There is a logical answer to this question – if your heart hurts, then it is no longer healthy. But in reality, other conditions may be revealed. People who complain to doctors about pains in the heart may often are given an unclear diagnosis – cardialgia or false angina. This term, unless there is strong indication of angina pectoris, usually applies to all types of pain localized to the left of the sternum or anywhere in the left half of the chest.
Human psychology is such that it demands an explanation for any disease a person may suspect having. Knowing perfectly well that the heart is located in the left side of the chest and having only vague understanding of what else could hurt in that area, most people would think that it’s the heart that hurts. This situation is facilitated by the fact that the overall level of common medical knowledge is limited to believing the most dangerous diseases are those of the heart.
Complaints of pains in the heart associated with any type of pain or discomfort in the left side of the chest cause quite a few problems for therapists. Firstly, it is not always easy to find the real cause of such pain as there could be many causes. Secondly, even when the cause has been found and happens to not be as serious as first thought, it is sometimes very difficult to convince the patient that it not a serious condition if he insists in thinking he has a ‘very dangerous’ heart disease. However, the other extreme is also unacceptable. Having read about the development of cardialgia, one should never attempt to diagnose oneself. The causes of such pain, although not cardiac, can be a manifestation of a serious disorder. As well, cardialgia does not rule out the simultaneous progression of coronary artery disease with real attacks of angina pains.
There are many causes of the pains perceived as heart pains. Sometimes, they can be caused by the changes happening in certain organs located near the heart such as:
Chronic Esophagitis (inflammation of the esophagus)
The proximity of the pains caused by esophagitis to the area of the heart, as well as the common innervation of the heart and esophagus, makes such pain indistinguishable from heart pain. It is particularly true when chronic esophagitis is associated with a recurring reflux of gastric acid into the esophagus. The irritation of the inflamed esophageal walls caused by gastric juices may sometimes cause severe pains.
All internal organs are interconnected by neural pathways. Such connections may develop unexpected effects. Patients with gallstones in an inflamed and hyperinflated gallbladder, by simply pressing on the area through the skin of the stomach may provoke sharp pains in the heart. Such pain is called telalgia or referred pain. In some patients it may even appear without pressing. A gallbladder with stones becomes the source of nervous irritation on its own and that can result in referred heart pain. Moreover, cholelithiasis may provoke attacks of real angina pains in patients with coronary artery disease. Again, this confirms the idea that no matter what pains are felt in the area of the heart, one should always seek medical advice. Only a medical specialist can make a determination as to whether or not these pains will prove dangerous for the patient.
Degenerative Processes of the Spine
With regard to referred pains, it is important to point out the major role various nervous control disorders play in the development of cardialgia. Quite often such disorders are associated with the degenerative changes occurring in the spine. At a certain age, usually after 50 years, age-related changes occur and progress within the intervertebral cartilage. Due to trauma or poor posture, such changes may even start at a much younger age. As a result of these degenerative processes in the disks, the distances between vertebrae begin to reduce. This leads to the development of bone growths (osteophytes) on the spine. The result is a situation whereby the nervous roots within the spinal cord start experiencing the pressure of the bone tissue. As well, the blood circulation in the vascular system of the vertebral artery becomes disturbed. The pains caused as a result of this situation are typical in that they are experienced in the left part of the chest and often perceived by patients as heart pains. In the case of an injury or compression of the intercostal nerve provoked by some other reason, a girdle pain spreading in the intercostal space is experienced. This is called intercostal neuralgia and it can also be mistaken for heart pain.
Viral Infection of the Nerve Endings
Viral infections of nerve endings may cause severe pain. The symptoms are well-known – a rash around the lips or small blisters which become crusty. They are sometimes referred to as ‘fever’ blisters. The same viral infection can affect the nerve endings of the intercostal nerve. Besides causing a heart pain, such infection can also harm the heart. The virus can infect the nerve endings not only in the cutaneous branches of the nerve, but also in internal organs, including the heart. Such progression of the infection can lead to the development of arrhythmias and other changes in the ECG.
Discomfort in the heart area may be the result of some general changes happening in the body. Such disorders include a psychosomatic condition called cardioneurosis. This is characterized by pains that do not lead to the development of any organic changes in the heart and do not cause heart failure. Cardioneurosis can develop in puberty. Besides small pains, it causes palpitations and extrasystole. This neurosis disappears as the person gets older. Such cardioneurosis develops due to the changes in the endocrine system occurring during puberty.
Evident changes of the endocrine system occur during another period of human life – menopause. These changes are much more evident in women, although male menopause can be accompanied with cardioneurosis as well. Woman experience a whole range of cardiovascular symptoms during menopause – hot flushes, sweating, palpations, dizziness, etc. Sever pains in the heart that are hard to distinguish from angina attacks may occur with the onset of menopause. These pains can be accompanied with ECG changes similar to those characteristic of some types of myocardial infarction.
Some other causes of cardialgia not mentioned above are pulmonary infarction, vegeto-vascular dystonia (which is most often accompanied by cardioneurosis) and various muscle diseases (inflammatory or dystrophic ones). It should be obvious that it can be quite a task to discover if the causes of perceived pains in the heart. So, can a healthy heart hurt? Yes, it can and it can honestly be in the heart or a perception of the patient. The diagnosis can only be given by a medical specialist.