Chest pain when taking a deep breath. What can cause pain in the middle of the sternum Why does the chest hurt when you inhale hard?

A symptom such as chest pain that occurs when breathing deeply is often mistaken by people for a purely pulmonary problem. However, there are a number of pathologies not related to the respiratory system, the manifestation of which is pain when inhaling.

The chest is formed:

• sternum;
• ribs;
• collarbones;
• thoracic spine.

The bone apparatus is surrounded by muscle mass and penetrated by nerve fibers. All these formations can become a source of pain. And with a number of pathologies of the musculoskeletal system, pain appears precisely when taking a deep breath. The reason for this is the movement of the chest during breathing.

As you inhale, it rises and expands, which can lead to pain in some pathologies.

Degenerative pathology of the spine, which affects more than half of the adult population of the planet. With osteochondrosis, atrophic changes in the intervertebral disc occur. The nucleus pulposus of the disc loses its elasticity due to its pronounced hydrophilic properties. The moisture leaves, the disc becomes less elastic and more flattened.

The fibrous ring, which normally maintains the proper volume of the nucleus pulposus, also suffers. Due to the displacement and approach of neighboring vertebrae to each other, radial cracks may appear on the ring. The ligaments that support the spinal segment are destroyed. Its instability develops, the vertebrae shift, causing radicular syndrome with pain.

Such changes appear to varying degrees in all people as they age. They are more pronounced in the presence of excess weight, irrational physical activity, and a long-term sedentary lifestyle. Chest pain when inhaling appears with osteochondrosis of the thoracic spine, when the movement of the chest affects the affected vertebral segments.

Important! Pain with osteochondrosis radiates to the interscapular region or upper limbs.

A neurovascular bundle runs along the lower edge of all ribs. The nerves passing through it are often the source of neuralgia.

The etiology of this lesion is different:

• hypothermia;
• infringement;
• infection;
• irritation.

The most common episodes of intercostal neuralgia occur against the background of spinal osteochondrosis.

Slightly less often, the pain is caused by herpes zoster, a herpetic infection. Activation of the herpes virus can be triggered by hypothermia and always occurs against the background of a natural decrease in immunity:

• in old age;
• for diabetes mellitus;
• with primary and secondary immunodeficiencies.

With intercostal neuralgia, the pain is constant, it is localized on the affected side. Its intensification during inspiration is also associated with the movement of the chest, in particular the ribs. The nature of the pain is strong and burning, radiating along the entire length of the nerve fiber, from the sternum to the spine.

Closed chest trauma in more than half of the situations is complicated by damage to the ribs. This occurs more often in older people, due to increased fragility and fragility of bones. Depending on the number of broken ribs, a person's condition can range from moderate to very severe.

Fractures of 1-2 ribs are usually not severe and do not require hospital treatment. With fractures of 3 or more ribs, the risk of damage to the chest organs increases: the heart, lungs, and large vessels. Multiple bilateral fractures always require emergency medical attention.

Chest pain associated with rib fractures is localized to the site of the impact or suspected fracture. It intensifies even with shallow breathing and coughing, which can lead to forced hypoventilation and pneumonia.

Heart pathologies

Chest pain associated with breathing may also be a sign of one of the dangerous pathologies of the heart or blood vessels. Myocardial infarction or angina pectoris are common, but they are characterized by constant pressure sensations not associated with breathing. Let us consider in more detail exactly those pathologies in which pain appears or intensifies on inspiration.

Important! For any chest pain in people over 40 years of age, an electrocardiogram should be performed.

Pain on inspiration accompanies only dry pericarditis. With it, fibrinous adhesions form in large quantities on the pericardial sheets, which significantly worsen the friction of the sheets during heartbeat. Sharp, painful sensations appear, which intensify with deep breathing.

The causes of dry pericarditis are varied:

• systemic diseases: systemic lupus erythematosus, rheumatoid arthritis, scleroderma;
• end-stage chronic kidney disease, in which urate is deposited on the pericardium;
• gout, with deposition of uric acid salts;
• tuberculosis.

In addition to chest pain, pericarditis may cause rhythm disturbances: paroxysmal tachycardia, extrasystoles. A person is worried about fatigue, shortness of breath, and a feeling of interruptions in the functioning of the heart. Without treatment, dry pericarditis can develop into exudative over time.

One of the life-threatening pathologies that requires emergency medical care. We are not talking about the fulminant form of thromboembolism of the large trunk of the pulmonary artery, in which a reflex cardiac arrest occurs.

Pain in the chest during inspiration is more typical for emboli of small branches, which can cause recurrent infarction-pneumonia. It is for her that chest pain is typical, diffuse, with intensification on inspiration. In addition to pain, a person is bothered by a cough, possibly with rusty sputum, and a high temperature. Symptoms of respiratory distress may occur.

Pulmonary embolism almost always occurs against the background of good health. But, upon examination, provoking causes can be identified:

Important! Prolonged immobilization, associated, for example, with a long flight or a complex operation, contributes to the appearance of an embolus.

Pathologies of the gastrointestinal tract

A number of problems with the gastrointestinal system can cause chest pain when inhaling:

• gastroesophageal reflux disease, esophagitis, hiatal hernia– burning, pressing pain. Localized in the central and upper part of the chest. Associated with belching and regurgitation;

  

  

• gastritis, gastric ulcer– pain predominantly in the center, combined with a feeling of rapid satiety, nausea, belching;

  

  

• duodenal ulcer, pancreatitis– pain in the lower part of the chest, more on the left. Attacks are typical at night, as well as 2-3 hours after eating;

  

• cholecystitis– pain in the lower part of the chest on the right. Combined with a feeling of heaviness in the hypochondrium, a feeling of bitterness in the mouth, and nausea.

Pulmonary pathologies

The lung tissue itself does not have pain receptors; its pathologies do not manifest themselves as pain if they do not affect the pleura. Among all the organs of the respiratory system, the pleura is the most innervated, which means that pain is associated precisely with its damage.

In some cases, the focus of inflammation during pneumonia may be located close to the pleural cavity. Then the inflammation spreads to the pleura, causing pain. It can be constant, or it can only appear with deep breathing. In any case, coughing and forced breathing significantly increase pain.

In addition to pain, a person is worried about:

• symptoms of intoxication - weakness, fatigue;
• heat;
• cough, usually with sputum.

High temperature is a symptom of pleuropnemonia

In the case of massive pneumonia, symptoms of respiratory failure may appear - shortness of breath, cyanosis, decreased saturation. The disease is most severe in the elderly, children and people with immunodeficiencies.

Important! The most common cause of pneumonia is Streptococcus pneumoniae.

Chest pain when inhaling is more typical of dry pleurisy. Its morphology is very similar to dry pericarditis: fibrinous threads deposited on the surface of the pleura. They make friction of the pleura painful. The pain intensifies when breathing, as well as the slightest cough, or when bending to the healthy side.

The condition is alleviated on the contrary, by tilting towards the affected lung. This reduces the tension of the inflamed pleura. It also becomes easier for a person with pleurisy when he lies on the side of inflammation. This reduces the excursion of the affected side of the chest, thereby relieving pain.

In addition to pain, there may be symptoms of inflammation:

• heat;
• weakness.

Often with pleurisy, a dry reflex cough occurs. The causes of fibrinous pleurisy can be:

• tuberculosis;
• chronic kidney disease;
• Dressler's syndrome;
• systemic diseases.

Another pulmonary cause of chest pain on inspiration. In this case, the pain is extremely sharp, acute, sudden.

Pneumothorax can be:

• open – with contact between the pleural cavity and the environment;
• closed – the pleural cavity is not in contact with the environment;
• valve - air is sucked into the cavity when you inhale, but does not come out of it when you exhale, gradually “squeezing” the lung.

In addition to pain, a person is bothered by severe symptoms of acute respiratory failure:

• dyspnea;
• cyanosis.

With massive pneumothorax, mediastinal organs may move toward the collapsed lung. This will manifest itself as symptoms of cardiovascular shock and can lead to cardiac arrest.

Among the causes of pneumothorax are:

• injuries with rib fractures;
• lung tumors;
• bullous disease is a source of spontaneous pneumothorax in young people.

Important! With valvular pneumothorax, it is possible to change the position of the mediastinal organs, moving to the side of the healthy lung.

Comparative characteristics

Finally, here is a table that summarizes the basic data on the most common causes of breathing-related chest pain.

Video - Why does the chest hurt?

Video - 3 deceptive pains in the heart. What hurts in my chest

Pain in the chest when inhaling can be a signal of a serious pathology in the body. This situation occurs at any age and is a reason to worry about your own health. To establish the exact cause, you will have to undergo diagnostics and laboratory tests.

Clinical picture

Painful sensations that occur when taking a deep breath can have different localizations: on the right, left or in the middle of the sternum. It is important to correctly describe to the doctor the area where the problem is felt. This will help in establishing the correct diagnosis. The nature and intensity of pain manifests itself in different ways.

Sometimes it occurs under the influence of physical activity, when walking, moving the body or taking a very deep breath.

As a rule, pain is accompanied by other symptoms:

• difficulty breathing;
• temperature increase;
• weakness;
• cough;
• dyspnea.

A significant indicator for the doctor will be an accurate determination of the nature of the pain: aching, sharp or pulling, constant or appearing during certain actions.

Possible causes of chest pain when inhaling

• Diseases of the cardiovascular system

Heart disease is traditionally associated with pain when inhaling in the chest on the left. This may be an attack of angina due to coronary artery disease. A spasm occurs, squeezing the sternum and radiating to the shoulder blade, neck and arm. The situation is complicated by dizziness and rapid heartbeat. Angina is provoked by physical exercise, stress, cold, and windy weather.

Pericarditis is inflammation of the heart lining. Pathology occurs as a complication after infectious diseases. Due to discomfort on the left side of the chest, the patient tries not to take a deep breath, his breathing becomes shallow.

• Respiratory pathologies

Diseases associated with the respiratory system are accompanied by a severe debilitating cough, shortness of breath, weakness, and lack of air.

Pain in the middle of the chest when inhaling is one of the signs of pneumonia, pleurisy or lung cancer. Pneumonia is the occurrence of a pathological inflammatory process in the lungs. A common cause of illness is the negative effect of fungi, viruses or microbes. People with weak immune systems are vulnerable to the disease, especially those who have had the flu, or have been exposed to hypothermia or severe stress. For complex complex treatment, patients are admitted to a hospital.

Inflammation is accompanied by the accumulation of fluid between the layers of the pleura, coughing, and burning in the chest.

The pain can be sharp and sharp, it intensifies with a deep breath. Diagnosis will require an x-ray and a pleural biopsy.

Pulmonary embolism - a pathology that occurs when a blood clot blocks one or more arteries that supply the organ with blood. Blood flow can be blocked by:

• a clot of fat;
• blood clot;
• tumor cells;
• air.

Embolism is a dangerous disease that often leads to death, so symptoms such as shortness of breath, wheezing in the chest and pain when taking a deep breath should not be ignored.

Discomfort when breathing deeply appears due to a tumor in the bronchi or lung. This disease is accompanied by a constant cough and bloody sputum. If you have such signs, you should not delay your visit to the oncologist.

• Chest injuries

Pain in the chest is a consequence of muscle strain and soreness after excessive physical exertion during sports. Damage to muscle tissue and large accumulations of lactic acid create discomfort when taking a deep breath.

In such a situation, the best way out is to take a break from training and reduce its intensity.

Injuries or damage to the ribs occur at home and at work. They are accompanied by hematomas, swelling, discomfort during palpation and deep breathing. In case of serious injury, internal bleeding and rupture of lung tissue should be ruled out.

• Intercostal neuralgia

Pain when taking a deep breath, coughing, or changing position occurs due to pinched nerve roots. An attack can occur at any moment, causing piercing pain under the shoulder blade. Often this condition is attributed to cardiac pathologies, without prescribing the necessary treatment.

Pain with intercostal neuralgia can be acute or dull. It appears for no reason and lasts for a long time.

• Pathologies of the digestive system

Disturbances in the functioning of the stomach, gall bladder and liver lead to the fact that a person feels sharp pain when breathing deeply. Localization of unpleasant sensations is observed on the right.

The cause of discomfort is:

• increased concentration of acid in the stomach;
• chronic liver diseases;
• cholecystitis;
• cholelithiasis;
• stomach ulcer.

Diagnosis and treatment methods

To determine the cause of the symptom, a comprehensive examination is carried out, including:

• clinical and biochemical blood test;
• radiography;
• fluorography;
• MRI or computed tomography;
• sputum samples;
• electrocardiography.

Modern laboratory and diagnostic equipment makes it possible to accurately identify pathology in the chest. Treatment depends on the diagnosis.

For lung diseases, the patient is prescribed:

• antibiotics;
• expectorants;
• inhalation;
• physiotherapy.

Detection of a blood clot in the arteries will require the administration of a coagulant. For inflammatory processes, corticosteroids and painkillers are prescribed.

Conservative treatment of pleurisy is carried out:

• antibacterial drugs;
• anti-inflammatory drugs;
• warming therapy (mustard plasters, thermal physiotherapy).

Fractures in the chest require wearing a fixation bandage until the bones heal. If the problem is related to vasospasm (angina), then the first step is to block the attack. Afterwards, the doctor prescribes medications that normalize heart function.

Chest pain when inhaling, or thoracalgia, is a fairly common complaint; everyone has experienced it to one degree or another. In its shape, the chest resembles a truncated cone, compressed from front to back; consists of the ribs, sternum and spinal column. The space of the chest is filled with the mediastinum, respiratory organs, digestive and part of the endocrine systems, main blood and lymph vessels. The inside of the entire cell is lined with tissue (membrane), which also covers the lungs (pleura). The respiratory excursion of the lungs (breathing frequency) is 14 movements per minute.

Classification of pain sensations

Chest pain when inhaling is divided according to localization, severity, intensity, duration, etc., they occur from the neck to the abdomen. It is most convenient to consider them by location: right and left sides, as well as in the center - to narrow the search for the cause:

1. In the middle - then we can assume damage to the diaphragm, heart, esophagus and lungs.
2. On the right - the cause may be rib injuries, sore throat, CVD, gastrointestinal tract, respiratory infections and oncology.
3. On the left - CVD, tumors and pleurisy, trauma, renal colic, inflammation of the pleura.

Why does pain occur? Common reasons:

• lesions of the skin and subcutaneous fat;
• damage to the bone frame and its joints, muscles, fascia and ligaments;
• lesions of the peripheral nervous system of the spine.

Pathologies that are accompanied by thoracalgia:

1. CVD - ischemic heart disease, myocardial infarction, aortic aneurysm, hypertension, heart valve damage, cardioneurosis, pulmonary embolism.
2. Diseases of the pulmonary system - pneumonia, pleurisy, tracheitis, bronchitis, pulmonary tuberculosis, oncology.
3. Pathologies of the spinal column and cell frame - neuralgia of the ribs, osteochondrosis, Schmorl's hernia, kyphosis, ankylosing spondylitis, trauma.
4. MPS - myofascial pain syndrome (up to 35% of all calls), osteoporosis, lesions of the vertebral joints, spinal stenosis.
5. Gastrointestinal tract pathologies (gastric or duodenal ulcer, biliary dyskinesia, gastroesophageal reflux, pancreatitis, esophageal pathologies).
6. Neoplasms - extrapulmonary and pulmonary.

Chest pain can occur with the following lung diseases:

1. Tuberculosis: chest pain always increases when inhaling, pallor, fatigue, weight loss, refusal to eat, sweating, fever, shortness of breath, coughing and hemoptysis are noted; The chest also hurts.
2. Pleurisy - develops for various reasons as an independent disease or an accompanying symptom. The cough is always dry, acute burning pain when inhaling, bluishness of the face, shortness of breath, chills.
3. With lung tumors - constant pain in the chest when inhaling, coughing up blood, shortness of breath, tachycardia, weight loss, pallor, in 60% there is a fever.
4. Pneumonia - subfebrile temperature, with a sharp increase in the evening, chills, night sweats and weakness, shortness of breath, hoarse breathing at a distance, friction noise of the inflamed pleura, wet and dry rales are heard on auscultation in the lungs, pain in the chest when breathing, wet cough with purulent sputum; when trying to turn to the healthy side, the pain intensifies again due to the tension of the membrane.
5. Pneumothorax - the pleural cavity always contains a little fluid to lubricate the pleura. If air gets into this cavity, then excursion and expansion of the lungs is impossible, their collapse develops, and pain in the chest inevitably appears when breathing. More often it develops in a road accident, a fall from a height, puncture wounds, and there is also a spontaneous variant of development. The most common: difficulty breathing and acute pain, weakness, feeling of pressure in the chest, shortness of breath, cyanosis of the face; Possible death from lack of oxygen.
6. Pulmonary embolism - PE - blockage of the pulmonary artery by a blood clot. Varicose veins in the legs are often the cause. Against the background of complete health, incredible pain suddenly appears when inhaling, tachycardia, a drop in blood pressure, shortness of breath, cyanosis, sweating, and a bloody cough. The condition is very dangerous - if emergency medical care is not provided, death can occur within a few minutes.
7. A dull pain behind the sternum during coughing is a sign of ARVI. Cough, joint pain, fever and other signs of a viral respiratory tract infection.

CVS pathologies:

1. Pericarditis (inflammation of the heart sac). Chest pain when breathing is localized on the left side of the sternum and in its middle; often occurs after infections. The pain is not very sharp, but tension intensifies it; breathing is gentle, shallow, the person is afraid to move; the pain goes away if only the patient leans forward, which is the patient’s forced position. Weakness, dry cough, low-grade fever, malaise, increased symptoms while lying down. The patient is subject to mandatory hospitalization.
2. Angina pectoris. Characterized by the development of attacks of spasms of the coronary vessels. The pain syndrome is always sudden, severe, and manifests itself during emotional or physical stress; it is so strong that it is impossible to breathe - the patient freezes and becomes numb. The face turns pale, cyanosis of the triangle appears, hypertension is noted, a feeling of squeezing and fullness in the chest, pain in the sternum; irradiation to the left half of the body; cold sticky sweat, nausea, fear of death. The duration of the spasm is up to 15 minutes; relieved by nitroglycerin.
3. Aortic aneurysm. Severe pain behind the sternum, radiating to the neck, back, stomach; the attack lasts up to several days. It does not depend on the posture; patients note a constant feeling of anxiety.
4. Myocardial infarction is the formation of an area of ​​ischemia in the myocardium with acute hypoxia and necrosis of myocardial cells due to impaired blood supply. The sensations resemble angina pectoris, but are more severe, pulsating, and do not go away after nitrates and at rest; localization behind the sternum, pain in the sternum on the left.
5. Myocarditis is inflammation of the myocardium. The pain is throbbing, persistent; malaise, fatigue, fever, tachycardia and pain when breathing. May resemble MI.
6. Mitral valve prolapse. Mitral valve insufficiency is acquired, often developing after rheumatism; there may be pain in the chest when breathing, palpitations and dizziness; gradually leads to heart failure.
7. Ischemic rupture of the cardiac arteries. Happens very rarely; fatal pathology. When a coronary artery ruptures, a sudden, severe bursting pain appears in the sternum when inhaling, radiating to the neck, back and abdomen.

Spinal pathologies:

1. Osteochondrosis. When the vertebrae are displaced or deformed, pain appears when breathing. They can cause such torment that the patient is forced to remain in one position.
2. Costal chondritis (Tietze syndrome) is an inflammation of the cartilage of the ribs at the edge of the sternum. Develops after injuries, strong blows; dull pain in the chest when breathing, intensifies with the depth of inspiration, upon palpation, fever and cough are possible.
3. Ankylosing spondylitis. Calcium salts accumulate in the ligaments of the spinal column, they destroy nerve endings; The pain here is lifelong, accompanied by shortness of breath.
4. Scheuermann-Mau disease. 1 person out of 100 is sick; pathology begins in adolescence. Leads to the development of kyphosis. The pain is localized between the shoulder blades and appears on inspiration.
5. Osteoporosis - calcium deficiency in bones; At the same time, osteoblasts do not absorb calcium, and it is not integrated into the voids of the bones. The entire spine suffers, it is bent, posture is disturbed, and moderate pain is observed in the thoracic spine when inhaling. Movements are limited due to the fact that the pain intensifies with them. There is also numbness in the limbs and painful asymmetrical points on palpation.

Chest pain may occur if the following gastrointestinal pathologies develop:

1. Gastroesophageal reflux disease (GERD). The stomach throws its contents into the esophagus after eating. This is especially evident when bending over or lying down. Heartburn is almost always present; it is accompanied by a sore throat, pain behind the sternum and in the chest.
2. Narrowing of the esophagus. Chest pain may occur when swallowing. If the pain intensifies over time and no food goes away, this is a symptom of esophageal cancer.
3. Stomach ulcer. Pain when breathing can radiate to the back and sternum. The pain subsides while eating or taking antacids.
4. Hiatal hernia. When the ring is weak, the upper abdomen moves to the lower chest after eating. In this case, a painful sigh and heartburn occur. They always increase if the patient is lying down.
5. Pancreatitis is inflammation of the pancreas. The pain is strong and sharp, pain behind the sternum is often present.
6. Gallbladder problems. Pain may appear in the right hypochondrium and in the lower part of the chest on the right; most often they occur after a fatty meal.

In addition to the above, pain can occur under the following conditions:

1. Intercostal neuralgia. Appears in diseases of the spinal cord, inflammation of the intercostal nerves. Prolonged pain when inhaling throughout the day, it becomes painful to breathe; the pain intensifies when changing position, moving and bending in the painful direction, when touching, palpating, laughing, sneezing, and breathing. The rib muscles are often swollen and enlarged, causing pressure on the nerves. The affected side is very sensitive to the touch. Symptoms can limit the patient's mobility for a long time.
2. MPS (myofascial pain syndrome). The pain is only when inhaling, the muscles are spasmodic and painful when palpated.
3. Rib fractures. Increased pain when coughing and breathing; it is limited to the fracture site. The area is painful on palpation.
4. Chest injuries. Occurs when falling from a height or accident; With bruises, swelling of the soft tissues develops, severe pain appears when inhaling. In case of bruises, an x-ray is required to rule out fractures. With unilateral damage to the ribs, the affected side lags behind when breathing; with rest the pain disappears.
5. Krepatura. After intense physical activity, muscle soreness may appear after some time. This is not a disease, although there is pain when inhaling.
6. Shingles. A disease of infectious origin. With it, pain in the chest appears a few days before the rash.
7. Neoplasms. Lung cancer - acute constant pain when breathing; Pancoast tumor (cancer of the apex of the lung) - the pain is burning, radiating to the upper extremities.

You will need an ambulance if:

• Along with pain in the chest, there are: a feeling of pressure, compression under the sternum, shortness of breath and irradiation to the left arm, lower jaw and scapula;
• present: nausea, dizziness, palpitations, gray skin, cold sweat, drop in blood pressure, weak thread-like pulse, lack of air and loss of consciousness;
• There is no improvement in the condition after taking nitroglycerin, and the duration of pain is more than 20 minutes. This may include chills, a cough with yellow-green mucus, difficulty swallowing, and persistent chest pain.

Diagnostic measures

For diagnosis the following may be prescribed:

• general blood analysis;
• biochemical blood test for markers of infarction;
• culture and analysis of sputum, pleural transudate;
• X-ray of the lungs and spine;
• if oncology is suspected - MRI; CT, ECG;
• Dopplerography of blood vessels;
• gastroscopy.

Treatment and prevention

Treatment depends on the pathology:

• for pulmonary embolism, anticoagulants and surgical removal of the thrombus are prescribed;
• for pneumonia, pleurisy, tracheitis - antibacterial and symptomatic therapy, analgesics, immunostimulants;
• for costochondritis - NSAIDs and physiotherapy;
• for CVD - beta blockers, analgesics, anticoagulants.

Pain when breathing may be a symptom of a serious illness. Therefore, if it does not go away, it is better to consult a doctor. And as a preventive measure - a balanced diet, exercise and quitting smoking and alcohol.

If a pressing pain in the middle of the chest suddenly appears and it’s hard to breathe, this most often indicates heart pathology, although other diseases can also cause this condition.

Eliminating discomfort in the sternum involves, as a primary task, identifying the cause of the mechanism of its development, since treatment directly depends on the disease that provokes the symptoms.

Causes of painful manifestations

The main causes of pain are the following pathological conditions:

1. Angina pectoris. The disease is accompanied by acute pain right in the center of the sternum, which can extend to the shoulder joint of the arm. Pain may occur in the neck or jaw area. Lying down causes the symptoms to worsen, so the patient is advised to sit for a while during an attack.
2. Aortic dissection. An extremely dangerous pathology, often causing death. A characteristic symptom is sharp pain, accompanied by a burning sensation and a feeling of intense pressure on the chest. Pale skin, increased sweating, instability of blood pressure, irregular heart rhythm, fainting are symptoms that indicate the need to urgently call an ambulance.
3. Pulmonary embolism. Blockage of the pulmonary artery is accompanied by aching pain, reminiscent of distension of the chest in the center and radiating to the back. Additional symptoms include arrhythmia, low blood pressure, difficulty breathing, temperature disturbances, and bluish skin. Ignoring such symptoms is fraught with serious complications, including death.
4. Stomach ulcer. Girdle pain is localized in the middle part of the chest, slightly below the chest. The most characteristic symptom is sucking pain that occurs at night.
5. Intercostal neuralgia. The inflammatory process, localized in the muscles, is accompanied by expressive symptoms - muscle discomfort, aggravated by coughing, and chest pain.
6. Osteochondrosis. Destructive changes in the condition of the intervertebral discs in thoracic osteochondrosis provoke pinching of the nerve roots, resulting in constant pain in the sternum, which intensifies with a deep breath.
7. Gastroesophageal reflux pathology. Weakening of the sphincter leads to the reflux of gastric juice or food fragments back into the esophagus, which causes pain due to contraction of the muscles of the esophagus. Pain in the middle of the sternum when inhaling makes it difficult to breathe freely, causing sour belching and heartburn.
8. Panic attacks. Pressing pain in the sternum occurs in overly emotional patients who experience fear. Susceptibility to depressive states, hysteria, and violent reactions to stressful situations is accompanied by a rush of blood to the head, ringing in the ears, confusion and difficulty breathing. Women are more susceptible to panic attacks; they are practically not observed in men.

These diseases should be considered as the most common factors that provoke a complex of negative symptoms, the most expressive of which is pain in the chest in the middle, causing difficulty breathing.

Other reasons

Sensations of compressive girdling pain are characteristic of conditions such as:

• exceeding permissible physical activity;
• taking certain medications;
• scoliosis;
• herniated discs;
• pancreatitis;
• cholelithiasis.

In childhood, the described complex of symptoms is observed in diseases of the upper respiratory tract - pharyngitis, laryngitis, tonsillitis.

Alarming symptoms

The occurrence of discomfort in the sternum, accompanied by a condition in which it is difficult to breathe, indicates the likelihood of the development of a life-threatening pathological process.

Therefore, at the first symptoms, you need to contact a general practitioner or family doctor, who, if necessary, will give a referral to a specialist.

Negative manifestations that require immediate consultation with a specialist:

• sharp pain in the middle of the sternum, accompanied by a burning sensation;
• increase or decrease in blood pressure;
• noise in ears;
• chills;
• dizziness;
• fainting state.

Postponing a visit to the clinic (in emergency situations, calling an ambulance) can cost the patient his life.

First aid

An acute pain attack requires calling a doctor. Before his arrival, it is recommended that you do the following:

1. It is necessary to take a comfortable position that allows you to minimize the onset of pain. It is recommended to sit or lie down and try to breathe more calmly.
2. If you have previously established angina, you should take a Nitroglycerin tablet. The doctor's call is not cancelled.
3. Deviations in blood pressure readings are normalized with the help of medications previously prescribed by the attending physician.

The patient should not be left unattended until medical workers arrive.

You should not rely on the help of folk remedies or drugs recommended by friends, especially if the etiology of the manifestation of negative symptoms is unknown.

Diagnostic features

Due to the fairly large variety of diseases that provoke pain in the chest, there is a need for differentiated diagnosis. Only if the disease that has become the primary source of negative clinical manifestations is identified, the doctor prescribes a therapeutic course of treatment.

Mandatory diagnostic procedures include laboratory and instrumental tests:

• clinical blood and urine analysis;

• electrocardiogram;
• X-ray of the chest area;

Establishing a diagnosis allows you to choose the right treatment tactics.

Treatment

The fundamental principle of therapeutic action is the relief of pain with the subsequent elimination of the disease that has become a provocateur of the pathological condition.

Treatment is prescribed based on the results of a diagnostic examination, taking into account the characteristics of the underlying disease:

1. In case of aortic dissection, there is a need for urgent hospitalization of the patient in the vascular surgery department, where he is administered painkillers. The use of sodium nitroprusside helps stop the process of aortic dissection. The further course of treatment consists of the use of vasodilators, adrenergic blockers and ACE inhibitors.
2. Treatment of angina pectoris is carried out under the supervision of a cardiologist. In addition to Nitroglycerin, which eliminates vasospasm and normalizes blood flow, potassium and magnesium preparations are prescribed. The patient is recommended a course of physiotherapeutic procedures - electrophoresis, laser therapy, magnetic therapy and medicinal baths.
3. Panic attacks, stress, depression require conversations with a psychotherapist or neurologist. Sedative medications are prescribed, one of the representatives of which is Persen. Acupuncture, massage, baths with chamomile, mint or thyme are recommended.
4. Pulmonary embolism. Drastic measures are required with the involvement of a resuscitator and surgeon. Before the embolus is surgically removed, the patient is ventilated and medications are administered to reduce blood clotting.
5. Peptic ulcer disease. The gastroenterologist prescribes antibacterial drugs (Tetracycline, Claricytomin), antihistamines (Nizatidine, Ranitidine). Lansoprazole normalizes the production of hydrochloric acid, Solcoseryl - for ulcer healing. Dietary nutrition is an integral part of the treatment course.
6. Intercostal neuralgia. The neurologist prescribes a course of Clonazepam, Dexamethasone, Prednisone, massage, electrophoresis, and the use of a warming patch.
7. Gastroesophageal reflux pathology. When treating the disease, medications Maalox, Pantoprazole, Cisapride and physiotherapy are used. Diet recommended.
8. Osteochondrosis. The effectiveness of using NSAIDs (Diclofenac, Naklofen), Mydocalm, Actovegin has been observed.

The use of traditional medicine methods for pain in the sternum, causing breathing difficulties, is allowed only as an additional treatment and solely on the recommendation of the attending physician.

Information about diseases and medications used to treat them is provided for informational purposes only. The course of treatment, dosage and frequency of taking medications is prescribed by a highly specialized doctor.

Patients experiencing the described complex of symptoms should not rely on luck and the possibility of eliminating them through self-medication. This approach to the problem will not only not bring relief from the pain syndrome, but may cause the development of irreversible consequences.

Chest pain when inhaling is an alarming sign indicating serious illness. The marked place contains the lungs, the heart - vital organs, and also large vessels - the aorta. Their defeat carries with it dangerous complications and a disappointing outcome. Sometimes chest pain when breathing can be the result of less serious illnesses. But they still need careful attention and a timely diagnosis.

The main causes of chest pain

Only a specialist can determine what is causing chest pain.

Unpleasant manifestations can occur in the following pathological conditions:

• respiratory tract diseases;
• intercostal neuralgia;
• spinal disorders;
• diseases of the cardiovascular system;
• digestive disorders;
• injuries.

To determine the pathology, differential diagnosis will be required. It is performed through a medical examination and additional research. You should not treat such a manifestation yourself, because these symptoms have different diseases and are easily confused.

Classification of pain

Painful sensations when breathing vary in strength, severity, duration and location. To determine the cause, it is rational to analyze by area of ​​placement (right, left, middle).

If the pain is localized:

• on the right – the factor is gastrointestinal disorders, traumatic injuries to the ribs, neoplasms, cardiovascular diseases, respiratory infections;
• on the left – the cause may be hidden in renal colic, oncology, inflammatory processes of the pleura;
• in the middle - you can suspect disorders of the esophagus, diaphragm, lung and heart disease.

When it stings in the area of ​​the heart or in the middle of the chest, you need to consult a specialist. Acute pain requires immediate medical attention.

Pneumonia

A typical expression of pneumonia is inflammation of the lungs, provoked by viruses, bacteria and other pathogenic microbes. It often appears due to weak immunity. The symptoms are as follows:

• chills and sudden increase in body temperature;
• lack of air;
• general malaise;
• chest pain when coughing or breathing heavily.

Accompanied by an intense or moderate cough with sputum production. Therapy should be carried out immediately, otherwise the inflammatory process will provoke dangerous complications in the form of suppuration and pleurisy. The disease predominates in diabetics, the elderly, in patients with pathologies of the heart, bronchi, and after surgery.

Pneumonia is treated comprehensively. The patient is prescribed antibiotics, anti-inflammatory drugs, and expectorants. Additional treatment methods include inhalation, breathing exercises and physiotherapy.

There is a blockage in the arteries that supply blood to the lungs. A factor may be small blood clots moved by bleeding into the organ from the veins of the lower extremities. Blockages can be created by fat particles and tumor cells. Clots in the arteries lead to inflammation, stimulation of the nerve roots of the pleural membrane, hence the pain when inhaling.

Pulmonary embolism is a complex pathology of the respiratory organs that requires immediate treatment. Sometimes the disease goes away without symptoms, creating an even greater health hazard. Acute embolism is a common cause of sudden death.

The symptoms are:

• pain when breathing;
• cough, lack of oxygen;
• hoarseness in the chest;
• temperature increase;
• tachycardia;
• discharge of bloody sputum.

Treatment is carried out with the help of coagulants, and in difficult situations, the blood clot is eliminated through surgery.

Neoplasms in the lungs are much more common than in other organs. The occurrence factors can be irradiation, tuberculosis, etc. The tumor can develop asymptomatically for a long time, which complicates detection at the initial stage. At a late stage, cancer manifests itself as respiratory ailments: pneumonia, bronchitis, influenza.

Symptoms of cancer pathology:

• shortness of breath, rapid heartbeat;
• chest pain when inhaling;
• dry cough with possible prolonged attacks;
• discharge of bloody sputum (advanced form).

These symptoms, including chest pain when breathing, are relieved by anti-inflammatory drugs, but later reappear. If for 1–2 months. attacks of the painful condition appeared several times - this is a clear sign of tumor progression.

Appears as a secondary disease after a tumor, chest injury or pneumonia. – inflammatory process of the serous membrane. Exudate accumulates or fibrinous formations form above the membrane.

The main signs are:

• lack of air;
• malaise, chills;
• pain when inhaling (can be dull or sharp);
• temperature increase;
• burning sensation in the center of the sternum;
• dry cough.

In order to determine the disease, X-rays are performed and a pleural biopsy is performed. Therapeutic measures involve taking antibacterial drugs, immunomodulators, and in rare cases, anti-tuberculosis drugs. Sometimes chemotherapy will be needed.

Pneumothorax

Sometimes pain when breathing is caused by pneumothorax. This is an accumulation of gases or air in the pleural area, causing lung collapse. In the primary form of development, air collects unexpectedly; in the secondary form, it is formed as a result of chronic pathologies.

Symptoms of the pathological condition:

• tightness and pain in the chest;
• panic state;
• impotence, pallor of the skin;
• labored breathing;
• lack of air;
• dry cough.

Primary pneumothorax heals on its own due to minor air accumulation. And if the content is high, it is removed with a syringe or through a drainage tube, since complications are possible leading to cardiac arrest.

You may experience dull, sharp, burning pain in the rib area when breathing. The symptom extends under the shoulder blade, lower back or into the collarbone. Painful attacks appear day and night lasting several hours. This is due to constriction of the nerve roots in the spine.

The following signs are observed:

• chest pain when pressed;
• at the time of the attack, muscle cramps, increased sweating, and tingling in the chest are noticed;
• numbness in the area of ​​pinched nerve endings;
• When sneezing, coughing, or squeezing the chest, the pain intensifies.

The cause of intercostal neuralgia is osteochondrosis, trauma, severe physical stress, and hypothermia. The first symptoms of the disease are often confused with cardiac disorders and are treated inappropriately, thereby aggravating the situation.

Cardiovascular diseases

The greatest danger is caused by pain in the chest caused by heart disease and blood vessels. Acute pathologies (aortic aneurysm, myocardial infarction) pose a significant threat to human life and require emergency care.

The pain is of a compressive nature and is located under the shoulder blade and left arm. The manifestation is intense, lasting approximately 10 minutes. and is accompanied by the following symptoms:

• constant shortness of breath;
• decrease or sharp increase in blood pressure;
• coughing up blood;
• panic fear;
• pale skin, cold sweat;
• arrhythmia, rapid heartbeat.

At the time of auscultation, rhythm changes, noises, and moist rales are heard. The patient's health with heart disease is usually severe.

A painful manifestation on the left or in the middle of the chest is considered the main sign of a heart disease that requires surgical intervention to prevent serious consequences.

Traumatic lesions

Fractures of the ribs and various bruises create pain when breathing or during movement. Symptoms depend on the type and degree of injury.

Signs may include:

• chest deformation;
• hematoma, swelling of soft tissues;
• pain when pressing;
• abrasions, bruises on the skin.

A rib fracture can provoke a violation of the integrity of the lung tissue and pleura, and this can cause hemorrhage and pneumothorax. Movement is difficult and it is painful for the patient to breathe.

Pain when inhaling occurs due to the inflammatory process of cartilage tissue and is localized in the area of ​​​​the junction of the bones of the ribs and sternum. Often the disease disappears spontaneously. The exact factor is not fully known, but even small injuries to the sternum, cartilage damage during surgical interventions, and respiratory infections can cause development.

Symptoms of costochondritis:

• acute pain, aggravated by breathing and sudden turns;
• increased body temperature;
• pain when pressing on the ribs.

Treatment includes anti-inflammatory medications, muscle relaxants, and physical therapy.

Digestive system disorders

In the thoracic region, the only digestive organs are the esophagus. And negative manifestations here are formed in the presence of a diaphragmatic hernia, esophagitis.

When pain occurs in the chest area, other signs are also noticed:

• bloating;
• bowel dysfunction;
• nausea, vomiting;
• feeling of bitterness in the mouth;
• belching, heartburn.

Such symptoms, along with pain, are mainly associated with dietary deviations and are absolutely not caused by breathing or movement. The acute form of manifestation is more intense and may be accompanied by tension in the peritoneal muscles.

Diagnostics

To understand why the chest hurts, additional examinations should be performed. Diagnostic measures involve the following procedures:

• blood and sputum tests;
• gastroscopy;
• electrocardiogram;
• coprogram;
• ultrasound examination of the peritoneal organs, heart;
• examination of pleural fluid;



The list of studies can increase relative to the clinical picture. You will need to consult a gastroenterologist, neurologist, cardiologist, etc. This is the only way to find out the cause of chest pain and prescribe the necessary treatment.

Treatment and prevention of chest pain

Therapy depends on the disease:

• For tracheitis, pneumonia and pleurisy, antibiotics, immunostimulants, and analgesics are used.
• In case of pulmonary embolism, anticoagulants are used and the blood clot is eliminated surgically.
• Heart diseases require the use of analgesics, anticoagulants, and beta blockers.
• Costochondritis requires physical treatment and NSAIDs.



Chest pain when inhaling can occur with a dangerous pathology. Therefore, when the symptom does not go away, it is better to consult a specialist. Preventive measures will include good nutrition, avoidance of bad habits and exercise.