Balaji Heart Center

Symptoms of Heart Attack

Hello! Good day, I’m Dr. Balaji. I’m a cardiologist, practicing at city of Hyderabad. Today I’m going to briefly educate you about the Chest pain.

Chest pain is one of the commonest symptoms that I keep seeing in my daily OPD. Different spectrum of age groups come to me with chest pain from very small children to the elderly people. People are very confused about the origin of chest pain, what I mean, if it any kind of chest pain any place in the body they think it’s something to do with the heart, they’re going to get a heart attack, it’s going to be a serious, life threatening condition and few of them come with a stricken of panic that they are going to collapse. Fortunately all chest pains are not heart pains and then today we are going to learn which kinds of pains are heart pains, which are not. When we need not go to a doctor, when we can just relax, when we need not get panicky and then probably we can also assure our friends, colleagues, family members if they have chest pain by gaining knowledge form this lecture.

See, once we have chest cage, the chest cage basically contains what? We have a skin, we have a hard tissue below that, we have a rib cage, we have a sternum, a vertical bone in the middle and we have nerves, we have arteries, we have lung tissue. We have lung tissue on either side and we have heart in middle and we have some blood valves coming from these. So, let us go one by one. Heart we know is important organ which gives pumping the blood all through our day and night and then the heart itself should get blood supply from arteries, these are called as coronary arteries. When these coronary are flowing and supplying the blood to the heart muscle then only the heart keeps pumping effectively without any pain.

So, let us just go to the, what are the causes of chest pain? What cause chest pain? The first thing I’ve said is the muscle symptoms. So, we know that the chest wall is made of muscles and when these muscles become sore, when they become sprained, strained. When you life a weight or you know you have some kind of trauma tissue, you joined the gym or you lie down on the bed and particularly in a bad posture you can get some kind of pain. So if somebody gets chest pain probably during these activities we think it is a muscle pain, one need not be panicky, it’s not heart pain. Okay!

The second pain is joint pains, what is called costochondritis. This is one of the very common pains in the practice. This middle bone this is called the breast bone or sternum hinges at the ribs through a joint. That’s how when we breathe, when we breathe our rib cage moves because our hinges have joints. So, this is called as costochondritis. This costochondritis is nothing but a joint inflammation. You see that red spots, these are the inflammations. That means if there is an inflammation in these joints you’ll have pain, the pains are localized, there are in the area not more than fingertip. They increase with pushing or pressing the chest and also they increase with deep breathing. So, if these kinds of pains are there, this can be because of the viral illnesses, there are innumerable, unknown causes of these kinds of problems. Pushing the weights, lifting heavy weights, this can also cause these symptoms. So, don’t worry, these are not heart pains.

The other problems now-a-days we’re seeing more with the software professionals, the persons who works systems, the persons who sit and do a job like clerical jobs, is spondylosis pain. You know this is the spine, you know we have a spine, which comes from, goes up to the coccyx. This is the spine which is a series of a bones arranged one above other like boxes and from between these boxes you’ll get the nerves. These nerves supply the chest in a manner where each nerve supplies a specific area for example these are the different colours you are seeing in this diagram. These are supplied by different nerve roots so each nerve root supplies an area of the chest. So, when these kinds of nerve roots gets compressed for example c5, c6 nerve root gets compressed you’ll feel pain along the hand. So, many of the patients come with, you know these software professional come with the pain that just goes along the hand. So this pain and we know by convention that you know that heart pains can go to the hands and is a popular belief even though there is no complete truth in it that heart pain always goes to the hand.

Most of times somebody complains about only pain in the hand especially in the neck, especially here in this region, this is basically a nerve root compression because of cervical spondylosis. As you see this, as I’ve said the spine is a series of boxes of bone, from in between the nerve roots come. When they get compressed you feel this pain along the hand and also sometimes in the upper chest and also in the neck. If this series of nerves gets compressed they can have pain all around, and sometimes this pain can also goes to the chest and this causes confusion whether some heart pain is there, but this is not the heart pains. Please make sure that no, these kinds of pains are not heart pains and these kinds of pain does not cause a heart attack.

You see this, in these cervical spondylosis where does the pain go? See in this man the pain goes to the clavicle, this collar bone, it goes to the shoulder. It also can go along the chest. So, the pain can go all along left upper limb, sometimes right upper limb and maybe there, only in the shoulders not into the chest or to the hands or maybe go little down to the arms. These are all cervical spondylosis pains, nerve root pains not heart pains. One need not be worried about this kind of a pain.
 

Risk factors associated with heart attack

So when do we get the heart attack? What kind of people gets the heart attack? Previously people used to think heart attack belongs to the elderly people, post-retirement people. No, the heart attacks are happening, like 20% of the heart attacks are happening in the 40s. Alarmingly we have seen last one week, the 30s, that is, the 30s are the new 40s. From age 30 onwards the heart attack incidents are increasing. So now we see that age is no longer a criteria or factor for heart attack, although overall we have seen that the elderly people are supposedly more prone to heart stroke more frequently than the younger people. The people with diabetes or sugar, with hypertension, people with high cholesterol, people who are obese, the people who are more than the normal weight, people whose family members had a heart attack at any age. For example, somebody’s ancestors or father or mother, or elder brother or younger, or elder sister had a heart attack, at 60 or at any age, then the chances of a heart attack are more in the person.

And of course, cigarette smoking. Cigarette smoking is an important cause of heart attack in any people. Cigarette smoking is one of the worst habits anybody can have, and it is killing many of the young people. Cigarette smoking is an important cause of heart attack and you must quit smoking altogether. Also, lack of exercise, and stress, physical or mental stress, anxiety- These are some of the risk factors that can be getting you a heart attack. If you are diabetic, have a tight control of your diabetes, if you have hypertension, you will regularly check your BP, check your sugar, take control of both of them. You should check your cholesterol, from age 20 onwards. If your cholesterol is high, control your cholesterol with a change in lifestyle and if a doctor prescribes you a tablet. Regularly check your cholesterol and keep it in control. Regular exercise is important, at least 30-40 minutes regularly, is must for everybody. If you are smoking, please quit smoking. Smoking is the commonest cause of death in any people. Young heart attack victims, most of them are smokers. If they quit smoking, the incidence comes down significantly. Take a balanced, healthy diet. Take small portions and see that your physical activities, not only the 30-40 minutes of exercise but all through the day you are physically active.

Can heart attack happen in women? Many people think that heart attack is a disease of men. Contrary to that popular belief, a heart attack is a number 1 killer in women as well. It is not breast cancer, ovarian cancer, cervical cancer; it is not any other illnesses, that we think women suffer from. It is the heart attack, which is number 1 killer in women as well. So women beware, it is not just men’s disease, it is your disease as well. And whatever I said about control, it applies to you all as well. Actually after age 50 onwards, after attaining menopause, women are more prone to heart attack than men. They have less prognosis, fewer survival rates, the chances of coming out of the hospital healthy is not equal to that of men. So women beware, you are more prone to heart attack than men, after age 50 than men. So as you see here, here is the evaluation; less than 30 years of age, heart attack rates are slowly increasing from 8.3 to 10.7, and as the year's progress, a number of young people are suffering a heart attack. It used to be a disease of the elderly more than 50 years of age, and now we are seeing the disease in the young people. And this is very, very alarming. Any victim, any heart attack victim, in families, small children fall prey to this disease, which is very, very alarming. You should have good knowledge of this condition and healthy lifestyle, and also, keep checking your parameters, your BP, and must keep checking or conducting tests, so that if something is happening (symptoms of heart attack) you can diagnose at an early age and prevent it.

What happens inside the heart when you get a heart attack? See, the cholesterol is here. There is no blood flow to the heart muscle. See this is a normal healthy heart, the heart muscles are reddish, but here it has become black when the heart attack is happening. That’s the inside story of what is happening. So inside the blood vessels, that is the blood vessels of the heart, the cholesterol is building up, the cholesterol blocks and captures, it causes blood clots. The blood clots for a few minutes, that is why the heart attack comes all of a sudden. The build up cholesterol takes weeks or months, but the heart attack comes very fast. So how do we treat? We can give medicines, do an angioplasty stenting. We all know about the stent. When the vessel is blocked, we put a stent, and then the vessel here is normal, it is flowing well now. Or we can do a bypass surgery.

When blocks are there in different places (of the heart), we can take a new pipe from the leg or from the chest and stitch it here, so that the blood flows to the new pipe, as the old pipes are blocked. So friends, today we have briefly discussed what is chest pain? All chest pains we found out do not heart pains. What is heart pain? What are the symptoms of heart pain? What it looks like? How to differentiate it? May it be the day, night, any kind of circumstances, you need to transport the patient to the nearest hospital. After getting treated for heart disease, it is a lifelong discipline that you need to maintain, the drugs are for lifelong, the medicines etc are all lifelong. You need to continue following the doctor’s advice and attend the doctor at periodic intervals. You have to quit smoking, you must take a healthier diet, you need to have an ideal body weight, you should exercise properly. And this knowledge, if you have gained anything, from my talk, then please spread to everybody; see that everybody is aware of this condition. As we discussed just now, that it is alarmingly true that the heart attack is happening in the 40s and the 30s, and that is an alarming situation.

You should make sure that everybody gets this knowledge and ultimately this knowledge will prevent this heart attack. Thank You very much- Dr. Balaji Rajamagiri, Cardiologist.
 

Symptoms of Heart Pain