後頚部の痛み
masuiBack neck pain
左肩の後頚部の痛みで来院。左後頚部や左肩が痛いと言うと、頚や肩周辺の筋肉が血行不良によって痛みを生じたのではと考えますが、左後頚部や左肩については、原因が肩こり以外でも起きる事があります。それが、心臓疾患で、狭心症や、心筋梗塞です。狭心症とは心臓に張り巡らされた冠動脈の血流が悪くなることで、血流が滞ると、送り届けられるはずの血液の赤血球（酸素供給）が届かず、心筋が酸素不足に陥り、心臓の機能が障害されます。心臓は全身に血液を送るという重要な働きをしていますが、心筋への酸素供給が減少すると、血液を十分に送りこむことができず、それにより胸が締めつけられるような痛みがでます。このときに放散痛といって、心臓から離れた場所、左後頚部や左肩左肩にあらわれることがあります。そのため頭痛や肩こりと勘違いしてしまうのです。胸痛がなく、放散痛だけあらわれるケースもあるため、左後頚部や左肩が特にこったり痛みがあるような場合は注意が必要です。狭心症の多くは生活習慣病である高血圧や高脂血症、糖尿病などが原因となります。これら生活習慣病で、全身に動脈硬化が進み、心臓においては冠動脈の狭窄を引き起します。狭心症のうちは、冠動脈の狭窄で、胸痛や息切れが数分間出る程度ですが、完全に血管が詰まると心筋梗塞となり命を落とすこともあります。心筋梗塞の場合は、早く血流を再開しないと心筋の壊死となり、最悪の場合は急死になったりします。死因別死亡者数の第２位が心疾患です。1位は癌。この2位の心疾患のうち急性心筋梗塞の占める割合は22％と多いです。左頚部や左肩部のコリやハリは軽く見ず、注意が必要といえます。今回の症例でも、循環器科への受診をすすめています。
The patient came to our clinic with posterior neck pain in the left shoulder. When we say "left posterior neck pain" or "left shoulder pain," we think that the pain is caused by poor circulation in the muscles around the neck and shoulder, but the cause of left posterior neck pain or left shoulder pain can be caused by something other than stiff shoulders. However, the cause of left posterior neck and shoulder pain can be caused by other factors than stiff shoulders. Angina pectoris is a condition in which blood flow in the coronary arteries lining the heart is impaired. When blood flow is blocked, the red blood cells (oxygen supply) that are supposed to be delivered do not reach the heart, resulting in a lack of oxygen to the heart muscle and impairing heart function. The heart performs the important function of pumping blood throughout the body, but when the oxygen supply to the myocardium is reduced, it cannot pump enough blood, resulting in chest tightening pain. Radiative pain, or radiating pain, may appear in areas away from the heart, such as the left posterior neck or left shoulder. This can be mistaken for a headache or stiff shoulders. In some cases, radiating pain is the only symptom without chest pain, so be careful if the left posterior neck or left shoulder is particularly stiff or painful. Most cases of angina are caused by lifestyle-related diseases such as hypertension, hyperlipidemia, and diabetes. These lifestyle-related diseases cause arteriosclerosis throughout the body, which leads to narrowing of the coronary arteries in the heart. In angina pectoris, the narrowing of the coronary arteries causes chest pain and shortness of breath for a few minutes, but if the arteries become completely blocked, a myocardial infarction may occur, which can be fatal. In the case of myocardial infarction, if blood flow is not restored quickly, necrosis of the myocardium may result, and in the worst case, sudden death. Cardiac disease is the second leading cause of death, followed by cancer. Acute myocardial infarction accounts for as much as 22% of this second leading cause of heart disease. It can be said that stiffness and tightness in the left neck and shoulder area should not be taken lightly. In this case, we also recommend a visit to a cardiologist.
