Tired of ads? Subscribers enjoy a distraction-free reading experience.
Click here to subscribe today or Login.

Chest pain isn’t always related to heart disease, but it can be associated with several serious medical conditions, so it’s always worth getting checked out.

Chest pain or discomfort that occurs when your heart isn’t getting enough blood is called angina, and it’s a symptom of coronary artery disease (CAD), which is a narrowing of arteries that lead to the heart due to fatty buildup.

Stable angina is usually felt during periods of physical activity or strong emotion, and it typically subsides with rest or medication.

Unstable angina is caused by blood clots that block an artery partially or completely, and it should be treated as a medical emergency. It usually occurs while you’re resting or exerting yourself very little, and it can lead to a heart attack.

Chest pain can also be a characteristic symptom of a heart attack, which is what happens when the heart is deprived of oxygen because its blood supply has been reduced or blocked. A heart attack is always a medical emergency, regardless of severity, but severity can dictate treatment.

In some cases, a heart attack can be treated with medications that break up blood clots or widen blood vessels. In others, an interventional procedure is necessary.

Interventional cardiologists use a minimally invasive technique called a cardiac catheterization to both diagnose and treat the heart and affected arteries during a heart attack. Using a small, thin tube called a catheter, they can produce diagnostic imagery, run tests and perform additional procedures.

An angioplasty restores the heart’s blood flow by opening blocked arteries. During an angioplasty, a catheter containing a tiny balloon is fed to the affected artery, where the balloon is inflated to gently widen the artery so blood can flow.

Another way to keep an affected artery open is to insert a small, wire tube called a stent. Once a stent is in place, it can prevent future heart attacks with the support of healthy lifestyle choices.

Sometimes, an open-heart procedure is necessary. For a severe blockage, arteries can be opened with coronary artery bypass graft surgery. Often abbreviated CABG (“cabbage”), these surgeries take a healthy artery from another part of the body and attach it to the blocked artery on one end and the heart on the other. This creates a new path for blood to flow, bypassing the blockage.

In severe cases, heart attacks can cause cardiac arrest, the sudden loss of heart function, or heart failure, inability of the heart to pump efficiently enough to feed blood to the rest of the body.

When cardiac arrest occurs, cardiopulmonary resuscitation (CPR) can renew its function or defibrillation can be used to send an electrical shock to the heart to reset its normal rhythm. Once the heart is beating again, the underlying cause (the heart attack) can be treated.

If a heart attack patient is in late-stage heart failure, a left-ventricular assist device (LVAD) can be implanted to help the heart’s pumping chamber do its job during and after recovery.

Some patients are so ill during a cardiac event that their heart and lungs need support and time to heal before a surgery can be safe to perform. In those cases, extracorporeal membrane oxygenation (ECMO) can be used to get them strong enough for a life-changing procedure.

So, you see, chest pain might start the same way for many people, but it can be indicative of many points along the chest pain – heart attack spectrum.

Fortunately, we’re lucky to have three Comprehensive Heart Attack Centers in Wilkes-Barre, Scranton and Danville. Geisinger Wyoming Valley Medical Center, Geisinger Community Medical Center and Geisinger Medical Center have met The Joint Commission’s standard for coordination among care teams who treat chest pain patients, so no matter where you are on this spectrum, you can get treated quickly and with expertise in our community.

***

Dr. Alfred Casale, a cardiothoracic surgeon, is chief medical officer for surgical services for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via [email protected].