Pain from the heart called Angina is an indication that heart tubes are blocked. This also is an indication that Heart Attack and Death can happen. So, we should be worried about any chest pain which can be a Heart Pain or Angina. Thus we should know how to distinguish Heart Pain and other kinds of Pain in the chest.
Diseases Usually Confused with Heart Disease
A. Gastric pain, Gastritis, Oesophagitis: Commonly known as gas problem or gastric pain, these can mimic the symptoms of angina. Many angina patients avoid going to the doctor and do not take any precautions as they are ignorant of the manifestations of angina. Association of breathlessness, radiation to arms, relief of pain with rest or Sorbitrate, sweating, choking sensation are the hallmark of angina whereas gastric pain usually manifests itself as burning sensation, spasmodic in nature and does not aggravate on exertion.
B. Muscular pain in the chest: There are muscles on the chest which can be easily injured or sprained. If this occurs on the left side of the chest it may often confuse the patient. Such pains may be relieved by applying pain ointments like Moov, Iodex etc., or by having pain killers. There is usually a history of muscular pull or injury.
C. Cervical Spondylosis: Cervical Spondylosis is also a stress related disease and it manifests as shoulder pain, left or right arm pain and chest pain. The difference is that cervical pain is continuously present in both the right and left side simultaneously and is relieved by pain killers (and not with sublingual Sorbitrates). It is also recommended to confirm cervical disease by an X-ray.
Heart Attack Pain
One must understand angina occurs when the blocks are more than 75-80%. This pain gets relieved as the patient takes rest. But when the heart attack takes place the block is 100% and some part of the heart is dying. The pain of heart attack is different. It is often described as the “worst pain that the patient have felt ever”. It is more severe than Angina and lasts longer. Patients often describe it as – squeezing, crushing, and sinking. Usually this pain involves the central portion of the chest. The most common accompanying features of heart attack are profuse sweating, restlessness, shortness of breath and palpitation. Dizziness or complete black out may also be there.
In small number of cases small (minor) attacks do not give much symptoms and just pass off without much discomfort. This is called “Silent Attack”.
For confirming Heart Attack one must get an ECG done immediately. This often diagnoses Heart Attack in 90% cases. But the final reconfirmation should be done by a blood test called “Trop Test”. Here one drop blood of the patient is put on a slide and we look for the color change. Within a few minutes the test gives result and confirms/excludes heart attack. Later on some “Cardiac Enzyme” tests can be done to reconfirm the heart attack.
Tests for Confirmation of Heart Disease/Angina
- Medical History
- Holter Monitoring
- Stress Thallium Test
- MRI Scan
- PET Scan
- Stress Derbutamine Test