Doctor, I am having chest pain, worried about it? By Dr Harold Gunatillake

You are not the only one. Most of us, when we pass the 60th year, slightest chest pain become a worry and cause anxiety. Seven million people around the world die from heart attacks every year and is the world’s leading killer. This video presentation will unravel some of the issues of chest pain. You may experience some muscular pains and cramps after a few stretches in your gym work or physical exercises. That sort of pain will subside within days. What we are concerned is about recurrent chest pain arising due to conditions within the chest. Chest pain appears in many forms, and you should be able to describe it to your doctor to clinch a preliminary diagnosis It ranges from a sharp stab to a dull ache. Sometimes you feel it is crushing or burning. If it is crushing, anginal pain due to insufficient blood flow to the heart muscle through your coronary arteries comes to your mind. If it is burning and burping heart burn due to acid refluxing into your gullet from your stomach is suspected, especially after an enjoyable meal accompanied with wines. If the pain travels to the jaw, neck, back or down one of the arms, your doctor will suspect unstable angina. It may come as a toothache, and you will see your dentist. The principal cause of unstable angina is coronary heart disease caused by a build up of plaque along the walls of your arteries. The plaque causes your arteries to narrow and become rigid. This reduces the blood flow to your heart muscle. When the heart muscle doesn’t have enough blood and oxygen, you feel chest pain. https://youtu.be/3Sp-6HODsPw Webpage:
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Unstable angina is more serious, and a warning sign of a heart attack, and you should seek urgent medical attention as mentioned earlier. The other type of angina is called Prinzmetal’s angina, a rare type caused by spasm in the coronary arteries and microvascular angina, which can be a symptom of disease in the small coronary arteries.
Sometimes, you may get a chronic stable angina, meaning that the chest pain occurs when your heart is working hard enough to need more oxygen, such as during walking and other exercises. With rest the pain may go away.
In addition to severe constrictive chest pain, you may have other symptoms which includes: Discomfort that feels like tightness, squeezing, crushing, burning, choking, or aching. Discomfort that occurs at rest and does not easily go away when you take medicine. Shortness of breath. Sweating. With this scenario, you need to visit your closest hospital for investigations, treatment, and surgical procedures. Women’s symptoms vary Women’s symptoms vary and could be different from that of men when it comes to heart disease. Only about 50% report chest pain. Most of them have early fatigue, or backache, jaw pain, light headedness. They should trust their intuition and visit the hospital for investigations. Radiating pain in the arms due to large breasts in women. I have observed during my practice working in a private hospital in Colombo, after retiring from Sydney practice, many women with large breasts used to see me to get their heavy breasts made smaller through a reduction process. Most of them were being treated for heart pain, some had scars on the wrist after an operation to relieve pressure on the nerves in the hand called ‘Carpel Tunnel Syndrome’. This pain mimic’s heart pain, but the real cause is due to the pressure on the shoulder on the brachial plexus, a bundle of nerves that goes into the arms. Invariable there is a pigmented groove due to constant rubbing of the bra strap on the skin. To diagnose this condition, you ask the patient one question, “Do you get the pains when you remove the bras when sleeping. The answer would be-‘no pain’. Let us discuss other non-cardiac chest pain. Another common condition that frightens you mimicking heart attack is GERD. GERD
stands for Gastro esophageal reflux disease. In this condition you get burning pain in the chest that usually occurs after eating and worsens when lying down. Belching, nausea or regurgitation, bitter taste, discomfort in upper abdomen, or a dry cough. In such a situation, when it especially happens in the night, just open the fridge, and drink
some cool milk. Your burning feeling instantly vanishes, you may burp and feel better instantly. That rules out anxiety that it would be a heart problem. Another common condition most active young people get is costochondritis of the ribs where it is joins the sternal bone in front of the chest. This could occur from physical strain from activities, such as heavy lifting and strenuous exercise. You may think it is a heart condition but pressing on the rib cage you feel the tenderness and your doctor will rule out a heart condition by getting an Xray of the chest to make sure there’s nothing abnormal going out with your lungs and also perform an ECG.

Other non-cardiac chest pain conditions are related to Muscle and bone problems, lung conditions or diseases, stress, anxiety, and depression. Muscle problems, also called esophageal motility disorders. Esophageal muscles can have abnormal activity when food passes through the esophagus due to esophageal spasm, that may mimic a heart problem. Barium swallow x rays can diagnose this condition. Lung conditions including diseases of the pleura the tissues that covers the lungs can get inflamed and mimic a heart attack. Pulmonary embolism can mimic a heart attack and is equally serious. A pulmonary embolism is a blood clot in an artery in the lungs. This clot cuts off blood flow, and the lung tissue begins to die. Early stage of shingles, caused due to an attenuated chicken pox virus, can cause chest pain, and mimic a heart attack. The first symptom is itchiness and burning skin with a rash appearing on the chest wall. Pancreatitis is another condition where the pancreas located behind the stomach gets inflamed, and the intense abdominal pain can radiate up to the chest and may mimic a heart attack. So, viewers, if you get any form of chest pain the message is to act when you have it and not ignore the pain. See your doctor soon to investigate and take adequate treatment. Lifestyle is huge with your heart health.

Hope this video article was useful Stay safe and goodbye for now.

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