Neuralgia in the Heart Area and Cardialgia: What's the Difference

A stabbing pain on the left side of your chest — and you're already googling "heart." Calm down: most chest pain is not related to the heart, and some of it is of nervous origin entirely. Let's sort out what cardialgia and neuralgia in the heart area are, how they differ, and which numbers and examinations actually help.

What cardialgia and neuralgia in the heart area are

Cardialgia is the term for pain in the heart area; the causes of such pain vary, and in most cases chest pain is not related to the heart. Neuralgia is damage to peripheral nerves with attacks of pain in the innervation zone of a specific nerve; it involves no motor disturbances or loss of sensation, and no structural changes are found in the nerve. The sources describe intercostal neuralgia rather than a separate "neuralgia of the heart." A separate scenario is intercostal neuralgia: severe pain in the rib area that worsens with coughing or sneezing and is most often associated with thoracic spine osteochondrosis.

Symptoms of neuralgia in the heart area

Pain in neuralgia is paroxysmal, accompanied by autonomic-vascular disturbances (skin redness, lacrimation) and sometimes a painful tic — local muscle cramps. In other cases the pain becomes continuous and resolves only after a painkiller. For comparison: pericarditis usually produces sudden acute stabbing pain that worsens with a deep breath or in a lying position. And pain from a strain or overexertion of the chest muscles starts after chest trauma or strain on the chest muscles, worsens on inhalation and eases at rest.

How pain of nervous origin differs from cardiac pain

The key reference point is the link to movement and breathing. Intercostal neuralgia worsens with coughing and sneezing; pain from strained chest muscles may worsen on inhalation and eases at rest; pericarditis worsens with a deep breath and in a lying position. A panic or anxiety attack often produces acute continuous pain against a background of agitation, rapid heartbeat, sweating, dizziness. Myth: "a stabbing pain on the left — that's the heart." Fact: in most cases chest pain is not caused by heart problems.

What causes of pain in the left half of the chest are possible

• Nervous and muscular causes: intercostal neuralgia, strained chest muscles, costochondritis — inflammation of the joints of the rib cage.
• Digestive: heartburn and reflux — pain starts after eating, with belching and a feeling of fullness.
• Pulmonary: pneumonia, pleurisy, pulmonary embolism.
• Psychogenic: anxiety, depression, panic attack.
• Cardiac: pericarditis, angina and heart attack — the latter have similar symptoms, but a heart attack is life-threatening.

Which examinations help to sort it out

The doctor assesses how the pain manifests and may order stress tests. The risk of heart problems is higher in older people and with risk factors for coronary artery disease: smoking, obesity, high blood pressure, diabetes, high cholesterol, a family history of heart attacks or angina in relatives under 60.

When chest pain requires emergency help

Stabbing pain on its own is not a reason to call an ambulance. Call 103 or 112 if the chest pain is sudden and does not go away, feels like squeezing or pressure; radiates to the left or right arm, neck, jaw, abdomen or back; is accompanied by sweating, nausea, dizziness or shortness of breath.

If the pain comes and goes or passes quickly but bothers you, a doctor's consultation is needed. This material is for reference and does not replace a doctor's consultation — the numbers and symptoms help you orient yourself, but the diagnosis is made by a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer