Chest Pain

Chest pain can be a serious symptom and may be a sign of a heart attack or other serious medical condition.

Angina is chest pain or discomfort that occurs when there is not enough blood flow and oxygen to the heart muscle. It is typically described as a squeezing, pressure, or burning sensation in the chest, although it can also be felt in the arms, neck, jaw, shoulder, or back. It often occurs during physical activity or emotional stress, but can also happen at rest.

The most common type of angina is called stable angina, which is caused by narrowed or blocked coronary arteries. This type of angina is predictable and usually occurs at the same level of exertion or stress each time. The pain or discomfort usually goes away with rest or with medication.

Unstable angina is a more serious type of angina that occurs when there is a sudden change in the pattern of chest pain or discomfort. It can happen at rest or with little exertion and can be more severe and longer-lasting than stable angina. Unstable angina is a medical emergency that requires immediate attention because it can be a sign of an impending heart attack.

It is important for patients to be aware of the following:

1. Seek medical attention immediately: If you are experiencing chest pain, it is important to seek medical attention immediately. Chest pain can be a sign of a heart attack, which is a medical emergency.
2. Describe the pain accurately: It is important to describe the chest pain accurately to your healthcare provider. This may include information about the location, intensity, and duration of the pain, as well as any other symptoms you are experiencing.
3. Follow your treatment plan: If you have been diagnosed with a condition that is causing your chest pain, it is important to follow your treatment plan as prescribed by your healthcare provider. This may include taking medications, making lifestyle changes, and following up with your healthcare provider regularly. Do not stop taking medications even if you are feeling very good without telling your doctor. Lot of patients stop taking medications because they are feeling good while on medications.
4. Know your risk factors: Certain factors, such as smoking, high blood pressure, and high cholesterol, can increase your risk of developing conditions that cause chest pain. It is important to be aware of your risk factors and to take steps to manage them to reduce your risk.

Higher Coronary Artery Disease [CAD] in SE Asians is probably due to small coronaries [blood vessels supplying blood to the heart muscles].

Some tests that will be done:

Echo report -says how strong heart walls are and how the valves/doors of the heart are functioning. We can’t see electrical connections and blood vessels on echocardiogram. (House strength and doors but not water pipes and electric connections of house).  If there are wall motion abnormalities on echocardiogram, it is an indication that something is wrong. Those patients might need Cath/angiogram to find out any blockages. 

If the heart becomes large due to HTN or has leaky valves, it can’t pump blood effectively and that causes congestion in the lung causing shortness of breath.  

Thickness of heart muscles, if increased, means that the heart is working harder causing increased thickness of heart walls. Usually, the left side of the heart is involved, it is called left ventricular hypertrophy. 

If [Ejection Fraction] EF is less than 30% persistently, ICD will be placed.  This prevents sudden death as heart with low EF can go into arrhythmias/erratic heart beats.

Cardiac Stress test cannot be done if wearing a nicotine patch.