How to understand that the heart hurts

Diseases of the cardiovascular system are leading among other causes of death. Early diagnosis of these pathologies and timely initiation of treatment can save a person's life, prolong it and improve quality. The symptoms of heart disease are numerous. One of the earliest is pain. If the heart hurts, this symptom is called cardialgia.

How does the heart hurt?

The heart is located in the chest, or more precisely, in the anterior mediastinum. The organ is placed centrally, however, due to the orientation of its axis from right to left, it is customary to talk about left-sided localization. Heart pain mainly occurs in the central part behind the sternum, but can radiate to the left side of the upper trunk.

There is no single characteristic of cardialgia. The localization and intensity of pain may differ in different patients due to the individual pain threshold, the number of receptors of certain types, the presence of concomitant diseases. However, the general parameters of heart pain are well known and doctors are guided by them during the initial diagnosis of diseases (before prescribing an examination).

Localization of pain

Cardialgia is usually localized closer to the central and anterior part of the chest with a slight shift to the left. The pain can be either pinpoint or occur in several places at once. It depends on the features of the topography of the heart and nerve endings in a particular patient. In the case of an abnormal (mirror) location of the organ, the pain will be localized behind the sternum with a shift to the right.


Heart pains localized in the chest are often given to other parts of the body, for example, in the back, shoulder blade, collarbone, shoulder, neck, lower jaw.

Usually, cardialgia radiates to the left side. However, central localization is possible (the pain is felt in the center of the back, spreads like a tie, grabbing the chest, neck, jaw, is felt on the inside of both hands). In rare cases, pain can be detected in the right half of the chest.


Ischemic and cardioneurological disorders are characterized by the concentration of pain in one or more points. Inflammatory processes can manifest as diffuse and extensive painful sensations.

The nature of painful sensations

Chest pains can be stabbing, cutting, aching, burning. However, the features of discomfort cannot be regarded as a specific sign of heart disease, since similar sensations can occur with pathologies of the respiratory or musculoskeletal system. The nature of the pain is important for the cardiologist when drawing up a patient examination plan.

Duration of pain

Ischemic pain is characterized by short duration and periodicity. Acute conditions can provoke prolonged pain from 30 minutes to several days. Weak, aching, constant pains accompany sluggish pathological processes of an inflammatory, dystrophic, and tumor nature.

What is the difference between heart pain and stomach pain?

The heart and stomach are located close, have adjacent innervation, so cardialgia is always differentiated with gastric pains. The following signs indicate a disease of the digestive organ:

  • localization in the upper abdomen, in the area of the xiphoid process of the sternum;

  • the presence of a connection with food intake (sometimes there may not be such a connection);

  • relief of the condition when taking antacid drugs;

  • the presence of concomitant dyspepsia (nausea, heaviness, flatulence, etc.)

  • Confusion may occur if the patient has features of the anatomy of organs. It is possible to understand that the heart hurts, not the stomach, by specific signs (migration of pain, sensitivity to nitroglycerin, cardiac arrhythmias).

When do I need to visit a doctor?

If the pain in the left side of the chest bothers slightly, periodically, does not limit activity and is not accompanied by other external signs of heart disease (shortness of breath, arrhythmia, increased blood pressure), it is worthwhile to visit a doctor as planned and exclude the connection of pain syndrome with cardiovascular pathology. Procrastination is unacceptable in the following situations:

  • localization and irradiation of pain characteristic of a heart attack;

  • rapid increase in pain syndrome;

  • the duration of unpleasant sensations is more than 30 minutes;

  • changing the nature of pain to cutting, unbearable;

  • re-occurrence;

  • concomitant changes in blood pressure or fainting.

  • Such symptoms may indicate an acute problem, so you should immediately call an ambulance.