Cardiogenic chest pain

Introduction When it comes to cardiogenic chest pain, people often think of coronary heart disease, angina pectoris, and even myocardial infarction, which are prone to middle-aged and elderly people. In fact, cardiogenic chest pain is not caused by coronary heart disease. At present, with the acceleration of people's life and work pace, many teenagers often have heart-induced chest pain. For cardiogenic chest pain, whether it is acute or chronic, cardiovascular specialists can correctly identify and give the best treatment. In terms of treatment methods and techniques, there are not much differences between some large cities in China and developed countries.

Cause

Various stimulating factors such as hypoxia, inflammation, muscle tone changes, tumor infiltration, tissue necrosis and physical and chemical factors can stimulate the chest sensory nerve fibers, produce painful impulses, upload to the pain center of the cerebral cortex, cause chest pain, and visceral lesions in the corresponding areas. The afferent nerves on the body surface enter the same stage of the spinal cord and are connected in the posterior horn. Therefore, the visceral sensory impulse can directly stimulate the sensory neurons of the spinal cord surface, causing pain in the corresponding body surface area.

an examination

Related inspection

Electrocardiogram

It is characterized by post-sternal compression pain. The clinical diagnosis can be confirmed by electrocardiogram, myocardial enzymology and coronary angiography. This disease is especially common in women, especially in menopausal women. It is characterized by chest tightness or chest pain. The pain is a little bit, a line, a small piece or a symmetrical pain in the chest and back. It lasts for a few hours or a whole day. It is comfortable to breathe, and it is accompanied by upset, palpitations and sweating. Poor sleep, and even feel that the room air is not enough. In a crowded place, I feel upset and chest tightness. I feel comfortable when I go outdoors or open the window. The seizures are related to emotional stress, stress, and overwork. It is not effective to take nitroglycerin or it takes more than 10 minutes to relieve.

Differential diagnosis

It is characterized by post-sternal compression pain and can be diagnosed clinically by electrocardiogram, myocardial enzymology and coronary angiography.

Differential diagnosis of cardiogenic chest pain:

1, hemoptysis with chest pain: hemoptysis (hemoptysis) refers to the respiratory organs below the throat bleeding through the coughing action from the mouth to discharge hemoptysis first with the mouth, pharynx, nose bleeding identification of oral and pharyngeal bleeding easily observed local bleeding. Most of the nasal bleeding occurs from the anterior nares, and it is often easier to diagnose the hemorrhage in the anterior and posterior septum. Sometimes the amount of bleeding in the back of the nasal cavity is more, can be misdiagnosed as hemoptysis. If you use nasopharyngoscopy to see blood flowing from the posterior nostril along the pharyngeal wall, you can confirm the diagnosis. A large number of hemoptysis must be differentiated from hematemesis (upper gastrointestinal bleeding). The former often has a history of tuberculosis, bronchiectasis, lung cancer, heart disease, etc. Before the bleeding, there is cough, throat itching, chest tightness, and the blood is bright red, mixed with foam. There is no tar-like stool; the latter often has a history of peptic ulcer, liver cirrhosis, etc. Before the bleeding, there is upper abdominal discomfort, nausea and vomiting, etc. The vomiting blood is brownish black or dark red, sometimes bright red, mixed with food residue gastric juice, tar The stool can last for several days after the hematemesis stops.

2, atypical chest pain: atypical chest pain, its chest pain symptoms are not typical, clinical chest pain, chest discomfort is a common symptom, its clinical manifestations vary. Such as stomach pain, neck pain, toothache, sore throat and so on.

3, angina pectoris: Angina pectoris (angina pectoris) is a clinical syndrome of coronary artery insufficiency, myocardial sharp, temporary ischemia and hypoxia caused by paroxysmal chest pain or chest discomfort. It is characterized by paroxysmal chest compression pain, which can be accompanied by other symptoms. The pain is mainly located in the posterior part of the sternum and can be radiated to the anterior and left upper limbs. It often occurs during labor or emotional excitement. ~5min, can be used once a day, or several times a day, rest or disappear after using nitrate ester preparation. The disease is more common in men, most patients are over 40 years old, tired, emotional, full of food, cold, rainy weather, acute circulatory failure are common causes.

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