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Chest pain

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You might think that your chest pain connected with the heart, but in fact it depends on the lungs.

This can happen in two common conditions that you must be aware of. One is dangerous and requires immediate attention, the other will make you sick, but usually does not threaten life.

Let's take a look at the less serious ones first. In a typical form, it is easy to recognize.

The lungs are covered with a two-layer “wrapping tissue” called pleura, which can become a victim of inflammation, irritation or infection leading to pleurisy.

If you have pleurisy, two layers of this “wrapper” rub against each other, and you feel sharp pain at the height of each deep breath.

Pleura is particularly susceptible to viruses.

  • Viral pleurisy often accompanied by fever and cough.
  • Pneumoniapneumonia often begins as pleurisy.

In any case, as follows: how difficult it is to breathe deeply, you have to take superficial breaths. Movement usually does not worsen the condition, but coughing is very painful.

Viral pleurisy usually lasts a few days, then passes by itself. The pain stops because the pleura releases a lubricating fluid between its two layers, and now when breathing, they glide smoothly against each other.

The consequences and treatment of pleurisy pain, however, depend on its cause. You can not worry too much with simple viral pleurisy.

But pleurisy may arise from a number of serious illnesses. One such disorder is blood clot embolism, in the lungs, which often makes pleurisy known.

Unfortunately, many patients and doctors forget about this pathology. A clot from another part of the body (usually from the legs or pelvis) enters the veins into the lungs and lingers there. At the same time, pleura is irritated, which leads to pain. The severity of the attack depends on the size of the clot and the amount of captured lung tissue. Therefore, symptoms of pulmonary embolism can range from sudden pain somewhere in the chest, which intensifies when breathing, to hemoptysis, a sharp drop in blood pressure (shock), and even death.

Just as there are factors that indicate a possible heart attack, so some conditions make you think about pulmonary embolism.

Here they are.

  • Recent phlebitisinflammation of the veins in the legs. A blood clot forms inside the vein, the pieces come off and are transferred to the lungs. This happens more often if you have varicose veins, if you have been in bed for a long time or spent a long time sitting in a car or plane.
  • Foot injury can also damage veins, causing clot formation. If the affected vessel is deep, you may not notice phlebitis caused by trauma - until an embolism breaks out.
  • Extended stay in bed slows down the flow of blood and, therefore, promotes the formation of clots. This is the main reason why doctors force patients to get up and start walking as soon as possible after an illness or surgery. Previously, when we did not understand this, we prescribed six weeks of complete immobility with a heart attack. Over time, it became apparent that this does not reduce heart complications and actually increases the likelihood of embolism. Here's a clear rule: no matter what the reason for putting you to bed, get up and move as soon as possible.
  • Nearly every operation, especially in the pelvic area, makes you more vulnerable to traveling blood clots.
  • Birth control pills, although very effective in themselves, make some women vulnerable to clots, especially those women who are 30-40 years old, who smoke and / or have high blood pressure.

Usually, chest pain with the characteristics of pleurisy (it hurts when you breathe deeply and especially when coughing) is not necessarily dangerous, but requires a quick assessment by your doctor.

There is one rather dramatic condition that causes a sudden chest painand lack of breath.

This happens when a section of the lungs collapses (becomes airless. - Ed.), Literally!

Strange, this is usually observed in young, healthy people, confident that they do not suffer from any lung disease. Therefore it’s hard to guess when will happen pneumothorax.

In honey. practice was a typical case.

The patient is a young, under 30 years old, foreign diplomat from the United Nations. He was physically completely healthy. The night before, right after dinner, he suddenly felt that he was short of breath, there was no cough, no temperature, but there was severe pain in the upper right chest.

On examination, he looked good, but complained of continued pain, especially with a deep breath. The doctor thought that this was the beginning of pleurisy, but when he began to listen to it, instead of the "friction" that I described earlier, he heard complete silence, there was no air movement at all - proof that the lungs were sleeping. An X-ray confirmed the diagnosis, and he sent the patient to the hospital. After several days of conservative treatment, he needed an operation (it is not always required) to eliminate a small hole in the lungs. He fully recovered.

Spontaneous pneumothorax it is usually the result of rupture of a small blister in the lungs, while air escapes into the chest cavity, and its pressure causes subsidence, compression of part or all of the lung. Before the break, no symptoms of pet. But in elderly patients with emphysema (in which the lungs are swollen, because too much air is trapped in them), such blisters on the lungs are frequent, easily burst, and also cause pneumothorax.

Under any conditions for the occurrence of pneumothorax, you should consult a doctor as soon as possible in order to prevent the fall of more and more of the lungs.

Here is another example of the same process, but with a different mechanism.

Alexander, 21 years old, college student, felt acute pain in the upper right back after vigorous rhythmic gymnastics. The doctor decided that this was a muscle spasm, and sent him to a specialist in physical methods of treatment. He confirmed the diagnosis and decided to relieve the pain by injection of novocaine.

Alexander turned a little pale at the sight of a needle, but it turned out that the injection was not as painful as he thought. But almost immediately after him, Alexander felt that he was short of breath. There was also pain, but he was expecting it. He was asked to move his right hand to see if the underlying pain had decreased. She did not decrease, and, moreover, he was short of breath.

Alexander was reassured by joking.

However (that specialist was about to call the next patient - Alexander was delaying the line), some other doctor listened to him with a stethoscope. Only then was pneumothorax diagnosed.

It was not spontaneous, like the case described above. It was caused not by a bursting bubble, but by a needle that injected novocaine and which went too far and pierced the lung. If you ever get an injection in your chest, for any reason, and you suddenly do not have enough breath, you now know why this is!

How to treat chest pain at home?

There are several steps you can take at home to eliminate chest pain and try to prevent future pain.

Important!
The following strategies should be applied only to people who have already been tested by a doctor and are sure that their pain is not associated with serious medical conditions such as a heart attack. In addition, these methods can not be used by people with angina pectoris, who should closely cooperate with the attending physician and strictly follow his recommendations.

Almonds help fight acid reflux and reduce the risk of heart disease.

If chest pain is caused by acid reflux, then to improve the condition you can eat a few almonds or drink a glass of almond milk.

There is no serious scientific evidence to support or explain the healing properties of almonds. Over time, people simply passed on to each other experience and knowledge about various home remedies, including almonds.

You should take into account the fact that almonds are a product rich in fat, and fat can cause acid reflux. If this occurs, chest pain may increase.

However, some studies have shown that eating almonds regularly reduces the risk of heart disease. Therefore, if this product can not immediately stop the pain in the chest, then it can have a positive effect on the vital functions of the body by maintaining a healthy cardiovascular system.

2. Ice Bubble

A common cause of chest pain is muscle injury. In such cases, a person can detect pain due to sprains received during sports training or other types of physical activity.

If this happens, then applying an ice pack to the affected area of ​​the body will help reduce swelling and ease pain.

Symptoms of chest pain: similarities and differences

People who do not like to see doctors (especially for men) often prefer to endure an attack by stopping it with an anesthetic. But the cost of error in the issue of chest pain is prohibitive: if you do not seek help in time for a heart attack, you can die.

On the other hand, many first thing and sin on the heart - because it is located in the chest, and intercostal neuralgia, in theory, should be felt from the side, between the ribs? In fact, the localization of pain can be different, in addition, pain is sometimes given to the arm and back.

The main difference between a heart attack and neuralgia is duration. Attacks of intercostal neuralgia are quite long, up to several days. Heart pains are short - for example, an attack of angina pectoris lasts 5-10 minutes.

Neuralgic pains are acute, and angina pain is dull, burning, with lack of air. In the old days, angina pectoris was called "angina pectoris" precisely because of the feeling that a heavy and cold toad was sitting on the chest. Pain with angina pectoris spreads to the entire chest area, a person finds it difficult to specify where exactly he has pain. With neuralgia, it is usually possible to accurately localize the main place of pain.

Another symptom that is very characteristic of neuralgia is a decrease or increase in the intensity of pain, depending on the position of the body, inspiration, expiration. Heart pain does not depend on the position of the body, with one exception - with myocardial infarction during movement, it intensifies.

A nitroglycerin tablet can stop an attack of heart pain, but will not stop the development of a heart attack. Therefore, if the pain after taking nitroglycerin continues, you must immediately call an ambulance.

3. Hot drinks

If the cause of pain is the formation of gases, then using hot drinks a person can get rid of gases or bloating. In addition, hot fluids often stimulate the digestive system.

Some drinks in such cases may work more efficiently than others. For example, it is believed that hibiscus tea brings a lot of health benefits to a person, including helping to eliminate bloating.

Hibiscus lowers blood pressure and cholesterol. These added benefits also help prevent future heart problems.

Why do chest pains occur?

A logical question: if everything was in relative order with health, why do attacks with high intensity immediately occur? In fact, rarely is anyone regularly examined by a cardiologist. Most cases of angina pectoris are the so-called angina pectoris that occurs after physical or emotional stress. If the attack occurred after sleep, it is angina pectoris.

Actually, angina pectoris is a violation of the blood supply in the heart muscle of a person. Such constant oxygen starvation leads to the development of coronary heart disease and heart attack. The main risk factors here are:

  • arterial hypertension,
  • impaired fat metabolism and atherosclerosis,
  • impaired carbohydrate metabolism and increased blood sugar
  • congenital or acquired heart disease.

Intercostal neuralgia is pain passing along the trunk and branches of any of the intercostal nerves (there are 11 pairs of them, and the 12th pair is the hypochondria). It occurs due to compression, irritation or inflammation of the nerve. The causes of neuralgia are many - and problems with the spine (osteochondrosis, displacement and herniation of the intervertebral discs), and infection (including flu), and radiculitis, neuritis, and trauma, hypothermia, and excessive muscle tone ...

4. Baking soda

Another popular remedy for fighting chest pain is baking soda diluted in warm or cold water. The resulting alkaline solution helps to reduce the acidity of the stomach and eliminate pain.

In 2013, American scientists published a study showing that soda really is able to effectively deal with heartburn, but at the same time it has a negative effect on overall heart health.

Garlic Helps Prevent Heart Disease

Garlic has long been considered an effective home remedy for eliminating chest pain, although this opinion also has no scientific evidence.

People can stir cloves or a couple of crushed cloves of garlic in a glass of warmed milk. But instead of consuming such a drink, it is better to chew a piece of garlic for maximum benefit.

Studies have shown that garlic helps reduce the risk of developing cardiovascular disease, and also cleans arteries from plaques.

Which doctors should I contact for help?

If you seek emergency help, doctors will help you navigate this issue by eliminating or confirming heart problems. If you had an attack of angina pectoris, then a cardiologist can’t do without an examination. However, even if the attack turned out to be neuralgia, a cardiologist is worth a visit.

With neuralgia, the situation is somewhat more complicated - first of all, you need to visit a neurologist, take an x-ray or undergo a tomography. After the cause is clarified, the doctor will be able to give further recommendations for treatment or to send for consultation to another specialist, for example an osteopath.

6. Apple cider vinegar

Apple cider vinegar is another home remedy that sometimes helps with chest pain. People believe that if you drink apple cider vinegar before or after a meal, you can prevent the development of heartburn. Despite the fact that many support this theory, it has no scientific basis.

Apple cider vinegar has minimal side effects, but people taking blood thinners should not eat this product, as it also makes blood more rare.

A person may try to reduce chest pain with aspirin. Painkillers, such as aspirin, sometimes help reduce pain. They usually show effectiveness in less serious cases.

Studies have shown that regular use of small doses of aspirin can reduce the risk of heart attacks. However, one must understand the danger posed by aspirin in terms of increasing the risk of bleeding.

Chest pain: what to do

First, minimize any physical activity and sit down or lie down. Often it’s impossible to lie down exactly - in this case, you should take a semi-recumbent position, putting pillows under the back. It is necessary to ensure the influx of fresh air into the room, unfasten the collar of clothing. If the cause of the pain is not clear, you should immediately take 1-2 tablets of nitroglycerin. (Remember that nitroglycerin can dramatically lower pressure.) If it is not there, at least validol, valocordin, or analogues. To calm down, you should additionally drink valerian or corvalol.

If the pain persists within 10-15 minutes, do not wait and call an ambulance. If the pain is acute, not changing with a change in body position, an ambulance should be called immediately.

With an attack of neuralgia, you can take painkillers, wrap your chest with a warm scarf, and use ointments that have a warming and pain-relieving effect.

In the future, the doctor may prescribe physiotherapy sessions, novocaine blockade of nerves, acupuncture. If osteochondrosis is the cause of recurring attacks of neuralgia, then it is advisable to seek the help of a chiropractor, attend medical massage and gymnastics. During exacerbation of neuralgia, you can’t sleep on a soft surface, the mattress should be hard.

Try to stay calm with an attack of chest pain, but in no case do not neglect the examination by a doctor later, even if it seems to you that the attack passed without a trace.

8. Lying body position

If there is pain in the chest, sometimes the condition can be improved if you take a horizontal position of the body with a raised head. With acid reflux, the body should be slightly deviated from the horizontal.

Считается, что имбирь, как и многие другие растения, имеет противовоспалительный эффект. More importantly, studies have proven ginger's ability to alleviate stomach problems and prevent vomiting.

10. Milk with turmeric

Turmeric also has anti-inflammatory properties, which means it is also able to eliminate chest pain.

Turmeric milk is a solution of a teaspoon of turmeric in a cup of warmed milk. Usually, such a potion is drunk before bedtime to relieve pain.

Studies have shown that long-term use of turmeric can prevent heart disease. In addition, it is able to lower cholesterol.

Causes of Chest Pain

Chest pain can be caused by acid reflux or GERD

Chest pain can have many different causes. Some of them require immediate evaluation by medical personnel, others do not pose a great danger and can be eliminated at home.

Common causes of chest pain include the following:

  • heart attack,
  • stable angina,
  • unstable angina,
  • heartburn,
  • acid reflux or gastroesophageal reflux disease (GERD),
  • muscle strain
  • muscle injuries.

Important!
A heart attack requires emergency medical attention. If a person thinks he may have a heart attack, he should immediately call a doctor.

Angina pectoris, which results from a blockage or narrowing of the coronary arteries, also requires treatment in close collaboration with the doctor.

Possible complications

The most dangerous cause of chest pain is a heart attack.

People should be aware of the symptoms of a heart attack and promptly call an ambulance if they suspect this condition.

Along with chest pain, symptoms of a heart attack include the following:

  • pain in other areas of the body, including the neck, jaw, or arm,
  • dyspnea,
  • nausea,
  • dizziness,
  • cold sweat.

Women should know that they are more likely to experience severe chest pain compared to men. They also often experience a feeling of uncomfortable pressure or tightness in the chest. The remaining symptoms of a heart attack are also more often manifested in the weaker sex.

When should you see a doctor with chest pain?

At the first symptoms of a heart attack, emergency medical attention must be called up.

You do not need to use any home remedies before the doctor arrives.

If chest pain is new and unusual for a person, he should go to the hospital to establish a diagnosis and exclude conditions that pose a serious threat to health.

Conclusion

Treatment at home often shows its effectiveness in case of slight pain in the chest, when the cause of the problem is known. In more serious cases, such as angina pectoris or a heart attack, it is necessary to use the services of health care providers.

If a person has doubts about the cause of chest pain, he is advised to refuse home treatment and go to the hospital as soon as possible.

Sudden acute chest pain with a heart attack

The main task in conducting a differential diagnosis in a patient with acute chest pain is to identify prognostically unfavorable forms of pathology, and especially myocardial infarction.

Acute strong compressive, constricting, tearing, burning pain behind the sternum or to the left of it is the most important symptom of this formidable disease. Pain can appear during exercise or at rest in the form of an attack, or often recurring attacks.

The pain is localized behind the sternum, often capturing the entire chest, radiating to the left shoulder blade or both shoulder blades, back, left arm or both hands, neck is characteristic. Its duration is from several tens of minutes to several days.

It is very important that heart attack pain is the earliest and up to a certain point the only symptom of the disease, and only later do characteristic ECG changes appear (ST segment elevation or depression, T wave inversion and the appearance of a pathological Q wave).

Often it is accompanied by the following symptoms:

  • shortness of breath
  • nausea
  • vomiting
  • weakness
  • increased sweating
  • heartbeat
  • fear of death.

Characteristically, the lack of effect with repeated administration of nitroglycerin. To relieve pain or reduce its intensity, you have to re-enter narcotic analgesics.

Sudden acute chest pain with angina pectoris

Short-term acute compressive pain behind the sternum or to the left of it, appearing in the form of seizures, is the main symptom of angina pectoris. Pain with angina pectoris can radiate to the left arm, left shoulder blade, neck, epigastrium, in contrast to other diseases, radiation to the teeth and lower jaw is possible.

The pain occurs at the height of physical stress - when walking, especially when trying to walk faster, climbing stairs or uphill, with heavy bags (angina pectoris), sometimes as a reaction to a cold wind.

Progression of the disease, further deterioration of coronary circulation lead to the appearance of angina attacks with less physical exertion, and then at rest. With angina pectoris, the pain is less intense than with myocardial infarction, significantly shorter, lasts most often no more than 10 - 15 minutes (cannot last for hours) and is usually relieved at rest when taking nitroglycerin.

Pain behind the sternum, appearing in the form of seizures, for a long time may be the only symptom of the disease. On the ECG, signs of a previous myocardial infarction may be recorded, at the time of a pain attack - signs of myocardial ischemia (depression or ST segment elevation or T wave inversion).

It should be noted that changes in the ECG without an appropriate history cannot be a criterion for angina pectoris (this diagnosis is made only with careful questioning of the patient).

On the other hand, careful examination of the patient, including electrocardiographic, even during a pain attack may not reveal significant deviations from the norm, although the patient may need emergency care.

In cases where acute, sharp, compressive pain behind the sternum or in the heart region radiating to the left shoulder, the lower jaw develops at rest (usually in a dream or in the morning), lasts 10-15 minutes, is accompanied by an increase in the ST segment at the time of the attack and quickly stopped with nitroglycerin or nifedipine (corinfar), you can think of variant angina (Prinzmetal angina).

Pain in the chest, which is indistinguishable from angina, occurs with stenosis of the mouth of the aorta. The diagnosis can be made on the basis of a characteristic auscultatory picture, signs of severe left ventricular hypertrophy.

Sudden acute chest pain with pericarditis

Pain with pericarditis is characterized by a gradual increase, but at the height of the process (with the appearance of exudate), the pain may decrease or disappear, it is associated with breathing and depends on the position of the body (usually decreases in the sitting position with an inclination forward).

The pain is often cutting or stitching, localized behind the sternum, can radiate to the neck, back, shoulders, epigastric region, and usually lasts several days. The pericardial friction noise detected by auscultation allows an accurate diagnosis to be made.

An ECG can reveal a synchronous (concordant) ST segment elevation in all leads, which often leads to an erroneous diagnosis of myocardial infarction. Typically, the lack of effect from taking nitroglycerin, pain is best stopped by non-narcotic analgesics.

Sudden acute chest pain with dissecting aortic aneurysm

Chest pain, in intensity not inferior to pain during myocardial infarction, and sometimes exceeding it, can be a symptom of a relatively rare disease - stratified aortic aneurysm.

The pain occurs acutely, often against the background of a hypertensive crisis or during exercise (physical or emotional), localized behind the sternum with irradiation along the spine, sometimes spreading along the aorta to the lower abdomen and legs.

It has a tearing, bursting, often wavy character, lasting from several minutes to several days. The pain can be accompanied by a pulse asymmetry in the carotid and radial arteries, rapid fluctuations in blood pressure (BP) from a sharp rise to a sudden drop until the development of a collapse. Often there is a significant difference in the level of blood pressure on the left and right hands, corresponding to the asymmetry of the pulse.

Due to the deposition of blood under the intima of the aorta, signs of anemia increase. A differential diagnosis with acute myocardial infarction is especially difficult in those cases when changes on the ECG appear - non-specific or in the form of depression, sometimes an ST segment elevation (although without the cyclic nature of ECG changes characteristic of myocardial infarction during dynamic observation).

Repeated administration of narcotic analgesics, including intravenous administration, often does not stop the pain syndrome.

Sudden acute chest pain with pulmonary thromboembolism

Pulmonary embolism often develops in patients who have undergone surgery, suffering from phlebotrombosis of the deep veins of the legs or atrial fibrillation.

In this case, acute, intense pain occurs in the center of the sternum, the right or left half of the chest (depending on the location of the pathological process), which lasts from 15 minutes to several hours. The pain can be accompanied by severe shortness of breath, a drop in blood pressure, in every tenth patient - fainting (syncope).

On the ECG, signs of an overload of the right heart can be recorded - a high pointed P wave in leads II, III, and VF, a deviation of the electrical axis of the heart to the right, McGin - White sign (deep S wave in I standard lead, deep Q wave in lead III ), incomplete blockade of the right bundle branch block. Pain is relieved by narcotic analgesics.

In lung diseases, chest pain is usually characterized by a clear association with breathing. The localization of pain with pleuropneumonia, pulmonary infarction, as a rule, depends on the location of the inflammatory focus in the lungs.

Respiratory movements, especially a deep breath and cough, lead to increased pain, which in these diseases is caused by pleural irritation. In this regard, when breathing, patients usually spare the affected side, breathing becomes shallow, the affected side lags behind.

It should be emphasized that with pleuropneumonia and pleurisy in the first hours and days of the disease, pain is often the main subjective symptom, against which other manifestations of the disease are less significant for the patient.

The most important role for making the correct diagnosis is played by percussion and auscultation of the lungs, which allow revealing objective signs of pulmonary pathology. Pain associated with pleural irritation is well controlled by non-narcotic analgesics.

Sudden acute chest pain with spontaneous pneumothorax

With spontaneous pneumothorax, the pain is usually prolonged, most pronounced at the time of development of pneumothorax, worse when breathing, then shortness of breath comes to the fore.

The pain is accompanied by the following symptoms:

  • pallor of the skin,
  • weakness
  • cold sweat
  • cyanosis
  • tachycardia
  • lowering blood pressure.

The lag of half of the chest during breathing and tympanitis detected during percussion on the affected side are characteristic, breathing over these sections is sharply weakened or not audible.

On the ECG, you can see a slight increase in the amplitude of the R wave in the chest leads or a sharp change in the electrical axis of the heart.

The appearance of severe chest pain in a patient with pneumonia, combined with severe shortness of breath, intoxication, sometimes collapse, is characteristic of a breakthrough of a lung abscess into the pleural cavity and the development of pyopneumothorax. In such patients, pneumonia from the very beginning may be abscessed or the abscess develops later.

Sudden acute chest pain in diseases of the esophagus

For acute chest pain caused by diseases of the esophagus (ulcerative esophagitis, damage to the mucous membrane of a foreign body, esophageal cancer), localization along the esophagus, a connection with the act of swallowing, the appearance or sharp increase in pain when food passes through the esophagus, a good effect of antispasmodics and local anesthetics funds.

The antispasmodic effect of nitroglycerin determines its effectiveness in pain due to esophageal spasm, which may complicate the differential diagnosis with an attack of angina pectoris.

Prolonged pain in the region of the lower third of the sternum in the xiphoid process, often combined with pain in the epigastric region and usually occurring immediately after eating, can be caused by a hernia of the esophageal opening of the diaphragm with the cardial part of the stomach leaving the chest cavity.

For these cases, in addition, the appearance of pain in the patient’s sitting or lying position and its decrease or complete disappearance in a vertical position are characteristic. Typically, upon examination, signs of reflux esophagitis (heartburn, increased salivation) and good exercise tolerance are detected.

Antispasmodic and antacid agents are effective (for example, maalox, rennie, etc.), nitroglycerin in this situation can also stop the pain syndrome. Often the pain caused by diseases of the esophagus or hernia of the esophageal opening of the diaphragm, in localization, and sometimes its character, resembles pain in angina pectoris.

The difficulty of differential diagnosis is exacerbated by the effectiveness of nitrates and possible electrocardiographic changes (negative T waves in the chest leads, which, however, often disappear when the ECG is recorded in a standing position).

It should also be borne in mind that with these diseases true angina attacks of a reflex nature are often observed.

Sudden acute chest pain with chest radiculitis

Acute prolonged chest pain associated with the movement of the body (tilts and turns) is the main symptom of chest radiculitis.

For pain with radiculitis, in addition, there is a lack of paroxysmal pain, aggravation during arm movements, tilting the head to the side, deep inspiration and localization along the nerve plexuses and intercostal nerves, and pronounced soreness is usually determined in the same place, as well as during palpation of the cervicothoracic spine. .

When determining local pain, it should be clarified with the patient whether it is the pain that forced him to seek medical help, or is it another, independent pain.

Reception of nitroglycerin, validol almost never reduces the intensity of pain, which often wanes after the use of analgin and mustard plasters.

Sudden acute chest pain with chest injury

With a chest injury, diagnostic difficulties can arise in cases where the pain does not appear immediately, but after a few days. However, a history of trauma, a clear localization of pain under the ribs, its intensification during palpation of the ribs, movement, coughing, deep inspiration, i.e., in those situations when there is some displacement of the ribs, make it easier to recognize the origin of the pain.

Sometimes there is a mismatch between the intensity of the pain and the nature (strength) of the injury. In such cases, it should be borne in mind that with the slightest injury, a latent pathology of the bone tissue of the ribs can be revealed, for example, with metastatic damage to them, myeloma.

Radiography of the ribs, spine, flat bones of the skull, pelvis helps to recognize the nature of bone pathology.

Sudden acute chest pain with shingles

Acute pain along the intercostal nerves is characteristic of shingles. Often the pain is so severe that it deprives the patient of sleep, is not relieved by repeated administration of analgin and somewhat decreases only after injection of narcotic analgesics. The pain occurs earlier than the skin rash typical of shingles, which complicates the diagnosis.

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