Dr. Kaushik Biswas
Mr. S. Ghosh, a 58-year-old accountant was watching TV after dinner when he began to feel an odd pressure in the center of his chest. It wasn’t exactly painful—just tight, like someone had placed a heavy book on him. He dismissed it as gas. Fifteen minutes later, he collapsed. What Mr. Ghosh didn’t know was that he was experiencing the early signs of a heart attack—and like many others, he ignored the warning.
In India, heart disease remains the leading cause of death, and a major reason is delay in recognizing cardiac chest pain. A heart attack can happen at any time—at home, at work, or even during rest. But knowing how to identify cardiac chest pain can save your life or the life of someone you love.
What Is Cardiac Chest Pain?
Not every chest pain is a heart attack—but some types are far more dangerous than others. Cardiac chest pain is the discomfort that occurs when the heart muscle doesn’t get enough oxygen-rich blood. This is often due to blockages in the coronary arteries, the vessels that supply blood to the heart.
This pain, known medically as angina and in its extreme form manifested as myocardial infarction (when heart muscle begins to die), typically has the following features:
Key Features of Cardiac Chest Pain
- Location: Often in the center of the chest, sometimes slightly to the left
- Nature: A feeling of pressure, heaviness, squeezing, or tightness
- Radiation: May spread to the left arm, neck, jaw, shoulder, or back
- Duration: Typically lasts more than 5–10 minutes
- Triggers: Physical activity, emotional stress, cold weather,or heavy meals
- Relief: May improve with rest or nitroglycerin (if prescribed)
Associated Symptoms to Watch For
Even if the pain is mild or vague, pay attention to associated warning signs:
- Shortness of breath
- Sudden sweating (cold sweat)
- Nausea or vomiting
- Palpitations (fast heartbeat)
- Lightheadedness or fainting
- Extreme fatigue (especially in women and elderly)
In some people, particularly women, older adults, and those with diabetes, a heart attack might not cause classic chest pain at all. Instead, they might feel breathless, uneasy, or have what feels like gas, jaw pain, or unusual tiredness.
Plan of Action: What to Do Immediately
If you or someone near you shows these symptoms, do not delay. Time is muscle—delaying treatment causes more of the heart muscle to die.
Here’s what you should do:
- Call for Emergency Medical Help
- Chew and swallow an aspirin if available and not allergic—this helps prevent further clot formation.
- Keep the person calm and seated or lying down. Do not allow physical activity.
- Note the time of symptom onset—this helps doctors determine treatment options.
- Do not wait more than 5 minutes if symptoms persist. Even if the pain subsides, get evaluated.
What Happens in the Emergency Room?
- ECG (Electrocardiogram): to check for heart rhythm changes
- Blood tests (Troponin levels): to detect heart muscle damage
- Chest X-ray or echocardiography: to assess heart function
- Coronary angiography: if a heart attack is confirmed
Based on the diagnosis, treatment may include blood thinners, clot-busting drugs, or even angioplasty and stent placement to open blocked arteries.
How to Prevent a Heart Attack
While emergency treatment has improved survival, prevention remains the best cure. Cardiac events don’t happen out of the blue—they often result from years of silent damage caused by:
- High blood pressure
- Diabetes
- High cholesterol
- Smoking
- Obesity
- Sedentary lifestyle
- Stress and poor sleep
- Family history of heart disease
Simple lifestyle changes can drastically reduce risk:
- Eat a heart-healthy diet (low in salt, sugar, and bad fats)
- Exercise for at least 30 minutes most days
- Avoid tobacco and limit alcohol
- Manage stress and mental health
- Control chronic illnesses through regular checkups
If you’re unsure whether your chest pain is serious, assume the worst until proven otherwise. It is better to have a false alarm than to ignore a true emergency. The heart doesn’t shout. It whispers warnings—recognize them before it’s too late.
Let’s make awareness our first step toward a heart-healthy India.
(Author is MBBS, MD (Gen Medicine), DM (Cardiology), MRCP (UK),FESC,FSCAI, Consultant Cardiologist, Peerless Hospital, Kolkata. Views are personal.)
