Painful sensations in the chest occur in almost every person, not inferior in frequency of headache, abdominal pain, as reported by the Internet publication for girls and women from 14 to 35 years old Pannochka. net Complaints of chest pain (BvGr) are quite common in primary medical practice.

Each year, approximately 2% of all outpatient doctor visits are associated with complaints of BvGy.

These statistics rank BvGy among the ten most common problems addressed in primary care.. In Europe, chest pain is the primary reason for doctor visits in 56 out of 1000 adult patients. This is unlikely to seem strange, since vital and richly innervated organs are concentrated in the chest.. The predominantly vegetative innervation of these formations is precisely what causes vague, amorphous pain sensations that are difficult to assess by patients..

The importance of BvGr is that it is a key symptom of several life-threatening diseases that can be recognized and appropriately treated.. Perhaps just as important, most of the chest pain that occurs in primary care practice is caused by conditions that are not life threatening..

Therefore, it is very important to distinguish between dangerous and non-dangerous chest pain.. This is perhaps the most difficult decision-making challenge in primary health care..

The main causes of chest pain:.

- diseases of the musculoskeletal system: costal chondritis, rib fracture;

- cardiovascular diseases (CVD): ischemia of the heart caused by atherosclerosis of the vessels of the heart; unstable / stable angina; cardiac ischemia caused by coronary vasospasm (angina pectoris); mitral valve prolapse syndrome; cardiac arrhythmia; pericarditis.

- gastrointestinal diseases: gastroesophageal reflux, esophageal spasm, stomach and duodenal ulcer, gallbladder disease;

- anxiety states: vague anxiety or \;

- pulmonary diseases: pleurodynia (pleuralgia), acute bronchitis, pneumonia;

- neurological diseases;

- uncharacteristic definite or atypical chest pain.

Chest pain is not limited to a specific age group, but is more common in adults than in children.

The highest percentage is observed among adults over 65 years old, followed by male patients aged 45 to 65 years..

The position of the doctor in the initial interpretation of pain turns out to be no less difficult, when he tries to associate it with the pathology of one or another organ.. The observation of clinicians of the last century helped them formulate assumptions about the pathogenesis of pain - if an attack of pain occurs for no reason and stops on its own, then the pain is probably of a functional nature..

There are few works devoted to the detailed analysis of chest pain.; groupings of pains offered in them are far from perfect. These shortcomings are due to objective difficulties in analyzing the patient's feelings..

The complexity of the interpretation of pain in the chest is also due to the fact that the detected pathology of one or another organ of the chest or musculoskeletal formation does not mean that it is she who is the source of pain; in other words, the identification of a disease does not mean that the cause of the pain is precisely determined..

When evaluating patients with chest pain, the clinician must weigh all relevant options for potential causes of pain, determine when intervention is needed, and choose from a virtually limitless number of diagnostic and therapeutic strategies.. All of this needs to be done while responding to the distress experienced by patients concerned about a life-threatening illness..

The difficulty in diagnosis is further complicated by the fact that chest pain is often a complex interplay of psychological, pathological and psychosocial factors.. This makes it the most common problem in primary care..

When considering chest pain, there are (at least) the following five elements to consider: predisposing factors; characteristics of a pain attack; duration of painful episodes; description of the actual pain; pain relieving factors.

With all the variety of reasons that cause pain in the chest, pain syndromes can be grouped.

The approaches to groupings can be different, but they are mainly built on the nosological or organ principle..

Conventionally, 6 following groups can be distinguished:.

Pain due to heart disease (called heart pain). These pain sensations can be the result of damage or dysfunction of the coronary arteries - coronary artery pain. The " In the future, we will use the terms "

Pain caused by pathology of large vessels (aorta, pulmonary artery and its branches).

Pain caused by pathology of the bronchopulmonary apparatus and pleura.

Pain associated with pathology of the spine, anterior chest wall and muscles of the shoulder girdle.

Pain due to pathology of the mediastinal organs.

Pain associated with diseases of the abdominal organs and pathology of the diaphragm.

Pain is also divided into acute and long-term, with a clear cause and no apparent reason, " Naturally, the first step is to establish whether the pain is dangerous or not.. "

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The main causes of acute BvGy. dangerous to life:.

- cardiac: acute or unstable angina pectoris, myocardial infarction, dissecting aortic aneurysm;

- pulmonary: pulmonary embolism; tension pneumothorax.

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