The thorax is a very large area which can therefore be the site of numerous pathologies which can have very varied origins. They can affect organs such as the lungs, the heart or the liver, affect the ribs or the esophagus, and have a digestive or cardiac origin. Chest pain is not trivial and should be taken seriously.
Or se find THE thorax ?
On a daily basis, when we talk about the thorax, we tend to talk about the chest. The thorax is an area of the body located between the first and twelfth vertebra. It includes the ribs (we have 24, or 12 pairs of ribs), the rib cage (which contains the heart, lungs, esophagus, etc.) and the sternum (this is the flat bone that can be touched in the middle of the chest, between the breasts.)
Chest pain, watch out for myocardial infarction
Chest pain is the first warning signal of myocardial infarction, a complication of coronary artery disease.
The pain is sudden and gradually increases in intensity. It is located in the middle of the thorax, behind the sternum, and is accompanied by a feeling of intense oppression. It can radiate to the jaws, the shoulder, the arms (the left arm but not only) and even the wrists. “It may be associated with intense fatigue, sweating, paleness, shortness of breath, palpitations, malaise, a feeling of imminent death, or even digestive signs: nausea and vomiting. The symptoms vary depending on the individual and are often atypical in women in whom respiratory and digestive symptoms are frequently at the forefront..”, also specifies the French Federation of Cardiology.
What should be done ? as soon as you suspect a myocardial infarction – or as soon as chest pain appears suddenly, at rest – it is essential to call for help: call 112 (European number) or 15 (for SAMU). We must act as quickly as possible, rapid support is crucial.
What can cause chest pain?
Fortunately, chest pain is not always caused by a heart attack. Other pathologies may be involved.
Chest pain: rib fracture
It’s what ? Rib fractures are the most common chest trauma: very painful, fortunately they are not serious. It can be linked to a shock (a fall against the corner of a table or against a sink, an elbow to the chest, a traffic accident, etc.), to a disease that weakens the bones (osteoporosis, for example). ) or even a simple sneeze, or even a simple cough.
The pain is well localized on a “point” or on an “area”, and manifests itself in particular when you inhale as much as possible. The person has difficulty raising their arms, and we sometimes observe difficulty breathing (dyspnea).
What should be done ? You make an appointment (without emergency) with your doctor who will prescribe a chest x-ray as well as analgesic medication to calm the pain. This generally disappears within 3 weeks / 1 month. You have to be patient.
Chest pain: intercostal pain may be the cause
Intercostal pain, also called intercostal neuralgia, is damage or inflammation of one of the intercostal nerves. The pain is localized between the ribs, intense, and aggravated by breathing, coughing or sneezing. In some cases, this intercostal pain can have a muscular origin.
Chest pain: gastroesophageal reflux
It’s what ? Gastroesophageal reflux (which corresponds to inflammation of the esophagus, caused by a rise in acidic stomach contents) can cause retrosternal pain, mainly on the left side of the body.
Retrosternal pain “burns” and is linked to meals: it can be aggravated or relieved by eating. You may also notice an unpleasant taste in the mouth.
What should be done ? If the retrosternal pain is accompanied by fever and/or blood in the stools, it is essential to urgently consult your doctor or go to the hospital. If retrosternal chest pain is recurrent, it may be wise to make an appointment (without emergency) with your doctor.
Referred chest pain: a possible digestive cause
There chest pain is also a symptom of appendicitis (characterized by cramp-like pain under the ribs on the right), peptic ulcer (pain feels like a feeling of hunger above the navel) or even acute cholecystitis (there is fever, liver pain and nausea). We then speak of “referred pain”.
Chest pain: the liver may be responsible
It’s what ? Chest pain can also indicate the presence of a liver disorder – that is to say: a liver problem. Thus, after a meal that is too copious, we can suffer from a “liver attack”: we have pain just under the ribs, on the right side of the body, we feel “heavy”, we have a headache, we feel tired, we feel nauseous…
What should be done ? We wait for it to pass (around 3 – 4 hours). If the pain persists, make an appointment quickly with your doctor.
Attention : if the chest pain (located at the level of the liver: under the ribs, to the right of the body) is accompanied by yellowing of the white of the eye and/or the skin of the face, you must go to the Emergency Department or to the doctor as quickly as possible: it could be cirrhosis or hepatitis!
To know : chest pain can reveal the presence of hepatic colic (if the pain is similar to a “stab” in the liver, possibly with vomiting) or even a pancreatic disease (pancreatitis may be suspected acute in case of “stabbing” pain under the ribs, in the middle, with fever and/or nausea).
Chest pain, stress, feeling of oppression: what if it was an anxiety attack?
It is not uncommon for stress or anxiety to cause a feeling of tightness in the chest, difficulty breathing or even real pain in the chest.
How do you know if it’s muscle or heart pain?
It is not always easy to identify the origin of chest pain. We must therefore be attentive to the associated symptoms but also to the context in which this pain appears. Sudden, intense pain accompanied by a feeling of tightness in the chest requires urgent consultation to rule out a myocardial infarction.
thanks to Adrien Ezineosteopath in Bry-sur-Marne (94).
Read also :
⋙ Liver diseases: how to identify that a liver is diseased?
⋙ Chest pain, stomach aches… Urgent or not?
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