Precordial pain

In daily life, many people always experience pain in the precordial area. Sometimes there will be an obvious attack of the disease and cause angina pectoris. Precordial pain is angina pectoris, which is mainly due to damage to the muscle and soft tissue of the heart, coupled with esophageal damage, which will lead to coronary artery sclerosis of the heart, and finally cause myocardial infarction and angina pectoris. The harm is quite large. If not treated in time, it may also involve other organs.

Is precordial pain angina pectoris?

There are many causes of precordial pain, the most common of which are muscle and soft tissue injuries and esophageal acid reflux. The most common serious consequences are angina pectoris and myocardial infarction caused by severe coronary artery disease, rupture of thoracic aortic aneurysm and pulmonary thrombosis. Precordial pain may also occur frequently due to other causes, such as acute pericarditis, pleurisy, pneumonia, etc.

Precordial pain caused by coronary heart disease is often related to activity and fatigue. Symptoms will quickly ease after rest. Sometimes it is accompanied by radiating pain to the neck and shoulders, as well as shortness of breath, dizziness, fatigue and other symptoms. These symptoms should be taken seriously. Especially for males over 45 years old and females over 55 years old, patients with risk factors such as family history, smoking history, hypertension, hyperlipidemia, diabetes, etc. should receive further examination.

There are both non-invasive and invasive examination methods. Your doctor will recommend a specific examination method based on your symptoms, risk factors, and electrocardiogram and blood tests. Noninvasive methods include exercise treadmill, exercise treadmill or drug-induced plus imaging methods, such as exercise or drug echocardiography, exercise or drug nuclear medicine, drug-induced cardiac magnetic resonance imaging, and CT coronary angiography. Each inspection has its advantages and disadvantages. In short, the sensitivity of a single exercise treadmill test is relatively low, 55-60%. Adding imaging methods can significantly improve sensitivity and specificity. Nuclear medicine examinations are widely used, but they involve radiation exposure and should not be repeated too many times.

Cardiac ultrasound is convenient, inexpensive, and does not involve radiation exposure, but it is less sensitive to small areas of ischemia, and image quality is sometimes affected by soft tissue scars, lungs, and obesity. Cardiac MRI offers the highest specificity and sensitivity without radiation exposure, but it has higher technical requirements and is not available in every hospital. Cardiac CT angiography can provide clear coronary artery diagnosis, especially for normal coronary vessels. Once the diagnosis is clear, treatment becomes easier.

The development of thoracic aortic aneurysm is a chronic process. Although diagnostic methods include cardiac magnetic resonance imaging or cardiac CT. Follow-up is also needed to ensure that the growth does not exceed 0.5 cm per year or that the aneurysm is smaller than 5.5 cm, or that the aneurysm is smaller than 4.5-5 cm if the patient has congenital bicuspid aorta or Marfan's syndrome. These are indications for surgical repair.

Pulmonary thrombosis is also a common and high-risk acute disease. An emergency usually caused by a blood clot in the lower limbs that breaks off and travels to the lungs. It is common in patients who have undergone lower limb surgery, have been bedridden for a long time, have tumors, and have abnormal blood coagulation. Chest CT or nuclear medicine plus blood tests and lower extremity ultrasound often provide the diagnosis. Anticoagulation should be started as soon as possible.

Other precordial pains are rarely life threatening. Most precordial pain is nonspecific, such as soft tissue injury and esophageal reflux, and can be treated accordingly.