Know the signs, symptoms of heart disease

Published Feb. 26, 2009
By Lt. Col. (Dr.) Della Dillard
Family Medicine, 72nd Medical Group

TINKER AIR FORCE BASE, Okla., -- Coronary artery disease is the main cause of death in the United States. When severe, the disease may initially present itself as chest pain. If you have chest pain, ask yourself some questions.

First, does the chest pain start in the middle of the chest or on the left side and go up the neck or jaw or down into either arm? Does the pain feel like a tightness, squeezing or pressure like something sitting on your chest? These are the classic symptoms of a heart attack. Go to the emergency room if the chest pain persists more than a few minutes.

If you are sweaty, weak or feeling faint and have no one to take you to the ER, call 911. If you are a female or have diabetes, you are much more at risk for a "silent heart attack," that may only feel like a stronger than usual sense of fatigue.

Do you have high blood pressure, high cholesterol, diabetes or smoke tobacco? If so, you are at a higher risk for having a heart attack. If you already have CAD or have had a heart attack, an angioplasty (balloon), a stent or bypass surgery, you can still have chest pain due to blockage in other blood vessels or in the bypass or stent itself. This pain may be similar to previous episodes of chest pain, but, it may also be very different.

If you have CAD and have also taken an erectile dysfunction drug within the last few hours prior to the chest pain, inform the emergency medical staff. Do not be embarrassed, the ER needs to know, because if you are given nitroglycerin after using these medications, your blood pressure can drop dangerously low.

If you have CAD and find yourself using multiple pillows or sleeping in a recliner to be able to breathe comfortably at night, see your doctor, your heart may be getting weaker. Are you under a lot of stress lately? Spasm of the esophagus can produce severe squeezing chest pain that actually improves with nitroglycerin.

Heartburn can produce chest pain that is associated with eating and has a burning sensation. Antacids or acid blocker medications may be helpful for this gastric acid reflux. Caffeine in high energy drinks, sodas, teas or energy supplements can cause chest pain, anxiety, heart palpitations and severe fatigue, just like methamphetamines and cocaine.

Have you done any strenuous activity that you are not used to doing in the last three or four days? Stiffness and inflammation of the chest wall muscles can seem like a sharp pain just over your heart and usually in a specific area that is tender to touch. Ibuprofen or Naprosyn may help with the pain of pulled or strained muscles.

Have you been dieting or had a major change in lifestyle? For example: obesity surgery, pregnancy, menopause or use of diet pills? These events can cause basic changes in the body's chemistry and can cause gallstones to develop.

If you have gallstones and eat a greasy or spicy meal, you may develop pain two to three hours after eating. This can be extremely painful, similar to a heart attack and include palpitations. Belching or increased gas can also be present. Changes of this nature may not be realized unless family members voice their concerns.

Have any family members had stents placed in their heart or bypass surgery? Don't assume that if your parents or grandparents had their heart attacks in their 70s that you don't have to worry until then. Heart disease develops with obesity and diabetes and is occurring at earlier ages. Take care of yourself. See your doctor for an annual examination.

For more information go to American Heart Association at www.americanheart.org and National Heart Lung and Blood Institute at www.nhbli.nih.gov