A common question I get is: “How do I know I have a heart problem?” Today, we will explore the common symptoms that may indicate that you have such a problem.

Before we get into the specific symptoms that you may experience, one key point to remember is that heart disease may be silent, and so regular check-ups with your family physician is a good way to make the determination. This is especially true for younger people.

At this time of year, as schoolchildren go on holiday and parents grapple with all of the expenses of the summer break and back-to-school preparations, the “back-to-school medical” is one big item on the agenda.

The “back-to-school medical” is probably the most important thing you can do for your child, and it should not be short-changed. Do not ask a “doctor friend” to just sign the child’s form without actually examining the child. This exercise, that parents find annoying and expensive, can make the difference between finding out your child has a health condition, or collapsing on the field at school from undetected heart or other health condition.

For older people who do not have any symptoms, it is recommended that you get a medical examination at age 20 with your family doctor and every five years thereafter, if this baseline medical is normal. This medical examination should include the following:

* Complete review of your history or what we call a symptom review

* Detailed physical examination – weight, height, blood pressure, heart rate, heart examination, chest examination

* Blood tests – kidney and electrolytes, cholesterol profile, fasting blood glucose and complete blood count

* ECG – especially if you have a family history of heart disease, or any hypertension is detected on your screening

* Additional tests determined by your physician

For people who have heart disease, the symptoms that one might experience include:

* Shortness of breath

* Chest pain

* Palpitations

* Cough

* Fainting or near fainting spells

SHORTNESS OF BREATH

Shortness of breath is often described as breathing faster than usual, or having difficulty catching one’s breath. There are certain circumstances under which shortness of breath will be “normal”, for example during or after physical exertion, such as climbing the stairs, running, brisk walking, swimming, or playing a strenuous sport. Shortness of breath becomes significant if it occurs while sitting or lying down, or if there is a change in your level of fitness. For example, if you were able to climb a flight of stairs without feeling short of breath and now you have to stop several times to catch your breath before you get to the top.

While shortness of breath may indicate the presence of significant heart disease, it may also indicate the following:

* Anaemia or low blood count

* Lung disease – example asthma

It is therefore very important that you see your family physician to explore some of these possibilities before assuming it is a heart problem.

CHEST PAIN

Chest pain may be caused by several different conditions, among them:

* Heart disease for

* Lung disease – example, pneumonia

* Muscle/joint problems – for example, inflammation of the joints between the breast plate and the ribs called costochondritis

* Acid reflux or stomach ulcer

Chest pain that is likely to be coming from the heart may be due to coronary artery disease (poor circulation to the heart), known as angina or inflammation of the lining of the heart, called pericarditis.

Angina pain tends to have the following characteristics: usually just below the breast plate; heavy, or pressing feeling; usually brought by exertion but may occur at rest.

If you have been experiencing this type of pain, you need to visit your physician.

If you experience chest pain at rest, which fits these criteria, this is considered a medical emergency and should be treated as such. You should call for help and get someone to drive you to the emergency room or call an ambulance. It could mean that you are having a heart attack.

CHEST PAIN EMERGENCY IF:

* Chest pain at rest or with minimal exertion

* Lasts more than 10 minutes

* Is pressing/heavy in nature

* You are 40 years or older

* You have a history of hypertension, diabetes, high cholesterol, you smoke, or have family history of heart attack.

A heart attack or suspected heart attack is a medical emergency. You will need to have an urgent ECG and blood tests to confirm or rule out the heart attack, or other potentially life-threatening causes of persistent chest pain, such as clot on the lung pulmonary embolism or tear in the major artery (aortic dissection).

Dr Claudine Lewis is an adult cardiologist and medical director at Heart Smart Centre in Montego Bay. She is also a cardiologist at the Cornwall Regional Hospital and an associate lecturer with the University of the West Indies. Questions may be sent to questions@heartsmartcentre.com and for additional information call 684-9989 or visit the website www.heartsmartcentre.com