Heartache - causes and therapy

Heartache - causes and therapy

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Heartache is a serious symptom in any case. As a vital hollow muscle organ, the heart secures blood circulation and sufficient blood flow to all organs through rhythmic contractions. Cardiac dysfunction, which can have serious to life-threatening health consequences, often manifests itself in heart pain. However, supposed heart pain can also result from tension, which is far less dangerous.

Heartache - brief overview

The spectrum of possible causes of heart pain is wide and it can certainly be a medical emergency, in which the emergency services must be contacted immediately. A quick summary of the complaints in advance:

  • Contact emergency callif heart pain suddenly occurs, gets worse, symptoms such as tightness in the chest, radiating pain in the left arm, sudden shortness of breath, sweating, abdominal pain, nausea, vomiting, impaired consciousness or fainting and fear of death are added!
  • causes: Diseases of the cardiovascular system such as high blood pressure (hypertension), coronary artery disease, cardiac arrhythmia, inflammation of the inner skin of the heart (endocarditis), pericarditis (inflammation of the pericardium), heart muscle inflammation (myocarditis), heart valve defects, heart weakness, heart attack; psychological causes (broken heart syndrome, heart neurosis) and various diseases that cause chest pain, which can be erroneously attributed to the heart.
  • diagnosis: Medical history with questions about intensity, location, duration of heart pain, the time of first appearance and existing medical conditions; Blood pressure measurement and eavesdropping on the chest with a stethoscope. Depending on requirements, blood tests, EKG (electrocardiogram), echocardiography, stress echocardiography, chest X-rays, computed tomography, magnetic resonance imaging, coronary angiography and various other examination methods follow.
  • treatment: depending on the causes, often with special medication, possibly heart operations, also psychotherapy for psychologically related complaints.
  • Naturopathy and holistic medicine: against psychological heart problems medicinal plants such as hawthorn flowers and valerian root, biofeedback, hypnosis therapy, relaxation methods such as yoga or autogenic training, exercise therapy to alleviate the symptoms and prevent heart diseases.

Different forms of heartache

Heartache is often a sign of serious health risks and should therefore be examined urgently by a doctor. A cardiologist can usually determine the cardiovascular causes of the symptoms relatively clearly and initiate appropriate countermeasures.

Today it is clear that the colloquial mental ailments, for example after a breakup or a heartache, can actually lead to heart problems in the form of broken heart syndrome, which is why psychological triggers of the symptoms are also considered in this article. This also includes functional heart pains, which in medical practice represent a relatively frequently described symptoms, to which the so-called cardiac neuroses are primarily assigned.

A distinction from heart pain in the true sense is chest pain that does not originate directly in the heart. The chest pain can also indicate a disturbance in lung function and occasionally diaphragmatic cramps are also perceived by those affected as a kind of heart prick. The so-called reflux, in which gastric acid flows back into the esophagus, is often perceived as a prick in the chest, so that those affected easily think of a heart disease. In addition, the more superficial pain in a broken rib is sometimes confused with heart pain. The same applies to nerve irritation, muscle tension, inflammation of the esophagus, inflammation of the stomach (gastritis), tracheitis, inflammation of the diaphragm, an aortic aneurysm and various other diseases such as the so-called Tietze syndrome - a painful swelling in the area of ​​the sternum.

Symptoms of heart pain

Heart pain is usually expressed as a pulling, painful feeling of pressure, burning or stinging in the chest. Since the symptoms can be signs of a serious illness, medical help should be urgently requested at the latest if they occur repeatedly. In any case, most of those affected by cardiac pain are sensitized and ready to see a doctor early because they fear a heart attack or similar serious health problems.

Important: If, in addition to the heart pain, other symptoms such as radiating pain in the left arm, sudden shortness of breath, profuse sweating, tightness in the chest, shortness of breath, nausea and vomiting, impaired consciousness or fainting and fear of death should be contacted immediately. Until it arrives, first aid with cardiac massage should be provided.


The original heart pain is based on diseases of the heart or cardiovascular system, which in most cases require medical care for those affected. For example, coronary heart disease (CHD), myocarditis and heart attacks are mentioned in the specialist literature as causes of cardiac pain.

Direct heart pain can be clearly distinguished from general chest pain (chest), the cause of which can also be other diseases such as pulmonary dysfunction, pulmonary embolism, muscle tension, diaphragmatic cramps, esophageal disorders (e.g. reflux or movement disorders of the esophagus), gastric mucosal inflammation, spine or joint problems . It is often difficult for those affected to make the distinction, since when the patient pulls, stabs or feels pressure in the chest, inevitably they think of complaints from the heart, but with medical support, the actual heart pain can usually be distinguished relatively clearly from other chest pain.

Due to the subjective perception of heart pain, diagnosis can sometimes be made significantly more difficult. If no physical illnesses can be identified as the cause of the heart pain, even though those affected obviously suffer from severe symptoms and fear a heart attack, a so-called cardiac neurosis (cardiophobia) or a broken heart syndrome may also trigger the heart pain. Here, the fear of a threatening heart disease or a heart attack causes even functional disorders of the cardiovascular and respiratory system, which can manifest itself as pain in the chest area.

Cardiovascular diseases as the cause

The physical causes of heart pain include numerous diseases of the cardiovascular system such as high blood pressure (hypertension), coronary heart disease or cardiac arrhythmias. Heart pain can also be caused by inflammation of the inner lining of the heart (endocarditis), pericarditis (inflammation of the pericardium), inflammation of the heart muscle (myocarditis), heart valve defects, aneurysms (enlargement of the arteries) and heart failure. In addition, an acute life-threatening heart attack can be the cause of the heart pain, in which case there is often considerable inner restlessness, massive nausea, sweating and shortness of breath. Heart pain should always be examined by a specialist and emergency medical services urgently contacted if a heart attack is suspected.

If a CHD is already known to trigger the complaint in the affected person, the corresponding emergency medication should be taken immediately at the first signs in order to avoid an expansion of the symptoms. In the case of angina pectoris, this would be, for example, nitroglycerin sprays or capsules, which are prescribed to those affected by a doctor. If possible, the nitroglycerin preparations should always be carried as emergency medication. However, if the medication shows no effect, this condition is called unstable angina pectoris, which can also be assessed as a possible sign of a heart attack. The complaints should therefore be taken extremely seriously and the emergency services should be alerted immediately. There may also be signs of unstable angina pectoris or a heart attack if the symptoms appear for the first time during exercise, become worse / more frequent, do not decrease even when at rest and differ in intensity or location from known heart pains.

Heartache from mental stress

Those affected who experience heart pain due to special mental stress usually describe very clear physical symptoms such as a pulling, stinging and tightness in the chest, which may also radiate into the back, abdomen, arms and shoulders (mostly on the left). In addition, the heart pain is often accompanied by stumbling, rapid heartbeat and shortness of breath. It is not uncommon for those affected to experience fear of death due to the symptoms, although the symptoms often intensify in the course of panic-like fear.

A special form of heart complaint due to psychological stress is broken heart syndrome, which usually occurs after special stressful situations such as the loss of a close person and is expressed on the ECG or in laboratory tests similar to a heart attack. It is therefore entirely justified that heartache and emotional distress are often referred to as heartache. Because the psychological problems can actually bring about organic complaints in the area of ​​the heart.


In addition to the immediate measures that must be taken, for example, in the case of heart pain due to an unstable angina pectoris or a heart attack, those affected should undergo long-term therapeutic treatment that addresses the causes of the heart pain. However, a precise medical diagnosis is imperative for this. The question of the intensity, location and duration of heart pain is at the beginning of the diagnosis. In addition, blood is drawn from the affected person for the laboratory examination, because this way, for example, the typical enzymes for a heart attack (cardiac enzymes) and possible inflammations in the area of ​​the heart can be determined.

Those affected are usually examined with the help of an electrocardiogram (EKG) in order to rule out the diagnosis of a heart attack as the cause of the heart pain or, in the worst case, to confirm it. The exercise ECG, which records the cardiac parameters under stress, a long-term ECG and ultrasound examinations of the heart, serve as further examination methods. Special computer tomography (CT) and magnetic resonance imaging (MRI) procedures can also be used to determine the causes of heart pain. In addition, X-ray examination of the coronary arteries and positron emission tomography (PET) offer further options for diagnosis.

Heartache in young people

Overall, heart pain is not uncommon, but it is far from being associated with serious illnesses. Persistent stress and emotional stress are considered a general risk factor for the occurrence of heart problems regardless of age. Today, adolescents also suffer more frequently from diseases such as cardiac arrhythmias, which can trigger the symptoms. In addition, an excessive lifestyle with excessive alcohol, tobacco or drug use is often the cause of the complaints in young people, while in the elderly cardiovascular diseases, vascular diseases and heart diseases are the cause of the heart pain.

Treatment of heart pain

Depending on what causes the heart pain in the course of the examinations, different therapeutic approaches are available to combat the complaints. Depending on the underlying diseases, certain medications are used to treat heart pain, for example, although these must be explicitly coordinated with the respective complaints.

For example, while the nitroglycerin preparations are used for angina pectoris, frequency regulating and stabilizing drugs such as adenosine, ajmaline, atropine, or so-called beta blockers are used for cardiac arrhythmia, but their use is not without controversy. If inflammation in the heart area, such as bacterial endocarditis, is the cause of the pain, it is usually treated with antibiotics.

For various other causes of cardiac pain, such as heart valve defects, aneurysms or aortic dissections (rupture of the aorta), surgical interventions on the heart or emergency operations may be required.

As part of long-term treatment or prevention, avoiding risk factors for heart diseases such as alcohol or tobacco consumption, unhealthy nutrition and obesity also play an important role. Those affected are often asked to clearly change their lifestyle in order to avoid the occurrence of heart pain in the long term. A balanced diet, the avoidance of alcohol and tobacco as well as sufficient physical activity are recommended in particular to patients in whom cardiovascular diseases are the cause of the heart pain.

Treatment for psychological causes

Not all causes of heart pain can be remedied by conventional therapeutic measures. This applies in particular to the psychological complaints such as the so-called heart neuroses. For example, the psychologically related heart pain often requires a different approach to therapy. In the case of cardiac neuroses, for example, psychotherapy is an essential element of treatment.

In the so-called "broken heart syndrome", anti-anxiety and stress-reducing drugs are also used, since it is suspected that an excess of stress hormones is responsible for the symptoms. Stress avoidance or coping strategies can help to alleviate and prevent heart pain.

Naturopathy and holistic medicine

Naturopathic procedures can be used to treat chest pain in particular, which is not due to an immediate heart disease. For example, osteopathy and Rolfing can mechanically improve the movement in the chest area in order to counteract muscle tension and the so-called Tietze syndrome.

The entire body and its statics are included in the treatment. The chest and its structures are placed in relation to the rest of the body as part of the therapy and the distribution of tension in the organism is analyzed. At this point, for example, osteopathy also takes into account complaints that occur in addition to the heart pain, such as TMJ problems, back pain, foot pain or other joint problems.

Heartache caused by psychological complaints can in turn respond positively to regular use of medicinal plant formulations that calm the vegetative nervous system and at the same time have a cardiac strengthening effect. At this point, for example, herbal tea made from hawthorn blossoms, valerian root, lemon balm, rosemary leaves and arnica blossoms are used to treat the psychologically related heartache in a naturopathic way. The ritual of preparation alone and the associated time-outs often already calm the nervous system.

In addition, ointments with similar ingredients are used for external use, whereby regular rubbing should also have a calming effect. Homeopathic remedies are also used in low potencies for the holistic treatment of psychologically related heart pains, preferably Coffea (coffee), Convallaria (lily of the valley) or Valeriana (valerian). In addition, the so-called biofeedback method is used to positively influence the psychological complaints. Breathing techniques, imagination, meditation or inner suggestions are used to tackle the symptoms.

If there is a suspicion of underlying psychological problems as the cause of the heart pain, these can also be worked up with the help of modern hypnotherapy. Furthermore, relaxation methods such as yoga or autogenic training are well-suited methods against stress, which can help alleviate the symptoms and prevent new heart pains.

Last but not least, exercise therapy or sport can also be an important part of treatment and today special training programs are often offered for this purpose. Strengthening the heart through heart training is the motto here. However, you must urgently consult a doctor before starting training in order to weigh up possible risks and adjust the exercises if necessary. (fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters


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