Lightning pain in chest

Introduction If the chest pain is very short and is like a lightning tingling, most of them are not angina, it is likely to be intercostal neuralgia.

Cause

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.

an examination

Related inspection

Blood routine neurological examination

There was a sting in the chest, although not intense, it felt like a bolt of lightning across the chest. In the intercostal neuralgia of the intercostal neuralgia, it can be seen that the pain is delayed from the posterior to the posterior and 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. Frequent pain in one or several intercostal spaces occurs mostly in the 5-9 intercostal space on the right side. It is sometimes exacerbated, sometimes stimulated by breathing action, and the pain is aggravated by coughing and sneezing. During the examination, the hypersensitivity of the corresponding skin area and the tenderness of the corresponding rib edge can be found. Especially after the intercostal nerve penetrates the intervertebral foramen, the back, chest side wall and front chest piercing are particularly prominent. The angina pectoris is in the left apex, the time is longer, there is a sense of sudden death during the attack, and nitroglycerin can be relieved.

Differential diagnosis

Differential diagnosis of chest lightning pain:

1. Anxiety causes chest pain: symptoms of chest pain due to excessive anxiety. The patient claims that the pain lasts for hours, days, years, or even more than ten years; the entire chest may be painful, usually the patient feels [], [muffy]; at rest, for example, sitting down, lying down, or not working Hands, the patient begins to feel chest discomfort; it does not work at work or during exercise; when the patient sees the doctor sitting down, he is anxious to say a variety of "symptoms": dizziness, sweating, nausea, shortness of breath, fear of heat, fear Cold, hands, feet or lips are paralyzed. I really want the doctor to "go" his illness.

2. Chest pain during inhalation: Chest pain during inhalation is one of the clinical manifestations of chest wall pain.

3, chest pain when exhaling: pleurisy, also known as "pleural inflammation", is inflammation of the pleura. The most common symptom of pleurisy is chest pain. Chest pain often occurs suddenly, and the degree of difference is large. It may be unclear discomfort or severe tingling. It may occur only when the patient takes a deep breath or cough. It may also persist and be exacerbated by deep breathing or coughing.

4, 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 must first identify the oral and pharyngeal bleeding with oral, pharyngeal, nasal 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.

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