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Many patients I see or speak to are understandably worried that they have a symptom or two or indeed three which might suggest a heart problem – usually 1. chest pain, 2. Breathlessness  and 3.palpitations or a combination of these. We all know how important the heart is in pumping blood around our bodies and as we get older, the heart can start to strain and run into trouble which can impact that person’s health but also that of their carer. Related to the three symptoms I mentioned above, I am going to cover 4 different conditions we commonly see and that you may be aware of, but also measures you can take to improve your heart health and hopefully prevent your pump running into trouble.

Many of us experience chest pain, breathlessness or palpitations and most of us worry that it is coming from our heart but these symptoms don’t always mean there is a heart problem. Heart conditions become more common as people get older, but can affect younger people. Whilst, sadly, we have not come up with an antidote to ageing (yet!!!) there are 4 heart disease risk factors that we can control – they are smoking, high blood pressure, diabetes and cholesterol – I will mention these again at the end.

The 4 common heart conditions are:

  1. Angina: When the arteries supplying blood and oxygen to the heart muscle start to narrow causing the symptoms of chest pain and / or breathlessness, particularly when the person is exerting themselves, perhaps going up the stairs or walking the dog. This is called angina. As the narrowing increases, the pain or breathlessness will come on more quickly. Of course chest pain and / or breathlessness can arise from other causes including chest muscle pain or lung problems however you should mention this symptom to your GP as soon as possible so they can work out with you and your carer what the cause might be and get you investigated and treated as necessary. If the pain comes on at rest, then this can mean that the angina is getting worse, something called unstable angina, and needs emergency investigation and treatment in hospital.
  1. Heart attack (myocardial infarction): If the artery closes off, which happens suddenly, this then causes a heart attack (known as a myocardial infarction) where the heart muscle gets no blood and dies very quickly. The classic symptom is sudden resting chest pain, nausea, breathlessness and feeling generally unwell. This is an emergency and needs a 999 call to be treated so that the dying heart muscle can be saved usually with a stent. Amazingly many people, nowadays, are in and out of hospital with in a day or two of having a heart attack which shows just how much medicine has progressed.
  1. Electrical problems (arrhythmia): Apart from needing blood and oxygen to work, the heart also needs electricity to generate ‘the pump’ to push the blood out and around the body. The bigger the push, the higher your blood pressure. If the electricity plays up, then this is called an ‘arrhythmia’ and this can come and go. Common symptoms of an electrical problem include palpitations where you become aware of your heart beat, but also feeling breathless and sometimes light headed if the pump is not working well and the blood pressure drops. Common electrical problems many of you would have heard about include atrial fibrillation (irregular heart beat) which is investigated with an ecg and treated with medication. Another condition is called heart block which often means the person needs a pace maker to help the heart work better. If you have any palpitations, breathlessness or episodes of feeling light headed, then please mention these to your GP as soon as possible.
  1. Heart failure: The forth condition can result from a heart attack or an electrical problem that I have mentioned above and is called heart failure. This is where the heart pump does not work very well to push blood around the body meaning that blood can build up in the ankles causing swelling or on the lungs causing breathlessness, particularly on exertion. Again, these symptoms can be subtle but are easy to investigate with a blood test (called a bnp) and if this is positive we can get a heart ultrasound (echocardiogram) done. Many people have these symptoms and it turns out not to be heart failure, but it is important for you and us to work out what is going on so we can treat you and help you feel better.

At the start of this blog I mentioned the 4 risk factors we can influence both for ourselves and our loved ones. They are additive, so the more you have the more you risk your arteries furring up. Less people smoke now then they used to which is great news and it is never too late to stop. Sadly diabetes, particularly type 2, is becoming more common as we put on weight. This condition can be greatly  improved either by losing weight and exercising or taking medication tablets or in some cases, insulin. The NHS is much better at looking for high cholesterol and high blood pressure nowadays and treating these 2 important risk factors with medications long before they cause a heart attack. However, we still miss people and they are so easy to test for, so again, please approach your practice where a nurse or health care assistant or pharmacist will help you.

Finally, we are working much closer with our pharmacy colleagues both in a chemist, but also many practices have an ‘in house’ pharmacist. They are fantastic colleagues and such a valuable addition to our team who help to look after you. Please ask them or your GP any questions around your heart concerns.

I have covered a lot in this blog and hopefully made more understandable conditions you may have already heard of, or indeed you or your loved ones might have. I have mentioned the 3 key symptoms that can indicate a heart problems (chest pain, breathlessness and palpitations) and also described 4 common heart conditions (angina, heart attack, arrhythmia and heart failure) that can underlie the 3 key symptoms. I have also explained the 4 areas (smoking, diabetes, cholesterol and blood pressure) where we can all work together, usually through lifestyle choices, to reduce your chances of having a heart problem.

If you have any concerns about any symptoms, particularly chest pain, breathlessness and palpitations, then please contact your GP surgery.

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