Definition
A very clear definition for this type of pain is not easy to find. The character of the pain can be very different and can range from stabbing to pressing to pulling pain. The decisive aspect in this context, however, is the fact that the pain is dependent on the movement of the thorax through breathing. However, this is only a symptom of an underlying disease, which should be further clarified.
The possible causes
The causes of pain when breathing in on the left side are extremely varied, with more frequent and less frequent causes. The more frequent causes are usually related to the lungs or the adjacent ribs. Less frequently, the cause is in the area of the upper abdomen, the heart or even the esophagus.
Inflammation of the mucous membranes of the stomach can have various causes; independently of this, however, it can lead to pain when inhaled. Anatomically, the stomach lies in the left to middle part of the upper abdomen and is separated from the lungs by the diaphragm. In rare cases, the stomach can become adhesions with the diaphragm above it.
Since the diaphragm rises and falls slightly with each breath, but shifts significantly with deep breaths, this movement can be transferred to the stomach. Since the inflamed stomach mucosa is sensitive to pain, this movement can cause pain. Pulmonary embolism is a potentially dangerous disease in which blood vessels that carry the blood towards the lungs to enrich them with oxygen become blocked.
In many cases, pulmonary embolism occurs in very small blood vessels, which do not present a problem; rarely, however, the blood clots that block the vessel can be so large that one of the main blood vessels is affected. As a result, a large part of the lung can no longer be supplied with blood. Persons suffering from pulmonary embolism may experience acute pain, mainly due to the occlusion of a large blood vessel, or develop pneumonia with consequent inflammation of the lung membrane, which is accompanied by pain.
Inflammation of the esophagus can have various causes, but in most cases it is due to a so-called reflux disease, which is better known as heartburn. The acidic gastric juice hits the skin of the esophagus, which is not designed for this, which then becomes inflamed and begins to hurt. Rarely, however, this clinical picture is expressed by pain in the area of the left breast.
Although the transition from the esophagus to the stomach is more likely to be in the left upper abdomen, the pain of an esophagitis usually projects more towards the middle of the chest. Of course, anatomical variations are possible in which the esophagus runs much further to the left, which could explain left-sided pain. However, this is an absolute exception.
By taking an exact anamnesis, however, the doctor can quickly come to the conclusion that certain symptoms can only be an inflammation of the esophagus. A heart attack is a disease that is fatal in principle, with pain in the left breast being the classic cause. If one relies on medical textbooks, this left-sided chest pain is of an extremely painful character, up to the fear of dying because of the pain.
The pain typically radiates into the left arm and cannot be relieved by any movement or breathing techniques. In addition, heart attacks are classically characterized by so-called angina pectoris symptoms, a massive feeling of tightness in the chest – as if a heavy stone had been placed on the chest. However, not all heart attacks are textbook, so that one or both of these symptoms may be missing.
Women in particular tend to report these symptoms only in exceptional cases. Due to the danger of a heart attack, however, pain in the left breast that has occurred suddenly is first assumed to be a heart attack until the diagnosis has ruled it out with certainty. An aortic aneurysm is an expansion of the so-called abdominal artery, i.e. the blood vessel that is essential for the blood supply of the body.Up to a certain diameter, this bulge is not a cause for concern.
However, once an aortic aneurysm has been diagnosed, it should be checked at regular intervals in order to take note of any increase in size and to initiate therapeutic measures if necessary. The abdominal aorta also passes the heart on the left side, i.e. it tends to move to the left side. If the lung expands during breathing, it is possible that the lung touches the widened abdominal artery.
This contact, which does not normally occur, can trigger a painful stimulus to the pleura or the dilated abdominal artery. An aortic aneurysm can occur throughout the entire course of the abdominal artery, from its exit from the heart to its branching out in the pelvis. Per se it is not dangerous, but it can lead to life-threatening bleeding if a rupture of the taut aortic wall occurs.
As a rule, a so-called aortic rupture is then fatal. pleurisy is usually the result of pneumonia and is usually more painful than a simple pneumonia. The pleura forms a boundary layer between the lung tissue and the inner chest.
The lung and the ribs each have a layer of fluid between them, which allows the two structures to glide against each other with little contact. In addition, the pleura differs from the lung tissue in that it is itself pervaded by nerves that perceive pain, which is not the case with lung tissue. In the case of pleurisy, the inflammatory messengers lead to increased stimulation of these pain-sensitive nerves the more the lung expands.
Thus, in pleurisy, every expansion of the lung is associated with pain, just like every contraction. Since the inflammation is associated with the production of thick mucus, there may also be adhesions between the two layers of the pleura. If the pleurisy is not treated properly, adhesions may occur, which can lead to pain when breathing even after the acute illness has subsided.
Problems of the shoulder blade can be of various kinds and can cause pain when breathing in in so far as the shoulder blade is a movable structure that is supported on the ribs by muscle tension. Accordingly, the scapula is subject to a small amount of movement each time the ribs are raised or lowered. If the scapula is broken, the breathing movements cause small displacements of the broken parts against each other, which can cause pain.
In addition, the scapula can irritate nerves that pass through it or run along it. This can also cause pain. Furthermore, an inflammation of the joint in which the shoulder blade and collarbone are connected to each other is also conceivable.
Here too, movements of the shoulder blade as a result of breathing lead to movement in the inflamed joint, which causes pain. As a result of cardiac dysrhythmia, angina pectoris (tightness of the chest) symptoms can occur, as is also known from heart attacks. This is caused by a reduced blood flow in the coronary arteries.
While the coronary arteries are completely blocked in a heart attack, fulminant arrhythmias cause the heart to no longer pump enough blood to transport it into the coronary arteries. This results in a temporary reduction in the supply of blood to the heart tissue. Just like a heart attack, this pain, if present, radiates into the left arm and, in the case of cardiac arrhythmia, may be associated with shortness of breath. This pain is usually not respiratory, but may increase in intensity when inhaled, since the expanded lung leaves the heart itself less room to expand.
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