Diagnosis

Depending on the clinical suspicion, the diagnostic measures are often different. First, a detailed description of pain quality, pain intensity and pain character is necessary for further evaluation by the physician.It is important to know when the pain occurs preferentially, where it is located exactly, whether it radiates, what aggravates or improves it and how strong it is. Depending on this and the patient’s general clinical condition, the most likely clinical pictures are then further clarified. If the oesophagus or stomach is in the foreground, it can be tested whether the symptoms improve with the administration of gastric acid blockers (so-called proton pump inhibitors, or PPI for short).

Therapy

For the many very different clinical pictures mentioned, there are of course also different therapeutic approaches. In the case of complaints in the context of gastritis or reflux disease, the therapy mainly consists of reducing the acid production of the stomach in order to keep the additional irritation of the mucous membranes as low as possible. For diseases affecting the heart, long-term therapy is aimed at, since the cardiovascular system is of crucial importance for the entire organism.

In the acute situation of a heart attack, substances are used which, on the one hand, are intended to dilate the vessels, reduce the heart rate and take away the pain and anxiety. In the long term, a blood pressure and blood lipid-lowering therapy is then usually initiated, and if necessary, blood thinning and relief for the pumping function of the heart is aimed for. If the lungs are affected, the cause is treated in each case.

In the case of a pulmonary embolism, for example, the thrombus must be dissolved, in the case of a pneumothorax the lungs must be unfolded again, and in the case of pleuritis the infection must be combated. Orthopedic clinical pictures are usually treated with painkillers. If necessary, in the case of chronic BWS syndrome, surgery should also be performed to relieve the strain. Common to all clinical pictures with pain behind the breastbone or other chest pain is the pain-relieving therapy. The first treatment is usually always an administration of painkillers.