Pulmonary Embolism
Pulmonary embolism is the technical term for the occlusion of a blood vessel in the lung by a thrombus (blood clot). This thrombus usually originates in the veins of the leg (thrombosis), is finally washed away from there and reaches the pulmonary vessels via the heart. If the affected vessel is located in the upper part of the lung, pulmonary embolism can simulate a disease of the collarbone, because pulmonary embolism also causes respiratory chest pain.
However, a typical symptom that distinguishes pulmonary embolism from bony injuries to the collarbone is severe shortness of breath. In addition, sudden outbreaks of sweating or palpitations, but also fever, can be triggered. If pulmonary embolism is suspected, medical attention should be sought immediately. The physician has a wide range of examination options at his disposal, such as ECG, perfusion scintigraphy or pulomonalis angiography, which can confirm the diagnosis of a pulmonary embolism and thus enable urgently needed therapy.
Hiatal hernia
Surprisingly, diaphragmatic diseases can also cause pain in the collarbone area. The reason for this is the phenomenon of the so-called head zones: Diseases of internal organs project themselves onto skin areas at completely different locations. This is due to the fact that the nerve cells that transmit pain signals from the organ and the nerve cells that transmit pain signals from the associated skin area “get close” to each other in the spinal cord and this spatial proximity means that a disease of the organ can “feign” a superficial disease at a completely different location to the patient.
The head zone of the diaphragm is now located in the area of the acromion and clavicle. The most common disease of the diaphragm is the diaphragmatic hernia. In this case, stomach or intestinal loops enter the chest through weak points in the diaphragm.
In about 90% of the cases a diaphragmatic hernia remains asymptomatic. However, if it does cause discomfort, it can be easily distinguished from the other possible causes of pain in the collarbone region thanks to the accompanying symptoms. In addition to swallowing difficulties and heartburn, nausea and vomiting frequently occur.
A feeling of fullness is also characteristic. Larger diaphragmatic hernias can cause palpitations. A reliable diagnosis and differentiation from other internal causes is made by the physician with the help of a gastroscopy or an x-ray, before which the patient swallows a pulp containing a contrast medium to increase the contrast (“x-ray pulp swallow”).
