Chest discomfort: Acidity or heart attack?
The sudden untimely death of popular actor Sidharth Shukla’s at the young age of 40 has left many fans and the public shaken and gasping for answers. From what I could gather, he was young, and fit and popular, and seemed to have been fine and normal till the previous evening.
It was around 3 at night that he experienced chest pain which he possibly attributed to acid or gas, drank some water and tried going back to sleep. The pain persisted in the morning, for which his doctor advised him to go to the hospital butby the time he did, he was dead.
Most “cardiac” chest pains are no longer as typically described in text books: crushing type in the center of the chest, radiating to the left shoulder or arm, associated with sweating or breathlessness.
More often the initial symptoms are of gaseousness or heartburn or vomiting, and are often put down to “indigestion” or GER (Gastroesophageal reflux). Many patients pop antacid pills or drink cold water to soothe their food pipes. Further, symptoms of the two can overlap considerably!
For doctors too, the line dividing “don’t worry, take some antacids” or “rush to a hospital right away” pieces of advice is becoming blurred. The traditional differentiators: age, sex and fitness are not so predictable anymore!
Cardiac deaths are making us redraw our guidelines. They are occurring with increasing frequency in younger people, even in females, and in many who seem to be eating right, going regularly to the gym, and maintaining normal body weights. Stress of course remains an unmeasurable factor! The “heart scare” has already set in. A study revealed that over 50% of those who presented to the emergency at night with discomfort in the chest had normal cardiac tests.
But what about the other 50%? My 35-year old colleague had attended a hospital at 9 PM when a nagging chest pain had refused to die down through the day, Four hours and 2 hospitals later, he was diagnosed to have suffered a heart attack. He is luckily well 6 years later after undergoing a coronary stenting.
It is good to remember that acidity and gas do not kill, but heart attacks may. The embarrassing choice is between waking others up at night and going to the emergency and being taunted as a hypochondriac should the test be normal, or wait till the morning! Time can sometimes be of essence in matters of the heart.