How do you differentiate between heartburn and coronary angina? - By Dr harold Gunatillake

How do you differentiate between heartburn and coronary angina? – By Dr harold Gunatillake

Happy Easter

Harold-Gunethilake

Transcript:

The symptoms of a can also be indigestion, which includes abdominal discomfort. For example, they may include a feeling of heaviness in your chest, a stomachache or heartburn. A heart attack can happen at any time, including while resting. If heart pain lasts longer than 15 minutes, it may be the start of a heart attack. There may be other prodromal signs, such as anxiety, breathlessness, fatigue, etc.

Now, how do you differentiate between such a tight feeling in the chest with heartburn from acid reflux from your stomach, which also gives heartburn and similar symptoms? Stomach acid is needed to break down your food, something your stomach has no trouble handling. Your oesophagus, on the other hand, is irritated by it.

That is what we are going to discuss today.

GERD or gastro-oesophagal reflux disease also can arise suddenly after a heavy meal with drinking spirits and present with heartburn and chest pain, and quite common when you are asleep. Since patients with GERD have an increased risk of angina pectoris in the year after GERD diagnosis, physicians must be concerned about missing clinically significant coronary artery disease while evaluating patients for GERD symptoms.

Those suffering from acid reflux may have frequent attacks and may subside with antacids and burping. But the problem is when it happens for the first time.

Let me relate a story that happened to my wife a few years ago. We returned after dinner to a friend’s house late at night. My wife complained of severe chest pain, and I was about to call the ambulance. She did not have any other prodromal signs.

I always carry a pocket ECG tracing machine with me, and that night took a quick tracing by placing it on her chest. The reading said typical normal ECG waveform.

I requested her to drink a glass of cool milk from the fridge. She did that, burped immediately, and the pain was gone.
So, she had acid reflux and heartburn after a heavy meal, including a glass of white wine, and she does not suffer from GERD.

How does one get heartburn?

At the junction of the lower oesophagus and the upper stomach, called the cardia, a valvular mechanism usually prevents acid refluxing into the lower gullet.

What is the main cause of such acid reflux to cause heartburn?

Acid reflux is caused by weakness or relaxation of the lower oesophagal sphincter (valve), as mentioned. Usually, this valve closes tightly after the food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise into the oesophagus. Stomach acids flow back or reflux up into the oesophagus, causing inflammation or redness of the lower third of the oesophagus, feeling like heartburn.

This results in a burning sensation behind your heart. In another situation, you could get frequent heartburn due to a hiatus hernia. A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes up into the chest through an opening (“hiatus”) in the diaphragm. The diaphragm is a large, thin sheet of muscle between the chest and the abdomen (tummy).

The diaphragmatic opening through which the oesophagus passes can stretch, mainly caused by obesity, which causes the upper part of the stomach to squeeze into the chest.

Another common cause of a hiatal hernia is increased pressure in the abdominal cavity. Your abdominal cavity is the space in the middle of your body that holds several organs, including the: Lower part of the oesophagus and stomach: the small intestine, colon and rectum. The treatment for this condition is surgical.

What are the common triggers of heartburn?

Overeating or eating too quickly
Lying down too soon after eating
Consuming certain foods, including
caffeine, carbonated beverages, alcohol,
peppermint, citrus, tomato-based products,
chocolate and fatty or spicy foods
Being overweight
Smoking
Stress and anxiety

We are talking today about GERD caused by weakness of the valvular mechanism at the junction of the oesophagus and the stomach, triggered by the mentioned factors.

This situation is treated palliatively with antacids, which help neutralise stomach acid. Antacids may provide quick relief.
H2 blockers, which can reduce stomach acid. H2 blockers don’t act as quickly as antacids but may provide more extended relief. … Proton pump inhibitors also can reduce stomach acid. Let us discuss the home remedies for heartburn due to acid reflux.

Keep a food journal and avoid trigger foods.
Resist the urge to overeat or eat quickly
Avoid late meals, snacking before bed and eating before exercising
Eat alkaline foods, like a ripe banana
Wear loose-fitting clothing
Adjust your sleep position
Take steps to lose weight if you are overweight
Reduce stress

If you do not get relief from the above regime, you may have to consult your doctor, who will prescribe one of the medications listed above.

For the first time, you experience heartburn with other symptoms mentioned earlier. If there is no relief after 15 minutes, you need to assume that it may be a heart attack and seek urgent treatment in casualty.

Hope this video article was helpful.

Stay safe until we meet again. Goodbye for now.

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