Joints

Can the heart hurt with intercostal neuralgia? How to understand whether your heart hurts or neuralgia

When a spasm occurs in the sternum, anyone can fall into a panic state. Doctors say that with neuralgic manifestations, the performance of the heart is not impaired, it continues to work as before and no changes occur. However, in a state of panic, its activity is also disrupted. In this regard, a non-specialist is faced with the question of how to distinguish heart pain from neuralgia, because this determines the method of treatment.

There are many vascular and cardiac pathologies that manifest themselves as pain in the chest area. For some pathologies, an accurate diagnosis can only be established after undergoing an examination. However, if pain occurs in the area where the heart is located, urgent medical attention is required. In some cases, it is this factor that saves the patient’s life.

There are many reasons why the heart hurts. These may be diseases such as myocardial infarction, rheumatic lesions or inflammation, as well as angina pectoris. Heart pain with the sudden onset of various diseases can manifest itself in different ways. In some cases it is felt in the entire chest area, in others - in a fairly small area. At the same time, it can be stabbing or pressing, aching or pulling.

Based on their origin, such pains are divided into two groups:

Angious pain. They occur with ischemic disease, angina pectoris. Their appearance is possible with increased workload or manifestation of emotional stress. They occur in attacks during stress or when walking. At rest, the pain goes away. Quickly removed with Nitroglycerin. Manifest in the form of burning, pressing or squeezing sensations. They often radiate under the shoulder blade, into the left shoulder, sometimes into the lower jaw. Often accompanied by shortness of breath.
Cardialgia. Occurs with rheumatism of the heart, inflammation of the outer lining of the heart (pericarditis), myocarditis. The pain arising on the left side of the sternum is prolonged, aching or stabbing in nature. May be worsened by coughing or deep breathing. Nitroglycerin does not relieve them, but they may weaken when taking painkillers.

The nuances that manifest themselves in heart disease are as follows:

Angina pectoris. The nature of heart pain in the left side of the chest can be either pressing or cutting. Dull sensations may be felt in the left arm, between the shoulder blades, or in the neck. When changing body position, the nature of the pain remains the same, but may intensify due to any load or changes in ambient temperature. The attack may be short-lived or last up to twenty minutes. It may recur after a short sedation.
Heart attack. Acute myocardial infarction is indicated by severe burning and tearing, pressing and squeezing pain, which manifests itself in the left side of the chest. May respond in the spinal column. Such intensity is possible that a person loses consciousness. There is a pressure in the chest that makes it impossible to lie down. This is one of the symptoms of a very dangerous pathology. At the same time, such pain is not relieved by Nitroglycerin and does not change in severity when moving, but additionally causes a pinching sensation.
Hypertension. When the pressure increases, the head hurts, it feels like the heart is squeezing and aching. When an attack occurs, the face turns red, various dots appear before the eyes. A loss of strength sets in, and the gait becomes very unsteady.

How does neuralgia manifest?

The concept of neuralgia is defined as the spread of pain along the course of a nerve. With the development of intercostal neuralgia, such unpleasant manifestations are felt in the area between the ribs, in the places where the nerve endings pass. Cardiovascular diseases such as heart attack and angina are also accompanied by pain in the same area. Therefore, it is difficult for a non-specialist to distinguish whether it is pain in the heart or neuralgia.

Infringement of the spinal root that occurs in the thoracic region can be caused by a sudden movement or cough. This disorder often occurs when lifting heavy objects. It manifests itself as a pronounced shooting and burning pain. The feeling intensifies when you turn your body and take a deep breath.

Neuralgic pain syndrome is accompanied by painful manifestations that can move from a point in the chest to the spinal column, and sometimes to the scapula. At the same time, the patient himself is not always able to accurately indicate the location. Sometimes the pain is referred. In these cases, it is difficult to determine the source of the discomfort.

In addition to pain, when intercostal nerve endings are compressed, unexpected, but this makes even more unpleasant symptoms appear. Clearly noticeable muscle contractions, accompanied by twitching, are possible. At the same time, intense sweating begins, the skin changes its color, becoming red or becoming painfully pale. The skin in the area where the nerve endings are pinched or damaged begins to burn and tingle, its sensitivity is lost, and this area becomes numb.

Often, with intercostal neuralgia, a person has to remain in a special antalgic position. The patient takes a position bent towards the healthy part of the body, trying not to change it. At the same time, the intercostal spaces are stretched, which reduces pressure on irritated nerve endings. The pain is relieved. Because of the fear of new unpleasant sensations, the patient maintains this position for a long time.

First aid

How to eliminate pain directly depends on the cause of its occurrence. If the “culprit” is the heart, then such sensations can be relieved by taking Nitroglycerin or Validol. In this case, the tablet of the first drug is dissolved, and the second is placed under the tongue. The patient must be seated or placed in a reclining position. To do this, pillows are placed under the back. A person needs air, so you need to unfasten the collar, loosen the clasps or belt. After performing these procedures, a call to the medical team is required.

And yet how to distinguish these pains

Neuralgia is pain that occurs along the injured nerve. These sensations spread between the ribs, where these endings are located. In this case, long-term pain is felt, occurring equally often both during the day and at night. They get worse when coughing, trying to take a deep breath, or when moving around the room. Medicines that help with heart disease have no effect. The performance of the organ does not change.

The pain caused by cardiovascular diseases is short-term and periodic. Most often they last no more than 10 minutes. Treated with Nitroglycerin or Validol. Taking a deep breath or changing position does not increase pain. Cardiac dysfunction also occurs.

Need to remember. If you experience pain in the chest area, you need to pay attention to such a fact as the presence of risk factors for the development of heart disease. The pain may be atypical for angina, but the following factors are present:

the patient is already 45 years old;
one of the direct relatives suffered a stroke or heart attack;
the patient smokes;
there is constant high blood pressure;
tests indicated elevated sugar levels.

If these factors are present, then any pain in the sternum area must be treated as a potential danger. No need to guess what it could be. It is necessary to provide immediate assistance and then call a medical team.

Neuralgia is a symptom of a disease. The pain begins due to a damaged nerve. Since nerves are present throughout the body, pain can appear anywhere: in the arms, in the lower back, in the back of the head. The name depends on the location of the pain: intercostal, occipital, facial, trigeminal, sciatic nerve. It happens that neurological pain can be confused with pain of any organ. It often occurs that there is a feeling that the heart hurts, but in fact, it is intercostal neuralgia. Let's look at how to distinguish heart pain from neuralgia below.

Before starting treatment for neuralgia, you must pay attention and find the cause of pain. These reasons may be injuries, intoxication, for example, alcohol, infections, herniated intervertebral discs, diabetes, oncology, and immunity problems. Other causes may include osteochondrosis, hypothermia, diseases associated with the musculoskeletal system, including congenital ones, atherosclerosis, peripheral vascular diseases that disrupt the blood supply to nerve endings.

Still, it’s worth contacting a clinic to establish an accurate diagnosis and causes of neuralgia. A specialist will make a diagnosis, conduct an examination and prescribe treatment. In modern medicine, they do not treat symptoms, but look for the cause of their occurrence and treat it. Group B drugs are usually prescribed; they not only eliminate pain, but have a beneficial effect on the nerve fiber, restore and stimulate the nutrition of the nervous tissue. For neuralgia, vitamins, antibiotics, painkillers, anticonvulsants, sedatives and restoratives are prescribed.

How to differentiate neuralgia and heart pain

Often neuralgia is disguised as other diseases, for example, renal colic, toothache, heart pain. How to distinguish heart pain from neuralgia? Pain in the heart area, usually radiating to the back and shoulder blade. When taking medications, the pain continues, which means it is either neuralgia or another pathology.

Frequently recurring pain is a reason to call an ambulance. Doctors will determine the cause of the pain and make a diagnosis, prescribe medications, and may even recommend massage. Also, sometimes experts prescribe rubbing and physiotherapy. A cardiologist may prescribe anti-inflammatory medications intramuscularly.

So, with neuralgia, the pain radiates to the back and under the shoulder blade, the pain can be stabbing. May last 10-20 minutes. This disease is mainly attributed to adults and is rarely found in children. Painful sensations do not go away after taking medications such as validol or nitroglycerin. Heart rate is normal. You need to pay attention to the duration of the pain. In case of cardiovascular pathologies and heart attacks, painful sensations last for several minutes. As a rule, they appear after stressful situations and physical exertion. The pain in the heart is mainly pressing, and with neuralgia it is stabbing

If it is intercostal neuralgia, the pain is not easy to overcome. The pain in the heart is mainly pressing, and with neuralgia it is a stabbing sensation that intensifies with movement. May occur against the background of osteochondrosis of the neck. To check, you can take validol and if the pain does not go away, then it is neuralgia. To eliminate pain, you can take Ibuprofen, you can also use anesthetic ointment.

Intercostal neuralgia is detected by the presence of points on the body in the chest area that are sensitive to touch; these are the exit points of the affected nerve fibers. Also, painful sensations may become stronger when inhaling and exhaling. With intercostal neuralgia, when the pain lasts for a long time, the nerve root begins to die and the painful sensations recede. But this is not considered the end of the disease; in this condition it is most difficult to cure the disease.

Clinical picture of neuralgia

The symptoms of neuralgia are a pain that cannot be confused with any other, it is sharp, shooting, stabbing, several times stronger than a toothache. The duration of pain varies from several seconds to several hours, and can occur at any time of the day. Also with neuralgia, muscle reflex movements are noted. For example, you may encounter cramps in the muscles of the face or muscles of the limbs.

Sometimes the irritative process captures the sympathetic fibers in the diseased nerve. You can find watery eyes on the side of the face where ternary neuralgia is present, and sometimes a flow from the nose. With intercostal neuralgia, herpetic blisters appear at the site of painful sensations.

If we consider the affected areas, the following symptoms can be identified.
When the trinity nerve is damaged, salivation, lacrimation, pain when touching the chin, and jaw spasms can be noted.

When the lumbar nerve is damaged, shooting pain appears.
When the intercostal nerve is damaged, a shooting pain of a paroxysmal nature is observed, which can intensify when turning the body.
When the sciatic nerve is damaged, aching pain is noted, burning and debilitating, as small nerve cells are affected.

Additional examination methods

There are also more accurate examination methods, these include ultrasound and MRI examinations and electroneuromyography.

Using ultrasound and a tomograph, you can see the presence of compression of the nervous tissue from the outside. It could be a cyst, tumor, inflammation. And also whether there is a disorder of local blood circulation in the area of pain. This is a big plus when diagnosing, since you can see a lesion that can be eliminated with surgical treatment.

Diagnosing osteochondrosis has become much easier thanks to the MRI machine, as it allows you to see the cause of compression of the nerve roots that has arisen in the intervertebral discs, you can also see spondylolisthesis - displacement of the vertebrae or a disorder in the spinal cord, such as stenosis - narrowing of the spinal canal.

There are two types of tomographs, which allow you to see smaller details, up to 1 mm in size, and which can reveal details of 5 mm or more. This depends on the magnetic field, in the first case it is equal to 1.5 Tesla, and in the second, 0.4 Tesla is sufficient.

Also, the procedure with this device has contraindications, the most important of which is the presence of metal objects in the body. The magnetic field of the tomograph will not only attract the object to itself, but also heat it up.

If neuralgia occurs as a result of hypothermia or awkward movement, an MRI examination will be useless.

Electroneuromyography or ENMG diagnoses a disorder in the behavior of an uneven impulse along a selected nerve. This procedure begins with mild stimulation of the nerve with an electrical current, also known as neurostimulation. If the nerve is motor, then muscle irritation of the muscles occurs, and an analysis of the muscle response is performed.

If a nerve with neuralgia is examined, then the reaction to irritation is assessed. This procedure is painless. It happens that during ENMG, needle-like electrons are injected into the muscles, which can cause tingling and burning in the muscles. The needles are similar to those used in acupuncture.

Pain in the chest and heart area: causes, types and signs of disease, how to treat

Intercostal neuralgia in most cases is associated with the cervical or thoracic spine, a common and most common disease between the ages of 40 and 60 years. First symptoms of intercostal neuralgia: pain - severe, painful, burning. On - the absence of any signs of cardiac pathology, in the blood test (ESR, leukocytes) everything is also calm. The patient’s body temperature is normal, but the pain makes the person unable to work, and the clinic gives him a sick leave sheet with the appropriate diagnosis. By the way, the diagnosis of intercostal neuralgia is usually established if the doctor, after tests and an ECG, does not see heart disease, but at the same time cannot accurately determine the place where the pain originates.

The causes of chest pain are quite varied., although the patients themselves, in most cases, confidently claim that their pain is located precisely in the region of the heart and associate it with cardiac pathology, although, of course, this also happens, but at the same time there may be other reasons.

Pain in the heart area is called cardialgia, its appearance is caused by many factors, therefore, if it occurs, differential diagnosis with other diseases should be carried out in order to find the true cause of the pain.

The cause of pain is the heart and blood vessels

Of course, the first to be excluded from the list of “suspects” are cardiac problems and vascular pathology:

vascular walls;
Arterial;
Valve: and, prolapse;
branches of the pulmonary artery (PE);
Delaminate;
infectious-allergic origin;
Bacterial;
Functional disorders of the heart (functional cardialgia, psychogenic cardialgia and cardialgia) accompanying neuroses, neurosis-like conditions;
associated with endocrine disorders.

Pain in the heart area is caused by the presence of cardiovascular pathology of various origins, which can be found during laboratory, instrumental examinations, bicycle ergometer tests and other tests that reveal abnormalities in the functioning of the cardiovascular system.

Spinal problems and heart pain

Pain in the chest area is often a sign of diseases of the musculoskeletal system and nervous system:

Osteochondrosis of the cervical and/or thoracic spine, causing vertebrogenic cardialgia;
Perichondritis - inflammatory processes occurring in the costal cartilages (II - IV rib on the left - Tietze syndrome);
Lesions of the muscles of the chest wall (anterior) - pectoralis major syndrome, myalgia, myositis.

The consequence of these diseases is usually cardialgia, which in everyday life is simply called: thoracic neuralgia or neuralgia of the heart. It should be noted that here we often mean intercostal neuralgia, which is often the result of pathological processes in the cervicothoracic region, affecting bones, muscles and nerves.

Although a symptom of intercostal neuralgia is also considered pain, called cardialgia, the true cause of its occurrence is the changes that have occurred in the thoracic and/or cervical spine as a result of:

Bone growths (osteophytes) of intervertebral joints;
Compression of the thoracic roots by damaged intervertebral discs (radicular syndrome);
Intervertebral disc herniation.

Exacerbation of existing chronic processes in the spine can be provoked by hypothermia, excessive load on certain parts, heavy physical work, and stress. Meanwhile, thoracic neuralgia does not produce a temperature reaction, changes in the electrocardiogram, or deviations in laboratory parameters..

Severe cardialgia syndrome, in addition to intercostal neuralgia, is observed with herpes zoster, and its intensity is so great that sometimes even the most powerful analgesics do not provide a noticeable improvement. Usually people, without further ado, call these and all of the listed diseases “neuralgia of the heart.” Of course, there is no such definition in the ICD.

History will help find the cause

The following pathology can also mislead cardiologists and neurologists:

Chest injuries;
The appearance of air in the pleural cavity; (pneumothorax);
Lung diseases (inflammation, emphysema, tuberculosis, cancer);
Inflammation of the mediastinal organs.
Respiratory diseases.

Cardialgia caused by respiratory pathology can be recognized by observing the dependence of pain on respiratory movements. For example, taking a deep breath increases pain, while holding your breath, on the contrary, reduces pain.

Diseases of the mediastinal organs occur with prolonged nagging and aching pain, which intensifies over time. In addition, shortness of breath is often associated with cardialgia.

Pathology of the gastrointestinal tract can give symptoms of cardialgia, which refers to important reflexogenic zones that form a pain syndrome reminiscent of angina pectoris:

Hiatal hernia;
Peptic esophagitis;
Cholangitis, cholecystitis;
Pancreatitis;
Stomach ulcer.

Pain associated with the pathological condition of some organs of the digestive system tends to intensify in a supine position and is localized in the lower third of the chest region. In addition, cardialgia in diseases of the gastrointestinal tract is usually accompanied by such phenomena as heartburn, regurgitation, and sometimes nausea and vomiting, which suggests the need to examine the patient in this area. However, we should not forget that reflex cardialgia is often combined with symptoms. In such a situation, the patient may not pay attention to pain, citing a chronic disease of the stomach, gallbladder or pancreas, and as a result, miss the onset of IHD.

Thus, when during the examination of the patient (tests, ECG, R-graphy, FGDS, etc.) the listed pathology is excluded, the doctor makes a diagnosis - intercostal neuralgia, which, as mentioned above, ordinary people will call neuralgia of the heart.

Each cardialgia has its own character

Heart pain

It is not difficult to guess that the symptoms of cardialgia can be expressed in a few words - pain that is localized in the chest. However, to find out its origin, to determine whether the heart hurts or intercostal neuralgia is bothering you, anamnesis and the nature of the pain, their exact localization, irradiation, time of onset of the attack, its duration, connection with physical activity, and the effect of taking nitroglycerin will help.

A very prolonged attack, accompanied by intense chest pain that grows in waves, and the lack of help from anyone, give reason to believe that the person has suffered from myocardial infarction.
Pain in the precordial area with fever and tachycardia gives reason to suspect infectious-allergic myocarditis.
Pericarditis manifests itself as chest pain, the intensity of which decreases if the patient takes a sitting position.
Functional cardialgia, which is an almost constant companion neurocirculatory or autonomic dysfunction (different names for the same disease), gives a picture of unusual (extremely unpleasant) sensations similar to the pain syndrome of angina pectoris - a prolonged pain of aching or stabbing nature. However, heart medications do not help, and noticeable improvement occurs after sedative medications.
Cardialgia of vegetative crisis occurs against the background vegetative-vascular paroxysm, which, in addition to pain in the chest on the left, instability of blood pressure, emotional instability and other symptoms, is often accompanied by “paroxysmal shortness of breath of a neurotic person.”
Shortness of breath, cough, fluctuations in blood pressure, severe emotional lability, neurotic disorders, the patient’s desire to pay attention to himself and his “inhuman suffering”, and, of course, severe pain in the heart area - this is how one can characterize psychogenic cardialgia arising from the soil neuroses and neurosis-like conditions.
At dyshormonal myocardial dystrophy simulate an attack of angina, aching, prolonged pain, which, in addition, is accompanied by a neurotic-type reaction (numbness of the fingers, a feeling of “unsatisfactory inhalation,” etc.). This condition is typical for menopause and some gynecological diseases associated with hormonal disorders.

And again to the spine and intercostal neuralgia

If intercostal neuralgia is a consequence and symptom of disorders in the musculoskeletal system, and pain along the spine is often caused by the presence of chronic diseases (spondylitis, spondylosis, osteoporosis, etc.), then to effectively combat it, it is necessary to know its cause and treat the underlying pathology, otherwise all measures will simply be ineffective or very short-lived.

Before proceeding to the diagnostic details, it would be useful to thoroughly study the history of the patient’s life and illness, dwelling on the nature of pain and their connections with certain factors. After all, the symptoms of intercostal neuralgia are not just pain. Patients themselves usually willingly talk about where it hurts, how and what it is connected with.

What does vertebrogenic cardialgia “tell” about?

It is probably quite obvious to the reader that the signs of neuralgia (intercostal neuralgia and cardialgia) are only symptoms accompanying various lesions of the spine, and not independent diseases. Thus, the diagnosis of “intercostal neuralgia” can be made initially (before x-ray examination), and then changed taking into account the real cause of pain.

Tietze syndrome (perichondritis), which for some reason prefers localization on the left, is accompanied by cardialgia and is associated with frequent chest injuries in people engaged in heavy physical work.

In addition to the pain that occupies the atrial region and radiates to the back, left arm and left part of the cervical spine, a companion to the syndrome is a long-lasting “nasty” cough, which prevents you from sleeping at night. When examining the spine by palpation, a painful swelling can be detected in the projection of the II-IV ribs, while no abnormalities are observed on the R-gram and ECG. Heart medications do not help, but analgesics have a noticeable positive effect.

Anterior chest wall syndrome, which is attributed to an autoimmune origin, is characterized by aching, prolonged pain in the precordial area that does not radiate anywhere. Palpation often reveals pain along the left sternum.
Osteochondrosis of the cervical and/or thoracic spine- a fairly common disease, which is often accompanied by symptoms of intercostal neuralgia, and, of course, cardialgia. Pain in osteochondrosis, as a rule, is not associated with physical activity; rather, on the contrary, it appears during prolonged stay in one position (sitting, lying down), and the provocateur of the appearance of sharp pain is movements of the arms and turns of the head. Cardialgia syndrome can be fleeting, or it can last for a long time (days and weeks).

It is not difficult to distinguish pain due to osteochondrosis if you know its signs for a given case:

Cardialgia is accompanied by pain in the arm and shoulder blade, worsening at night;
Painful sensations are often associated with the position of the body during sleep (throwing back the head, turning, movements in the left shoulder);
The pain is intense and prolonged, while the patient knows that he has already had something similar (“lumbago”, myalgia, plexitis, radiculitis).

The doctor, based on the questioning and examination of the patient, notes a sensory disorder of the radicular type and the absence of any abnormalities on the ECG. Analgesics have a positive effect. The diagnosis is established after an X-ray examination, which indicates straightening of the cervical lordosis, decreased mobility in the vertebral segment, narrowing of the intervertebral space, spondyloarthrosis, spondylolisthesis, osteophytes, etc.

The pain syndrome associated with osteochondrosis is a sign of neuralgia and occurs as a result painful lumps in the thickness of the muscles of the chest, in the places where they pass into the tendons. These lumps are most often localized on the left; the pain is significant, radiating to the shoulder and scapula. On palpation, pain in the intercostal spaces is noted, that is, intercostal neuralgia. However, this is still a syndrome that accompanies the underlying disease - spinal osteochondrosis.

Video: three tests for chest pain

What to treat: heart or spine?

It is clear that with vertebrogenic cardialgia or intercostal neuralgia, cardiac medications will be completely ineffective, since the resulting pain is not caused by cardiac pathology, but has a completely different origin. Here, the pain syndrome comes from the spinal column, so the spine should be treated taking into account the changes that have occurred in it. However, the first step is to alleviate a person’s suffering, that is, to relieve pain. As a rule, patients themselves try to do this first, so they are always interested in which pills for neuralgia are now “in high esteem” and how they should be taken.

Of course, the main ones at the very early stage of treatment will be analgesics (analgin, baralgin) and non-steroidal anti-inflammatory drugs (NSAIDs) with an analgesic effect (Nise, indomethacin, ibuprofen, ketorol), which can be combined well with antispasmodics (nosh-pa) and vitamin B 12 . Along with pain relief, they begin to treat the underlying disease that caused unexpected problems, that is, osteochondrosis. There are many ways to combat it today (novocaine blockades, physiotherapeutic treatment, water procedures, acupuncture, exercise therapy and massage), which are prescribed in a hospital during an exacerbation.

Intercostal neuralgia can also be treated at home using drugs that have an analgesic and anti-inflammatory effect: finalgon, fastum gel, nimesulide gel, voltaren, which are applied topically and do not have a negative effect on the gastrointestinal tract. However, they themselves medications will be ineffective if the patient does not follow basic rules which the doctor recommends to him:

Avoid hypothermia, anxiety and stress.

It is reasonable to calculate physical activity without excessively straining your spine.

Do not ignore physical therapy classes.

Sign up for the pool.

Try not to make sudden movements.

While working in one position, do not forget to periodically get up, walk around, and use “frozen” muscles during a physical training break.

A disease such as intercostal neuralgia simply could not do without traditional medicine in all centuries, especially in villages where it was necessary to sow, plow, and harvest crops in conditions far from modern ones. A man who had “broken his back” sought help from the means that were available to him. The author remembers how in his childhood his grandfather, in order to ease the pain of his back and go to haymaking again the next day, rubbed his back with “bodyaga”.

This medicine was prepared in advance and kept in every home until the occasion. It's easy to do:

You need to get a freshwater sponge bodyaga and infuse it with a home-made alcohol-containing liquid called moonshine. True, now moonshine is successfully replaced by vodka or alcohol, so there are even fewer problems. Treatment is also simple: rub your back in the evening before bed.

Ointments containing camphor (50 ml), dry mustard powder (50 g) and raw egg white (100 ml), or ointments containing turpentine are widely used.

Everything happens for the first time. Many people are so sure that their spine is invulnerable that they don’t even want to listen about any kind of prevention, and yet it is precisely this that can delay this “first time” of the appearance of symptoms of intercostal neuralgia. A person just needs to think and listen to the advice of those who treat such patients every day. Displacing intervertebral discs or pinching a root is not so difficult (this happens on its own over time), but putting everything in place is not an easy task, so the spine must be protected.

Video: chest and heart pain - doctor’s opinion

Intercostal neuralgia is a very painful and unpleasant condition. It is caused by irritation of nerve fibers or their compression. Neuralgia in the heart area, the symptoms of which are most often detected in older patients, is associated with age-related changes characteristic of the condition of their blood vessels. In children, pathology is found relatively rarely. Next, let's take a closer look at what neuralgia in the heart area is. Symptoms and treatment will also be described in the article.
General information
The pathology is often accompanied by Neuralgia - this is a syndrome that appears reflexively. This condition, as mentioned above, is the result of an effect on nerve endings. Often the pathology develops against the background of osteochondrosis in an advanced stage. This occurs due to compression of the roots caused by intervertebral hernias.
Reasons for development
Neuralgia in the heart area can appear due to various pathologies. In particular, these include spondylitis, hormonal spondylopathy, progressive kyphosis, as well as neoplasms localized in the spine. An attack can be triggered by hypothermia, a cold, infection or poisoning, trauma or psychological stress. In addition to the above, factors that increase the likelihood of the disease include strong physical activity to which a person is exposed without prior necessary warming up or out of habit. Among the main reasons due to which intercostal neuralgia in the heart area can develop are infections, cooling, overexertion and intoxication.
Other factors
Quite often in clinical practice, neuralgia in the heart area develops as a result of herpetic lesions. Often, pathology acts as a specific response to irritation, which is aimed at the nerve trunks. This, in turn, is the result of the course of pathological processes in the area of neighboring organs and tissues. Such conditions, in particular, include diseases of the spine and ribs, pleurisy, and others. The generalized intoxication variant also corresponds to such a reason as the use of a number of medications. Against the background of such drug therapy, complications often arise when taking certain drugs for a long time, which are caused by the breakdown of drug components in the patient’s body. In general, experts note that staying in conditions with a high content of toxic compounds and inhaling metal salts contribute to the acceleration of damage to the nervous system, the accompanying syndrome of which is often neuralgia in the heart area.
Clinical picture
Signs of neuralgia in the heart area are not so difficult to distinguish from other pathologies. Manifestations are neuropathic in nature. The main symptom of neuralgia is pain in the heart area. This manifestation is due to certain pathologies associated with the nervous system and its components, as well as damage relevant to them. Despite its neuropathic nature, pain can be expressed in different ways. For example, it can be burning, dull, aching or sharp. At the same time, some patients may complain of episodic manifestations, while others may complain of its constant presence. As physical activity increases, the pain intensity also increases. This can occur with a sharp turn of the body, sneezing, or loud conversation.
Features of the clinical picture
Pain may appear when touching certain areas of the body. These include, in particular, the area of the spine and chest. Discomfort may also occur when palpating the intercostal area. It should be noted that this manifestation, regardless of its location, cannot be permanent. This is due to the fact that over time, necrosis of the nerve root occurs. This undoubtedly brings peace to the patient. However, this fact does not eliminate the pathology.
Other manifestations
In addition to what is described above, neuralgia in the heart area can be accompanied by quite noticeable muscle contractions or twitching. In some patients, sweating increases, and there may be a change in the color of the skin - it may turn pale or red. There is also often tingling of the skin or numbness in some areas. The pain is characterized by patients as “girdling.” This is explained by its development along the spaces of the bone elements of the sternum. There are also external signs of neuralgia in the heart area. So, for example, some patients may be in the so-called antalgic position. It looks like this: the torso bends towards the healthy side. This is how the patient stretches the intercostal spaces. This helps reduce pressure and reduce irritation of nerve endings. As a result, these manipulations reduce pain. In this tactic, psychological fear plays an additional role. It is associated with the anticipation of an attack of pain. As a result, the patient strives to stay in this position for as long as possible.
Difference from cardiovascular pathologies
Here, a special role belongs to determining the nature of the pain. It is a thorough analysis of the patient’s condition that allows us to identify its cause. It should be noted that, despite the fact that pain is the main manifestation of both neuralgia and cardiovascular pathologies, its nature is different in different cases. So, in the first case, the condition differs in duration. The pain in most cases is constant, lasting for a relatively long time. Accordingly, it cannot be eliminated using traditional means, such as Nitroglycerin. If we talk about any cardiovascular disease, the pain is most often short-term and periodic. When taking the same drug "Nitroglycerin" it is usually suppressed. In addition, pain in cardiovascular pathologies does not increase during body movement. At the same time, there is a change in pressure and rhythm. Neuralgia in the heart area, the treatment of which will be described below, is not accompanied by these manifestations. Pulse and blood pressure remain normal.
Neuralgia in the heart area: treatment
Therapeutic measures should be aimed primarily at eliminating the main manifestation. You can get rid of pain when the influence that provokes it is completely eliminated. If there is displacement of certain elements of the spine, a specialist can prescribe procedures to help put them in place. This includes, in particular, massage and physiotherapy. In some cases, the doctor may schedule a visit. All manipulations must be carried out by a qualified doctor. Otherwise, there is a high risk of serious complications, including disability. Osteopathy is used as an additional measure. During the procedures, the position of each incorrectly positioned segment of the spine is restored. This contributes to the rapid normalization of blood and lymph flow, which has a beneficial effect on the condition of nerve endings, muscle fibers and the body as a whole.
For neuralgia, reflexology is also recommended. Physical therapy with a specially designed set of exercises can be added to it. As adjuncts, you can use various kinds of external (local) medications in the form of ointments, gels with an analgesic effect (Diclofenac, Capsicam, etc.). In particularly severe cases, the doctor may prescribe analgesics (Ketorolac, Lornoxicam, etc.) orally (by mouth).

Under certain circumstances, diagnosing diseases is difficult even for specialists - it may be impossible to figure out why a particular symptom occurred without testing. For example, it is difficult to understand whether pain is in the heart or bothering the patient.
Symptoms of heart pain are very similar
What's the difficulty?

It is impossible for a person to distinguish pain in the heart from neuralgia on the left - both are characterized by pain in the chest. Most often, a pinched nerve is mistaken for a cardiac pathology.

However, these pains may have other explanations:

Intercostal neuralgia – pinching of the intercostal nerve;

Psychovegetative syndrome;

Pathological processes of other organs of the chest and mediastinum.

Despite the fact that the symptoms of neuralgia and cardiac pathology are similar, there are also differences. You need to know: your heart hurts or neuralgia is manifesting itself, so that, if necessary, you can provide adequate first aid.

How do heart diseases manifest?

Various disorders in the functioning of the cardiovascular system have their own characteristics.

. Spasms occur clearly in the heart area, but the sensations are characterized by blurriness and patients report pain throughout the sternum. The pain can be described in different ways: as cutting or pressing. They can radiate to the left arm, neck, under the shoulder blade. The pain does not go away when changing body position, attacks can be repeated many times in a short period of time. Their duration ranges from a couple of seconds to 20 minutes. In addition, there is a feeling of suffocation and lack of air. The fear of death appears.

. It is accompanied by sharp pain of high intensity; it can hurt in the left half of the sternum and the spinal column. Always accompanied by pale skin and increased sweating. The pain is so severe that it can lead to loss of consciousness. It is felt in the area of the heart. Any movement leads to an increase in pain and increased breathing. The fear of death appears.

Myocarditis and pericarditis. Inflammatory processes in the myocardium and pericardium are manifested by moderate intensity nagging pain. When the myocardium becomes inflamed, sharp stabbing sensations appear. With myocarditis, pain is localized in the left half of the body - under the shoulder blade, just above the heart or in the upper abdomen. An attack of pericaditis is accompanied by pain in the upper part of the heart, radiating to the right arm. The pain increases when trying to lie down, coughing, or taking a deep breath. Shortness of breath occurs. With both pericarditis and myocarditis, an increase in temperature and a change in heart rate may be observed.

Aortic aneurysm. Accompanied by pain in the upper chest. In this case, the pain can be prolonged - if no measures are taken, it can last for several days. When trying to move, their intensity increases.

Pulmonary embolism. The nature of the pain is similar to that of pain, but does not radiate to other organs and departments. Accompanied by increased heart rate and shortness of breath. Blueness of the skin and lips is observed, and a sharp drop in arterial blood pressure is noted.

. A sharp jump in blood pressure leads to the stabbing, pressing sensations in the heart being duplicated in the head. At the time of the attack, pronounced facial hyperemia is observed. “Goosebumps” and spots appear before the eyes, and confidence is lost when walking.

- one of the causes of heart pain
Initial symptoms of cardiac pathology will include:

Burning;

Tingling;

Pressure in the region of the heart.

These symptoms are also characteristic of angina pectoris. During a heart attack, the arteries are blocked, so blood does not flow to the myocardium. The result is a sharp pressing pain that goes away fairly quickly.

With angina pectoris, the vessels are blocked by fatty plaques, and blood does not flow in the required quantity to the heart. It is necessary to pay attention to the presence of provoking factors. For example, an attack of angina may develop after high physical exertion or as a result of psychological trauma or severe stress. Nitroglycerin will help to quickly relieve these sensations, but you should definitely consult a doctor.

How does neuralgia manifest itself?

Neuralgia can occur anywhere where nerves pass, i.e. almost everywhere. Pain in the heart area occurs when the intercostal nerves are pinched.

It is necessary to know the distinctive features of pain due to neuralgia:

Neuralgia is always accompanied by pain of high intensity, which increases with movement, inhalation, exhalation, and can also intensify without additional provoking factors.

Spasms can vary in description: from stabbing to burning.

Neuralgia can manifest itself in frequent attacks or continuously. The duration of pain can reach several days.

Pain can be traced along the course of the nerve. If you touch the intercostal area, the pain becomes unbearable along the entire length of the nerve. It can radiate to the arm, lower back, neck, chest.

Loss of sensation in the area of the pinched nerve.

Pale skin and increased sweating, muscle cramps. The cause is insufficient blood supply to the area.

Local decrease in temperature (only in the area where the nerve is pinched).

In some cases, nausea and vomiting occur.

To summarize, we can say how to distinguish neuralgia from heart disease:

The duration of pain in cardiac pathologies is shorter. Its intensity does not increase with palpation of its localization area.

Cardiac medications do not help with neuralgia, but the pain may decrease slightly after taking a sedative.

Heart diseases are accompanied by arrhythmias, difficulty breathing, and pressure surges. Neuralgia is not accompanied by shortness of breath, and the change in heart rate is of a psychological nature, so it goes away quickly.

Physical activity does not have a significant effect on pain intensity. With neuralgia, movements increase pain, and the patient cannot always move.

You can recognize the cause by which drug will help eliminate the pain. Pain in coronary pathology is relieved by glycerin; non-steroidal anti-inflammatory drugs help with intercostal neuralgia. It could be Nurofen.

A provoking factor for an attack associated with the work of the heart can be physical activity or stress. With neuralgia, sudden movement and uncomfortable posture act as a trigger.

Neuralgia is more common in older people. Heart pathologies can develop regardless of age.

Heart diseases are always accompanied by high blood pressure and arrhythmias
Diagnostic research methods

Additional research will tell you how to distinguish neuralgia from heart pain. First, the doctor focuses on the patient’s medical history and complaints. Then the following may be assigned:

ECG. Electrocardiography is performed in cases where there is a suspicion of coronary pathology. Thanks to this study, it is possible to determine heart rhythm disturbances and dysfunction of the conduction system. This clinic is typical for heart attack and ischemia. In case of ischemia, a study at rest may not reveal abnormalities; an ECG with stress is necessary.

Coronary angiography. Coronary angiography involves the use of a contrast agent to determine the patency of blood vessels. By studying how the contrast agent is distributed, you can see the location and degree of stenosis of the main artery of the heart.

Echocardiography. This ultrasound examination is performed if there is a suspicion of heart pathologies not related to the condition of the coronary artery. Thanks to ultrasound, you can find out the thickness of the walls and volume of the heart chamber, as well as see how the valves work. This method allows you to identify various heart defects and inflammatory processes.

Tomography of the spine. It is carried out if heart pathologies are not confirmed.

What to do if you experience pain under the ribs?

If intercostal neuralgia is severe and does not go away within a few days, you should consult a doctor. Full treatment is possible only after identifying the cause that caused the neuralgia, i.e. after diagnostics. In any case, treatment will be comprehensive and should include pain management and treatment of the underlying cause.

If the pain is very severe, bed rest is required. In this case, the surface must be hard. As for treatment, painkillers and anti-inflammatory drugs are used, as well as blockades with novocaine.

Physiotherapeutic procedures have proven their effectiveness in treatment. Ultraviolet heating, UHF, electrophoresis, and acupuncture may be prescribed. Ointments and gels with anti-inflammatory, warming, and analgesic effects are suitable for external use. They are necessary to relieve muscle spasms, normalize metabolic processes, and improve blood supply.

To prevent a neuralgic attack from leading to the development of a chronic disease, precautions must be taken. Prevention includes:

Avoid high physical activity;

Avoid being in drafts;

Keep your back straight and watch your posture, especially for those who spend a lot of time at the computer;

Provide additional intake of vitamins and microelements.