What Are Common Causes of Referred Pain?

Posterior sternum pain, usually refers to pain above the mid-xiphoid process in the anterior area of the sternum. This kind of pain is more common, and there are many reasons for this kind of pain, mainly including:

Pain behind the sternum

Posterior sternum pain is often seen in the clinic. It refers to the pain between the neck and the lower edge of the thorax (middle or side of the chest). The nature of the pain can be various and is one of the common symptoms. It is usually caused by chest disease (including chest wall disease ). After some people experience post-sternal pain, they often suspect coronary heart disease and treat it blindly. In fact, there are many causes of posterior sternum pain. Cardiovascular, pulmonary, mediastinal, esophagus, etc. may be ill. Once the posterior sternum is painful, you should go to the hospital as soon as possible, and confirm the diagnosis with clinical symptoms.

Pathology and Causes of Back Sternal Pain

Posterior sternum pain, usually refers to pain above the mid-xiphoid process in the anterior area of the sternum. This kind of pain is more common, and there are many reasons for this kind of pain, mainly including:

1. Angina pectoris and myocardial infarction: This kind of pain is often paroxysmal and bloating, with obvious chest urgency, and can be pulled or radiated to the shoulder and arm, etc. It is common in the elderly and often accompanied by hypertension ; Physical work, emotional excitement, fullness, alcoholism, cold attacks, strenuous exercise, etc. can all be induced.

2. Viral infection: This kind of chest pain often has precursor symptoms such as throat pain, fever, and loss of appetite, followed by sudden severe sternum pain, which is often exacerbated by coughing, sneezing, and turning the body. The pain often disappears within 3 to 7 days.

3. Mediastinal disease: persistent pain caused by mediastinal tumors compressing local nerves, and may be accompanied by symptoms such as difficulty breathing, hoarseness, and difficulty swallowing. Can also be seen in acute mediastinitis, pain at the same time behind the sternum, accompanied by high fever, chills and other symptoms.

4, esophageal diseases: such as esophagitis, can also cause pain behind the sternum. This pain is often exacerbated when eating or starving, and is accompanied by symptoms such as pantothenic acid, belching, and loss of appetite. ^[1]

Common disorders of sternum pain

Posterior sternum pain is often seen in the clinic. After some people experience post sternum pain, they often suspect that they have coronary heart disease, and blindly treat coronary heart disease. In fact, there are many causes of posterior sternum pain. Here are some of the more common diseases.

1. Angina pectoris: typical symptoms are sudden onset of sternum pain. Typical pain properties are tightening and pressure-like sensations, often accompanied by anxiety and fear, of varying degrees. In severe cases, patients are often forced to stop moving automatically, with pale and sweating. , The pain lasts 1-5 minutes. For angina pectoris, nitroglycerin and nifedipine are delicious. The two drugs are used alternately. Calcium antagonists are the drugs of choice for preventing seizures.

2. Aortic dissection aneurysm: It is a severe cardiovascular emergency in which blood penetrates into the middle layer of the aorta to form a dissection hematoma, and extends and peels along the aorta. The onset of pain is severe tear-like pain, which cannot be relieved with morphine. The pain can affect the head and neck, hind chest, waist, upper limbs and even lower limbs. Although there are shock-like symptoms, blood pressure does not decrease, but rises early in the onset.

3. Pulmonary embolism: When a long-term bedridden patient, venous thrombosis of the lower extremity, pelvic surgery and lower extremity venous surgery, femoral neck fracture, pelvic fracture, chest pain, you should think of this possibility. Chest pain is sometimes severe and sometimes mild. It is often sudden chest pain with hemoptysis, dyspnea, shock, and even arrhythmia.

4. Acute mediastinitis: The pain caused by the disease is posterior sternum pain, which is persistent dull pain and drilling pain, which radiates to the neck or causes ear pain. The pain is exacerbated by swallowing and deep breathing. In addition to the corresponding treatment for the cause, large-dose broad-spectrum antibiotics should be given.

5. Mediastinal emphysema: Mediastinal emphysema is caused by the gas entering the mediastinum and the connective tissue space in the pleura. When the air volume accumulates in the mediastinum and cannot escape, it can compress the large blood vessels in it and cause chest pain, which can be radiated to the neck and shoulders. , Chest pain with shortness of breath, dyspnea, cyanosis, irritability.

6. Acute trachea and bronchitis: Most of them are post-sternum burning and discomfort. Onset often has symptoms of upper respiratory tract infections, such as nasal congestion, runny nose, sneezing, sore throat, etc., which can be accompanied by chills, fever, headache and other body Symptoms and respiratory symptoms such as cough and sputum.

7. Esophageal cancer: The chest pain of this disease manifests as pain behind the sternum or xiphoid when swallowing food, with burning-like, acupuncture-like, or stretch-like pain, accompanied by dysphagia, food retention, and foreign body sensation. A few patients Symptoms such as sternal discomfort, back pain, and belching.

8. Reflux esophagitis: Reflux esophagitis with prominent chest pain without obvious symptoms of gastroesophageal reflux such as acid reflux, belching, heartburn, etc., is prone to long-term misdiagnosis. The chest pain caused by the disease is characterized by lying position, which is easy to develop at night, rest and drinking or eating, but it is reduced after activities. Some people call this disease nighttime chest pain, and the pain symptoms can be alleviated by nitroglycerin.

9. Esophageal hiatal hernia: common symptoms are pain behind the sternum, which is 1/3 below the sternum, and can be radiated to the shoulders and arms. It usually occurs in the supine position, bending over, squatting, coughing, and full meal. The pain is accompanied by burning. With difficulty in swallowing, vomiting, vomiting blood, occasionally major bleeding, etc., the pain and burning sensation will be relieved when sitting, standing or walking. ^[2]

What causes posterior sternum pain?

Posterior sternum pain is often seen in the clinic. After some people experience post sternum pain, they often suspect that they have coronary heart disease, and blindly treat coronary heart disease. In fact, there are many causes of posterior sternum pain, and posterior sternum pain is more common. In addition to coronary heart disease, there are many causes of such pain, mainly: angina pectoris, myocardial infarction, viral infection, mediastinal diseases such as acute mediastinitis, mediastinal emphysema , Esophageal diseases such as esophagitis, esophageal cancer. ^[3]