Chest pain: Angina

Cardiac pain: Angina


Chest pain of any intensity should never be ignored. It should promptly be recognized, investigated and treated. The cardiac and vascular causes of chest pain can be fatal and so need to be promptly treated.


Chest pain can be due to a variety of reasons. It can be due to causes related to the heart, the lungs, food-pipe, spine and muscles.

Let us learn about how to differentiate between some of them!


 Some of the causes of chest pain are:


  • Cardiac pain: is also called Angina. It is caused by blockages in the heart blood vessels due to cholesterol deposition. The pain is classical in nature and easy to recognize. Most of the time it is described as heaviness in chest (compression or a tight feeling). Some of patient may have burning pain in chest. It increases on exercise. It decreases at rest. This is caused by blockages in the arteries which progress slowly over months and so called stable. The pain in this condition is called Stable Angina. They are confirmed by a test in which one exercises and the ECGs are monitored. The test is called treadmill stress test. Sometimes, the blockage gets complicated due to blood clot formation. This causes total occlusion of the artery and is riskier. The pain here is severe in intensity, sudden in onset and even at rest. It does not subside with routine medicines. It is called Unstable Angina. The condition is diagnosed by ECGs and blood tests. If not promptly treated, patients may progress to have a heart attack.


  • Lung pain: The covering layer of the lungs produces pain which is sharp and increases on deep breathing. This pain can be due to infection or other causes which need to be investigated. The lung tissues normally do not cause pain but can cause cough and breathlessness. Most of the time it is diagnosed by an X-ray of the chest and can be promptly treated.


  • Food-pipe/ Esophageal pain: This is caused by increased acidity and mild erosion of the food-pipe. The pain here is burning type, normally increases on an empty stomach. It is normally associated with belching and sour eructations. The test preferred is a Scopy of the upper gut where in a tube with a small camera is passed into the food-pipe to diagnose the problem. It is easily treated with antacids and drugs to reduce acid secretion.


  • Spine problems: Here, the pain is dull or sharp but always localized to the spine. It originates from the spine and most of the time radiates to the sides. Movement of the spine makes the pain worst. An X-ray or MRI of the spine may be necessary to assess the severity of the problem. Most of the time the pain subsides with medical treatment. It is relieved with analgesics and muscle relaxants.


  • Muscular pain: These are normally associated with soreness of the muscle and dull aching in nature. They are easy to recognize and so easily treatable with analgesic and some exercises.

These are the common causes of chest pain. One needs to be cautious when it is in the center of the chest and associated with breathlessness.




Exercise: The Best Medicine.

Exercise: The Best Medicine.

Let us talk about Exercise!

Tell me which is the cheapest medicine?

Exercise! And why is that?

Exercise has lots of advantages. Let us learn about its benefits!

  1. Exercise decreases blood pressure.
  2. Exercise reduces blood sugar levels.
  3. It decreases the incidence of diabetes.
  4. It improves lung and heart capacity.
  5. It improves exercise tolerance.
  6. It increases bone density making them stronger.
  7. Prevents age related osteoarthritis.
  8. It reduces joint problems, especially arthritis of the knees.
  9. It strengthens the spine.
  10. It improves mental health and elevates the mood.
  11.  It reduces anxiety.
  12. It reduces incidence of heart attacks and debilitating strokes.
  13. Reduces progression of dementia.
  14. It reduces frequency of angina in patients with coronary heart disease.
  15. It improves cardiac capacity in patients with heart failure (weak hearts).

The list of benefits is endless!

 And What is the best part?

It is totally FREE unlike a visit to the doctor or buying medicines. Does not cost a penny!

You just need to walk (brisk walking preferable) 30-45 minutes at least 5 times in a week!

So why would one not exercise! Its free and has so many benefits. So put on your walking shoes and move out of the door! Just walk! Just do it! Experience the benefits!

Good Luck! I am sure you will do well and soon start motivating others soon!

Heart Attack!

Heart Attack! A medical condition which evokes fear in the patients and their relatives.


What causes heart attacks? Are they fatal? Are there any measures which can save your life? What are the treatment options? What medicines to take after a heart attack? These are some of the common questions which most of us have regarding a heart attack. So let’s answer them!


What is a Heart Attack?


A Heart attack is a term applied to injury caused to the heart muscle due to sudden blockage of the artery carrying blood to the heart. The heart is a pump which pumps blood to the whole body. For this the heart needs oxygen which is supplied by three small blood vessels called coronary arteries. When one has sudden blockage of one of these arteries, it is called a heart attack. During the heart attack the artery gets suddenly blocked almost 100% by a blood clot and thus there is less blood supply to the heart. This causes damage to the heart muscle and can be fatal if it is severe.


What are the symptoms experienced by the patient?


The blocked artery causes damage to the heart muscle. This causes severe chest pain in the center of the chest. Some times the pain can radiate to the arms, back, upper part of the tummy and the jaw. Some patients may experience giddiness, palpitations, shortness of breath and sweating. Some patients may experience burning in the chest and stomach with nausea and vomiting. They may delay treatment thinking that it’s a gastric (acidity) problem.


Are all heart attacks fatal?


No. Most of them are not fatal. However, 25% of patients can die if the heart stops suddenly. This is called as Sudden Cardiac Arrest. Majority of the patients survive a heart attack but it needs to be treated promptly.


What can you do at home?


  1. Remain calm. Do not panic. Do not run. Rest and wait for the ambulance to arrive OR.
  2. Visit the nearest hospital with an ICU facility by a vehicle. Do not walk down to the hospital.
  3.  If you are breathless, sit upright.
  4. Chew 300 mg of Aspirin tablet. Or powder it and keep it below your tongue. Do not gulp it down with water
  5. If you have chest pain, place a 5 mg tablet of Sorbitrate below your tongue. Ensure that you are in a sitting position and do not stand if you are feeling giddy. One can place a maximum of 3 tablets below the tongue at 5 minute intervals. Do not take Sorbitrate if you are feeling giddy.
  6. Get an ECG immediately and report to the doctor.


How is a Heart Attack Diagnosed?


A Heart Attack is diagnosed by an ECG and a blood test called Troponin. Your ECG will show changes suggestive of less blood supply to the heart. A positive Troponin blood test also suggests decreased blood to the heart.


What are the treatment options?


A heart attack is caused by sudden total (100%) block of the coronary artery. So the main treatment goal is to open the artery. There are 2 ways by which one can open the artery.


1. Angioplasty. During angioplasty, the block is directly opened with a balloon and then a stent is placed in the artery.


2. Clot Buster Injection: This is the medical option called Thrombolysis. Here a Drug is administered intravenously to dissolve the clot and restore the blood supply to the heart. These vary in their charge from INR 2500 to 35000/-. Some of the drugs used are Streptokinase, Tenecteplase (available as Elaxim or Metalyse), and Reteplase etc.).



What other drugs are required subsequently?


Once a patient is stabilized, majority of them will be on the following drugs:

  1. Blood thinners: like Aspirin to improve blood flow.
  2. BP medicines: to control the blood pressure and decrease load on the heart.
  3. Statin: these are medicines to reduce cholesterol levels and prevent heart attacks
  4. Diabetes medicine: to control your diabetes.

All patients need regular follow up with a Cardiologist and Life-long Medications!

Take care of your heart! Chao!