Causes by localization

In the case of left-sided pressure on the chest, the left-sided heart located in the chest area should be considered first as the trigger. In addition to myocardial infarction, subtotal occlusion of coronary arteries or cardiac dysrhythmias such as extrasystoles or atrial fibrillation can also lead to a feeling of left-thoracic pressure. If left-thoracic pressure occurs for the first time and is not due to previous sporting activity with subsequent muscle soreness, a doctor should be consulted – depending on the overall situation of the person affected – to further clarify the symptoms.

A feeling of pressure located centrally in the thorax is relatively typical of heartburn in the context of reflux esophagitis. However, nerve affections, sore muscles and damage to the spine can also be the cause. Rarely does the central aorta cause a feeling of pressure in the chest.

In a panic attack, the pressure in the chest is usually also localized in the middle. In the case of pneumonia or pneumothorax, unilateral chest pain on the affected side (both left and right) can occur. Lung cancer (bronchial carcinoma) does not cause symptoms until it is in a very advanced stage, and thoracic pressure is a rather untypical symptom.Of course, nerve affections and problems in the area of the spine can also lead to one-sided chest pressure.

Diagnosis

When a patient comes to the doctor with the symptom of pressure on the chest, various diagnostic steps are taken. First of all, the medical history is crucial. The doctor asks about the patient’s age, previous illnesses, illnesses in the family, type of complaints, time of occurrence and duration of the complaints and regular medication.

The doctor also asks about other accompanying symptoms. Next comes the physical examination. Particular attention is paid to palpation of the chest, listening to the lungs and examining the spine and ribs.

If a lung disease is suspected, an X-ray may be necessary. Depending on the results of the conversation, an ECG can be written to rule out a heart attack or cardiac arrhythmia. However, a definite exclusion of a heart attack is only possible by means of an ECG and two-stage blood sampling.

Even cardiac arrhythmias do not have to show up in an ECG that records only a few seconds of the heart action. If the presence of cardiac arrhythmia is suspected, a long-term ECG examination would therefore be appropriate. Furthermore, the treating physician can decide whether a blood sample should be taken.

Here, among other things, the cardiac enzymes and inflammation values can be checked. If heartburn is suspected, a gastroscopy can be performed in case of doubt. However, this is not absolutely necessary for a diagnosis. If a panic attack is suspected, only an empathetic conversation can reveal more details.