Is Chest Pain A Definite Sign for Heart Attack?

When someone is having a serious pain in the chest, the first thing that comes to our mind is: is he or she having a heart attack (or myocardial infarction)?

Serious pain in the chest seems to be an obvious sign of a heart attack. Researchers from the Hospital of the University of Pennsylvania, however, did not appear to agree.

In their paper published in August 2011 in the ‘Annals of Emergency Medicine’, they pointed out that a high degree of pain does not indicate that someone entering the emergency room with chest pains is having a heart attack.

After examining and following for 30 days more than 3,000 patients who arrived at the UPenn hospital emergency department complaining of chest pain, the researchers found that most severe chest pain was not a good predictor for identifying patients who were having heart attack or who were more prone to having one over the next month. Meanwhile, they also stressed that a patient who does not have severe chest pain does not mean that he or she is not having a heart attack.

The results of their study showed that pain that lasted more than an hour was not a useful sign of heart attack versus other conditions, and the pain of a heart attack also does not always settle in the chest area but might be in the chest, arm, jaw back or abdomen.

According to the researchers, failure to diagnose acute myocardial infarction accounted for 30 percent of malpractice claims paid out, with 2 to 5 percent of patients who were having heart attack being inappropriately discharged from emergency departments.

Though pain severity was not a good predictor, it could correctly identify people who had such symptom and arrived at the emergency department in an ambulance. This might be due to the fact that people tend to ignore chest pain until it is serious enough to call for emergency services.

While the cause of chest pain might or might not be a heart attack, people who have such experience should not ignore it because something serious must have emerged.

Heart Disease Can Be Caused By Childhood Hardship!

While a number of risk factors including diabetes, hypertension (high blood pressure), overweight, smoking and high alcohol intake can lead to heart disease, childhood hardship can well be one of them.

Researchers from New Zealand's University of Otago revealed in the paper they published in August 2011 in ‘Archives of General Psychiatry’ that children who are abused, lose a parent or suffer other hardships might be at a higher risk of getting heart disease later in their life.

Among more than 18,000 adults in 10 countries, the researchers found that those who said they had faced childhood adversities such as abuse, death of a parent, or a parent’s alcohol or drug abuse had a higher chance of getting heart disease, arthritis, asthma, diabetes and other conditions. Similar pattern was seen among people who said they had suffered from depression, anxiety or other mental health conditions before the age of 21.

Though the findings did not prove that serious stresses in childhood would directly cause poor physical health later on, there were a few reasons behind the link between the two.

According to researchers, early adverse experiences could affect people’s behavior and lifestyle. Some people might just adopt smoking, drinking or over-eating as a way of dealing with the stresses. Likewise, young people with depression or other mental disorders might use smoking or drinking as a way to self-medicate. It is possible that severe childhood stress might have more direct biological effects.

Meanwhile, participants reported at least 3 childhood adversities had a higher risk of all 6 physical health problems that were assessed in the study. They had twice the risk of heart disease, compared with men and women with no adversities.

Similar results were seen among adults who said they had mental health conditions, especially depression, post-traumatic stress disorder or panic disorders, before the age of 21. Their risks of heart disease, asthma, arthritis and chronic back pain or headaches were between 43 percent and 66 percent higher than risks in adults with no early mental health disorders. Current psychological status, however, did not appear to account for the link.

Why People Have Hypertension?

Hypertension, more commonly known as high blood pressure, could lead to hardening of arteries (atherosclerosis) and development of heart failure. That is why it has long been regarded as a major risk factor for heart disease. According to World Health Organization (WHO), around a billion people worldwide, including more than 200 million Chinese, suffer from hypertension.

When the cause of hypertension can be identified, the condition is called secondary hypertension. Kidney disease is the highest risk factor for this type of hypertension. For majority of the hypertensive patients, the causes are not known, though several factors including smoking, high salt intake, stress, sedentary lifestyle, overweight or obese, high alcohol consumption, aging and genetics are believed to play an important role. This kind of hypertension is known as essential hypertension.

Recently, researchers from Beijing Chaoyang Hospital’s Cardiology Center identified a common virus known as human cytomegalovirus (HCMV) that could be responsible for causing hypertension. HCMV infects most adults but is repressed by the body’s immune system and rarely causes any symptoms. Their findings, which linked HCMV to essential hypertension, were published in August 2011 in the medical journal ‘Circulation’.

Such findings might present a new strategy for preventing and treating cardiovascular disease. However, the researchers pointed out that their research was still in its early stage and more tests with a wider scope of patients should be carried out. Once conclusive evidence of the relationship is obtained, better medical vaccines and remedies for hypertension could then be made available to treat millions of patients around the world.

Another recent study conducted by the Tulane University School of Public Health and Tropical Medicine in New Orleans found that hypertension plays a part in 2.3 million cardiovascular deaths in China each year. Among these victims, 1.3 million were premature deaths. This means that victims died before the age of 72 in men and 75 in women, the average lifespan in China in 2005.

What Is the Link Between Westernization and Heart Disease?

As a result of ‘Westernization’, the number of South Koreans with multiple risk factors for heart disease and diabetes has steadily increased. Westernization is the conversation to or adoption of western cultures including technology, politics, economics, lifestyle, diet, language and values.

A study published online on April 19, 2011 in the journal ‘Diabetes Care’ reported that one-third of Korean adults have risk factors associated with diabetes and heart disease. Since the late-1990s, Korea has become more westernized. Researchers from Gil Medical Center in Incheon intended to look at Korea's changing rate of metabolic syndrome, a collection of risk factors for Type-2 diabetes, heart disease and stroke.

Based on a periodic government health study on Korean adults aged 20 and above, the researchers found that 25 percent of Korean adults had metabolic syndrome in 1998. But by 2007, the figure had risen beyond 31 percent, which was closed to the rate of 34 percent seen in the United States at that time.

Such hike was seen amid a period of fast economic growth in Korea, together with the adoption of the less-than-healthy lifestyle often accompanying with it. Korean are eating more ‘Western’ food, watching more TV and having less exercise than a decade ago.

This is not the first study to link Westernization to health problems in Asian countries undergoing rapid economic growth. A recent study in urban Indian also found steadily increasing rate of obesity, high blood pressure and diabetes among young adults who were followed for 7 years. The researchers who conducted the study accused declining levels of physical activity and high smoking rate as the culprits for causing such health problems.

Meanwhile, several other recent studies in South and Southeastern Asia have also highlighted heart disease and diabetes as growing problems. A World Bank study on India and other South Asian countries had warned that people in the region get their first heart attack at the age of 53, which is 6 years earlier than people anywhere else.

To prevent from ending up with such health problems, people must change their lifestyle. For instance, they should perform regular exercise and adopt a healthy diet with low sodium (salt), carbohydrates and fat.