Chest pain in women and men

Together with experts Kirill Kulikov and Tatyana Gavrilova, we discussed what diseases cause chest pain in women and men, what methods of its treatment exist and what preventive measures should be observed at home

Pain in the chest or in medical terminology “thoracology” worries both men and women. Painful sensations are sharp and aching, constant and periodic, on inhalation or exhalation – there are many options. The causes of chest pain in women and men are also very diverse – from pathologies of the musculoskeletal system to cardiovascular and oncological diseases.

We talked to our experts about the most common causes of chest pain. We learned what tests and examinations a doctor can order, and what therapeutic methods are used to treat chest pain.

Physiology of men and women

The chest contains many vital organs: the heart, lungs, esophagus, trachea, bronchi and pleura. Large blood vessels are also located here: the aortic arch and its branches, part of the superior vena cava, pulmonary veins and arteries. In the same area are the ribs and the thoracic spine. The structure of the chest in women and men is not fundamentally different, therefore, the causes of pain in them are identical with one exception. Women may experience pain and discomfort in diseases of the mammary glands – mastopathy and malignant neoplasms.

Causes of chest pain

The most common cause of thoracalgia is the pathology of the organs that are in the chest – the heart, lungs, bronchi. However, it also happens that pain occurs in diseases of other organs and systems, for example, the stomach, gallbladder, pancreas. Depending on the cause, the intensity and localization of pain varies, for example:

pain behind the sternum most often indicates problems with the heart;
pain just below the sternum – “under the spoon” – is characteristic of diseases of the digestive tract;
pain without a clear localization occurs with tuberculosis and lung cancer.

Consider the most common causes of chest pain in women and men. These are pathologies of the heart, blood vessels, lungs, digestive tract, and in women – diseases of the mammary glands.

Coronary artery disease (CHD)

With this disease, the blood supply to the myocardium worsens and the heart begins to experience a lack of oxygen.¹. One of the forms of coronary artery disease is angina pectoris, in which there is pain in the chest during stress and physical exertion.¹. Painful sensations are localized in the sternum, can be given to the left arm, back and lower jaw¹. The pain is accompanied by shortness of breath and a burning sensation and pressure in the chest¹.

Myocardial infarction

In myocardial infarction, some heart muscle cells die from lack of oxygen due to blockage of blood vessels. The larger the area of necrosis, the higher the likelihood of complications and death.². The pain during a heart attack is intense, often accompanied by a feeling of pressure and fullness, as if there is a brick in the chest. The pain is localized behind the sternum, can be given to the left arm, lower jaw and under the shoulder blade². Often accompanied by shortness of breath, decreased blood pressure, feeling of weakness, sweating, loss of consciousness².

Myocarditis

This is an inflammation of the heart muscle, which most often develops against the background of an infectious disease. With myocarditis, patients complain of chest pain, fever and shortness of breath.

Pneumonia

With pneumonia, chest pain appears on the background of coughing and fever. With unilateral pneumonia, the left or right half of the chest hurts. Painful sensations are sharp and aching, aggravated by coughing, accompanied by shortness of breath and weakness.

Pulmonary embolism, or PE

A life-threatening condition that occurs when a pulmonary artery is blocked by a blood clot – a thrombus. Accompanied by chest pain and shortness of breath, may be aggravated by deep breathing and coughing. In patients, the heart rate increases and blood pressure decreases.

Stomach ulcer

Damage to the gastric mucosa provokes bouts of burning pain, which most often occurs after eating³. Painful sensations are localized “under the pit of the stomach” and can be given to the left half of the chest³.

Gastroesophageal reflux

In this condition, the acidic contents of the stomach are “thrown” back into the esophagus. Gastric juice corrodes the mucosa of the esophagus, which causes heartburn, belching and severe pain “under the spoon” and in the left side of the chest. Attacks often begin after a large dinner or a large amount of coffee drunk.

Intercostal neuralgia

A very common condition that develops when the intercostal nerves are damaged due to inflammation, infringement, and other reasons. Pain in intercostal neuralgia is most often acute, encircling, spreading from the spine to the sternum. Pain is very strong and resembles an electric shock. Attacks of pain last from a few seconds to 2-3 minutes.

disease of the breast

The growth of connective tissue in the mammary gland can cause painful sensations of varying intensity, which are localized in different parts of the mammary glands and can radiate to the chest area⁴.

Treating chest pain

The expression “treatment of chest pain” is not entirely correct. Doctors are treating the disease that provoked thoracalgia. Adequate therapy can stop the progression of the disease, prevent complications and eliminate associated symptoms, including chest pain. Treatment begins with a comprehensive diagnosis.

Diagnostics

The first stage of diagnosis is inspection. The doctor listens to the patient’s complaints, checks the condition of the internal organs, measures blood pressure and heart rate. When making a preliminary diagnosis, the age and gender of the patient are taken into account. For example, in girls and women, chest pain is very rarely associated with heart disease. In middle-aged and elderly men, on the contrary, the coronary origin of thoracalgia is primarily excluded or confirmed.

Based on the results of the examination, the doctor draws up an examination plan, which may include:

electrocardiography – to exclude or confirm heart pathologies;
echocardiography, which allows you to assess the contractility of the heart muscle and the condition of the valves;
Holter monitoring – to clarify the diagnosis in case of suspected arrhythmia, coronary artery disease and other cardiac pathologies;
radiography – to assess the condition of the lungs
Ultrasound of the abdominal cavity – to identify or exclude pathologies of the pancreas, stomach, gallbladder;
gastroscopy – with suspicion of diseases of the stomach and esophagus;
mammography and ultrasound of the mammary glands – for the diagnosis of cysts, mastopathy, malignant tumors.

In addition, the patient takes a general and biochemical blood test. In the analyzes, you can detect signs of an inflammatory process, pathologies of the myocardium, liver and biliary system. The list may include other studies, such as a biopsy for suspected cancer.

Modern treatments

Treatment for chest pain is selected depending on the nature and stage of the disease that caused unpleasant symptoms. In emergencies, such as myocardial infarction or PE, intensive care and surgery are required. Most diseases are treated with conservative therapy.

Patients are prescribed drugs from the following groups:

nonsteroidal anti-inflammatory drugs;
antianginal drugs;
thrombolytics;
antacids;
antibiotics;
preparations of female sex hormones;
cytostatics;
analgesics, including narcotics.

In addition to drug therapy, other methods of treatment are also used. With intercostal neuralgia, physiotherapy exercises and manual therapy sessions help well. With pathologies of the gastrointestinal tract, spa treatment and physiotherapy can be prescribed.

Prevention of chest pain at home

The best prevention of chest pain will be a healthy lifestyle – a normal daily routine, proper nutrition, moderate exercise, and the rejection of bad habits. It is recommended to undergo an annual medical examination in order to diagnose the disease in a timely manner and begin treatment.