Act swiftly when you feel heaviness in your chest
— Chest pain is one of the most common reasons for seeking emergency medical care and has many possible causes. It may be due to disease involving the skin, musculoskeletal or digestive system. In one out of four patients with chest pain, the pain is due to a life threatening cardiovascular cause like heart attack (acute coronary syndrome). The difficulty lies in identifying patients with these life threatening conditions from those with non-cardiovascular, non-life threatening chest pains.
Most heart attacks occur when the blood supply to a part of the heart muscle is blocked. This usually starts with a process of fat deposition (plaque) in the inner lining of blood vessel which suddenly becomes fragile and ruptures. Plaque rupture cause blood clot formation which causes sudden blockage in blood flow in the artery that supplies the heart (coronary artery).
Chest pain relating to heart attack is often felt as heaviness or squeezing sensation along the left side of chest or midline associated with sweating and breathing difficulty. The discomfort often radiates to the shoulders, neck, or arm. It typically increases in intensity over a period of a few minutes. The pain may begin with exercise or psychological stress. But atypical presentation can occur in women, elderly persons and diabetics where the presenting symptom may be only breathing difficulty, giddiness, sweating or extreme tiredness.
It is often difficult to come to a conclusion of the cause of chest pain, its best to go the nearest medical centre for further evaluation. Avoid giving anything by mouth. If patient is experiencing severe pain and feeling dizzy then keep him in lying down posture, loosen his clothing and shift by ambulance to the nearest hospital.
Do not administer any medications unless advised by your doctor. Every moment is precious in a patient with suspected heart attack. So act fast and do not hesitate to get medical help presuming would be a non-cardiac pain.
Immediate recognition and treatment of cardiac type chest pain is necessary to improve outcomes and avoid complications. Clinical assessment, blood markers for myocardial injury and ECG are the basic tools used in evaluation of a patient with chest pain. One set of these investigations being normal does not rule out the possibility of having a cardiac problem.
If the diagnosis is heart attack, then the aim of treatment is to restore blood flow at the earliest and minimise the amount of heart muscle damage. Time is the key to prevent irreversible damage to the cardiac muscle.
The treatment options are either to use a clot busting medicine (thrombolysis) or to locate the clot/ blockage at angiography. The clot is then removed by a tiny balloon dilatation (primary angioplasty) combined with placement of a small wire mesh tube (stent). Primary angioplasty offers much better outcomes in a heart attack patient as compared to thrombolysis.
— By Dr K.G. Sundar Kumar, Specialist Interventional Cardiologist, International Modern Hospital (This article has been sponsored by the advertiser)