Heart tingling

Introduction Costal cartilage inflammation, caused by inflammation or injury of costal cartilage, occurs in 20 to 30 women, male to female ratio is 1:9. Most of the lesions are located in the 2nd - 5th costal cartilage of the chest. The 2nd and 3rd costal cartilage are the most common, and can also invade the sternum, the medial and the anterior and posterior rib cartilage. Acute cases can suddenly occur, feeling chest tingling, jumping pain or soreness; those with painful pain are slow onset, and unconsciously make the ribs and costal cartilage junction bow, swelling, dull pain, sometimes radiating to the shoulders and back, sputum Department, neck and chest, sometimes chest tightness, suffocation, pain relief during rest or lying, deep breathing, cough, supine, chest and fatigue, the pain is aggravated. The pain is more limited, and there is a fixed tender point, the lesion rib cartilage bulge. Most women with costal cartilage are treated with breast pain.

Cause

The cause may be related to viral infection or trauma. The course of the disease can last for hours or days, but it can recur, often self-healing within a few months, and can last for several years.

(1) Physical exertion: Excessive fatigue and long-lasting labor.

(2) Full food, drinking and excessive smoking.

(3) Excessive stimulation and excitement of the mental nerves.

(4) severe cardiac insufficiency: unstable angina.

(5) low potassium, hypomagnesemia.

(6) Certain antiarrhythmic drugs.

an examination

Related inspection

M-mode echocardiography (ME) Doppler echocardiogram electrocardiogram

Affected costal cartilage at the chest is dull or sharp, with tenderness and swelling, deep inhalation, coughing or increased pain in the upper limbs of the affected side, sometimes loosening to the shoulders or back. Even unable to lift the arm. But local skin No change; the degree of pain varies, often prolonged and unhealed, affecting the patient's work and study. After the pain disappears, the enlarged costal cartilage may last for months or years. Sometimes, after the tiredness, the pain will also occur. The incidence is urgent and slow.

The pain due to costal cartilage is often transmitted to the breast. Intercostal neuralgia is divided into secondary and primary, including thoracic degeneration, thoracic tuberculosis, thoracic spine injury, thoracic duralitis, tumor, ankylosing spondylitis, etc. The disease may be secondary to intercostal neuralgia; ribs, mediastinum or pleural lesions may be secondary to intercostal neuralgia. Primary intercostal neuralgia is rare. In the onset of intercostal neuralgia, pain can be seen Forward, radiating a semi-annular shape along the corresponding intercostal space; the pain is stinging or burning pain. Pain worsens when coughing, taking a deep breath, or sneezing. The pain is more common in one nerve on one side. Physical examination found that the thoracic spinous process and intercostal space had obvious tenderness; typical patients with root intercostal neuralgia had a positive neck test; the affected nerves often had neurological impairment such as hyperesthesia or hypoesthesia.

Differential diagnosis

Differential diagnosis of heart tingling:

1, unstable angina: unstable angina (acute coronary dysfunction; pre-infarction angina; exacerbatory angina; intermediate syndrome), characterized by progressive increases in angina symptoms, new episodes of rest or nocturnal angina or angina The duration is extended.

2. Pain in the precordial area: Pain in the precordial area is mainly seen in the fibrin exudation stage of inflammatory changes in acute pericarditis. The visceral layer of the pericardium and the inner surface of the parietal layer are painless, and the outer surface of the parietal layer below the fifth or sixth intercostal level has a distribution of pain fibers of the phrenic nerve, so when the lesion spreads to this part of the pericardium or nearby pleura, mediastinum Pain occurs only when you are sick. Pain in the precordial area is often caused by changes in body position, deep breathing, coughing, swallowing, and lying position, especially when lifting the leg or the left lateral position, and reducing it when sitting or leaning forward. Pain is usually limited to the substernal or anterior region of the chest, often radiating to the left shoulder, back, neck or upper abdomen, even to the lower jaw, left forearm and hand radiation.

3, heart and soul pain: People often call the heart and soul pain called stomach cramps, most of the pain in this part comes from stomach and duodenal diseases. In addition to the stomach and duodenum, organs such as the gallbladder, pancreas, left lobe of the liver, common bile duct, and heart are close to or close to the heart, and lesions in these organs can also cause "stomach pain."

Affected costal cartilage at the chest is dull or sharp, with tenderness and swelling, deep inhalation, coughing or increased pain in the upper limbs of the affected side, sometimes loosening to the shoulders or back. Even unable to lift the arm. But local skin No change; the degree of pain varies, often prolonged, affecting the patient's work and study. After the pain disappears, the enlarged costal cartilage may last for months or years. Sometimes, after exertion, the pain will also occur, and the onset is urgent and slow.

The pain due to costal cartilage is often radiated to the breast. Intercostal neuralgia is divided into secondary and primary, and thoracic degeneration, thoracic tuberculosis, thoracic vertebrae injury, thoracic dural meningitis, tumor, ankylosing spondylitis and other diseases can be secondary to intercostal neuralgia; Ribs, mediastinum or pleural lesions are secondary to intercostal neuralgia. Primary intercostal neuralgia is rare. In the onset of intercostal neuralgia, it can be seen that the pain is delayed from the posterior to the posterior, along the corresponding intercostal space; the pain is stinging or burning pain. The pain is aggravated when coughing, deep breathing or sneezing. The pain is more common on one side. Branch nerve. Physical examination found that thoracic spinous process and intercostal space have obvious tenderness; typical root intercostal neuralgia patients, positive neck test; affected nerve distribution area, often have sensory allergy or hypothyroidism and other neurological impairment.

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