More Than Just Chest Pains

A man experiencing difficulty breathing while having his palm on his chest and in obvious pain is the classic image one may associate with a heart attack or heart disease. While the scenario is indeed possible, Dr Shahrul Zuraidi Idris, consultant interventional cardiologist and physician at Columbia Asia Hospital – Klang, reveals that there is more to heart attacks than excruciating chest pains.

“The most classic signs of a heart attack, especially among males, are a central crushing pain, feeling of pressure around the chest, and pain radiating towards the arm or jaw. Females can have atypical symptoms. The nature of their pain or discomfort may vary from males, including an electrical sensation, pins and needles, giddiness, neck pain, and numbness on the arm without any chest pain at all.”

In addition, a significant number of people who have diabetes can develop “silent angina” or “silent heart attack” where they can have coronary artery blockage without any chest pain symptoms. As the signs of heart disease or a heart attack are diverse, Dr Shahrul warns not to be fooled by the various types of pain or downplay the seriousness of these symptoms.

A greater danger is when people live in denial about the possibility of having heart diseases due to age or lifestyle. He says, “Nowadays, people of the younger generation also get heart attacks. In my years of practice, the youngest heart attack patient I have treated was 15 years of age.

“Sometimes, people are in denial about heart issues because they play sports and believe they do not have a problem, but there are people who died while playing sports because they may have experienced pain in the past yet did not turn to a medical professional to investigate.”

For this reason, Dr Shahrul believes it is best to investigate for heart issues than to live in oblivion. He recommends taking extra precaution and going for a heart check-up should individuals ever feel any kind of pain around the central chest area as it could be a turning point in life. As heart disease is a chronic condition, patients may require long-term treatment and incur huge financial costs should they fail to receive early diagnosis and treatment.

The unfortunate reality, however, is that females tend to only consult a doctor or cardiologist at a later stage because they are not aware of the subtle and atypical signs to look out for. People should thus be concerned with the various risk factors associated with heart disease, which include smoking, family history of heart disease, diabetes, hypertension, high cholesterol, lack of exercise and high daily stress levels.

Regarding people who may have heart disease even if they lead an active lifestyle, Dr Shahrul says, “When you talk about sports or exercise, you are only talking about reducing one risk factor. It is never mentioned that if you do a lot of sports, your blood pressure, cholesterol and sugar levels will always be low. Addressing only one risk factor may not be enough.

“Heart disease affects everyone. There are modifiable and non-modifiable risks. Hence, doctors stress the importance of undergoing health screenings, especially for people over the age of 40.” According to him, most prolonged and severe chest pain should be treated seriously unless proven harmless by medical tests, be they an electrocardiogram (electrical conduction of the heart), echocardiogram (ultrasound of the heart), blood tests, stress test or coronary angiogram.

He points out that even if a chest pain symptom was not caused by a heart attack, other conditions that require immediate medical attention are aortic dissection (the tearing or bursting of the aorta wall), perforated stomach (gastritis due to ulcer), pneumothorax (where the lung covering gets in contact with air) and pulmonary embolism (blood clot in lung tissues).