Cardiology and Cardiothoracic Surgery/Chest Pain
Chest pain caused by cardiac ischaemia is called angina. It is most often triggered by exertion. Angina can also be precipitated by emotional stress, exposure to cold and sometimes may occur after eating a large meal. Usually it decreases when the patient rests and increases if the exertion is continued.
Insufficient blood flow to the heart results in an area of the heart muscle becoming deprived of Oxygen which then stimulates pain fibres.
The underlying pathology is narrowing of the blood vessels by fatty deposits called Atheroma. These narrowings restrict the amount of blood that can flow through the blood vessels. As the individual exercises the energy requirements and therefore oxygen needs of the heart muscle increases. If the blood flow to an area of the heart is not able to increase to cope with the heart muscles requirements Angina may result.
The main risk factors for developing Angina are: Hypertension, Hyperlipidaemia, smoking, age, Diabetes and obesity. It is important to note that not all episodes of cardiac ischaemia are associated with pain, so called Silent Ischaemia which is found more often in people with Diabetes.