What does pain in the sternum mean: causes and diagnosis

The chest is the part of the body where the organs of the respiratory and cardiovascular systems are located, as well as numerous nerve fibers, blood vessels, and bone tissue.

The thoracic vertebrae, the heart and the arteries are located in the chest cavity, which supply it with blood, the esophagus and the upper section of the diaphragm tube. When a person has pain in the chest, the reason may lie in the pathological processes occurring in the tissues of any of the above organs. Therefore, to assume that such a symptom speaks only of problems with the heart is wrong.

Treatment of diseases that cause chest pain should be prescribed exclusively by a specialist. Without carrying out all the necessary diagnostic measures and finding out the reasons for indisposition, the use of any drugs at random can have very dangerous consequences.

What it is?

Complaints of patients about pain in the chest - a common phenomenon for practicing physicians - therapists, pulmonologists, TB specialists, etc. This deviation is called retrosternal pain, which occurs in the mediastinum - anatomical region located behind the sternum.

The essence of the problem lies in the organs located in this zone:

  • esophagus;
  • trachea;
  • hearts;
  • bronchopulmonary system.

In addition to them, a large number of large blood vessels and lymph nodes are concentrated in the mediastinal zone. When the functioning of the above organs is impaired, a direct effect is created on the nerve fibers passing through the mediastinum zone. As a result of this, pain in the chest occurs.

Less commonly, pain is caused by the development of pancreatitis, and extremely rarely by mental disorders. Anyway, and painful sensations behind a breast - a serious symptom which cannot be ignored in any case.

Chest pain: main causes

The sternum is the oblong bone, which is located in the middle of the chest, and to which the ribs are attached. Together, these bone formations form the rib cage. It is a reliable protection for the heart, lungs, aorta and esophagus from mechanical damage and injury.

Pain in the chest can be caused by many different pathological processes. Consider the most common ones.

CAS diseases

Chest pain may be associated with the development of pathologies of the cardiovascular system. Often they occur when:

  • angina pectoris;
  • myocardial infarction;
  • cardiac arrhythmias;
  • hypertensive crisis;
  • the development of pulmonary thromboembolism;
  • pericarditis;
  • myocarditis;
  • exfoliation or rupture of an aortic aneurysm.

In each of the above cases of chest pain are accompanied by specific symptoms, ignoring which, the patient risks not only his health, but often his life.

Intercostal neuralgia

Such an unpleasant phenomenon as intercostal neuralgia, is familiar to many. It is accompanied by "pinching" of the intercostal nerve fibers with spastic muscles located in close proximity to them. This pain is called thoracalgia of vertrebogenic origin. This term refers to the pain behind the sternum caused by diseases of the spine.

Diseases of the stomach or esophagus

Chest pain can occur on the background:

  • gastroesophageal reflux disease;
  • inflammation of the mucous membranes of the esophagus - esophagitis;
  • strain of the mucous membrane of the esophagus.

In this case, the pathologist is engaged in the treatment of pathologies by a gastroenterologist.

Other reasons

For other reasons that can cause chest pain, include:

  • injuries (bruises, faces, fractures);
  • deformation of the sternum - congenital or acquired;
  • development of inflammatory diseases in the upper respiratory tract (tracheitis, pneumonia);
  • oncological processes - lymphomas, or cancer of other localization, metastasizing to the mediastinal lymph nodes.

Chest pain may be acute or chronic.

  1. Acute pain is sudden paroxysmal in nature. It may be harsh, unbearable, but for each patient it manifests itself in different ways. Such pain can be caused by acute diseases such as infarction, paroxysmal tachycardia, dissecting aneurysm, etc. This type of pain syndrome can also accompany esophageal rupture or sternum fracture. In the presence of potentially life-threatening conditions for the patient, acute chest pain becomes intolerable.
  2. Chronic pain may not cause much discomfort to patients, so they later seek the advice of specialists. Such pain syndrome may accompany angina pectoris, sternum deformity, GERD, and other diseases.

To determine the cause of the patient's discomfort, the doctor must carefully collect an anamnesis and prescribe a number of additional diagnostic tests.

Heart disease

With the emergence of chest pains to begin with, it is necessary to exclude heart damage. Often this symptom is associated with coronary heart disease (CHD). It develops on the background of insufficient oxygen supply along with blood to the heart muscle.

During hypoxia, primarily myocardium suffers. Pain is a specific signal of a developing disease. Clinical forms of coronary artery disease can be infarction or angina, but these pathologies are accompanied by different types of pain.

Angina pectoris

For this pathological condition characterized by the occurrence of pressing chest pains. The patient himself can describe it as if something heavy is on his chest.

The pain can be given in the left arm or neck, and is usually paroxysmal. The duration of one attack can reach 20 minutes.

Important! Pain with angina is eliminated after taking nitroglycerin.

Heart attack

Myocardial infarction develops with an acute lack of oxygen, which results in the death of the tissue of the heart muscle. This pathological process is characterized by the occurrence of a pressing, burning pain in the retrosternal region. But in this case, the pain syndrome is expressed much brighter than with angina.

The pain can also be given to the neck, left arm, and also spread throughout the chest, and even to the abdomen. In this case, the patient may experience panic attacks, accompanied by the release of cold sticky sweat on the face. Patients describe pain as unbearable, painful. The duration of the attack exceeds the 20-minute interval, in addition, it can not be stopped with nitroglycerin.

Other cardiac pathologies

Among the common cardiac causes of chest pain, myocarditis and pericarditis are among the most common. As a rule, they arise after the infectious diseases suffered by the patient. Inflammatory diseases of the heart are accompanied by:

  • pain in the sternum and chest;
  • fever;
  • weakness and general malaise.

Neurological diseases and pathologies of the musculoskeletal system

Often, chest pain is caused by scoliosis and osteochondrosis of the thoracic or cervical spine. In this case, the source of the pain will be located in the center of the chest cavity. The nature of the pain syndrome is oppressive, but at the same time intense. Unpleasant sensations are amplified when a person assumes a lying position.

Similar symptoms are observed and PI intercostal neuralgia, which develops when squeezing or pinching the nerve roots in the intercostal space. In this case, the pain is sharp, shooting, and may have a different intensity. Sometimes it may feel as if an electric current passed between the ribs - this is another manifestation of acute neuralgia.

When chronization of the pathological process of pain also occurs suddenly, flashes. But in this case, they are distinguished by a burning and dull character.

Diseases of the digestive tract

Pain in the middle of the chest can also indicate the development of gastrointestinal diseases. Often their causes are rooted in the development of reflux esophagitis, accompanied by the casting of gastric contents into the esophagus, and gastritis, acute or acute chronic.

Bad habits, stress, unhealthy diet, taking certain groups of medicines can lead to such a deviation. The above mentioned pathologies of the gastrointestinal tract can be accompanied by:

  • aching chest pain - in the center and to the left;
  • pain in the upper abdomen;
  • heartburn;
  • feeling of heat in the throat;
  • nausea;
  • discomfort or heaviness when swallowing;
  • feeling of coma in the throat;
  • rarely - vomiting.

Attacks of acute chest pain may be perceived as a manifestation of a heart attack, but in reality they are caused by GAL or duodenum. So, with YABZH pain arise on an empty stomach; with gastritis - almost immediately after a meal; with diseases of the duodenum - an hour after eating.

In pregnant women, chest pains caused by gastrointestinal disorders are often accompanied by heaviness in the stomach and bouts of severe heartburn.

Respiratory diseases

Pain in the center of the chest, accompanied by cough, is the main sign of the development of pathologies of the respiratory system:

  • tracheitis;
  • pneumonia;
  • pleurisy;
  • bronchitis.

Such pathologies are accompanied by:

  • shortness of breath;
  • constriction of the chest;
  • inability to take a deep breath;
  • bouts of productive or unproductive cough;
  • jump in body temperature;
  • general weakness;
  • chills;
  • episodes of acne;
  • pale skin;
  • the formation of edema.

Injuries and bruises

Chest pain often occurs on the background of injuries sustained during strokes, falls, accidents, or under other circumstances. They often lead to rupture of the muscles, which causes intense pain. In this case, the unpleasant symptoms will be aggravated with a deep breath and exhale, sudden jerks, turns or bends.

With a strong injury, the pain will occur even with a slight pressure on the central region of the chest, or with a simple touch of the hand to it. Often, such an anomaly speaks of a fracture or a bone fracture.

To determine the cause of indisposition, radiography will help, to which the surgeon may refer the patient. Before going to the doctor, you should avoid any physical exertion, and refuse to engage in sports.


In the event of pain in the sternum, the patient should try to identify the factors that could contribute to the appearance of the symptom. If any external effects are excluded, then the cause should be sought in the work of the internal organs, and for this you should consult a doctor and undergo a comprehensive examination. If the pain is too painful and intense, you cannot do anything on your own - you need to call an ambulance and wait for the arrival of the doctors.

To determine the cause of the ailment, the doctor may refer the patient to conduct:

  • Oak;
  • biochemical analysis of blood;
  • bacterial sputum culture;
  • pulse oximetry;
  • X-ray radiography;
  • electrocardiogram;
  • oncomarkers for myocardial infarction;
  • diagnostic use of drugs;
  • MRI

If there is a possibility that the pain in the chest cell is the result of osteochondrosis, the diagnostic scheme also includes:

  • CT of the cervical and thoracic spine;
  • contrast discography;
  • myelography is a manipulation during which the spinal cord is examined after prior injection of a contrast agent.

Additional diagnostic procedures are prescribed exclusively by a specialist, based on the data of the initial examination, and on the patient's complaints. Initiation of therapy is possible only if the diagnosis is accurate.

What to do if the chest hurts in the middle?

After determining the cause of indisposition, all efforts should be directed at eliminating not only the symptoms, but also the disease itself. Treatment is prescribed taking into account the characteristics of a particular pathology and the degree of its severity.

In most cases, pharmacotherapy is conducted, aimed at restoring the normal functioning of the diseased organ. Below are the main ways to deal with an unpleasant symptom.

  1. Angina pain in the chest is successfully arrested with the use of sublingual nitroglycerin. To eliminate the pain you need to dissolve 1-2 tablets. The effect should occur within 5 minutes, but if this does not happen, you should immediately seek medical help to find out the cause of the ailment.
  2. Pain in chest osteochondrosis is eliminated through regular exercise with a special gymnastics. But physical activity is allowed only in the period of remission of the disease! In parallel with exercise therapy, it is recommended to undergo a course of therapy with the use of fortifying drugs.
  3. Pain in the CC with inflammatory pathologies of the respiratory organs are treated through the use of anti-inflammatory, antiviral and expectorant drugs.
  4. Neuralgic pains require vitamin therapy using intramuscular injections of B vitamins and painkillers.
  5. Cardiac neurotic chest pain requires mandatory adjustment of lifestyle. Avoiding stress, proper nutrition, visiting a course of relaxation massage, the use of sedative phytotherapy - all these methods are very effective in this situation.
  6. YABZH requires special therapy, which can appoint only a doctor. It is obligatory not only to take medications, but also to follow a diet that is gentle to the stomach.
  7. Chest pain with NDC. Vegetative-vascular dystonia requires a comprehensive approach to the issue of therapy. To this end, patients are shown courses of physiotherapy, psychotherapy, as well as taking sedatives and vitamins.

It is important to remember that the treatment of pain in the HA has a close relationship with etiological factors. In some cases, this symptom may require urgent hospitalization with further inpatient therapy.

Consequences and complications

Quite often, many patients ignore pain in the sternum for a long period of time. Often the result of such neglect of their own health becomes hospitalization with a myocardial infarction, fraught with not only the development of CHF, but also the death of the patient.

Other diseases that are accompanied by pain in the area of ​​HA can also go into the phase of chronicity. Chronic diseases of the stomach and respiratory organs can result in malignant tumors in the mediastinum area. In view of this, any pain in the chest should be the basis for seeking medical help.


There are no specific measures for the prevention of chest pain. This is due to the fact that this anomaly is not a separate disease, but only one of the symptoms of pathological processes.

Maintaining healthy lifestyles, proper nutrition, avoidance of hypothermia and timely treatment of respiratory diseases - these are only the simplest recommendations that can be given in this situation.Another important requirement that must be met is that each of us must undergo an x-ray and prophylactic examination by doctors every year (once in 6-12 months).

Watch the video: Chest Pain in Children. Frequently Asked Questions. Cincinnati Children's (December 2019).


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