Guide on Chest Pain
Ageing and other complex factors cause the blood vessels to become hard. In addition, cholesterol and minerals from the blood are deposited on the inner surface of the coronary arteries. When this material builds up, they form a plaque. A raised plaque may restrict the blood flow through the coronary artery.
What is Angina or chest pain?
Angina is chest pain or discomfort that occurs when the heart muscle does not get enough blood. Angina is a symptom of Coronary Artery Disease (CAD), the most common type of heart disease. It occurs when plaque builds up in the coronary arteries and blocks the arteries to reduce blood flow. This decreases the oxygen supply to the heart muscle.
What are the types of angina?
There are three types of angina
Stable angina: This is the most common type of angina. It occurs during physical effort or emotional stress. The pain usually goes away in a few minutes after one takes rest or takes angina medicine. It is not a heart attack but makes it more likely that one may have a heart attack in the future.
Unstable angina: This is a very dangerous condition requires emergency treatment. It can occur without physical exertion and is not relieved by a rest or medicine. It is the sign that heart attack could occur soon.
Variant angina: This is a rare type of angina. It usually occurs at rest. The pain can be severe and usually occurs between midnight and early morning. It is relieved by medicine.
What are the signs and symptoms of angina?
Pain and discomfort are the main symptoms of angina. These symptoms are often described as pressure, squeezing, burning or tightness in the chest. Usually starts in the chest behind the breast – bone and may also occur in the arms, shoulders, neck jaw, throat, or back. Sometimes it may feel like indigestion. Some people say that angina discomfort is hard to describe or that they can’t tell exactly where the pain is coming from.
What is the difference between heart attack and angina?
A heart attack happens when a narrowed coronary artery becomes blocked by a blood clot. The chest pain associated with heart attack is more severe than angina. It also lasts longer and does not usually go away with rest.
Normal artery and artery with artherosclerosis blood clot
NORMAL ARTERY (Image) ATHEROSCLEROSIS AND BLOOD CLOT
How is angina diagnosed?
To find out if one has angina, the doctor will ask about the symptoms, risk factors and family history of Coronary Heart Disease (CAD) and sometimes advice one or more tests to make a diagnosis. These tests are usually carried out in the hospital as a day care (which means that the patient does not have to stay overnight).
Exercise electro cardiography (TMT) – Angina often occurs with physical activity. This means that, if the ECG is done while you are resting, it may show a normal reading. For this reason you may be asked to do an ‘exercise ECG’ or a ‘Tread mill test’. This is an ECG carried out while you are pedaling an exercise bicycle or walking to the Treadmill. For patients of stable angina, TMT is often more useful than simple ECG.
(Image)
CTA (computed tomography angiography) – It is non – invasive test using an advanced CT scanner (64-slice CT) to detect presence of coronary artery disease. The advantage of CTA is that it is done as an out – patient procedure and can be performed in a very short time. Compared to coronary angiography which involves placing catheters in to the arteries, CTA contrast is injected into a vein in the forearm using a small plastic needle – making the procedure very comfortable. This type of exam has been used to screen large number of individuals for arterial disease, identifying aneurysms and detecting thrombosis (clots) in veins. CTA can also detect narrowing or obstruction of arteries in the pelvis and in the carotid arteries, which bring blood from the heart to the brain.
Coronary angiography – A coronary angiogram is a special X- ray that uses dye to show the insides of coronary arteries. It’s done to find out if coronary arteries are blocked or narrowed, where and by how much. An angiogram can help a doctor to see if one needs treatment such as angioplasty or stent, Coronary Artery Bypass Surgery (CABG) or medical therapy.
How is angina treated?
Most patients who are diagnosed with angina will have drug treatment at first, but some will need coronary angioplasty or coronary bypass surgery. Medical treatment can happen in a various ways. They can
- Reduce the chance of blood clots development increase the chance of blood supply to your heart
- Reduce the work your heart has to do
- Help keep your blood cholesterol level down
- Remember: never run out of your tablets
If coronary arteries are narrowed and if drugs do not relieve symptoms, or if angina is life threatening, one may be advised to have Coronary angioplasty or Coronary bypass surgery.
How can angina be prevented?
Make lifestyle changes – One can prevent or lower risk of angina and heart disease by making healthy lifestyle choices:
By physically active, as directed by your doctor
Lose weight, if you are overweight
Eat a healthy diet to prevent or reduce high blood pressure, high blood cholesterol and obesity.
Quit smoking, if you smoke. Smoking is a major cause of coronary heart disease, especially among younger patients. Pipe and cigar smoking also increase the risk. Within five years of stopping smoking, the risk of having a heart attack falls to about half of that of a smoker. Your doctor can also give you advice, including information on nicotine replacement products such as chewing gum, skin patches and tablets.
Treat related conditions – In addition to make a lifestyle changes follow your Doctor’s advice to reduce.
High blood cholesterol – take medications to lower your cholesterol as directed.
High blood pressure – keep your blood pressure levels under control. Take blood pressure medications as directed.
Diabetes (high blood sugar) – Keep your blood sugar levels under control and take medications as directed.
Overweight or obesity – talk to your doctor how to lose weight safely
Quick response time – Door to balloon response time is well within internationally accepted time (90) min
Onsite interventional cardiologist and cardiac surgeons
Male, Female, Arabic & Asian cardiologists
Multidisciplinary team – cardiology unit is backed by cardiothoracic, emergency and critical care – 24 x 7
Versatile range of Non- invasive, Interventional cardiology and Cardiothoracic vascular surgery
Interventional cardiology
- 24 hour acute coronary care
- Interventions (Coronary, Structural and Vascular)
- Angiograms, angioplasty, valvuloplasty and pacemaker insertions
Non- invasive cardiology
- ECG, Holter, TMT/ETT, TEE
- Stress, 2D, 3D – ECHO with Color Doppler
- 64 slice CT
Backups
- Ambulances, ICU and Emergency services
- IABP (Intra-aortic balloon pump), Heart – Lung machine
Cardiothoracic
- Coronary artery bypass surgery – On pump and off pump
- Valve surgery – Valve repair & Valve replacement