Chest Pain Awareness

Posted on Healthcare By Dr. Sakib Nazir -MRCP , MBBS , FRCP - Published on 2014-01-15

chest-painThere is an urgent need to diagnose the cause of any new onset of chest pain to ensure that serious and life-threatening conditions are not missed. Early detection of Heart Disease as a cause for new onset of chest pain can prevent heart attack and save lives.

Why should you take chest pain seriously?
There may be several causes for chest pain. One of the serious causes is Coronary Heart Disease and it is the number one killer worldwide. Chest pain resulting from Coronary Heart Disease is called ANGINA.

Things you should know about Angina or the heart pain
Angina is chest pain that comes mostly on exertion but can occur at rest too.

Nature of the pain:
People describe it as a tightness across the chest, it could also be a feeling of heaviness. For some, it is a dull ache or gripping pain typically in the middle of the chest or sometimes either left or rarely at the right side of the chest wall. It can be felt in between the shoulder blades too.
Angina may commonly move down to the left arm or up to the jaw. On occasions, it may radiate to both shoulders or upper arms.

Associated symptoms:
Nausea, dizziness, breathlessness and sweating.

Aggravating factors:
Physical activities like exercise, lifting, climbing steps and carrying shopping bags.

Relieving factors:
Taking rest typically reliefs the pain. Taking a spray or tablet for Angina under the tongue can also ease off the pain quickly.

What causes Angina?
The heart acts as a pumping organ for blood circulation and like any part of the body, it requires it’s own blood supply. The blood vessels that supply the heart are called Coronary Arteries. If the blood supply diminishes for any reason then the heart is under stress. Angina is like a distress or warning signal to the patient.

The most common cause of reduced blood flow through the coronary arteries is narrowing or blockages resulting from deposition of cholesterol rich fatty substance called ‘Plaque’. This process of deposition of plaque is called Artherosclerosis.

Why is early diagnosis of Angina important?

  • Patients who have developed Angina have significant narrowing in one or more than one heart arteries. Therefore, this will restrict a patient’s life unless something is done about it.
  • The worse thing about these narrowings or ‘Plaques’ is that they could rupture anytime causing immediate clot formation inside the blood vessel. This results in total blockage of that particular blood vessel and lack of blood supply for a short time, which may lead to the damage of some parts of the heart muscles, which is commonly known as a ‘Heart attack’. ‘Myocardial Infarction’ is the medical terminology for a heart attack. The consequences are dangerous, unless measures are taken to open up the blocked artery as soon as possible by a procedure called Coronary Angioplasty or Stenting. A ‘Clot buster’ injection can also be given to dissolve the clot in case this procedure is not readily available.

We all know that a heart attack can cause death and weakening of the heart muscle. But if Angina can be diagnosed early then a heart attack or even death can be prevented by timely intervention with medical and other forms of treatment.


How doctors diagnose Angina?

  • A heart specialist takes a medical history and assesses the overall risk for heart disease.
  • Tests: An ECG,CXR,ECHO (Ultrasound scan of the heart) and blood tests.
  • Further tests: The specialist usually arranges for an exercise test (Treadmill) after reviewing the ECG and ECHO. Your doctor may advise for other kind of test if the Treadmill test shows abnormalities or someone is not suitable to walk on it.

What happens after the tests?

  • The Specialist will reassure you if the clinical and investigation findings are not in favor of Angina.
  • The patient will be given appropriate medical advice and treatment if Angina is diagnosed.
  • Angina patients will be adequately counseled and in depth discussion will take place with regards to the future investigations or management plan.
  • If necessary, the patient will be referred to other specialists, such as a dietician.
  • A follow-up arrangement will be made to ensure that the symptoms have improved with treatment.
  • On some occasions, the Specialist may recommend hospitalization in view of grossly abnormal investigation findings or severity of symptoms.



About Author

Dr. Sakib Nazir -MRCP , MBBS , FRCP

Dr. Sakib graduated from Dhaka Medical College, Bangladesh in 1991 and joined the National Health Service in the UK in 1994 after passing the PLAB examination. The next four years he worked as a Senior House Officer in various specialties like Gastroenterology, Endocrinology, Elderly medicine, Chest Medicine, Rheumatology, Haematology and Cardiology. He obtained his MRCP in 1996 and FRCP in 2007 from the Royal College of Physicians. Dr.Sakib completed a five years training and experience in both Non-invasive and Interventional Cardiology as a Registrar and had the opportunity to work in a world renowned Cardiac Center like the Yorshire Heart Center at The Leeds Teaching Hospital, Leeds, UK. His first Consultant post as a Cardiologist was in 2001 at Dewsbury And District Hospital,UK which he finished in January 2013 before coming to Dubai. However, in between (2004-2009) he took a career break and worked in one of the largest Indian corporate hospital groups called ‘The Apollo Hospitals’ in Dhaka. During this time he also had the opportunity to gain professional experience at Cleveland Clinics in Ohio, USA and in other Asia-Pacific countries. Dr.Sakib has more than a decade of work experience in a senior position and is highly skilled in looking after both acute and chronic cases related to heart conditions.

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