Chest pain man


Chest pain is very much feared by patients of all age groups - one inevitably associates it with problems with the heart, in the worst case a heart attack. However, chest pain or chest pulling does not always have to be associated with a heart attack; various other, relatively harmless causes can also play a role.

In the case of chest pain, both the emergency doctor and the rescue service always assume the worst, since a heart attack is an absolutely life-threatening complication and must be treated as quickly as possible. If chest pain occurs, it should definitely be taken seriously. Of course, there can be chest pain where the cause can be traced back to a clear event, such as an accident or a sports injury.

You can also read about the causes of chest pain in our article Chest pain.

In all other cases extreme caution is required. If the chest pain also radiates to the left arm, the emergency services should be called immediately. Those affected often wonder which doctor they should contact for an unnecessarily long time. A call to the rescue service with a description of radiating chest pain always results in an emergency doctor being alerted. Even in the preclinical stage, he or she has the necessary means and medication to fight a heart attack.

Causes of chest pain in men

First of all, cardiac causes, such as the heart attack, must be ruled out before fractures or anything else are investigated.

If we consider chest pain in men, we can trace them back to a few large areas. First, the largest, and most important field: cardiac complaints, speaks heart attack, angina pectoris, and general coronary artery disease (CHD). Second, sports injuries and traumatic events - that is, chest pain caused by exogenous factors. And third, psychogenic chest pain, as a result of depression, or psychosis.

The causes of the first area of ​​chest pain in men, cardiac complaints, are typically stress, overexertion, and chronic illnesses. These include, for example, persistent high blood pressure and an unhealthy lifestyle. An unhealthy lifestyle is based on many different factors: obesity, smoking, high blood lipid levels, little exercise, a lot of stress, constant high blood pressure, little sleep, and psychological factors, to name just a few.

Read more on the subject at: Heart pounding

The cause of coronary heart disease (KHKs) is almost always based on the closure of a vessel that supplies the heart. With every beat, the heart not only supplies the entire body with fresh, oxygen-rich blood, but also itself. The oxygen in the blood is required to provide energy for muscle work; it is essential for survival. Without oxygen, muscle cells die, brain tissue perishes, and survival is impossible. It is not for nothing that a motto in emergency medicine is “Provide every cell in the body with as much oxygen as possible”.

If muscle tissue dies on the legs or arms, this is not a problem for the time being. But when you consider that the heart is one big muscle, it quickly becomes clear why an untreated heart attack is always fatal. The less muscle tissue is able to pump the blood into the body's circulation, the less oxygen reaches the heart muscle and the less muscle tissue is in turn able to carry oxygen-rich blood on - a vicious circle.

But how does a heart attack come about, what are the specific causes? High blood lipid levels result in fat deposits in the blood vessels. The doctor speaks of arteriosclerosis. In addition to fat deposits, vascular constrictions can also be caused by thrombi, calcium, and loose connective tissue. Human blood is extremely rigorous when it comes to foreign bodies in the vessels: As soon as something is discovered that does not actually belong in the bloodstream, a blood clot forms around the foreign body.

This actually makes a lot of sense when you think of injuries: after all, it prevents us from bleeding to death from every little thing. In the blood vessels, however, the consequence of this is that small lumps form that are washed away with the flow of blood until they eventually get stuck in a small vessel and then block it.

Such a small vessel can be a coronary artery, for example. Some coronary arteries can still be supplied via collaterals, if these are then also clogged over time, the corresponding supply area is underperfused. Depending on the localization, one speaks of an anterior or posterior wall infarction, depending on whether the anterior or posterior wall of the heart is affected.

This process manifests itself in the person affected by chest pain, shortness of breath, panic, and an accelerated pulse. The patients are scared to death. If the pain disappears again after 1-5 minutes, one speaks of angina pectoris, in German "Chest tightness". It represents a harbinger of a heart attack, a kind of warning shot. Angina pectoris is divided into different stages, depending on whether the pain occurs at rest or when moving.

Many patients always have a small pump spray with them that contains nitrolingual especially for this case. This is a drug that contains the chemical compound "Nitroglycerin“Contains - known as explosives from various war films. The effect of the nitrolingual can be described in a similar way: It "ruptures" closed or cramped blood vessels again, thus ensuring sufficient blood flow to the subsequent vessels. The effect usually occurs within seconds.

For chest pain that is in the area of ​​the heart and possibly radiating from the middle of the chest to the left (see: Chest pain on the left), the following always applies: Do not hesitate, call the emergency services, every second counts. An emergency doctor is automatically alerted. Particular caution is required in women and diabetics, in whom the pain and radiation into the left arm may be completely absent. The second group of chest pain in men is traumatic, or chronic pain. Although a heart attack should never be ruled out in the case of chest pain without prior examination, there are various causes that make other clinical pictures appear more likely.

Intercostal neuralgia

An example of this is intercostal neuralgia: Intercostal neuralgia is a pain syndrome in the intercostal area that typically causes sharp chest pain. The nerves lying between the ribs are compressed by various causes, which results in pain.
Possible factors are irritation of the nerve roots, herniated discs of the thoracic spine, broken ribs, misalignments of the spine, herpes zoster ("Shingles"), Or more rarely: tumors.
Read more on the topic: Intercostal neuralgia

The nerve root compressed in this way causes a sharp, persistent sensation of pain, especially when coughing or when breathing in, which, however, cannot be attributed to a cardiac event. The diagnosis is made by palpating and tapping various pressure points on the chest. If these chest pains, which can clearly be triggered from the outside, cause the diagnosis is relatively clear. Fractures, mainly of the chest, also fall into the same field. While fractures of individual ribs often go unnoticed, rib fractures usually cause severe pain.

These occur after sports injuries or accidents, the cause of the chest pain is then relatively clear. However, you can always have lice and fleas, as the saying goes.

Psychogenic brood pain

A third group are psychogenic brood pains. They are common in men when they are under severe stress or suffer from depression. This type of brooding pain is the most ungrateful for the doctor, as he is walking on thin ice in every respect: On the one hand, there is always the possibility of a misdiagnosis, which the person affected will vehemently claim. On the other hand, one must try to give the patient his dignity, since with the diagnosis "psychogenic"Also always the word"insane“Is associated. However, this is absolutely not the case: A lot of stress, both physical and psychological, can very quickly affect the body. Psychosomatic illnesses are very common and affect all age and occupational groups.

Unfortunately, the term is still unnecessarily shamed in Germany.
The patients also feel that they are not being taken seriously, as they actually experience the pain and also feel great fear. It is important to recognize this illness as such, and possibly to take a step shorter professionally. In the long run, psychosomatic illnesses can of course also lead to manifest, actual illnesses. In any case, a special degree of sensitivity and tactical skill is required on the part of the doctor in order to be able to treat this form of chest pain.


The symptoms of brood pain can be of different types. Some patients feel it when they breathe in, others generally at rest, others only when they are exerted. The Symptoms provide conclusions on the nature of the disease.

Seizure-like chest tightness that disappears after a few minutes can be signs of a Angina pectoris be. Sick pain in the middle, around the entire chest, can result in a Intercostal neuralgia Clues. It is not uncommon for patients to feel fear, and Shortness of breath. A sharp pain across the middle of the chest radiating to the left arm is considered the classic for one Heart attack designated. However, this can also express itself completely differently, especially in women the symptoms are often very different: Some patients also come to the dentist with recurring toothache, whereby it ultimately turns out that the pain originates from the heart.

diabetic feel because of their Polyneuropathy often no pain at all, and are therefore particularly at risk. Rib fractures or bruises are usually caused by a traumatic event, and a cardiac event must not be assumed in the first place. A typical clinical picture of a serial rib fracture is the paradoxical breathing: When you breathe in, the chest retracts instead of expanding due to the thoracic instability. All symptoms have in common that one coronary heart desease should never be completely ruled out by the examiner.


If you have a heart attack, the Patient calms down constricting and tight clothing such as necktie or tight trousers are removed and fresh, cool air is provided. Under no circumstances should the patient be laid down, as otherwise the blood flows from the legs towards the heart and puts additional strain on it. Much more will be a "Upper body high“Position recommended. Does the patient have a pump spray like Nitrolingualthis should be applied immediately.

In addition, the emergency services must be notified immediately, the detour via the treating family doctor costs unnecessarily time. In an emergency, the emergency doctor usually goes to the MONAH- Scheme before: morphine against the pain, Oxygen (oxygen) to saturate the remaining blood in the body as much as possible. Furthermore N for Nitrates, like nitrolingual, to widen the vessels, and ASS plus Heparinto liquefy the blood as quickly as possible.

This is followed by a quick transport to the nearest one CPU (Chest pain unit) and there a further supply of the vascular relocation (usually Cardiac catheterization). In the case of traumatological events, such as sports injuries or neurological problems, there is usually no danger to life.

The therapy takes place by means of Protection, and possibly pain medication for chest pain. A psychosomatic diagnosis is allowed only after excluding all other possible diseases and we are then treated in psychosomatics. However, the cooperation ("Compliance”) Of the patients here relatively low, which makes therapy difficult. In any case, it is advisable to pay attention to a healthy lifestyle with as little stress as possible, if you do not want to accept the therapy concepts of psychosomatic medicine for the moment. After all, success in your job does not bring you anything if you die at a young age.


The diagnosis of a heart attack is usually made by a Electrocardiogram, short EKG posed. This is used to measure the electrical conduction and spread of the excitation to the heart. Emergency doctors recognize it very quickly typical patterns on the EKG, and then initiate appropriate therapy. The diagnosis of intercostal neuralgia is usually made through a physical examination and the triggering of chest pain through various pressure points. The same applies to the diagnosis of rib fractures, which is achieved by simply palpating and roentgen of the chest.


The prophylaxis of sports injuries should be clear to every athlete: In addition to suitable protective clothing and sufficient warm-up, an appropriate level of healthy self-assessment very useful in preventing injuries.

Avoiding heart disease is similarly simple in itself: Lots of exercise, one balanced nutrition, Waiver tobacco, and alcoholso like a healthy body weight contribute to a balanced lifestyle. Excessive stress should be avoided and, if necessary, work needs to be reduced. Your own health should always be a priority! If the family has already had heart disease, a regular one should also be given Medical check-up respectively.