CARDIAC CAUSES OF CHEST PAIN

Angina

Stable angina is pain, pressure, or a sense of heaviness in the chest beneath the breastbone. It is brought on by physical exertion and is relieved by rest. The discomfort or pain may also be felt in the left arm or shoulder, the neck, or the lower jaw. These are all areas of the body supplied by the same nerve that goes to the heart.

What is going on in the body?

Atherosclerosis, or hardening of the arteries, is a condition in which fatty deposits, also called plaque, form inside blood vessel walls. Atherosclerosis that involves the arteries supplying the heart is called coronary artery disease. Plaque that blocks the flow of blood through the arteries. The tissues that normally receive blood from these arteries supplying then begin to suffer damage from a lack of oxygen. When the heart does not have enough oxygen, it responds by causing the pain or discomfort known as angina.

What are the signs and symptoms of the conditions?

Symptoms of angina include:

·       Chest pain or discomfort that is brought on by exertion but goes away with rest.

·       Palpitations or an unusual awareness of the heart beating in the chest.

·       Shortness of breath.

How is the condition diagnosed?

Angina is usually diagnosed by a history of chest discomfort that is caused by exertion but goes away with rest. A physical exam may reveal signs of hardening of the arteries. An electrocardiogram or ECG is the recording of the heart’s electrical activity. An ECG is usually normal when a person has no pain, and it shows certain changes when pain develops. An ECG done during exercise will show similar changes even before angina develops. This is known as the TMT or the treadmill test.

A cardiac catheterization, or coronary angiogram, is a procedure that is used to look for narrowed coronary arteries. A contrast agent is injected into an artery and X-rays are then taken. This procedure can be used to find narrowed blood vessels supplying the heart. But this procedure is an invasive test and the blockages are estimated by visual interpretation only. This is why they are defined as 70%, 80%, 90%, and 99%, and so on. The estimations can vary from expert to expert whereas they could be 72% or 82.56% also.  Moreover, this procedure is done only to prepare the patient for revascularization surgeries like ballooning or bypass which is only a temporary process to relieve angina. Hence this test is generally advised by SAAOL which aims at the reversal of heart disease only.

Other Cardiac Causes for Chest Pain

1.    Myocarditis:  It is an inflammation of the heart muscle from any cause. Inflammation can change the heart in many ways. It can make it weaker and affect the way it functions. Inflammation can cause certain areas of the heart muscle to die. Sometimes only a small area is affected, but serious cases may involve the entire heart. Symptom wise, besides chest discomfort it may cause fatigue or weakness.

2.    Constrictive Pericarditis: The sac of fibrous tissues that surrounds the heart is called the pericardium. Constrictive Pericarditis results from scarring of this lining. The scar encases the heart and may limit its ability to pump blood. The pericardium is a thin sac that covers the heart. As it heals from an infection or injury, a scar may form. The pericardium becomes rigid due to the scarring. This may restrict the filling of the heart with blood and cause other health problems. 

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