Pain in the chest with a deep breath: what is caused and dangerous? More information here!

This symptom, like chest pain that occurs with deep breathing, is often taken by people for a purely pulmonary problem. However, there are a number of pathologies that are not related to the respiratory system, the manifestation of which is pain during inspiration.

Chest pain with deep inspiration

pain in the chest with a deep breath

Content material

  • 1 Pathology of the musculoskeletal system
    • 1.1 osteochondrosis
    • 1.2 intercostal neuralgia
    • 1.3 broken ribs
  • 2 heart Pathology
    • 2.1 Pericarditis
    • 2.2 Pulmonary embolism
  • 3 pathology of the gastrointestinal tract
  • 4 Pulmonary pathology
    • 4.1 Pleuropneumonia
    • 4.2 Pleurisy
    • 4.3 Pneumothorax
  • 5 Comparative characteristic of
    • 5.1 Video - Whychest hurts
    • 5.2 Video - 3 deceptive pains in the heart. What hurts in the chest

Pathology of the musculoskeletal system

The thorax is formed:

  • sternum;
  • ribs;
  • with collarbones;
  • by the thoracic spine.
Structure of the chest

Structure of the chest

Human thorax

Human thorax

The bone apparatus is surrounded by muscle mass, permeated with nerve fibers. All these formations can become a source of pain. And with a number of pathologies of the musculoskeletal system, pain occurs precisely with a deep inspiration. The reason for this - the movement of the chest during breathing.

The position of the ribs at the entrance and exhalation

The position of the ribs at the entrance and exhalation of the

During inhalation, it rises and expands, which can lead to painful sensations in some pathologies.


Degenerative pathology of the spine, which affects more than half of the adult population of the planet. At an osteochondrosis there are atrophic changes of an intervertebral disk. The pelvic nucleus of the disc loses its elasticity due to its pronounced hydrophilic properties. Moisture leaves, the disc becomes less elastic and more flattened.

Stages of osteochondrosis

Stages of osteochondrosis

Fibrous ring, normally supporting the proper volume of the pulpous core, also suffers. Due to the displacement and approaching adjacent vertebrae on the ring, radial cracks may appear. The ligaments supporting the vertebral segment are destroyed. Develops its instability, vertebrae are shifted, causing radicular syndrome with pain.

Osteochondrosis of the thoracic spine

Osteochondrosis of the thoracic spine

Similar changes in varying degrees occur in all people over the course of the age. They are more pronounced in the presence of excess weight, irrational physical activity, long-term sedentary lifestyle. Pain in the chest on inspiration appears with osteochondrosis of the thoracic spine, when the movement of the chest affects affected vertebral segments.

Localization of pain

Pain localization

Important! Pain in osteochondrosis irradiates into the interlopar area or upper limbs.

Intercostal neuralgia

A vascular bundle of nerves passes along the lower edge of all the ribs. Nerves passing through it are often a source of neuralgia.

Intercostal neuralgia

Intercostal neuralgia

The etiology of this lesion is different:

  • hypothermia;
  • infringement;
  • infection;
  • irritation.

The most common episodes of intercostal neuralgia in the background of osteochondrosis of the spine.

Pain with intercostal neuralgia

Pain in intercostal neuralgia

A little less often the pain is caused by herpes zoster - herpetic infection. Activation of the herpes virus can be triggered by hypothermia and always occurs against the background of a natural decrease in immunity:

  • in the elderly;
  • for diabetes mellitus;
  • for primary and secondary immunodeficiencies.
Shingles( Herpes zoster)

Shingles( Herpes zoster)

With intercostal neuralgia, the pain is constant, it is localized from the side of the lesion. Its reinforcement on inspiration is also associated with the movement of the thorax, in particular, the ribs. By nature, the pain is strong and burning, irradiating along the entire length of the nerve fiber, from the sternum to the spine.

Fracture of ribs

Closed chest trauma in more than half of the situations is complicated by rib injuries. More often it occurs in the elderly, which is explained by the increased brittleness and fragility of bones. Depending on the number of broken ribs, a person's condition can be from an average severity to a very heavy one.

Fracture of ribs

Fracture of ribs

Fractures of 1-2 ribs usually do not take place very hard, they do not need inpatient treatment. With fractures of 3 or more ribs, the risk of damage to the organs of the chest increases: the heart, lungs, large vessels. Multiple bilateral fractures always require emergency medical care.

Mechanism of fracture of ribs

Rib fracture mechanism

Chest pain associated with fracture of the ribs is localized at the site of the impact or suspected fracture. It intensifies even with shallow breathing and coughing, which can lead to forced hypoventilation and pneumonia.

Pain in fractured ribs

Pain in fracture of the ribs

Heart pathology

Chest pain associated with breathing may be a sign of one of the dangerous pathologies of the heart or vessels. Often there are myocardial infarction or angina pectoris, but they are characterized by persistent pressures that are not associated with breathing. Let us examine in more detail precisely those pathologies in which soreness appears or is strengthened by inhalation.

Important! For any pain in the chest, people older than 40 years of age should undergo electrocardiography.


Pericarditis of the heart

Pericarditis of the heart

Pain on inspiration accompanies only dry pericarditis. With it on the leaves of the pericardium, fibrinous adhesions are formed in large numbers, which significantly impair the friction of the leaves during palpitation. There are sharp, painful sensations that intensify with deep breathing.

Location of the pericardium

Location of the pericardium

The causes of dry pericarditis are diverse:

  • systemic diseases: systemic lupus erythematosus, rheumatoid arthritis, scleroderma;
  • terminal chronic kidney disease, at which urate deposition occurs on pericardial sheets;
  • gout, with the deposition of salts of uric acid;
  • tuberculosis.
Pericarditis, etiology

Pericarditis, etiology

In addition to chest pain, pericardial disorders can occur rhythm disturbances: paroxysmal tachycardia, extrasystole. A person is worried about fatigue, shortness of breath, a feeling of disruption in the work of the heart. Without treatment, dry pericarditis over time can develop into exudative.

Pain with pericarditis

Pericardial pain

Pulmonary embolism of the

One of the life-threatening pathologies that requires emergency medical attention. It is not a question of the lightning-fast form of thromboembolism of a large pulmonary artery trunk, at which a reflex stop of cardiac activity occurs.

Pulmonary embolism

Thromboembolism of the pulmonary artery

The chest pain is more common in inspiration for the emboli of small branches that can cause recurrent infarct-pneumonia. It is typical for her pain in the chest, poured, with an increase in inspiration. In addition to pain, a person is disturbed by a cough, possibly with rusty sputum, high fever. Symptoms of respiratory failure may appear.

Symptoms of thromboembolism of the pulmonary artery

Symptoms of pulmonary embolism of the pulmonary artery

Pulmonary thromboembolism almost always occurs against a background of well-being. But, at inspection, it is possible to reveal provoking reasons:

  • a deep vein thrombosis;
    Deep vein thrombosis

    Deep vein thrombosis

  • cardiac pathologies in which emboli can be formed: atrial fibrillation, cardiomyopathy;
    Schematic explanation of arrhythmia

    Schematic explanation of arrhythmia

  • oncological pathology;
  • antiphospholipid syndrome;

    Antiphospholipid syndrome

  • various thrombophilia.
    A thrombus in the vessel

    Thrombus in the vessel

Important! Contributes to the appearance of the embolus, a prolonged immobilization, associated, for example, with a multi-hour flight or a complex operation.

Gastrointestinal pathology

A number of problems with the gastrointestinal system can cause chest pain on inspiration:

  • gastroesophageal reflux disease, esophagitis, hernia of the esophagus of the diaphragm - pain burning, pressing. Localized in the central and upper chest. It is combined with eructations and regurgitation;
    Gastroesophageal reflux disease( GERD)

    Gastroesophageal reflux disease( GERD)

    Hernia of the esophageal opening of the diaphragm

    Hernia of the esophagus of the diaphragm

  • gastritis, gastric ulcer - pain predominantly in the center, combined with a sense of rapid satiety, nausea, belching;


    Stomach ulcer

    Stomach Ulcer

  • duodenal ulcer, pancreatitis - pain in the lower part of the chest, more on the left. Characteristic of night attacks, and also after 2-3 hours after eating;


  • cholecystitis - soreness in the lower part of the thorax to the right. It is combined with a feeling of heaviness in the hypochondrium, a feeling of bitterness in the mouth, nausea.
    Cholecystitis - inflammation of the gallbladder

    Cholecystitis - inflammation of the gallbladder

Pulmonary pathology

The pulmonary tissue of pain receptors does not have a proper pathology, its pathologies do not show painfulness, if not affect the pleura. Among all the organs of the respiratory system, the pleura is most innervated, which means that the pain sensations are associated with its defeat.




In some cases, the focus of inflammation in pneumonia may be located close to the pleural cavity. Then the inflammation passes to the pleura, causing pain. It can be permanent, but can only appear with deep breathing. In any case, coughing and forced breathing significantly increase pain.

In addition to the pain of a person concerned:

  • symptoms of intoxication - weakness, fatigue;
  • high temperature;
  • cough, usually with phlegm.
High fever is a symptom of pleuropneumonia

High temperature - symptom of pleuropneumonia

In case of massive pneumonia on the area, symptoms of respiratory failure may appear - dyspnea, cyanosis, reduction of saturation. The disease is most serious in the elderly, children and people with immunodeficiencies.

Important! The most common pneumonia is caused by Streptococcus pneumoniae.

Streptococcus pneumoniae

Streptococcus pneumoniae


Pain in the chest on inspiration is more characteristic for dry pleurisy. Its morphology is very similar to dry pericarditis: fibrinous threads deposited on the surface of the pleura. They make the friction of the pleura sheets painful. The pain increases with breathing, as well as the slightest cough, when tilted to a healthy side.



The state is reversed by tilting to the side of the affected lung. Thus, the tension of the inflamed pleura leaves decreases. Also, a person with pleurisy becomes lighter when he lies on the side of the inflammation. At the same time, the excursion of the affected side of the chest decreases, which alleviates the pain.

Pain in the pleurisy

Pleural pain

In addition to pain, there may be inflammation symptoms:

  • high fever;
  • weakness.

Often with pleurisy there is a dry reflex cough. The causes of fibrinous pleurisy can be:

  • tuberculosis;
  • chronic kidney disease;
  • Dressler's syndrome;
  • systemic diseases.
Complications from pleurisy

Complications from pleurisy


Another pulmonary cause of chest pain on inspiration. At the same time, the painful sensations are extremely sharp, sharp, sudden.

Types of pneumothorax

Types of pneumothorax

Pneumothorax can be:

  • open - with the contact of the pleural cavity and the environment;
  • closed - the pleural cavity with the environment does not contact;
  • Valve - the air is inhaled inhaled into the cavity, and on exhalation does not come out of it, gradually "pushing" the lung.
Spontaneous pneumothorax to the right

Spontaneous pneumothorax on the right

Scheme of open pneumothorax

Scheme of open pneumothorax

In addition to pain, a person is concerned about the severe symptoms of acute respiratory failure:

  • dyspnea;
  • cyanosis.
Cyanosis( blue lips and skin)

Cyanosis( blue lips and skin)

With massive pneumothorax, movement of the mediastinal organs can occur in the direction of the asleep lung. This will manifest itself with symptoms of cardiovascular shock, can lead to cardiac arrest.

Among the causes of pneumothorax are:

  • injuries with broken ribs;
  • lung tumors;
  • Bullous disease is the source of spontaneous pneumothorax in young people.
Bullous disease

Bullous Disease

Important! With valve pneumothorax, it is possible to change the position of the mediastinal organs, moving the side of a healthy lung.

Comparative characteristic

At the end, we give a table in which we summarize the main data on the most common causes of chest pain, depending on the breath.

disease circumstances preceding pain pain radiating necessary examinations


-voltage, long-term physical load in the arms, shoulders, back X-ray of the thoracic spine, computed tomography
Fractures of the ribs

Rib fractures

Trauma chest cells in place Radiography


Infection, CKD In the left half of the thorax Radiography, ECG, ECHOX


Venous thrombosis, lengthImmobilisation, flight, against a background of complete well-being Across the chest or locally Chest X-ray, angiopulmonography, determination of the D-dimer concentration


Dysfunction, gallstone disease in the history of Into the epigastric region, in the right vertebral ultrasound examination


pleura infection pleurisy side X-ray, ultrasound


Injury oron the background of full well-being To the affected side of the chest Radiography, computed tomography

Video - Why does the chest hurt

Video - 3 deceptive pains in the heart. What hurts in the chest

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