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.
Other differences between neuralgia and heart pain
Often, neuralgia disguises itself as other diseases, for example, renal colic, toothache, heart pain. How to distinguish heart pain from neuralgia? Pain in the region of the heart, usually extending to the back and shoulder blade. When taking medication, the pain continues, which means this is either neuralgia or another pathology.
Often repeated pain is an occasion to call an ambulance. Doctors determine the cause of the pain and make a diagnosis, prescribe medications, and may even recommend massage. Also, sometimes experts prescribe rubbing and physiotherapy. A cardiologist may prescribe anti-inflammatory drugs intramuscularly.
So, with neuralgia, pain is given to the back and under the shoulder blade, pain can be stitching. May last 10-20 minutes. This ailment is mainly attributed to adults, rarely found in children. Pain does not go away after taking medications such as validol or nitroglycerin. The heart rate is normal.
The pain in the heart is mostly pressing, and with neuralgia – stitching
If this is intercostal neuralgia, the pain is not easy to overcome. The pain in the heart is mostly pressing, and with neuralgia it is a stitching sensation that intensifies with movement. May occur against osteochondrosis of the neck. For verification, you can take validol and, if the pain has not passed, then this is neuralgia. To eliminate pain, Ibuprofen can be taken, you can also use anesthetic ointment.
Intercostal neuralgia is detected by the presence of points on the body in the chest area that are sensitive to touch – these are the exit points of the affected nerve fibers. Also, pain can become stronger with inhalation and exhalation. With intercostal neuralgia, when the pain lasts for a long time, the root of the nerve fiber begins to die and the pain sensations recede. But this is not considered the end of the disease, in this condition the most difficult to cure the disease.
When answering the question of how to distinguish intercostal neuralgia from heart pain, it is first of all worth noting that sensations of a neurological nature are most often disturbed in the form of seizures that can be triggered by a sudden movement of the body, sneezing, coughing, weight lifting. Such discomfort is intense, it shoots and burns, aggravated by turning the body, taking a deep breath, coughing. Additionally, vegetative symptoms may appear:
- blanching of the skin of the face;
Also, during attacks, pressure may increase, limited movement may appear. When taking anti-inflammatory drugs, the pain syndrome weakens, and sometimes it completely disappears.
There are many vascular and cardiac pathologies that declare their manifestation of pain in the chest area. With some pathologies, an accurate diagnosis can be established only after passing the examination. However, with the manifestation of pain in the area of the location of the heart, urgent medical care is required. In some cases, it is this factor that saves the patient’s life.
The reasons for which the heart hurts are many. These can be diseases such as myocardial infarction, rheumatic lesions or inflammation, as well as angina pectoris. Heart pain with the sudden onset of various diseases can manifest itself in different ways. In some cases, it is felt in the entire chest, in others – in a rather small area. Moreover, it can be stitching or pressing, aching or pulling.
By origin, such pains are divided into two groups:
- Religious pain. They occur with coronary disease, angina pectoris. Their appearance is possible with increased load or the manifestation of emotional stress. They occur in seizures during stress or when walking. At rest, the pain releases. Quickly removed by Nitroglycerin. Manifested in the form of burning, pressing or compressing sensations. Often given under the shoulder blade, in the left shoulder, sometimes in the lower jaw. Often accompanied by shortness of breath.
- Cardialgia. They occur with rheumatism of the heart, inflammation of the outer heart membrane (pericarditis), myocarditis. The pains arising on the left side of the sternum are prolonged, worn aching or stitching. May intensify due to coughing or deep breathing. Nitroglycerin does not remove them, but can weaken when taking painkillers.
The nuances that appear with heart disease are as follows:
- Angina pectoris. The nature of the heart pain in the left side of the chest can be either oppressive or cutting. Dull sensations can respond in the left hand, between the shoulder blades or in the neck. With a change in body position, the nature of the pain remains the same, but may increase due to any load or changes in ambient temperature. The attack can be short-term or last up to twenty minutes. Perhaps its recurrence after a short sedation.
- Heart attack. Acute myocardial infarction is indicated by a strong burning and tearing, pressing and compressing pain, which manifests itself in the left side of the chest. It can respond in the spinal column. Such intensity is possible that a person loses consciousness. There is pressure in the chest that makes it impossible to lie down. This is one of the symptoms of a very dangerous pathology. At the same time, such pain is not relieved by Nitroglycerin and does not change in movement by the strength of the manifestation, but additionally causes a pinching sensation.
- Hypertension. When the pressure rises, the head hurts, it creates a feeling that the heart is contracting and at the same time aching. When an attack occurs, the face turns red, various points appear in front of the eyes. There is a breakdown, a gait becomes very uncertain.
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.
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.
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.
Pain in the heart or neuralgia – you can distinguish by studying in detail the symptoms of the diseases described above. In addition to them, there are criteria that will help quickly identify the origin of the ailment.
|In the course of the intercostal arch.||Exclusively on the left side of the chest. It extends to the left hand.|
|Pain is not an antispasmodic type.||Periodic cramps lasting from 2 min.|
|Aching character of pain. It decreases after taking painkillers.||Acute pain, often of a constricting nature. Burning, tingling sensation.||Cramps, fever, sweating.||Shortness of breath, dizziness, loss of consciousness, palpitations.|
|Age||It does not depend on age.||From 45-50 years old.|
|Duration||A few days.||Several hours.|
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.
How does neuralgia manifest
The concept of neuralgia is defined as the spread of pain along a nerve. With the development of intercostal neuralgia, such unpleasant manifestations are felt in the area between the ribs, in the places where the nerve endings pass. Cardiovascular diseases such as heart attack and angina are also accompanied by pain manifestations in the same area.
Therefore, it is difficult for a non-specialist to distinguish whether these are pains in the heart or neuralgia. An injury to the spinal root that occurred in the thoracic region can be caused by a sudden movement or cough. Often such a violation occurs when lifting weights. It manifests itself as a pronounced shooting and burning pain.
Neuralgic pain syndrome is accompanied by painful manifestations that can pass from a point in the chest to the spinal column, and sometimes to the scapula. Moreover, the patient himself is not always able to accurately indicate the location of localization. Sometimes the pains are reflected. In these cases, it is difficult to determine the source of the discomfort.
In addition to pain during compression of the intercostal nerve endings, unexpected, but even more unpleasant symptoms may appear. Distinct muscle contractions are possible, accompanied by twitching. At the same time, intense sweating begins, the skin changes color, becoming red or acquiring a painful pallor. The skin in the area of pinched or damaged nerve endings begins to burn and tingle, its sensitivity is lost, this area is numb.
Often with intercostal neuralgia, a person has to stay in a special antalgic posture. The patient takes a position bent towards the healthy part of the body, trying not to change it. In this case, the intercostal spaces are stretched, which reduces the pressure on the irritated nerve endings. Soreness is relieved. Due to the fear of the appearance of new unpleasant sensations, the patient maintains this pose for a long time.
4. Aortic aneurysm.
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.
What are some signs of heart pain?
The main cause of heart pain is the lack of oxygen to the heart muscle. Usually this happens as a result of narrowing of the gaps of the vessels that feed certain parts of our “motor”. To understand whether the heart really hurts, you should pay attention to the following symptoms:
- Localization – in most cases, heart pain is localized in the left part of the chest or in the middle of the sternum. Sometimes she gives to the left hand, to the chin and between the shoulder blades.
- The nature of the pain syndrome – with heart diseases, the pain usually has a compressive or compressive character, and also happens to be dagger or baking.
- The presence of provoking factors – a disease such as angina pectoris, is most often manifested by a painful sensation after physical exertion and does not bother at rest. Although in the event that the vessel has narrowed critically, discomfort occurs in the middle of the night.
- Duration of pain – when it comes to angina pectoris, it is worth talking about a short-term pain syndrome that worries no more than 15 minutes. If the chest hurts and stabs for many hours or days, then most likely the reason lies in the problems of bones or muscles. However, it should be borne in mind that intense, burning heart pain lasting more than 20 minutes can indicate a formidable pathology – myocardial infarction.
In some cases, the heart hurts due to diseases that are in no way associated with this organ:
- Aortic aneurysm. At the top of the chest is a breaking pain. When moving, it intensifies. With the progression of pathology, the sensation increases, the pain becomes sharply bursting. Possible loss of consciousness.
- Acute obstruction of the pulmonary artery. The pains are similar to those that are felt with angina pectoris, but are not given away in other parts of the body. The heart beats very often, the lips turn blue, the pressure drops sharply.
- Thoracic sciatica. In this case, pain sensations change when the body is rotated, chest movements during inhalation or exhalation. The intensity of their manifestation is not affected by the use of such conventional cardiac drugs as Validol, Nitroglycerin and others.
- Osteocondritis of the spine. At the time of pinched nerves, it can hurt in completely different parts of the body. It depends on which ending is pinched. Shortness of breath and coughing are possible.
- Inflammation of the lungs, pleurisy, or bronchitis. Due to improper opening of the lungs and movement of the ribs, pain in the chest is possible. Difficulty breathing, coughing, severe weakness.
- Diseases of the stomach and pancreas. With bloating, pressure on all organs, including the heart, is possible. Also, unpleasant sensations can be associated with the intake of a certain type of food, starvation.
Causes of Heartache
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.
4. Aortic aneurysm.
Therapy of neuralgia consists of 2 stages, focused on the elimination of pain and the source of the disease.
Drug therapy consists of:
- non-stero />
- sedative (mild sedative) drugs – Valerian, Neuroplant, Motherwort and others;
- ointments warming up and eliminating inflammation – Voltaren, Ortofen and others;
- pepper patch;
- mustard plaster;
- novocaine blockade (with low effectiveness of painkillers);
- vitamin preparations of group B.
In parallel with taking medication, treatment is carried out with the following methods:
- the adoption of radon and hydrogen sulfide baths;
- mud treatment;
- laser therapy;
- applications with paraffin and ozokerite.
During relapse, it is recommended to sleep on a hard bed and perform exercise therapy daily. In exceptional cases, surgery may be indicated.
In order to prevent the serious consequences of neuralgia and its transition to a chronic condition, a number of rules must be observed.
During treatment, experts recommend:
- not allow large physical exertion;
- avo />
- control posture;
- additionally take a complex of vitamins and minerals.
Along with drug therapy, it is permissible to use traditional medicine methods for the treatment of peripheral nerves. Sufficiently effective means are: taking a decoction of willow and rubbing the inflamed area with ointment from glycerol and iodine. Before using these funds, you need to consult a doctor.
Before starting treatment for neuralgia, you must definitely pay attention and find the cause of the pain. These reasons can be injuries, intoxications, for example, alcohol, infections, herniated discs, diabetes mellitus, oncology, problems with immunity. Other causes may include osteochondrosis, hypothermia, diseases associated with the musculoskeletal system, including congenital, atherosclerosis, peripheral vascular diseases that disrupt the blood supply to nerve endings.
Nevertheless, it is worth contacting the clinic to establish an accurate diagnosis and causes of neuralgia. The specialist will diagnose, conduct an examination and prescribe treatment. In modern medicine, they do not treat symptoms, but look for the cause of their occurrence and treat it. Typically, group B drugs are prescribed, they not only eliminate pain, but have a beneficial effect on the nerve fiber, restore and stimulate the nutrition of nerve tissue. With neuralgia, vitamins, antibiotics, painkillers, anticonvulsants, sedatives and restorative drugs are prescribed.
How to eliminate pain depends on the cause of their occurrence. If the “culprit” is the heart, then such sensations can be removed by taking Nitroglycerin, Validol. In this case, the tablet of the first drug is resorbed, and the second is placed under the tongue. The patient must be seated or laid in a “reclining” position. To do this, pillows are placed under the back. A person needs air, so you need to unfasten the collar, loosen the buckles or belt. After performing these procedures, a call to the medical team is required.
And yet how to distinguish these pains
Neuralgia is pain that goes along an injured nerve. These sensations spread between the ribs, where these endings are located. At the same time, prolonged pains are felt, arising equally often, both during the day and at night. They intensify with coughing, trying to take a deep breath or with possible movements around the room. Medicines that help with heart disease have no effect. The performance of the body does not change.
The pain caused by cardiovascular diseases is short-term, they are periodic. Moreover, most often they last no more than 10 minutes. Stopped by Nitroglycerin or Validolum. A deep breath or a change in position does not increase the pain. There is also a violation of cardiac activity.
Must remember. If you experience pain in the chest area, you need to pay attention to such a fact as the presence of risk factors for heart disease. Pain can be atypical for angina pectoris, but the following factors are present:
- the patient is already 45 years old;
- one of the direct relatives suffered a stroke or heart attack;
- the patient smokes;
- there is a constant increased pressure;
- analyzes indicated elevated sugar.
If these factors are present, then any pain in the sternum should be treated as a potential danger. No wonder what it could be. It is necessary to provide urgent help, and then call a medical team.
How does neuralgia manifest itself?
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.
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