Chest Pain 101

For people with chest pain, known as angina, the symptoms are often a warning sign of an impending heart attack. Angina occurs when the tiny coronary arteries that provide oxygen rich blood to the heart muscle aren’t able to keep up with the hearts demands. With less blood flow from narrowing caused by atherosclerotic plaques, the heart muscle is literally starving for oxygen. This in turn causes pain, shortness of breath, fatigue and anxiety.

What to Do:  People with chest pain should see their health care provider or go to an ER ASAP. These are the kinds of symptoms that shouldn’t be ignored, but evaluated immediately. Chest pain can occur from many different causes including:

Causes

  • Heart Attack
  • Angina
  • A pulled muscle
  • Acid reflux or GERD (Gastro Esophageal Reflux Disease)
  • Panic Attack
  • Blood clot in the lung, and
  • Gallbladder attack.
Women are Different
Many women don’t experience chest pain with coronary artery disease and heart attack. They may just feel fatigued, be nauseated, and have some sweating. These symptoms are often mistaken for other conditions.
 
With 1 in 8 women having heart disease, which may have more subtle and silent symptoms, it’s important to get regular screenings for blood pressure and cholesterol levels. 
 
Treatments
If a person has a new onset of chest pain that’s caused by coronary artery disease, when they’re in the ER, the treatments may include:
 
Medical Treatments
  • Oxygen – provides more oxygen to the heart muscle
  • Nitroglycerin – to help dilate the coronary arteries and restore the blood flow
  • Pain medication – people in pain breathe faster, have more adrenaline in their system and thus use up more oxygen. Decreasing pain will help the muscles relax and oxygen to get to the heart muscle more efficiently
  • Blood pressure and other heart medications – to lower blood pressure and heart rate as well as helping to prevent the irregular and abnormal heart rhythms
  • Blood thinners and clot busting medication – these can help dissolve blood clots and prevent new ones from forming, and
  • Cholesterol medications – To reduce cholesterol in the blood that contributes to the atherosclerotic plaques that build up within the coronary arteries, causing blockage or narrowing.
Diagnosing 
Before any surgical procedure, the cardiovascular surgeon needs to know exactly where the narrowing and blockages in the coronary arteries are. They do that with a procedure known as a Cardiac catheterization:

Here’s a video of that procedure.

Surgical Procedures
Coronary Artery Angioplasty – In order to open up the blocked or narrowed coronary arteries, a tiny catheter can be inserted in the person’s leg and gently guided up to the heart. The catheter will be carefully placed directly into the coronary artery and an even tinier balloon will be inflated. This balloon will push and compress the atherosclerotic plaque outward, creating a larger opening for blood to go through.  Often a stent is placed that is left in place to create a tube within the artery for blood to flow through.

Coronary Artery Bypass -  In this type of surgery, a vein or artery from the person’s leg or arms are used to replace or “bypass” the area of the coronary artery that’s blocked. The new vessel is grafted above and below the area of blockage which enables blood to flow past the area that’s blocked.

Innovative Non-Surgical Procedures
EECP - Enhanced External Counterpulsation – This is an innovative treatment for people who have stable angina, or who have already had surgical procedures to treat their coronary artery disease.  With  EECP  the person has specialized pressure cuffs placed on their legs.  These are synchronized with the person’s own heart beat via an EKG. When the heart is resting (which is milli-seconds), the cuffs inflate to provide counterpulsation. This in turn increases the blood flow to the heart and can help reduce or eliminate angina.

Read Here to Learn More.

Disclaimer

I hope you'll join me for the Day of Dance on Saturday February 25th. This is part of a nationwide event to help all of us get up and get moving to reduce our risk of heart disease.   I'm delighted to be working with El Camino Hospital to inform people about the incredible services available there, including their Heart and Vascular Institute.

Follow me on Twitter@NurseBarbDehn.

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