Angina pectoris symptoms caused by thoracic spine disorders. Clinical examination and treatment.

Pain identical with angina pectoris can be released from the disks Th4-5, Th5-6 and Th6-7. Most common, cardiac-like pain is elicited from Th5-6. Physical stress such as lifting, rotation of the thorax and heavy work is especially symptom provoking. It is not unusual that movements in the bed during the night can provoke a pain attack. The pain can subside after a while but more often it continues for a long time in spite of rest. In all patients with symptoms of angina pectoris the thoracic spine should be examined. Pressing on the spinous process of the Th5 usually elicits an intensive and typical pain. The verification of the diagnosis is made by "specific" investigation of the spin and - ex juvantibus - by the momentary relief of pain after manipulation of the actual spinal segment.