A stinging in the chest that occurs while breathing is stabbing pain that is either triggered or exacerbated by inhaling or exhaling.
Sudden, sharp pain is often perceived as very disturbing. The pain may cause breathing to become shallower. This is intended to achieve pain relief.
The lungs themselves are not sensitive to pain. Pain in the area of the lungs is only caused by irritation of the pleura surrounding the lungs or the pleura with which the inside of the chest is lined.
Breath-independent stinging is to be differentiated from breath-dependent stinging in the chest. With this one must think of other clinical pictures. In general, persistent chest pain should always be clarified by a doctor.
Read the general article about this: Stinging in the chest
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The causes of sharp pain when breathing are diverse.
On the one hand, the pain can originate from organs located in the chest. Mainly the heart, lungs and esophagus should be mentioned here.
Another possible cause is pneumonia. In addition to other symptoms, this is also noticeable as a stabbing pain, provided it is located close to the lung membrane.
The lungs are surrounded by the pulmonary membrane; if it ruptures, air from the lungs can reach the chest. This clinical picture is called pneumothorax and is an acute emergency that requires urgent treatment.
The pleura, called the visceral pleura, can also be inflamed.
Diseases of the gastrointestinal tract, such as inflammation or damage to the esophagus or the stomach, can also manifest as breath-dependent pain in the lower chest or upper abdominal area.
However, the stinging can also be triggered by mechanical irritation of nerves in the chest area. In healthy people, breathing is associated with strong movement of the ribs. As part of this movement, nerve roots, here the nerve emerges from the spinal cord, can be squeezed and further irritated by protruding the intervertebral discs. The nerves that run along the lower edge of the ribs can also be damaged further away from the spinal cord; pressure on these nerves during breathing can also lead to breath-dependent stinging.
Injuries to the chest, such as bruises or fractures of the ribs, also trigger severe pain, which is particularly exacerbated when breathing deeply.
The lungs are surrounded by the pulmonary membrane, the inside of the chest is lined with the pleura, in healthy people these two layers can slide past each other and allow the lungs to expand. With pneumonia, also known as pleurisy, this sliding is disturbed and stabbing pain occurs, which is noticeably improved when you hold your breath.
Inflammation of the most important respiratory muscle can also lead to sharp pain when inhaling. The most important respiratory muscle is the diaphragm. This lowers when you breathe in, the lungs expand and air flows into the lungs. The lowering of the diaphragm increases the pressure in the abdomen, which can lead to stabbing pain in the upper abdomen or in the chest if the stomach is inflamed.
A tear in the lung membrane, called a pneumothorax, causes sudden sharp pain and shortness of breath.
Another cause of sharp pain when inhaling could be a pulmonary embolism, which is caused by the spreading of a blood clot that usually forms in the deep veins of the legs. The pulmonary embolism is accompanied by sudden onset of shortness of breath and must be treated as quickly as possible.
An inflammation of the heart muscle, also called myocarditis, can be painless. However, if the pericardium (the so-called pericardium) is involved, perimyocarditis is present. This disease can also lead to sharp pain when inhaling.
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$config[ads_text3] not foundIn addition, a bruised rib also leads to the development of pain when breathing. However, this is indirectly a consequence of the crushing. Often times, people try to breathe shallowly to avoid great pain. Read more on the subject below: Bruised ribs
Stinging pain when exhaling can also be triggered by lung inflammation: the pleura and pleura slide past each other when exhaling, causing stabbing pain.
In addition, irritated nerves can become noticeable as stabbing pain when you breathe out.
Stinging breath-dependent pain that is only localized on one side suggests a pneumothorax, which can develop on the left as well as on the right. Another clinical picture in which the stinging can be localized on the left is inflammation of the pericardium (pericarditis).
In this case, the pain improves in a bent position.
A rib fracture or bruise of the ribs on the left side are other causes of left-sided breath-dependent stinging. A pulmonary embolism in pulmonary arteries that is close to the pulmonary membrane and localized on the left can also manifest itself as a left-sided, breath-dependent stinging. If the pain is not breath-dependent and is likely to radiate into the left arm, back or jaw, coronary artery disease or even a heart attack must be considered.
Breath-dependent stinging in the right side of the chest can also indicate a pneumothorax.
Broken ribs or bruised ribs can also cause pain on the right side.
Pulmonary embolism localized in the right lung and close to the pulmonary membrane can cause a right-sided stinging.
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For more information, also read: Stitching in the right chest
If a doctor is consulted because of severe chest pain or severe stabbing in the chest, he will want to rule out life-threatening diseases as soon as possible.
The diagnosis begins with the so-called anamnesis, i.e. questions about the current ailment and history. The doctor asks the patient to be able to pinpoint the pain. To do this, he uses questions about the onset of the pain, its location, the nature of the complaints and factors that aggravate or improve the pain. In addition, previous illnesses and the current medication intake are queried.
This is followed by a targeted physical examination, including the so-called vital parameters (oxygen saturation of the blood, pulse, blood pressure).
In addition, the heart and lungs are monitored.
An electrocardiogram (EKG) is then made, blood drawn and examined for irregularities. In addition, imaging diagnostics can follow, for example an X-ray or a computed tomogram of the chest.
A common accompanying symptom with stinging in the chest is shortness of breath.
On the one hand, this can be triggered by the fact that deep breathing is not possible or is avoided due to the stinging. This can lead to an objective shortness of breath, i.e. associated with a drop in blood oxygen saturation.
A subjective shortage of breath is also possible: the inability to breathe deeply can cause panic.
If there are inflammatory changes, a fever may occur.
In the case of pericarditis, the filling of the heart chambers is disturbed, which increases the pressure in the veins. The superficial veins on the neck (jugular veins) can be congested and become visible on the surface. In addition, the heart rate increases because the heart can pump less blood per beat.
You might also be interested in: Pain in the back when breathing
If the breath-dependent stinging in the chest is accompanied by a burning sensation, irritation of the esophagus or stomach should be considered in the first place.
If stomach acid rises into the esophagus, what is known as heartburn occurs.
Heartburn can result from excessive acid production, stress or diet-related. On the other hand, the sphincter that separates the esophagus from the stomach can become weak and allow the acid to rise. If the burning sensation comes from the stomach, the symptoms may be more pronounced after large meals or when lying down.
Please also read: Home remedies to treat heartburn, symptoms of heartburn
If, in addition to sharp pain, a pulling in the chest is felt when breathing, a muscular cause of the pain is likely.
If a muscle is damaged or overloaded, the muscle becomes reflexively tensed. This tension in the muscle can be felt as a kind of pulling. For example, if an intercostal muscle has been injured as a result of trauma, the stabbing pain when breathing may be accompanied by pulling.
In women, chest pulling may be related to cycle-dependent changes in the mammary gland.
Please also read: Torn muscle fiber between the ribs
Some forms of breath-dependent stinging in the chest do not require treatment and after a certain time they go away on their own. If a doctor identifies an illness that requires treatment, conventional measures may be sufficient. Depending on the cause of the pain, even physical rest can provide a remedy.
For some diseases, however, more intensive therapies are necessary. These range from administering medication to emergency operations:
Broken ribs have a good prognosis, but they are painful for a few weeks.
The prognosis of pleurisy varies greatly, especially in young patients the pleurisy often heals without consequences, however, a so-called pleural rind can develop due to adhesions between the pleura and pleura, and the adhesions can calcify, which limits breathing.
A small pneumothorax has a good prognosis in young patients, while the prognosis is significantly worse in older patients with accompanying lung diseases. In this case, the pneumothorax can turn into life-threatening situations.
Heart muscle inflammation caused by viruses usually heals without consequences. However, the heart can also be permanently damaged. A complication of pericarditis is the "armored heart", which leads to calcification of the pericardium.
In the case of pulmonary embolism, the prognosis is heavily dependent on the size of the lung area no longer supplied with blood. It is important to reopen the pulmonary arteries as early as possible.
After a pulmonary embolism, the risk of relapse is very high. Adequate anticoagulation is therefore important.
Gastrointestinal diseases usually have a good prognosis if the causes are found and remedied early on. Early treatment of damage to the mucous membrane is important, since chronic mucosal damage is an important risk factor for the development of gastric cancer.
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