Dr. B S Bhatiya

Your heart is the most important and vital organ of all and regulates the flow of heart to all parts of the body. Thus, the valves and the arteries which take the blood to your heart are also an important component in ensuring that the circulation is constant. Thus, any hindrance to this process will put a lot of pressure on your heart and lead to more serious problems in the long run. Coronary artery disease is one such problem and can seriously put the health of your heart at risk.

What is coronary heart disease?
Coronary arteries are very important blood vessels, which carry nutrients, blood and oxygen to your heart. If the level of bad cholesterol is high in your blood, it will start leaving deposits on the walls of the arteries which are commonly known as plaque. This plaque will start building up over time causing blockage of the arteries and disrupting proper blood flow. Excessive build up of the plaque may then rupture the lining of the plaque. This will then induce blood clotting and further prevent the normal flow of blood.

Symptoms
Primary symptoms may include

1. Shortness of breath: This may occur while you are exercising or performing activities which are mildly exerting.
2. Heart beats very hard and fast: Your heart may beat very hard and fast, especially when doing everyday activities such as climbing stairs or walking for a prolonged distance.
3. Angina or chest pain: You may experience pain in your chest as if someone was pressing against it with a lot of force. Angina is also triggered due to stressful activities or even emotional stress. It usually occurs on the left or the middle of the chest and may even be felt in the back, arms, and neck.
4. Heart attack: Heart attacks are the most common and the most serious complications of coronary heart disease. You would feel extreme pain, akin to crushing on your chest, shoulder, or arm. It may even be accompanied by jaw pain, and sweatiness.

Treatment
Non invasive forms of treatment are always preferable rather than invasive surgeries or procedures to treat coronary heart disease, especially where the risk of serious complications such as heart attack are still on the lower side. Some of the treatments used for coronary heart disease are as follows:

1. Making lifestyle changes: Quit smoking, reduce alcohol consumption along with consumption of regulated diet will automatically start cleaning plaque that has built up within the arteries. Losing weight also tends to help.
2. Medications: Special medications can take care of cases wherein the deposits are still lesser and the plaque buildup can be removed without the requirement of extensive surgery. Anti-cholesterol medications are one example of this.
3. Surgical procedures: These are usually employed when the blockage is severe and cannot be corrected by the conventional methods mentioned above. Some of the procedures are angioplasty, stent replacement, as well as coronary artery bypass surgery. If you wish to discuss about any specific problem, you can consult a cardiologist and ask a free question.

If you thought that chest pain occurred only due to a heart-related issue like a heart attack, you are wrong. Chest pain is one of the most common reasons that people visit the emergency services and it can be caused due to problems with your heart, lungs and digestive system. 

Chest pain can be due to either of these two main reasons:

Heart- related Issues

1. Heart attacks called myocardial infarctions are very common reasons for chest pains. During a heart attack, the blood supply that serves the heart with oxygen is cut off due to plaque build-up in heart arteries causing the death of heart muscles. 

• Other reasons for heart attacks are blood clots or torn blood vessels. 
• Not all people having a heart attack have symptoms. Usually, people report symptoms like chest pain, upper body pain, nausea, sweating, fatigue, and trouble breathing.
• A heart attack is a serious medical emergency for which immediate care is needed.

2. Angina pectoris is a type of chest pain that results from reduced blood flow to the heart. Low blood flow means your heart doesn’t get enough oxygen. The angina pain is often triggered by physical activity or emotional stress and feels like a vice squeezing your chest or a heavy weight on your chest. It can also spread from your chest to your neck, arms, and shoulders. Other symptoms are fatigue, dizziness and nausea and these normally last up to 15 minutes only.

3. Unstable angina which causes crushing chest pains suddenly and even when you are not doing anything strenuous is a medical emergency as it can lead to a heart attack. This usually shows that your heart, arteries are narrowing alarmingly.

4. Other heat-related reasons for chest pains are-

• Mitral valve narrowing or stenosis
• Heart arrhythmias
• Coronary Artery disease
• Inflammation of heart muscles or pericardium and weakening of the heart muscles. 

All of these are emergencies and need immediate medical attention to prevent a fatality.

Not Heart- related:

1. Lung conditions like Pneumonia, Bronchitis, Pulmonary embolism. 

• Pneumonia is an infection in one or both lungs caused by fungi, bacteria, or viruses. It causes inflammation in your lung’s air sacs and makes them full of pus which makes it difficult to breathe and causes chest pains, amongst other debilitating symptoms.
• Bronchitis is an inflammation of your bronchial tubes. It can be chronic or acute and it can cause a cough with mucus and chest pains. 
• Pulmonary embolism is a blood clot that occurs in the lungs. It can go on to damage parts of your lung due to limited blood flow. Apart from this, it can also decrease oxygen levels in the blood and affect other organs. 

It can be life-threatening due to permanent lung damage. The most common symptom of a pulmonary embolism is gradual or sudden shortness of breath. 

There is also- 

• bluish skin tone 
• anxiety
• fainting
• hest pain that extends into your arm, jaw, neck, and shoulder
• lightheadedness

2. Rib cage inflammation or Costochondritis is also known as Tietze’s syndrome. It is an inflammation of the cartilage in the rib cage. Patients experience chest pain in the upper and middle rib area on either side of the body due to this. The pain can also radiate to the back or the abdomen, getting worse if you move, stretch, or breathe deeply.

3. Food pipe disease or Esophagitis is any inflammation or irritation of the oesophagus, a tube that sends food from your throat down to your stomach.

Common causes of food pipe disease are acid reflux or GERD and bacterial or viral infections. 

GERD- This condition occurs when the stomach contents and acids back up into the oesophagus. This causes chest pain that can mimic a heart disease. There may also be oesophagal spasms due to GERD. If you wish to discuss about any specific problem, you can consult a general physician.