Shortness of breath and chest pain

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Heaviness in the chest and difficulty breathing: causes

When visiting a doctor, you can often hear complaints that the patient feels heaviness in the chest. This gives rise to reasonable concerns, because the symptom may indicate a serious pathology requiring medical intervention.

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But it is not so easy to say why an unpleasant feeling arises - a detailed examination is necessary.

Causes and mechanisms

The feeling of heaviness cannot be called normal. This is not pain yet, but it may become so with the further development of the pathological process. And it is important to find out in time what is wrong in the body. But only a doctor can do this, because the source of unpleasant symptoms can be pathology from various organs and systems:

  1. Lungs and pleura (pneumonia, tuberculosis, emphysema, pleurisy, hemo- and pneumothorax).
  2. Bronchi (bronchial asthma, obstructive disease).
  3. Heart (coronary disease, pericarditis, valve defects).
  4. Stomach and esophagus (reflux esophagitis, achalasia cardia, diaphragmatic hernia).
  5. Mediastinum (enlarged lymph nodes, tumors).
  6. Chest and spine (injuries, osteochondrosis, intervertebral hernia).
  7. Neuropsychic state (neuroses and depression).

Pain and heaviness in the chest is a fairly common situation, and it should not be ignored. Considering the multiple nature of the origin of this symptom, the examination process cannot do without a thorough differential diagnosis. By eliminating the possibility of some conditions, the existence of others is confirmed, and gradually the doctor identifies the source of discomfort in a particular patient.

The question of the origin of heaviness in the chest is not so simple, because there are quite a few reasons for this condition. But an experienced doctor will always figure out what’s going on.

Symptoms

The cause of a pathology is always hidden behind its symptoms. Therefore, the analysis of the clinical picture comes first in the diagnostic process. The doctor first evaluates the patient’s complaints and finds out from him how the disease progressed before seeking medical help. Then the subjective information is supported by the results of an objective study: examination and other physical methods (palpation, percussion, auscultation).

Pathology of the lungs and pleura

If you suddenly feel heaviness in your chest, then you can’t help but think about pulmonary-pleural pathology. Most often we are talking about inflammatory pathology – pneumonia or exudative pleurisy. In these cases, pay attention to local and general symptoms:

  • Cough (dry or wet).
  • Mixed shortness of breath.
  • Chest pain when breathing (right or left).
  • Fever.
  • Malaise.

Unlike these conditions, tuberculosis develops gradually. For a long time it manifests itself as general weakness, low-grade fever, and loss of appetite. Periodic cough does not always attract attention, especially in smokers. But over time, signs of respiratory failure appear and hemoptysis occurs.

In people with pneumothorax, the condition worsens quite quickly. Air entering the pleural cavity compresses the lung. Because of this, it becomes difficult to breathe, sharp pain appears, radiating to the neck and behind the sternum. The neck veins swell, the heart rate increases, the skin turns pale, and patients become anxious.

Upon examination, many conditions are accompanied by a lag in breathing of the affected half of the chest. Percussion is determined by dullness of sound (pneumonia, exudative pleurisy, hemothorax), its box-like tone (emphysema) or tympanitis (pneumothorax). Auscultation reveals weakened breathing, pleural friction noise, moist rales or crepitus.

Bronchial diseases

Difficulty breathing and heaviness in the chest are not uncommon with pathology of the bronchial tree. In the vast majority of cases, the process is infectious and inflammatory in nature with the involvement of allergic factors. Bronchial asthma and obstructive disease have much in common:

  • Chronic course.
  • Shortness of breath with prolongation of expiration.
  • Cough with scanty sputum.
  • Expansion of the chest.
  • Dry wheezing on auscultation.

An exacerbation of bronchial asthma is associated with exposure to allergens on the body and occurs in the form of an attack of suffocation - the patient assumes a forced position, his pulse quickens, his breathing becomes shallow and frequent, and cold sweat appears. At the end of the attack, glassy, ​​transparent and viscous sputum comes out with a cough.

Obstructive disease is accompanied by a gradual but steady progression of shortness of breath. It develops in patients with a long history of smoking and working in dusty conditions. An exacerbation is provoked by infection and is characterized by increased cough and shortness of breath, an increase in the volume of sputum and an increase in its purulence. Bronchial obstruction necessarily leads to emphysema.

Respiratory pathology occupies a prominent place among the probable causes of heaviness in the chest and is associated with damage to the lungs, pleura or bronchi.

Heart diseases

The greatest danger to the patient is cardiac pathology. Pressing pain and heaviness behind the sternum are a typical manifestation of coronary heart disease. Unpleasant sensations radiate to the left arm and under the shoulder blade; they are provoked by physical activity or emotional stress.

And if during angina pectoris the attack does not last long (up to 10 minutes) and is relieved with nitroglycerin, then myocardial infarction is accompanied by the opposite phenomena. But besides pain, there will be other signs of ischemic changes in the heart muscle:

  • Dyspnea on exertion and at rest.
  • Anxiety and fear of death.
  • Increased heart rate.
  • Pale and sweating.
  • Muffled heart sounds.

If pleurisy is suspected, then the pain will be localized to the left of the sternum - in the pericardial region. They are aggravated by breathing, coughing and movement, but are relieved by lying down. Auscultation reveals a pericardial friction rub, which becomes more pronounced when pressing on the chest with a stethoscope. Many valve defects are accompanied by signs of heart failure: shortness of breath, pallor and cyanosis of the skin, reduced tolerance to physical activity. Heart murmurs are heard.

Diseases of the gastrointestinal tract

Diseases of the digestive tract also manifest themselves as pain and heaviness behind the sternum. A distinctive feature is that they occur mainly after eating (on their own, against the background of physical activity, when bending over, while lying down) and are accompanied by other signs:

  • Swallowing disorders (dysphagia).
  • Belching and regurgitation.
  • Heartburn.
  • Vomit.
  • Discomfort and pain in the epigastrium.

With gastroesophageal reflux, there is a backflow of gastric contents into the esophagus, which is accompanied by heartburn. Achalasia cardia is the opposite situation, when the sphincter does not completely relax or, on the contrary, closes when food enters. A diaphragmatic hernia is characterized by penetration of the cardiac part of the stomach into the dilated esophageal ring. And all of these conditions can be accompanied by pain and a feeling of heaviness in combination with dyspeptic disorders.

Some diseases of the digestive tract, in particular the esophagus and stomach, very often cause pain and a feeling of heaviness in the chest that occurs after eating.

Mediastinal pathology

Volumetric processes in the mediastinum have a direct impact on the organs located in this anatomical region: bronchi, vessels, esophagus, pericardium. Therefore, heaviness in the sternum and pain become a constant companion for such patients. The clinical picture is dominated by signs of compression of the bronchi (shortness of breath and wheezing, paroxysmal cough), esophagus (dysphonia), sympathetic nerve trunk (drooping eyelid, constriction of the pupil, retraction of the eye) and the superior vena cava. The latter include the following symptoms:

  • Headache.
  • Swelling and cyanosis of the face.
  • Swelling of the neck veins.
  • Noise in the head.

Malignant tumors grow into nearby tissues, causing angina pain, pericarditis and pleurisy, and fever. Patients report general malaise, loss of appetite, and weight loss. The oncological process metastasizes to the lymph nodes and other organs, causing the patient’s condition to suffer even more.

Skeletal system problems

Damage to the bone frame represented by the chest and spine is another reason for the feeling of heaviness. With bruises and fractures, it becomes difficult to breathe, touching the affected areas is painful, swelling, bruises and bruises are noticeable on the skin. Many diseases of the spinal column (osteochondrosis, hernia) are accompanied by compression of the nerve roots extending from the spinal cord. This leads to pain in the chest (left or right) and lower back, impaired movement, numbness and decreased sensitivity in certain areas. On palpation, the back muscles are tense, paravertebral points are painful.

Neuropsychiatric diseases

When considering the causes of a condition in which patients have difficulty breathing, one cannot help but recall the pathology of a neuropsychic nature. After all, such sensations sometimes have no physical basis, but are provoked by functional disorders or are only in consciousness. In such cases, the symptoms are quite numerous:

  • Emotional lability.
  • Anxiety and irritability.
  • Dizziness.
  • Headache.
  • Dissatisfaction with inhalation.
  • "Lump in the throat.
  • Rapid heartbeat, etc.

Patients with neurotic reactions and depression often turn to various doctors, but during examination they do not find any morphological changes. Therefore, for a long time the diagnosis may be hidden behind other conditions.

Unexplained heaviness in the chest or pain that does not fit into the clinical picture of organic pathology may have a neuropsychic origin.

Additional diagnostics

The nature of the unpleasant sensations can only be determined based on the results of a comprehensive examination. Given the variety of causes of the phenomenon under consideration, various diagnostic measures may be required:

  1. General blood and urine tests.
  2. Blood biochemistry (inflammatory markers, lipid spectrum, coagulogram, immunoglobulins).
  3. Analysis of sputum and pleural fluid (cytology, culture).
  4. Chest X-ray.
  5. Tomography.
  6. Spirometry.
  7. Electrocardiography.
  8. Ultrasound of the heart.
  9. Fibrogastroscopy, etc.

By pointing to the source of the disturbance, these methods will allow the doctor to make a final conclusion about the patient’s condition. Often this requires the help of related specialists: a pulmonologist and TB specialist, a cardiologist and gastroenterologist, a neurologist and vertebrologist, an oncologist and a psychotherapist. And only after determining the cause of the symptoms will it be possible to prescribe appropriate treatment.

Source: http://elaxsir.ru/simptomy/drugie/tyazhest-v-grudnoj-kletke.html

Causes of shortness of breath: advice from a general practitioner

One of the main complaints most often voiced by patients is shortness of breath. This subjective feeling forces the patient to go to the clinic, call an ambulance, and may even be an indication for emergency hospitalization. So what is shortness of breath and what are the main reasons that cause it? You will find answers to these questions in this article. So…

What is shortness of breath

As mentioned above, shortness of breath (or dyspnea) is a subjective human sensation, an acute, subacute or chronic feeling of lack of air, manifested by tightness in the chest, clinically - an increase in the respiratory rate above 18 per minute and an increase in its depth.

A healthy person at rest does not pay attention to his breathing. With moderate physical activity, the frequency and depth of breathing change - the person is aware of this, but this condition does not cause him discomfort, and breathing parameters return to normal within a few minutes after stopping the exercise. If shortness of breath becomes more pronounced during moderate exertion, or appears when a person performs basic actions (tying shoelaces, walking around the house), or, even worse, does not go away at rest, we are talking about pathological shortness of breath, indicating a particular disease .

Classification of shortness of breath

If the patient has difficulty breathing, this is called inspiratory shortness of breath. It appears when the lumen of the trachea and large bronchi narrows (for example, in patients with bronchial asthma or as a result of compression of the bronchus from the outside - with pneumothorax, pleurisy, etc.).

If discomfort occurs during exhalation, such shortness of breath is called expiratory shortness of breath. It occurs due to narrowing of the lumen of the small bronchi and is a sign of chronic obstructive pulmonary disease or emphysema.

There are a number of reasons that cause mixed shortness of breath - with disturbances in both inhalation and exhalation. The main ones are heart failure and lung diseases in late, advanced stages.

There are 5 degrees of severity of shortness of breath, determined based on the patient’s complaints - the MRC scale (Medical Research Council Dyspnea Scale).

Causes of shortness of breath

The main causes of shortness of breath can be divided into 4 groups:

  1. Respiratory failure caused by:
    • violation of bronchial obstruction;
    • diffuse diseases of the tissue (parenchyma) of the lungs;
    • pulmonary vascular diseases;
    • diseases of the respiratory muscles or chest.
  2. Heart failure.
  3. Hyperventilation syndrome (with neurocirculatory dystonia and neuroses).
  4. Metabolic disorders.

Shortness of breath due to lung pathology

This symptom is observed in all diseases of the bronchi and lungs. Depending on the pathology, shortness of breath can occur acutely (pleurisy, pneumothorax) or bother the patient for many weeks, months and years (chronic obstructive pulmonary disease, or COPD).

Shortness of breath in COPD is caused by a narrowing of the airways and the accumulation of viscous secretions in them. It is constant, expiratory in nature, and in the absence of adequate treatment becomes more and more pronounced. Often combined with a cough followed by sputum discharge.

In bronchial asthma, shortness of breath manifests itself in the form of sudden attacks of suffocation. It is expiratory in nature - a light short inhalation is followed by a noisy, difficult exhalation. When you inhale special medications that dilate the bronchi, breathing quickly normalizes. Choking attacks usually occur after contact with allergens - when inhaling them or eating them. In especially severe cases, the attack is not stopped by bronchomimetics - the patient’s condition progressively worsens, he loses consciousness. This is an extremely life-threatening condition that requires emergency medical attention.

Accompanies shortness of breath and acute infectious diseases - bronchitis and pneumonia. Its severity depends on the severity of the underlying disease and the extent of the process. In addition to shortness of breath, the patient is concerned about a number of other symptoms:

  • increase in temperature from subfebrile to febrile numbers;
  • weakness, lethargy, sweating and other symptoms of intoxication;
  • nonproductive (dry) or productive (with sputum) cough;
  • chest pain.

With timely treatment of bronchitis and pneumonia, their symptoms stop within a few days and recovery occurs. In severe cases of pneumonia, respiratory failure is accompanied by cardiac failure - shortness of breath increases significantly and some other characteristic symptoms appear.

Lung tumors in the early stages are asymptomatic. If a recently emerging tumor was not detected by chance (during preventive fluorography or as an accidental finding in the process of diagnosing non-pulmonary diseases), it gradually grows and, when it reaches a sufficiently large size, causes certain symptoms:

  • at first mild, but gradually increasing constant shortness of breath;
  • hacking cough with minimal sputum;
  • hemoptysis;
  • chest pain;
  • weight loss, weakness, pallor of the patient.

Treatment of lung tumors may include surgery to remove the tumor, chemotherapy and/or radiation therapy, and other modern treatment methods.

The greatest threat to the patient's life is caused by shortness of breath conditions such as pulmonary embolism, or PE, local airway obstruction and toxic pulmonary edema.

PE is a condition in which one or more branches of the pulmonary artery are blocked by blood clots, as a result of which part of the lungs is excluded from the act of breathing. The clinical manifestations of this pathology depend on the volume of lung damage. It usually manifests itself as sudden shortness of breath, disturbing the patient during moderate or minor physical activity or even at rest, a feeling of suffocation, tightness and chest pain similar to that of angina pectoris, often with hemoptysis. The diagnosis is confirmed by corresponding changes in the ECG, chest x-ray, and angiopulmography.

Airway obstruction is also manifested by the symptom complex of suffocation. The shortness of breath is inspiratory in nature, breathing can be heard from a distance - noisy, stridorous. A frequent accompaniment of shortness of breath in this pathology is a painful cough, especially when changing body position. The diagnosis is made on the basis of spirometry, bronchoscopy, X-ray or tomographic examination.

Airway obstruction can result from:

  • violation of the patency of the trachea or bronchi due to compression of this organ from the outside (aortic aneurysm, goiter);
  • damage to the trachea or bronchi by a tumor (cancer, papillomas);
  • entry (aspiration) of a foreign body;
  • formation of cicatricial stenosis;
  • chronic inflammation leading to destruction and fibrosis of the cartilage tissue of the trachea (in rheumatic diseases - systemic lupus erythematosus, rheumatoid arthritis, Wegener's granulomatosis).

Bronchodilator therapy for this pathology is ineffective. The main role in treatment belongs to adequate therapy of the underlying disease and mechanical restoration of airway patency.

Toxic pulmonary edema can occur against the background of an infectious disease accompanied by severe intoxication or due to exposure to toxic substances in the respiratory tract. At the first stage, this condition manifests itself only as gradually increasing shortness of breath and rapid breathing. After some time, shortness of breath gives way to painful suffocation, accompanied by bubbling breathing. The leading direction of treatment is detoxification.

Less commonly, the following lung diseases manifest themselves as shortness of breath:

  • pneumothorax is an acute condition in which air penetrates the pleural cavity and lingers there, compressing the lung and preventing the act of breathing; occurs due to injury or infectious processes in the lungs; requires emergency surgery;
  • pulmonary tuberculosis is a serious infectious disease caused by Mycobacterium tuberculosis; requires long-term specific treatment;
  • actinomycosis of the lungs - a disease caused by fungi;
  • emphysema is a disease in which the alveoli become stretched and lose their ability to carry out normal gas exchange; develops as an independent form or accompanies other chronic respiratory diseases;
  • silicosis is a group of occupational lung diseases resulting from the deposition of dust particles in the lung tissue; recovery is impossible, the patient is prescribed supportive symptomatic therapy;
  • scoliosis, defects of the thoracic vertebrae, ankylosing spondylitis - with these conditions, the shape of the chest is disrupted, which makes breathing difficult and causes shortness of breath.

Shortness of breath due to pathology of the cardiovascular system

People suffering from heart disease report shortness of breath as one of their main complaints. In the early stages of the disease, shortness of breath is perceived by patients as a feeling of lack of air during physical activity, but over time this feeling is caused by less and less exercise; in advanced stages it does not leave the patient even at rest. In addition, advanced stages of heart disease are characterized by paroxysmal nocturnal dyspnea - an attack of suffocation that develops at night, leading to the awakening of the patient. This condition is also known as cardiac asthma. It is caused by stagnation of fluid in the lungs.

Dyspnea in neurotic disorders

Complaints of shortness of breath of varying degrees are made by ¾ of patients of neurologists and psychiatrists. A feeling of lack of air, the inability to breathe deeply, often accompanied by anxiety, fear of death from suffocation, a feeling of a “blockage”, an obstruction in the chest that prevents a full breath - the complaints of patients are very diverse. Typically, such patients are excitable people who react sharply to stress, often with hypochondriacal tendencies. Psychogenic breathing disorders often appear against a background of anxiety and fear, depressed mood, or after experiencing nervous overexcitation. Even attacks of false asthma are possible - suddenly developing attacks of psychogenic shortness of breath. A clinical feature of psychogenic breathing features is its noise design - frequent sighs, groans, groans.

Neurologists and psychiatrists treat shortness of breath in neurotic and neurosis-like disorders.

Shortness of breath with anemia

Anemia is a group of diseases characterized by changes in the composition of the blood, namely a decrease in the content of hemoglobin and red blood cells. Since the transport of oxygen from the lungs directly to the organs and tissues is carried out precisely with the help of hemoglobin, when its amount decreases, the body begins to experience oxygen starvation - hypoxia. Of course, he tries to compensate for this condition, roughly speaking, to pump more oxygen into the blood, as a result of which the frequency and depth of breaths increases, i.e. shortness of breath occurs. There are different types of anemia and they arise due to different reasons:

  • insufficient intake of iron from food (for vegetarians, for example);
  • chronic bleeding (with peptic ulcer, uterine leiomyoma);
  • after recent severe infectious or somatic diseases;
  • for congenital metabolic disorders;
  • as a symptom of cancer, in particular blood cancer.

In addition to shortness of breath with anemia, the patient complains of:

  • severe weakness, loss of strength;
  • decreased quality of sleep, decreased appetite;
  • dizziness, headaches, decreased performance, impaired concentration and memory.

Persons suffering from anemia are distinguished by pale skin, and in some types of the disease - by a yellow tint, or jaundice.

Diagnosing anemia is easy - just take a general blood test. If there are changes in it that indicate anemia, a series of examinations, both laboratory and instrumental, will be prescribed to clarify the diagnosis and identify the causes of the disease. Treatment is prescribed by a hematologist.

Shortness of breath in diseases of the endocrine system

Persons suffering from diseases such as thyrotoxicosis, obesity and diabetes mellitus also often complain of shortness of breath.

With thyrotoxicosis, a condition characterized by excessive production of thyroid hormones, all metabolic processes in the body sharply increase - at the same time, it experiences an increased need for oxygen. In addition, an excess of hormones causes an increase in the number of heart contractions, as a result of which the heart loses the ability to fully pump blood to tissues and organs - they experience a lack of oxygen, which the body tries to compensate for, and shortness of breath occurs.

Excessive amounts of adipose tissue in the body during obesity impede the functioning of the respiratory muscles, heart, and lungs, as a result of which tissues and organs do not receive enough blood and lack oxygen.

With diabetes, sooner or later the vascular system of the body is affected, as a result of which all organs are in a state of chronic oxygen starvation. In addition, over time, the kidneys are also affected - diabetic nephropathy develops, which in turn provokes anemia, as a result of which hypoxia intensifies even more.

Shortness of breath in pregnant women

During pregnancy, a woman's respiratory and cardiovascular systems experience increased stress. This load is due to the increased volume of circulating blood, compression from below the diaphragm by the enlarged uterus (as a result of which the chest organs become crowded and breathing movements and heart contractions are somewhat difficult), the need for oxygen not only of the mother, but also of the growing embryo. All these physiological changes lead to many women experiencing shortness of breath during pregnancy. The breathing rate does not exceed 22–24 per minute; it becomes more frequent during physical activity and stress. As pregnancy progresses, shortness of breath also progresses. In addition, expectant mothers often suffer from anemia, which worsens shortness of breath.

If the respiratory rate exceeds the above figures, shortness of breath does not go away or does not decrease significantly at rest, the pregnant woman should definitely consult a doctor - an obstetrician-gynecologist or therapist.

Shortness of breath in children

The respiratory rate of children of different ages is different. Dyspnea should be suspected if:

  • in a child 0–6 months, the number of respiratory movements (RR) is more than 60 per minute;
  • in a child 6–12 months of age, the respiratory rate is over 50 per minute;
  • in a child over 1 year of age, the respiratory rate is over 40 per minute;
  • in a child over 5 years of age, the respiratory rate is over 25 per minute;
  • in a child 10–14 years old, the respiratory rate is over 20 per minute.

It is more correct to count breathing movements while the child is sleeping. A warm hand should be placed loosely on the baby’s chest and count the number of chest movements in 1 minute.

During emotional arousal, during physical activity, crying, and feeding, the respiratory rate is always higher, but if the respiratory rate is significantly higher than normal and slowly recovers at rest, you should inform your pediatrician about this.

Most often, shortness of breath in children occurs under the following pathological conditions:

  • respiratory distress syndrome of the newborn (often recorded in premature babies whose mothers suffer from diabetes mellitus, cardiovascular disorders, diseases of the genital area; it is facilitated by intrauterine hypoxia, asphyxia; clinically manifested by shortness of breath with a respiratory rate over 60 per minute, a blue tint of the skin and their pallor, chest rigidity is also noted; treatment must begin as early as possible - the most modern method is the introduction of pulmonary surfactant into the trachea of ​​the newborn in the first minutes of his life);
  • acute stenosing laryngotracheitis, or false croup (a feature of the structure of the larynx in children is its small lumen, which, with inflammatory changes in the mucous membrane of this organ, can lead to disruption of the passage of air through it; usually false croup develops at night - swelling increases in the area of ​​the vocal cords, leading to severe inspiratory shortness of breath and suffocation; in this condition, it is necessary to provide the child with a flow of fresh air and immediately call an ambulance);
  • congenital heart defects (due to intrauterine development disorders, the child develops pathological communications between the great vessels or cavities of the heart, leading to mixing of venous and arterial blood; as a result, the organs and tissues of the body receive blood that is not saturated with oxygen and experience hypoxia; depending on the severity dynamic observation and/or surgical treatment is indicated);
  • viral and bacterial bronchitis, pneumonia, bronchial asthma, allergies;
  • anemia.

In conclusion, it should be noted that only a specialist can determine the true cause of shortness of breath, therefore, if this complaint occurs, you should not self-medicate - the most correct decision would be to consult a doctor.

Which doctor should I contact?

If the diagnosis is not yet known to the patient, it is best to consult a therapist (pediatrician for children). After the examination, the doctor will be able to establish a presumptive diagnosis and, if necessary, refer the patient to a specialized specialist. If shortness of breath is associated with lung pathology, you should consult a pulmonologist; if you have heart disease, consult a cardiologist. Anemia is treated by a hematologist, diseases of the endocrine glands by an endocrinologist, pathology of the nervous system by a neurologist, mental disorders accompanied by shortness of breath by a psychiatrist.

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Commentary “Causes of shortness of breath: advice from a general practitioner”

Svetlana Emonkova

Shortness of breath began to appear from the age of 45, as well as “persistent” bronchitis, as I thought then. Later it turned out that these are some of the most striking symptoms of asthma. I also have a predisposition on my mother’s side. I treat asthma with basic therapy (currently I use a Foster inhaler), as well as long walks in the fresh air; I no longer have enough strength for other physical exercises. But I also try to support myself with breathing exercises (Strelnikova’s method, mainly). Pay attention to warning signs immediately.

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Chest pain

Chest pain and difficulty breathing are dangerous symptoms. They are characteristic of heart and lung diseases.

What is chest pain?

The chest is the upper section of the body, shaped like a truncated cone. The chest is formed by the thoracic spinal column, ribs and sternum. It protects vital organs (heart, lungs), is connected to the skeleton of the upper limbs, and is involved in the breathing process. Chest pain is one of the common ailments.

Causes of chest pain:

One of the reasons may be damage to the chest wall (for example, due to injury), dysfunction of the organs of the chest cavity (for example, heart, lungs), diseases of other organs, characterized by pain radiating to the chest. When a person has chest pain, he usually thinks that his heart hurts. Chest pain may be the first symptom of a myocardial infarction, although it is often caused by other dysfunctions of the body.

Chest pain caused by traumatic injuries to the chest (for example, bruise, broken skin, fractured ribs and/or sternum). Touching the damaged area causes severe pain in the patient. A rib fracture is often accompanied by shortness of breath and an irritating cough. The cause of chest pain can be injuries and diseases of the neck (for example, osteochondrosis of the lower cervical vertebrae), irritation of the nerve roots. In these cases, the pain is superficial; with pressure, you can find the most painful place. Very severe pain in the chest (along the intercostal nerve) can be caused by a herpes infection (Herpes zoster), which manifests itself as a blistering rash in the area of ​​the affected nerve.

Pain and breathing problems:

The combination of chest pain and difficulty breathing is especially dangerous for the patient. These symptoms may indicate serious problems. If the chest is compressed by a dull pain radiating to the upper extremities, this suggests angina pectoris; in the worst case, the patient may have a myocardial infarction. Chest pain occurs due to poor circulation in the heart muscle (myocardium), spasms or blockage of the coronary vessels. If the pain does not go away after a few minutes while lying down, a myocardial infarction may occur.

Other symptoms of myocardial infarction:

If you have the listed symptoms, you should immediately call an ambulance. If the patient experiences pain when inhaling, then pneumonia can be assumed. It is usually accompanied by pleurisy. Acute stabbing pain in the chest, shortness of breath, and attacks of suffocation may indicate a pulmonary embolism. If the listed symptoms are accompanied by an irritating cough with grayish-yellow sputum, this suggests pneumothorax. The same symptoms are characteristic of bronchitis, tuberculosis and other lung diseases. Chest pain, shortness of breath, suffocation are observed in mental disorders, for example, increased anxiety, vegetative dystonia.

Pain when moving:

Movement is usually not accompanied by pain. However, when performing certain movements, especially when bending forward, pain appears. Severe pain can be observed with an esophageal hernia, as well as in cases where the hernial orifice expands and part of the stomach protrudes through it into the chest cavity. Patients with such a hernia experience not only chest pain, but also sour belching and heartburn.

Chest pain occurs not only due to damage to the organs of the chest cavity, but also to other organs. For example, this symptom is observed with inflammation of the gallbladder or bile ducts. Pain behind the sternum is often observed with stomach diseases (for example, perforation of a stomach ulcer). After eating food, the pain subsides. Inflammation of the pancreas and splenic infarction may also be accompanied by chest pain. With persistent chest pain spreading along the back and sides, damage to the spine can be assumed (for example, spinal bone defects, herniated intervertebral discs).

Tumors and infections:

Chest pain can be caused by chest wall tumors and herpes zoster. In the latter case, bubbles with a clear liquid appear on the skin, which burst after a few days. Breast tenderness: Before menstruation, some women experience painful enlargement of the nipples and breasts. This condition is called mastodynia. The disease is unpleasant, but usually does not cause pathological changes. If you have severe pain, you should consult a gynecologist.

The cause of chest pain may be breast cancer (although pain is not noted at the initial stage). Therefore, it is very important to examine your breasts monthly for the presence of nodules and regularly visit your gynecologist.

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Causes of shortness of breath: symptoms of diseases, what to do to alleviate the condition

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Many patients complain of shortness of breath when visiting a therapist. Difficulty breathing does not mean that a person has lung problems. You can suspect a particular disease by the nature of shortness of breath and symptoms of accompanying conditions.

However, only a doctor can identify the true cause based on research data.

Shortness of breath - what is it?

Dyspnea is a deviation from the normal parameters of breathing depth and frequency. Normally, a person makes breathing movements every minute.

During the period of bearing a child, the respiratory rate in women increases to a minimum, but this increase is considered normal and is due to physiological changes in the body of the pregnant woman.

In children from the neonatal period until reaching age, the frequency of respiratory movements gradually decreases from 60 to 20 per minute.

Exceeding the normal respiratory rate in min. indicates the occurrence of shortness of breath. Subjectively (the patient’s sensations) shortness of breath is manifested by a feeling of lack of air, increased or decreased breathing.

Shortness of breath can be a temporary phenomenon, occur during physical activity or spontaneously at rest. In serious illnesses, breathing difficulties are often permanent.

Shortness of breath, medically called dyspnea, is a reflex reaction to a lack of oxygen in the tissues. Moreover, oxygen deficiency can be provoked by external factors: a sharp increase in physical activity when running, climbing stairs, etc.

This physiological shortness of breath goes away on its own after some time. Its occurrence is due to the physical training of a person. People leading a passive lifestyle feel tightness in the chest even with minimal physical stress.

And, conversely, athletes and people leading an active lifestyle require quite serious physical activity for shortness of breath to appear.

A more serious option is shortness of breath resulting from pathology of internal organs. In this case, it is impossible to eliminate breathing problems without medical help.

The patient's complaints can only indirectly indicate the affected organ. Only a full examination of the body will allow us to identify the cause of shortness of breath and prescribe appropriate treatment.

  1. Tachypnea - the respiratory rate is increased to more than 20 per minute, and breathing becomes shallow. Tachypnea is characteristic of feverish conditions, obesity, anemia, and hysterical seizures.
  2. Bradypnea - decrease in respiratory rate to 12 per minute. and less. Breathing can be both deep and shallow. Bradyapnea is recorded in cerebral pathology, a state of acidosis and diabetic coma.

Based on the nature of breathing problems, doctors consider:

  • Expiratory shortness of breath - with difficulty exhaling, most often caused by damage to the small bronchi and the lung tissue itself. Shortness of breath after coughing, debilitating the patient, is recorded in chronic lung diseases (emphysema).
  • Inspiratory dyspnea - with difficulty inhaling, occurs when large bronchi are damaged or lung tissue is compressed. More typical for bronchial asthma, pleurisy, allergic edema and laryngeal cancer.
  • Mixed shortness of breath - both inhalation and exhalation are difficult. This type of respiratory disorder often indicates cardiac asthma or advanced pulmonary pathology.

Depending on the physical activity required for the occurrence of breathing problems, shortness of breath is distinguished:

  • Grade 0 - for chest tightness to appear, quite serious physical stress is required (long distance running).
  • 1st degree (mild) - shortness of breath occurs at times when climbing stairs or walking quickly.
  • 2nd degree (moderate) - difficulty breathing provokes a slower step in a sick person in comparison with the pace of his movement, being in a healthy state. A person sometimes stops while walking to take a breath.
  • Grade 3 (severe) - the patient needs to stop every 100 m (approximate distance) or when climbing 1-2 flights of stairs. The patient's performance is sharply reduced.
  • Grade 4 (extremely severe) - even minimal physical activity or an emotional outburst can provoke shortness of breath in heart failure. Difficulty breathing often occurs at rest, even while sleeping at night. The patient is practically unable to do any work and spends most of his time at home.

Along with the above characteristics, the accompanying symptoms of shortness of breath play an important role.

Chest pain, cough, shortness of breath - is this a disease?

Constantly or frequently occurring (even at rest) shortness of breath is a serious symptom, indicating the progression of an already existing disease or the occurrence of a severe, rapidly developing pathology. Shortness of breath at rest is characteristic of the following diseases:

Severe angina and other heart diseases - chest pain, cough, shortness of breath at rest. Timely provision of qualified assistance to a patient can save his life and prevent the development of necrosis of the heart muscle.

Thrombembolism of the pulmonary arteries - often occurs against the background of varicose veins or thrombophlebitis, which occurs with increased blood clotting. Blockage of the pulmonary vessels is accompanied by severe bronchospasm. Often this condition occurs in the postoperative period, in paralyzed bedridden patients, and even during air travel.

To save the patient's life, immediate medical attention is required! Usually, it only takes a few minutes after the onset of severe symptoms to provide assistance for blockage of a large pulmonary vessel, otherwise death is inevitable.

Causes of shortness of breath when walking

The most common causes of shortness of breath when walking are:

  • Pathology of coronary circulation - stenosis of large heart vessels, atherosclerosis;
  • Heart defects - valve defects, aneurysm of the heart wall;
  • Severe lung damage - often constant shortness of breath accompanies pulmonary diseases;
  • Anemia - a significant decrease in hemoglobin levels is characterized by shortness of breath on exertion and sudden attacks of weakness, dizziness and decreased a/d up to loss of consciousness.

Cardiac shortness of breath (cardiac asthma), symptoms

Shortness of breath caused by heart disease progresses gradually or rapidly without treatment. The rate of increase in shortness of breath indicates the severity of cardiac pathology. The result is coronary circulatory failure and tissue hypoxia.

Severe shortness of breath when walking or at rest is accompanied by cyanosis of the nasolabial triangle, pallor of the skin, and heart pain.

Breathing problems that occur spontaneously during night sleep suggest heart failure. A characteristic symptom of cardiac asthma - ortapnea - is manifested by increased shortness of breath in the supine position. A person is forced to take a vertical position to facilitate breathing.

In chronic heart failure, shortness of breath is accompanied by deep breaths due to reflex replenishment of severe oxygen deficiency. The most unfavorable option—shortness of breath at rest—requires complex treatment of heart failure.

Cough and shortness of breath

Shortness of breath and cough with sputum are a “companion” of heavy smokers and an indicator of chronic pulmonary obstruction. Long-term smoking leads to atrophic changes in the bronchi, blockage of the smallest bronchioles with sputum.

  • Shortness of breath may be minimal at rest, but sharply increases when walking.

With bronchitis and pneumonia, shortness of breath and a wet cough are recorded (with the exception of the initial period of pneumonia - a dry cough). Dry cough and shortness of breath are characteristic of damage to the pleura, fibrosis, and the initial stage of pulmonary oncology. The larger the area of ​​damage to the respiratory system, the more severe the shortness of breath.

Noisy breathing, moist rales audible at a distance (“gurgling” in the lungs), and persistent shortness of breath may indicate severe lung damage: cancer or edema caused by acute coronary insufficiency.

Treatment - what to do if you have shortness of breath?

If the disease causing shortness of breath is identified, it must be treated in accordance with all recommendations of the attending physician. The following will also help ease your breathing:

  • Complete cessation of cigarettes, exclusion of passive smoking.
  • Ventilation of premises and regular cleaning (elimination of dust).
  • Exclusion from the diet of allergenic foods that contribute to the occurrence of bronchial asthma and asthmatic bronchitis.
  • Good nutrition - prevention of anemia.
  • Breathing exercises - take a deep breath through the nose and exhale through the mouth, accompanied by drawing in the abdomen.
  • If the cause of difficulty breathing has not been established, it is necessary to undergo a comprehensive examination. If shortness of breath develops rapidly, an urgent call to emergency assistance is required, and if breathing stops, artificial respiration must be used until doctors arrive.
  • Shortness of breath in bronchial asthma is eliminated with drugs that eliminate bronchospasm - Salbutamol, Fenoterol, Saltos, Eufillin.
  • The fastest results are achieved by using aerosols or injections of the drug. IM or IV injections are performed by a doctor!

Treatment of shortness of breath begins with identifying the cause of its occurrence. Breathing problems can only be eliminated with effective treatment of the underlying disease.

Which doctor should I contact for shortness of breath?

Since shortness of breath can be caused by various diseases, a person should initially consult a physician. Subsequently, the patient can be referred for consultation to specialized specialists: a cardiologist, pulmonologist, endocrinologist, neurologist.

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Shortness of breath is one of the dangerous symptoms of osteochondrosis

Shortness of breath is a symptom of a number of diseases: angina pectoris, myocardial infarction, pneumonia, emphysema, chronic heart failure, intercostal neuralgia and osteochondrosis. Most modern people lead a static lifestyle. For them, osteochondrosis is inevitable. Every second person suffering from this disease, in addition to pain in the back, head or neck, also receives a lot of concomitant pathologies. Shortness of breath with osteochondrosis is a dangerous symptom, indicating damage to the internal organs located in the chest.

What is shortness of breath

Shortness of breath is a change in the depth and frequency of breathing. This is an unpleasant feeling of lack of air, causing physical and psychological discomfort. Shortness of breath is a sign of a number of pathologies that require urgent treatment.

The development of shortness of breath is promoted by: bad habits, a sedentary lifestyle, excessive physical activity, and spinal injuries.

Osteochondrosis of the thoracic spine is one of the main causes of shortness of breath. The disease usually develops in people who do not take care of their posture, who are hunched over, or who slouch. Unnatural flexion of the vertebrae provokes the appearance of pathological changes in the chest. Over time, any awkward movement or sharp turn can cause pain.

Displacement of the vertebrae in thoracic osteochondrosis leads to disruption of the structure of the chest and pinching of large neurovascular bundles.

A deep breath is reflected by pain in the damaged segment of the spine, and breathing becomes shallow and frequent.

Causes of osteochondrosis

Osteochondrosis is a disease that is characterized by disturbances in the structure of the intervertebral discs, decreased elasticity of the skeleton and the appearance of associated health problems.

With thoracic osteochondrosis, the intervertebral discs of the corresponding part of the spine are affected. The distance between adjacent vertebrae gradually decreases, the nerve roots are pinched, and the function of absorbing pressure on the spinal column is disrupted. Pathological processes occurring in the neck and chest area lead to disruption of the mediastinal organs - the space inside the chest. First of all, these are the lungs and heart.

    The main causes of osteochondrosis:
  • genetic predisposition,
  • infections,
  • metabolic disease,
  • poor nutrition and excess body weight,
  • spinal injuries,
  • postural disorders, pathological kyphosis, scoliosis,
  • instability of spinal column segments,
  • environmental factor,
  • maintaining a sedentary lifestyle,
  • excessive physical activity,
  • pathologies of the musculoskeletal system,
  • flat feet,
  • wearing uncomfortable high-heeled shoes,
  • stress,
  • bad habits.

    • Shortness of breath as one of the symptoms of osteochondrosis of the thoracic spine

    Dyspnea with osteochondrosis does not occur immediately. At first, breathing becomes difficult, and patients feel worse after climbing stairs or walking quickly. Then it becomes difficult to breathe, the chest hurts when trying to take a deep breath or exhale.

    Difficulty breathing is gradually accompanied by disorders of the cardiovascular system, shortness of breath worsens and interferes with living a full life.

    Shortness of breath with osteochondrosis is often accompanied by:

    • discomfort and pain in the spine between the shoulder blades,
    • pressing or boring pain in the heart,
    • feeling of a “lump in the throat”,
    • difficulty raising your arms or bending your body,
    • constant headache
    • spasm of the back muscles,
    • aches and numbness of the hands,
    • stiffness of movements.

    These symptoms of osteochondrosis are associated with damage to nerve endings and compression of blood vessels, resulting in impaired blood supply to the brain, leading to hypoxia. Hypoxia is a lack of oxygen, which leads to the death of brain cells and human death.

    Osteochondrosis often manifests itself as shortness of breath and a feeling of a lump in the throat. This is explained by impaired innervation of the mediastinal organs, leading to esophageal dysfunction.

    Shortness of breath with osteochondrosis is often the result of irritation of the vagus nerve and disruption of the diaphragm. In addition to shortness of breath, patients experience hiccups, pain in the right hypochondrium and in the heart area. As oxygen deficiency increases, the central symptoms of hypoxia develop: rapid and shallow breathing, dizziness, night snoring, drowsiness, weakness, blurred vision, cyanosis (cyanosis) of the nasolabial triangle and fingertips.

    Another cause of shortness of breath in osteochondrosis is a decrease in the speed of blood flow through the vessels of the neck and impaired microcirculation in the brain. This leads to depression of the respiratory center and irreversible changes in the human body.

    If shortness of breath and osteochondrosis are not treated. Consequences

    Osteochondrosis is a disease that is easy to acquire, but difficult to diagnose and cure. If the disease is neglected, the doctor’s recommendations are ignored and not treated, severe complications will develop.

    1. The chest organs suffer greatly from lack of oxygen. This is manifested by a decrease in the performance of the heart and dysfunction of the entire cardiovascular system.
    2. Brain hypoxia leads to disruption of brain function, decreased attention and memory, constant headaches, and the development of encephalopathy and dementia.
    3. In the absence of timely and adequate treatment, shortness of breath with osteochondrosis can lead to partial loss of respiratory function, disability and even death.

    Treatment and prevention

    You can alleviate the condition and eliminate shortness of breath caused by osteochondrosis at home using simple procedures:

    • Hot foot baths with decoctions of medicinal herbs or mustard powder have a distracting effect, which helps ease breathing.
    • Inhalation with essential oils, potato peels or onion peels will help improve nasal breathing.

    Taking new generation non-steroidal anti-inflammatory drugs prescribed by your doctor will relieve pain when inhaling and reduce shortness of breath. In extreme cases, asthma medications can be used. But this can be dangerous, so it should be discussed with your doctor in advance.

    If you have an attack of suffocation, you should call an ambulance.

    A subcutaneous injection of adrenaline will help cope with the problem. Intravenous administration of anesthetics, as well as neuromuscular blockades, will eliminate neuralgia and pain.

    Basic preventive measures to prevent the development of shortness of breath in osteochondrosis:

    • daily gymnastics to strengthen the back muscles;
    • use of an orthopedic hard mattress and a low pillow for sleeping;
    • aromatherapy for relaxation and easier breathing;
    • breathing exercises;
    • regular walks in the fresh air will help reduce the risk of hypoxia;
    • strengthening the immune system with the help of natural and medicinal immunomodulators;
    • balanced diet, proper drinking regimen and giving up bad habits;
    • hardening.

    Shortness of breath with osteochondrosis is an alarming sign indicating damage to internal organs. To prevent further destruction of the body, it is necessary to begin treatment of the underlying disease in a timely and comprehensive manner.

    The video presents a set of wonderful exercises aimed at preventing and restoring impaired functions in the thoracic spine. Simple exercises will ensure normal mobility of all segments of the thoracic spine, relieve muscle spasms, ease the work of the heart and respiratory system, and eliminate shortness of breath as a symptom of osteochondrosis.

    Thank you for the interesting article, we learned a lot of interesting facts. But, there is a question. If a person is diagnosed with osteochondrosis, as well as bronchial asthma. What exactly causes shortness of breath and difficulty breathing?

    Hello, Sergey! Thanks for your feedback. Regarding your question. If a person has osteochondrosis, it can be an indirect cause of the development of asthma. But, of course, everything is very individual. To give a definite answer, it is necessary to study the medical history.

    I came across this problem. And it arose due to an inactive lifestyle. But I coped with it thanks to sports. And I began to spend time in the fresh air more and more often.

    I'll bookmark this article. Indeed, today's people lead a very passive lifestyle, no sports, daily surfing the Internet, all this leads to bad consequences, which is not very pleasing, because a person is very lazy and does not want to spend a huge amount of time every day on various exercises and so on. similar. However, realizing how far this all comes, you begin to understand how important a healthy lifestyle is, but in addition to understanding, somehow you also need to find the strength to fight it!

    There is only one reason – the spine.”

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    We strongly recommend that you consult your doctor before use.

    Source: http://pomogispine.com/zabolevaniya/osteohondroz/odyshka.html