AS TECH BLOGGER MALIK HAS HEART ATTACK WE REVIEW CHEST PAIN SIGNS OF HEART ATTACK AND TESTS AND EVALUATION OF CHEST PAIN

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I had a heart attack on Dec. 28. I was able to walk into the hospital for treatment that night and have been recovering here ever since. With the support of my family and my team, I am on the road to a full recovery. I am going to be OK. That is what Om Malik, author of the popular tech blog, GigaOm, wrote about his experience of a recent heart attack. That a young man of 41 can have a heart attack is a sobering reminder to us all of the importance of health and constant vigilance and how important it is that even the young and athletic not automatically discount chest pains. I wish him well.

Omega 3 and the Heart






There are many causes of chest pain. Each year, millions of people seek emergency medical care because of chest pain,(and foolishly many people ignore chest pain when they ought to call 911) the most common symptom of heart attack. For many, heart attack is the clear diagnosis, but annually more than 6 million people are admitted to the hospital because the answer isn’t clear. Besides a heart attack other cardiac causes include angina. Even a normal EKG is not necessarily enough to rule out a heart related condition.



Many times just the story, the history, is enough to convince the doctor to hospitalize a patient.If the electrocardiogram (EKG) is normal and initial blood tests for "heart enzymes" such as CPK and troponin don’t show signs of dying heart muscle, patients are usually admitted for observation, repeat EKGs, blood tests and other tests to rule out heart problems. Many cases of chest pain are not heart related. Even so, it's pretty obvious that the heart is right up there on the list of causes that the doctor has to think about and identify ASAP. So the doctor starts pointed questions about the chest pain. Questions like

How long does it last?

What is the family history?

What is the personal history, high blood pressure,heart problems?

Where is it located?

What brings it on?

What sort of risk factors does Joe have?





As she enters the room, Joe Johnson's doctor can't help but notice the look of trepidation on Joe's face. She's seen him many times before but this time something is clearly bothering him. As she says hello and asks Joe how he's doing, the reason for Joe's distess is soon apparent. It turns out that he has been experiencing chest pains for the past month that are alarming him.

Many Causes of Chest Pain

In Joe's case, he's been under a lot of stress, sometimes waking up at night with a "feeling" in his chest and it seems to occur also when he's lifting or exerting himself.

The EKG, the Stress Echo, the Stress Myocardial Perfusion Imaging

This certainly sounds like it could be cardiac so the doctor orders an electrocardiogram (EKG) in the office. The EKG is where they attach the wires with little sticky things to the chest and see the wavy lines drawn on graph paper by the machine. Both the doctor and Joe are relieved to see that the EKG as well a chest x ray are both "within normal limits".








But the problem is that a person's EKG can look "normal" and yet the person may still have some blockage of the coronary arteries, the arteries that feed the heart muscle itself.



So what next? Well, the doctor could order a coronary angiogram to look for blockage. In a coronary angiogram, they insert a catheter into a blood vessel in the groin and thread it up to the heart and inject a dye. The dye helps to make the blood vessels of the heart visible on x ray. Using a series of pictures it's possible to see narrowing and blockages of the coronary heart blood vessels. But this is often not the first test that will be ordered.

Pictures and What is an Angiogram



Instead there are a group of "noninvasive" tests that can be used to gauge how the blood supply of the heart is doing.

Non Invasive Tests of Heart Blockage

Many of the non invasive tests involve exercise and then seeing how the heart responds to it. In some cases the patient may not be capable of doing the sort of aerobic exercising needed. In that case, there are ways to "chemically stress" the heart. Among the tests are

Treadmill Test, the Stress Test

Here they have you run in a treadmill while they see how your heart responds on an EKG

Stress Echo

Here you are exercising again but now they are looking at your heart with an ulrasound, like using ultrasound to see a baby in a pregnant woman. The ultrasound is valuable because they can see how your heart is beating, how the walls are moving. When the heart walls don't move properly it can indicate that a part of the heart is functiong incorrectly due to inadequate blood flow.




Watch the Video Classic Symptoms of Heart Disease Click the Arrow to Start

Stress Myocardial Perfusion Imaging (myocardial means heart muscle)


Here again you are exercising. This is probably one of the more informative "non invasive" tests. Here they inject of a small amount of radioactive material which circulates in the bloodstream. The radioactive material accumulates in the heart tissue according to the degree of good blood supply in the heart. If they see that when you exercise there is decreased blood supply compared to resting it indicates ischemia.

PET Scan

The PET Scan can see the blood flow of the heart. PET stands for positron emission tomgraphy. The PET scan is a relatively high tech scan that is not yet widely used. For one thing, it's very expensive. But it works well .

See what the Heart Association Says About Imaging the Heart

Electron Beam CT

You've probably heard this advertised. You don't need to exercise for this test. The special CT scanner looks for the presence of calcium deposits in the arteries.High calcium deposits have been associated with blockage of the arteries.