Heart bites - heart bites: causes, symptoms and treatment

Heart bites - heart bites: causes, symptoms and treatment

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Heart bites are an extremely unpleasant symptom, which makes many sufferers think of a heart attack and brings with it the corresponding fear of death. Often, however, the heart stitches are an otherwise justified stinging in the chest. For example, muscle tension, diaphragmatic cramps, esophageal diseases or gastric mucosal inflammation can be behind the supposed heart pain. If the heart bites last for a longer period and are accompanied by radiating pain in the arms, upper abdomen or back, however, an emergency doctor should be contacted in any case, since in the worst case a heart attack can trigger the symptoms.


Severe stinging pains in the chest area are to be understood as heart stitches. In the narrower sense, the term refers exclusively to pain in the immediate heart region, i.e. at the level of the second to fifth rib directly behind the breastbone. However, those affected often cannot narrow their complaints so precisely, which is why the terms heart beats are used colloquially for a relatively wide range of chest pain.


Heart sting usually occurs as suddenly as it disappears. Those affected experience severe pain, which often subsides after a few seconds. If the heart bites persist for a long time (over several minutes), this should be seen as a possible indication of a more serious underlying illness. However, a heart attack does not necessarily have to be behind the symptoms.

If the heart bites are regularly observed under physical exertion, however, there is a suspicion of a heart disease. In general, the accompanying symptoms, which are then described in more detail in connection with the triggers of the stinging, provide important clues to the underlying underlying diseases.

Causes of the heart bites

Numerous different causes can be considered as triggering the heart bites. The spectrum ranges from rather harmless muscle tension and diaphragmatic cramps to diseases of the esophagus and disorders of the lung function up to potentially life-threatening impairments of the heart function.

Heart disease

Most of those affected automatically think of a heart disease when they have a heart prick. Not without reason, because numerous diseases of the heart are accompanied by a prick in the chest. Coronary artery disease (mostly caused by hardening of the arteries), inflammation of the pericardium (pericarditis), inflammation of the inner skin of the heart (endocarditis) and the heart muscle (myocarditis) can be mentioned here, for example. Heart valve defects and aneurysms (arterial dilation) can cause massive heart bites. The same applies to general heart failure (heart failure).

The unpleasant stinging of heart diseases is often accompanied by extreme tightness in the chest (angina pectoris), heart stumbling or cardiac arrhythmias and rapid heartbeat. If the heart pain lasts longer than 20 minutes and is accompanied by radiating pain in the arms, shoulder blade pain, abdominal pain or back pain as well as nausea, shortness of breath and sweating, this can indicate a heart attack and an emergency doctor should be alerted immediately.

Heart bites and other heart problems can also occur without a physical cause. In such a case, the technical term is “functional heart problems”. These can be observed, for example, in the context of a so-called cardiac neurosis (cardiophobia), in which the fear of a life-threatening heart disease or a heart attack alone leads to functional disorders of the cardiovascular and respiratory system. This in turn can cause chest pain or chest pressure.

Other causes of cardiac stinging

The esophagus lies immediately behind the heart. If this is inflamed (esophagitis), the patient suffers from so-called reflux (reflux of gastric acid into the esophagus) or achalasia (movement disorders of the esophagus). As a result, there may be a burning sensation in the chest and pain, which the affected person assigns to the heart. The same applies to a limited extent to gastritis (inflammation of the stomach).

Tension in the muscles in the chest area should also be mentioned as a possible cause of chest pain, which in turn is interpreted by many of those affected as heart bites.

The so-called Tietze syndrome describes a painful swelling of the sternum base of the ribs. In this case, the pain can be triggered by pressure on the swelling and is relatively easy to differentiate from the actual heart bites, since externally a swelling and reddening is visible.

Other possible triggers of chest pain, which are perceived as heart stinging, are pulmonary embolism and disturbances in breathing regulation (e.g. hyperventilation). If the pain in the chest area is sharp, this can be a symptom of the so-called intercostal neuralgia. This nerve pain along the intercostal nerves usually increases when coughing or laughing and is usually due to a disease of the lungs, pleura, ribs or spine.


As a rule, the actual heart bites can be differentiated relatively quickly from other forms of chest pain in the course of a medical examination. Pulse measurements, blood pressure measurements, a eavesdropping on the chest and an electrocardiogram (ECG), which is started immediately if a heart attack is suspected, can provide information about possibly more serious diseases of the heart.

Although there are often significant changes in cardiac function in the event of an infarction on the ECG, a blood test is required here for a reliable diagnosis in case of doubt. However, this can only be carried out a few hours after the actual event. So-called echocardiography (ultrasound examination of the heart) can also provide important clues for diagnosing heart complaints and is often used in emergency medicine to suspect a heart attack to assess the risk until a clear finding is available.

Eavesdropping on the chest often allows conclusions to be drawn about existing diseases of the respiratory tract. If there is suspicion of pulmonary embolism, further examinations using modern imaging methods (computer tomography, magnetic resonance tomography) are planned. If diseases of the heart and lungs could be ruled out in the course of the diagnosis, an esophagus or gastroscopy is then often performed in order to check possible causes in this area.

Treatment for stinging in the heart area

Immediate medical care is urgently needed, especially if a heart attack is suspected. The faster treatment steps such as so-called lysis therapy, PTCA (Percutaneous Transluminal Coronary Angioplasty) or any cardiac surgery that may be required, the higher the chances of survival for the patient.

So-called nitroglycerin sprays and morphine preparations (for pain relief) are used as medicines for a heart attack. In addition, depending on the individual symptoms of the infarct patient, a wide range of different medications, which, for example, help to calm down, facilitate blood flow and alleviate pain, can be used.

Pulmonary embolism also requires immediate medical care for the patient. Lysis therapy is used to counter the underlying occlusion of the blood vessels (thrombus), however mechanical destruction or surgical removal of the thrombus can also take place. Follow-up therapy includes, among other things, drug treatment with drugs to inhibit blood clotting to prevent the recurrence of a thrombus.

Therapy for inflammation of the esophagus and gastritis

Inflammation of the esophagus and gastritis are usually treated with medication using so-called acid inhibitors (antacids), whereby at the same time a change in diet and the avoidance of irritating substances (e.g. medication, alcohol, nicotine) are provided. In addition, the root cause of this inflammation is treated. For example, antibiotics can usually be successfully used to combat gastritis caused by bacteria.

Proven home remedies such as a freshly brewed tea with effective medicinal plants are very suitable for soothing the attacked gastric mucosa in a natural way. Chamomile, for example, provides relief because it has an anti-inflammatory and strengthening effect on the mucous membranes. Melissa ensures rest and relaxation and relieves cramps. Mint has a disinfectant effect and ensures that the mucous membrane is less sensitive to nausea-causing stimuli.

Tea recipe for strengthening the stomach
  1. Put a teaspoon of chamomile flowers, lemon balm and peppermint leaves in a cup
  2. Pour a quarter liter of boiling water over it
  3. Let the infusion steep for 10 minutes before straining
  4. It is best to drink the tea with food and in small sips

An inflammation of the esophagus can usually be completely remedied by the combination of drug treatment and a change in diet. In rare cases, however, complications may arise that require (minimally invasive) surgery.

Relieve heart stinging by relaxing

If muscle tension is the cause of the symptoms, massages, physiotherapy, acupuncture and osteopathy offer efficient therapeutic approaches, which in most cases can relieve or alleviate the symptoms.

In the case of psychologically related heart complaints, such as a cardiac neurosis, psychotherapeutic measures should be taken into account that reduce the fear of those affected and thus prevent the self-reinforcing effect of cardiophobia. Learning relaxation techniques to reduce stress (e.g. autogenic training or progressive muscle relaxation) can also be helpful here.

Ultimately, most of the causes of cardiac bites can be successfully treated and the symptoms do not represent an outstanding health risk, but increased sensitivity due to the possible connection with pulmonary embolism or a heart attack is definitely appropriate. (fp, nr)

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, Barbara Schindewolf-Lensch


  • Federal Medical Association (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Working Group of Scientific Medical Societies (AWMF): National Care Guideline Chronic KHK - long version, 5th edition. Version 1. 2019. DOI: 10.6101 / AZQ / 000419. (Call 09.09.2019), AWMF
  • Professional Association of German Internists e.V .: Arteriosclerosis (accessed: 09.09.2019), internists-in-the-network
  • German Heart Center Munich: diseases of the pericardium (retrieval: 09.09.2019), dhm
  • Uwe Kühl, Heinz-Peter Schultheiss: Myocarditis, Dtsch Arztebl Int 2012; 109 (20): 361-8; DOI: 10.3238 / arztebl.2012.0361, (accessed on 09.09.2019), aerzteblatt
  • National Organization for Rare Disorders (NORD): Tietze Syndrome (accessed: 09.09.2019), rarediseases.org
  • Thomas Lambert, Clemens Steinwender: Cardiovascular Medicine, Trauner Verlag, 1st edition, 2019

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