the strength of the bone. Quite often, such damage is combined with lung injury, which occurs both due to injury from bone fragments, and directly from the most negative effects. Such damage that occurs on the left or right, and sometimes on both sides, is.

Chest discomfort

A feeling of pressure on the sternum may occur in a small area, but the patient has difficulty breathing.

But this phenomenon can affect a large area, then in addition to difficulty breathing, pain is possible, extending to the arm, shoulder, abdomen, under the scapula and in the lower jaw.

Discomfort can be short-lived (lasting several minutes), but more often they disturb for a long time (several hours, and in serious cases, it can last several days). Discomfort may change with a change in patient position.

Osteochondrosis is a problem that affects so many. Today she began to meet even among young people. In the event that the pathology affects the thoracic region, pressing chest pains are provided. In the spine, pain will also occur and press in the area just below the shoulder blades. The nature of the pain is pressing, high intensity, exciting the entire chest.

10. Pulmonary thromboembolism

Pathology, in which the chest also hurts, is deadly and is characterized by blockage of a thrombus of a lung artery. A thrombus forms, which leads to blockage, most often in the veins of the legs or pelvis. Violation is not an independent disease, but is defined as a complication of leg vein thrombosis. According to medical statistics, this phenomenon takes the third place among the causes of sudden death. If medical care is provided in a timely manner, then the number of deaths is 8%.

Rare reasons

In addition to the main reasons for which the chest is crushing, rare ones are also isolated. They are poorly distributed and can not always be easily identified. This category of causes of pressing chest pain includes:

  • esophageal injury;
  • aortic aneurysm;
  • pericarditis;
  • angina pectoris;
  • pneumothorax;
  • pleurisy;
  • epidemic myalgia;
  • shingles;
  • esophagospasm;
  • oncological lesions;
  • scoliosis.

Heaviness in the chest may appear due to various reasons. To identify the true cause, the doctor should clarify the following details:

  • Where exactly squeezes in the chest.
  • The nature of the pain.
  • Is it hard when you inhale.
  • Where they give sensations.
  • Which helps to get rid of discomfort.
  • How long does the attack take?

What diseases can be diagnosed if there is pressure in the middle of the chest:

  • Pathology of the sternum bones.
  • Heart Disease.
  • Diseases of the digestive system.
  • Respiratory diseases.

Only a doctor can determine the exact disease that caused the pressing sensations in the chest area.

Who heals

When acute pressing chest pain occurs, an ambulance is required. What to do in other cases, when the patient is concerned about chest pain, the doctor determines who must be visited. Initially, it is advisable to visit a therapist, to determine the reason why it began to hurt in the chest, he will be able to determine which specialist will treat the patient. Therapy is carried out by a cardiologist, gastroenterologist, pulmonologist, oncologist, traumatologist or surgeon.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.