Differences between heart pain and neuralgia

The nature of pain with neuralgia

Soreness with neuralgia occurs as a result of spasm of the intercostal muscles or due to pinching of nerve endings in the spinal column. In the latter case, the problem may be an exacerbation of osteochondrosis, the appearance of a hernia or protrusion.

This type of pain is characterized by the following symptoms:

1. Most often, the pain is severe, but it can also manifest itself in the form of some discomfort.
2. It intensifies after a change in body position (bending, turning), as well as when coughing or sneezing.
3. It manifests itself as constant or paroxysmal.
4. Burning sensations, stitching, pressing.
5. Duration - from 1-2 hours to several days or more.
6. Even a slight touch on the intercostal spaces or in the paravertebral points makes the pain unbearable.
7. Irradiation is observed in the arm, back, neck, anterior part of the chest on the left. It is this symptom that often leads to a false interpretation of the cause of the disease, as it resembles a heart attack.
8. The skin along the trapped nerve changes sensitivity. There is paresthesia (distorted sensation) in the form of burning, crawling, tingling sensations. Sometimes a person complains of numbness in the affected area.
9. The attack is often accompanied by sweating, paleness, and cramps in muscle fibers. The latter symptom is caused by impaired blood flow in this area and irritation. The local temperature drops and the area of ​​the body becomes cool.

All of the above symptoms can occur at the same time. But it happens that only one or two signs appear. The degree of their severity depends on the threshold of sensitivity and other individual characteristics.

Heart disease with similar symptoms

I want to say that there are many cardiac and vascular pathologies that are accompanied by similar symptoms. I propose to consider the most common deviations, this will help to understand whether the heart or neuralgia caused pain.

Angina pectoris

Pain in this case occurs in the area of ​​the heart muscle (but do not forget that there are atypical seizures). It has a spilled character, a person is not able to indicate the exact location. Its strength and description is variable: it can be pressing, stabbing, cutting, baking. Gives to the left in the hand, under the scapula, neck, lower jaw. It does not depend on what position the body is in, but it can be provoked by physical overload, nervous stress, as well as sudden hypothermia or overheating.

At this moment, there is a fear of death, shortness of breath with difficulty breathing. The attack can be single, it is noted 1-2 times a day or more often. Its duration is from 3-5 to 20 minutes. Almost the same signs are characteristic of myocardial infarction. But unlike angina pectoris, the attack usually lasts a long time. The patient takes a certain posture in bed - sitting with lowered legs or lying on several pillows. More information about angina pectoris and how to deal with it can be found in the article at the link.

Myocarditis

Inflammatory diseases are accompanied by moderate soreness, which is characterized by monotony. It occurs in 90% of all patients. They describe her as aching or crushing. In the acute period, there are signs of inflammation (temperature, body aches), shortness of breath with impaired inhalation or exhalation. The history often reveals a recent infectious disease. There is no clear dependence on physical activity.

Often, myocarditis simulates angina pectoris, especially in the elderly, when pain and lack of air come to the fore, and the rest of the symptoms are smoothed out or do not appear.

Pericaditis

The pain with pericarditis gradually increases, but with the appearance of an effusion, it may significantly decrease or completely disappear. It is stabbing, cutting, gives to the neck, back, shoulder, to the right side, it lasts for a long time. Some relief comes from sitting with an anterior tilt.

In acute dry inflammation, an attempt to make a deep entrance increases the pain, therefore, with such a disease, a person breathes often and shallowly. On auscultation, in this case, I clearly heard the noise of pleural friction. The heart hurts most often with this type of pericarditis in the apex.

For a complete compilation of information on pericarditis and how it is treated, click here.

Aortic aneurysm

Symptoms in this acute condition are very similar to myocardial infarction. A sharp increase in pressure, stress or physical activity can serve as a provocation. The pain is tearing, bursting, localized in the retrosternal region, radiates to the neck, lower jaw, right side of the chest, sometimes runs along the spine. It has a wavy character. In some cases, it extends to the projection area of ​​the abdominal aorta and even to the legs.

At the same time, there are sharp jumps in pressure, with a fall, a collaptoid state may occur. There is an asymmetry of the pulse on the left and right hand. As blood begins to accumulate under the lining of the aorta, symptoms of anemia (pale and blue skin, dizziness) quickly develop.

Pulmonary embolism

Pulmonary embolism is accompanied by sharp and severe pain, which is localized in the center of the sternum, as well as to the left or right of it. It can last from several minutes to 3-5 hours and is associated with breathing movements of the chest. At the same time, lack of air, a sharp drop in pressure, up to collapse, come to the fore. Clinical manifestations depend on the location of the thrombus and its size. When the lumen of a large section of the vessel is blocked, cyanosis appears in the upper body, arrhythmia with an increase in the frequency of pulsation. With blockage of small arteries, blue skin develops, shortness of breath, pain is most often moderate, there is a cough and sputum streaked with blood.

How to distinguish

To distinguish heart pain from neuralgia and other pathologies that are successfully masked by cardialgia, it is necessary to take into account the following factors:

• duration;
• localization and depth;
• provocative factors;
• drugs to relieve symptoms.

When trying to determine the cause, I always pay attention to the accompanying symptoms. This allows a fairly accurate diagnosis of the disease, even at the stage of preliminary survey, before using additional research methods.

Angina pectoris lasts 3-20 minutes, and a heart attack is characterized by a long-term attack (the same pain is noted with inflammation of the myocardium, pericarditis and aneurysm). Various intensity and duration of suffering are observed with a pinched nerve, myositis.

It is necessary to determine the depth and location of the pain. In case of cardiac pathology or vascular problems, it is internal, as if going outward. Superficial sensations are characteristic of neuralgia, muscle inflammation. In this case, it is possible to distinguish infringement from pain in the heart with the help of palpation.

Psycho-emotional stress or physical overload becomes the provoking factors for the development of coronary artery disease. The latter factor can also provoke an exacerbation of osteochondrosis, hernia. Myositis, on the other hand, occurs against the background of general inflammation, hypothermia or intoxication.

If the attack is relieved by the sublingual intake of nitroglycerin, then angina pectoris should be assumed. For a heart attack, acute aneurysm or thromboembolism, such an effect will not have a significant effect; in this case, only narcotic analgesics, which are administered to the patient immediately after admission to the department, will help. To distinguish intercostal neuralgia from heart pain, one should know that the first pathology lends itself well to elimination with the help of non-steroidal anti-inflammatory drugs and the use of muscle relaxants, and cardiac problems cannot be solved in this way.

Required examinations

When I encounter such phenomena, I immediately refer the patient to an ECG. This is especially true for people after 45 years of age, even if the symptoms are not typical for myocardial ischemia. It is better to make sure that the person is not in danger, and only then calmly carry out therapy for neurological or other abnormalities. With angina pectoris, an ECG with stress should be done, since when the pain syndrome is eliminated, it may not show changes.

In some cases, it is necessary to use other instrumental methods:

1. Coronary angiography. It is carried out using the introduction of contrast, and helps to determine the presence of narrowing in the vessels of the heart.
2. EchoCG. For this, ultrasound is used. It allows you to see the structure of the chambers of the heart muscle, the state of the valves, the thickness of the walls, the presence of inflammatory processes.
3. Vertebral column tomography (or MRI). Performed after excluding cardiac pathology. During the manipulation, the size of the intervertebral spaces and the condition of the bone tissue, the presence of protrusions of the discs and infringement of the neurovascular roots are assessed.

In the laboratory, biochemical markers (ALT and AST) are evaluated, their increase indicates the development of a heart attack or myocarditis. More modern methods for determining acute necrosis is to increase the concentration of troponins in the blood.

How to eliminate pain

The provision of assistance depends on the cause of the pain, it is carried out in this way:

1. "Nitroglycerin" and "Aspirin" during angina pectoris.
2. "Analgin" or "Ibuprofen" for pinching the roots. Simultaneous use of ointments and gels "Dip-Rilif", "Menovazin".
3. In case of a heart attack, aneurysm or embolism, the relief of an attack is carried out in intensive care with the use of narcotic analgesics.

In case of irradiation of pain to the abdominal region, one should not independently prescribe treatment for oneself before the arrival of a doctor. This will help exclude an acute condition of the abdominal organs.