Many people have some feelings of chest discomfort, these can range from simple indigestion or heartburn to an actual heart attack. How can you tell the difference? When someone mentions chest pains, heart doctors worry that these could be angina or the warning signs of of a plugged up artery. Hardening of the arteries or atherosclerosis is a disease of the blood vessels where fatty deposits build up on the inside of blood vessels. As these deposits grow, the blood vessel is restricted and blood flow is reduced.
The heart is a muscle that is always working and it needs a continuous supply of blood flow. When you exercise, your heart pumps faster and harder and with peak exercise the blood flow to the heart quadruples. If there is a blockage in one or more arteries to the heart, the heart muscle does not get enough blood flow and this triggers an uncomfortable feeling or angina. If you have ever worked on something above your head for an extended period of time such as fixing a light fixture or using a screwdriver, eventually your arms will start to ache. This is due to not enough blood flowing up your arm muscles which are working hard on the project. If you simply stop and lower your arms, the blood will rush back in and the symptoms will stop immediately. The same symptoms occur when the heart is working hard, but not getting enough blood flow.
Although the heart sits in the middle of the chest, angina symptoms can occur almost anywhere between your ears and your belly button. "Textbook" symptoms are a squeezing or tightness or burning or heavinesss in the middle of the chest often more to the left side. Most patients are quick to add that this is not a "pain" but rather an uncomfortable feeling. Many times these symptoms radiate to the left shoulder or arm.
Some people never read the textbook. Women often have symptoms that are not as typical as I just described. Some patients with angina only get arm or wrist pains with exercise. Others will only get jaw or ear discomfort, some will feel sick to their stomach. Diabetic patients may not get any pain at all, sometimes their only symptoms are unusual shortness of breath with activity or simply a sense that "something is not right," without having any more specific symptoms.
Recently I saw a man who was developing bad shoulder pains. He had MRI scans and was found to have a shoulder injury. He saw an orthopedist to have surgery to repair his injury. As it turns out, the shoulder pains only occurred when he exercised and were not due to his shoulder injury, but rather due to a seriously plugged up heart artery. I placed a stent in his blocked artery and now he can exercise without his shoulder hurting!
Heart pains take a few seconds to begin and will build over the next minute or so. Uncomfortable feelings that occur instantly as if a light switch was just turned on or start out with maximum intensity like a bolt of lightnight are almost certainly not angina symptoms. If you have symptoms that seem to be worse after eating or with swallowing or the chest discomfort hurts more with a deep breath, you probably do not have a plugged up artery, but it would be a good idea to be checked out by your doctor.
Although there are both typical as well as unusual symptoms that can occur with heart blockages, the most important point is to listen to your body. If these symptoms persist, it would be much better to be seen by your doctor and be told that you are fine than to tough it out and risk missing the chance to catch a minor problem before it becomes a serious one! If something does not feel right, your body is talking to you. Are you listening?
