Chest pain can manifest itself in different ways. It can be short-term, pressing or stitching. Pain can go from the neck to the sternum, be diffuse or localized. Such pain has a different origin, but in any case, it should be a reason for urgent treatment to the doctor. So why pressure in the sternum in the middle and what to do?
What causes chest pain?
There are many causes of chest pain, but the most disturbing are heart and lung. Let's consider them.
Various heart conditions can lead to chest pain, which sometimes manifests itself in the form of slight discomfort and cramping. The pain can also cause a piercing sensation radiating to the neck, jaw, shoulders and arms, especially on the left. This condition can last for several minutes, worsen during exercise and decrease at rest. Some have a pressing pain in the middle of the sternum with a feeling of heaviness and difficulty breathing.
If the chest hurts in the middle, the reasons can be very diverse:
- Heart attack or myocardial infarction. It is accompanied by intense stiff pain and requires immediate medical attention.
- Aortic dissection, when blood falls between the layers of its walls and exposes them to further destruction.
- Pericarditis, that is, inflammation of the mucous membrane around the heart - the pericardium.
- Myocarditis is an inflammation of the heart itself.
- Hypertrophic cardiomyopathy is a disease that causes thickening of the heart walls.
Similar symptoms may indicate acute coronary artery disease. In this case, the occurrence of pain occurs during exercise or stress. Unlike pain of musculoskeletal origin, it does not increase with palpation. This condition is called angina pectoris. This is a chronic disease that can lead to a heart attack. About 4% of adults with coronary heart disease are susceptible to angina.
A particularly dangerous pathology is pulmonary embolism. This is a complete or partial obstruction of the pulmonary arteries with blood clots, usually from the lower extremities. This condition is usually accompanied by acute and sometimes recurring pain. Often there is shortness of breath, discomfort, loss of consciousness is possible. In this case, the diagnosis must be made very quickly, because there is a high risk of death.
If the pressure in the sternum is in the middle and it is difficult to breathe, it can be caused by pulmonary pathologies, such as:
- lung abscess;
- acute bronchitis in the context of cough, often accompanied by fever.
The pain in the sternum can also be caused by the following pathologies:-
- gastro-esophageal reflux, accompanied by heartburn;
- esophagus disease, spasm;
- stomach ulcer;
- pancreatitis with biliary colic;
- muscle pain, myalgia;
- pain in the bones, such as a broken rib;
- intercostal neuralgia;
- herniated disc;
- osteoarthritis of the spine;
- chronic anxiety, heart neurosis, and panic attacks;
- anterior chest wall syndrome.
How to give first aid?
It all depends on the cause of the pain. In all cases, moreover, when an unpleasant sensation creates stress, the pain in the chest reminds of the condition of the heart. First of all, you should immediately call an ambulance, and then follow these recommendations:
- Without falling into a panic, put the patient down, lifting his head high and ensuring access of fresh air.
- To relieve excitement, you can use sedatives in the form of drops, such as "Valocordin".
- It is necessary to measure the patient's pressure and heart rate. Check these indicators periodically every 7 minutes.
- Under reduced pressure, nitroglycerin is contraindicated, in other cases one tablet under the tongue does not hurt.
- Without fail, the patient should chew an aspirin pill. The drug will reduce blood clotting and improve the condition of the affected area of the heart with a possible myocardial infarction.
- If the patient is in an unconscious state, he does not have a pulse and breathing, you should immediately begin resuscitation actions. Apply a sharp punch to the center of the chest and begin an indirect heart-massaging with artificial respiration. Actions should be carried out, putting the patient on a rigid and equal surface.
Diagnosis of the disease
To find out the true cause of pain in the sternum, doctors conduct a number of diagnostic activities:
- All patients make an electrocardiogram to detect ischemic changes or pericarditis.
- In cases of suspected heart attack, troponins in the blood serum are examined.
- The echocardiogram allows to identify areas affected by a heart attack, the presence of fluid in the pericardium in the case of pericarditis or mitral valve prolapse.
- A chest x-ray eliminates pneumothorax or pneumonia.
- On esophagoscopy catarrhal changes and erosion of the esophagus, as well as the presence of a hernia are detected.
Thus, at the first stage of diagnostics, the patient’s vital signs — breath, pulse, and consciousness — are evaluated. The purpose of the second stage is to eliminate the acute causes of chest pain associated with danger to the life of the patient. These are risk factors for coronary heart disease, acute coronary syndrome, pericardial tamponade, pneumothorax. The third stage is carried out after the exclusion of the threat of life with the aim of diagnosis and the appointment of appropriate treatment.
From the above causes and symptoms of chest pain, it is clear that quickly relieve pain in such situations is impossible and it is extremely contraindicated to do it yourself. All therapeutic interventions should be carried out after diagnosis is made by qualified specialists.
It should be remembered that these symptoms can be associated with deadly conditions, and even occasional slight pain is often the cause of serious complications.
Any chest pain, especially if it recurs, requires prompt medical attention in order to eliminate incipient coronary insufficiency and danger to life. Be healthy!