Chest Pain


not too far

 Its alarming to have a chest pain. It bothers us too often, that we sometimes tend to ignore it. So today I decided to tell a few things in brief about chest pain that everybody should know. This post is intended for general health information and not for self-treatment.

As we already know there are many structures inside the chest like- ribs,muscles ,lungs, food pipes, heart etc. So pain in chest can arise from any of these structures, but each structure usually has some typical characteristics of pain which helps to determine the presumed site of origin. For example when chest pain is due to muscles/bones then there may be some local pain on touching or pressing; in case of lung the pain will be associated with breathing difficulty, cough and expectoration. Similarly when pain arises from the food pipes there will be associated symptoms like – difficulty in swallowing, nausea, vomiting. But the most alarming and serious chest pain is the one arising from heart.

The heart is basically made up of muscles and like any other muscle in the body it needs blood supply. Blood supply to the heart is done by coronary arteries.   There are two occasions when cardiac pain can occur, either it is due to reduced blood supply to the heart due to blockage in the coronary arteries, or due to excessive demand of the heart like thickening of heart muscles. Chest pain arising from the heart is called ANGINA. Angina has a typical character – it is felt as a heaviness, squeezing sensation, tightness or heaviness in the centre of the chest which is often also felt in left arm, jaw,neck, shoulder or back. It is precipitated by physical exertion , emotional excitability and is relieved by rest. Sometimes pain can be more severe and longer lasting when it indicates something more sinister like an heart attack.

If someone feels a chest pain which is bothering him/her then medical attention should be sought. Like I said in the beginning – this article is for general health information and any chest pain needs evaluation by a doctor and prompt and proper treatment.

Thank you



Diabetes and heart disease are closely related. Before discussing the heart problems in diabetes we will see what is diabetes mellitus. Diabetes mellitus is basically persistent elevation of blood sugar level due to inability to produce sufficient insulin or failure to respond appropriately to insulin. International guidelines define diabetes as fasting plasma glucose ≥ 126mg/dL or nonfasting plasma glucose ≥ 200mg/dL, or glycosylated hemoglobin ≥ 6.5%. Diabetes affects more than 200 million persons worldwide and by 2030 this figure will rise to >400 million persons.


Cardiovascular disease (CVD) remains the principal cause of suffering and death in diabetes. Diabetes causes widespread disease in heart and blood vessels like

1. Coronary artery disease- involvement of blood vessels of heart

2. Carebrovascular disease- involves the blood vessels of brain causing stroke

3. Peripheral vascular disease – involves blood vessels of limbs and aorta , may lead to loss of limbs

4. Heart failure

Coronary artery disease in diabetes:

Diabetes increases the risk of coronary artery disease manifold increasing the risk of having myocardial infarction (heart attack) and angina (chest pain). The level of increasing blood sugar directly influences the development and progression of CAD. Currently CAD is the principal cause of mortality in diabetes. People with diabetes are more likely to have severe coronary artery disease like involvement of multiple coronary arteries.

Heart failure in diabetes:

The most common causes of heart failure are coronary artery disease and hypertension which go hand in hand with diabetes. Presence of diabetes increases the risk of heart failure by 3 to 5 times and also worsens the outcome of treatment


Reading all these things are frightening but don’t worry there are ways to counter these problems


The risk of heart disease in diabetes is reduced significantly by the following measures

1. Strict control of blood sugar:

The first and foremost aspect of preventing heart disease in diabetes is control of blood sugar. Proper control is blood sugar reduces the risk of Heart disease

2. Strict control of BP:

Hypertension is present in ~70% of individuals with diabetes. Hypertension increases heart disease in diabetes. So strict control of blood pressure is mandatory. Many antihypertensives like ACE inhibitors ( ramipril, enalaprol) and ARB (losartan, telmisartan) have cardio protective and kidney protective action.

3. Treatment of coronary artery disease by medication , cardiac intervention / surgery reduces morbidity and mortality risk

4. Life style modifications like

– Cessation of smoking

– Regular brisk walking for > 40 minutes per day atleast five days in a week

– Restricting salt intake , fatty foods and increasing consumption of vegetables and fruits  reduce the risk of heart disease

You can find out about the cardiovascular effects of drugs used in diabetes under the ” medications” menu

Information about choosing between percutaneous cardiac intervention vs surgery is available under ” intervention” menu.

Thank you.

Dr. Anupam Jena

Risk Factors for Heart Disease

In the understanding of any disease one of the most important part is the understanding of risk factors or what are the things that makes us more vulnerable to a particular disease. In relation to heart disease there are some well-defined risk factors. It is important to understand that many new and novel risk factors are emerging. Some of the risk factors can be controlled while some are non-modifiable like age, family history , genetics etc. Presently the concept of predisposition to heart disease is changing and the current models consider multifactorial causation, the meaning of which is that many factors interact among themselves to cause disease. Nevertheless there are a few traditional risk factors which cause the majority of heart disease, which are:

  1. Diabetes Mellitus
  2. Hypertension – High Blood Pressure
  3. Smoking
  4. Elevated blood Cholesterol
  5. Family history of heart disease

These risk factors are responsible for around 80% of heart diseases. Even though many new and novel risk factors are coming up, these five factors are responsible for the majority of coronary artery diseases. Effective treatment of the first four of the above can reduce the risk of heart disease. You can’t do much about positive family history.

The old saying can’t be overemphasized- “Prevention is better than cure”.

Act when time is there. Take responsibility for your health.

In my next posts we will discuss about the risk factors and the benefit of proper treatment of them.

Thank you all and keep reading

Dr. Anupam Jena

Welcome to the Heart of Cardiology


Cardiovascular diseases are the biggest threats in today’s world and they kill more number of people than other diseases. Cardiovascular problems are preventable and effectively treated when interventions are done early and effectively. The importance of the old saying “Knowledge is Power” can’t be more than when it comes to deciding about one’s own health. This is the age of information and you have every right to be informed correctly about your health issues. The idea behind this site is to provide up-to-date information related to all issues in Cardiovascular Health.

This site provides information related but not limited to the following topics

  1. Risk factors for heart disease and effective control of then
  2. Common symptoms of heart disease and how to identify then early
  3. Heart diseases associated with other medical problems
  4. Heart problems in young children
  5. All information related to Cardiac procedures
  6. A section for medical students about important topics in cardiology
  7. Answers to your specific questions

And many more

Its all about taking responsibility for your health.

Thank you

Dr. Anupam Jena