Chest pain

Classification according to ICD-10
R07.1	Chest pain when breathing
R07.2	Precordial pain
R07.3	Other chest pain
R07.4	Chest pain, unspecified
ICD-10 online (WHO version 2019)

The chest pain (also chest pain and chest pain ) is a common symptom in medicine with a variety of different causes of danger. The organs involved are primarily the heart , lungs , esophagus , and the muscular and skeletal systems of the chest . A dangerous or life-threatening cause can be ruled out promptly in specialized emergency rooms in cardiological departments, the so-called Chest Pain Units .

heart

Possible localizations of pain sensation in angina pectoris
red: frequent and strong
pink: rare or radiating

Legend s. O.

Real coronary insufficiency

Discomfort caused by narrowing or occlusion of one or more coronary arteries in coronary heart disease

• Angina pectoris : dull, boring, pulling pain with tightness (Latin: angina), which is described as constricting or a great burden. Mostly behind the breastbone (Latin: pectus = chest), radiating into the left shoulder, less often into both shoulders, into the left arm and into the lower jaw. These pains are associated with fear (Latin root: angustus).
• Heart attack : as with angina pectoris, but usually more severe, with no improvement on nitroglycerin . Fear can turn into fear of death.

Relative coronary insufficiency

Circulation restriction of the coronary vessels without coronary heart disease with symptoms of typical angina pectoris

• Hypertrophic obstructive cardiomyopathy , decreased blood flow through the left ventricular outflow tract .
• Severe acquired aortic stenosis , decreased blood flow over the aortic valve
• Angina caerulea : pain associated with chronic cor pulmonale , possibly as an expression of a circulatory disorder of the right ventricle
• Syndrome X : Angina pectoris with a pathological stress ECG in healthy coronary arteries, most likely as a restriction of the coronary reserve with a good prognosis
• Tachycardia arrhythmia : precordial feeling of pressure
• Aneurysm spurium of the heart wall after myocardial rupture (tear of the heart muscle wall ) after infarction
• vasospastic Prinzmetal angina , pain like real angina pectoris

Others

• Pericarditis : sharp, breath-dependent pain on the left side radiating to the neck, back and shoulder. Improvement of complaints when sitting bent over.
  • bacterial or viral origin
  • uremic origin or tubercular cause, rather painless.
  • Dressler syndrome , a special case after a heart attack
• Aortic dissection of the thoracic aorta: therapy-refractory , suddenly shooting annihilation pain radiating to the back, neck , abdomen, possibly also legs

Lungs and pleura

• Pulmonary embolism : annihilation pain with accompanying dyspnoea, smaller embolisms often without pain
• Pleurisy : breath-related pain
• Tumor : slowly increasing pain
• Spontaneous pneumothorax : sudden onset of shortness of breath accompanied by breathing-dependent pain

esophagus

• Reflux esophagitis : burning pain behind the breastbone, often in the evening or at night, improvement when sitting or standing and after drinking fluids
• Esophageal spasm : pain behind the breastbone, regardless of food intake or posture, including at night
• Achalasia : diet-related retrosternal pain
• Mallory-Weiss syndrome and Boerhaave syndrome : retrosternal pain after vomiting
• Zenker's diverticulum : pain after swallowing

stomach

• Roemheld Syndrome : Pain after excessive meals, especially flatulent foods
• Gastritis , pain more in the upper abdomen

Skeletal system

• Spinal column syndrome : pain dependent on movement and posture, possibly with relieving posture
• Intercostal neuralgia : punctual or streak-shaped movement-dependent pain that can be amplified by pressure.
• Tietze syndrome : selective pain on pressure of the sternal cartilage attachments of the first and second, less often the third and fourth ribs
• Chest trauma and rib fracture : pressure and movement-dependent pain in a localized area
• Bone metastasis : selective pressure pain
• SAPHO syndrome : usually unilateral pain in the joint between the clavicle and sternum
• Eosinophilic granuloma : partly stress-dependent, partly also nocturnal localized bone pain

Musculature

• Myogelosis : punctual pressure pain in the hardened muscles, often next to the spine
• Dermatomyositis : symmetrical muscle pain
• Trichinosis : punctual muscular tenderness, possibly with palpable calcifications

Psychosomatic

• functional chest pain, heart anxiety , Da Costa syndrome
• Mental stress perceived as physical " heartache ", e.g. B. Lovesickness

Others

Localization of herpes zoster on the chest

• Herpes zoster : sometimes very painful burning sensation in a circumscribed dermatome
• Pancreatitis , pain in the upper abdomen
• Biliary colic , colic-like pain usually radiating to the right shoulder

swell

• Christian Mewis, Reimer Riessen, Ioakim Spyridopoulos (eds.): Kardiologie compact . 2nd Edition. Thieme, Stuttgart / New York 2006, ISBN 3-13-130742-0 , pp. 1-3 .

Individual evidence

1. ↑ Joachim Fichter: Langerhans cell histiocytosis in adults - an interdisciplinary challenge . In: Deutsches Ärzteblatt . April 19, 2007 ( aerzteblatt.de [accessed March 25, 2009]).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !