Written by Dr Jagadeesh H V A 28-year-old techie, who had been living in Bengaluru for six months, walked into the hospital, complaining of persistent chest discomfort. Like many others his age, he believed it to be a case of gastric trouble, considering he had irregular meal habits, and consulted a gastroenterologist. What he didn’t know was that he was experiencing a massive heart attack. Not only that, before the emergency team could get into action, the patient collapsed from cardiac arrest right in front of the medical staff. But because it happened in a hospital, we could save him. So what had happened? Unknown to him, there was a 100 per cent blockage in one of the heart’s main arteries. It had squeezed blood flow to the heart muscle, which disrupted the heart’s electrical signals, leading to abnormal heart rhythms or arrhythmia. His heart rate spiked dangerously and stopped supplying blood to vital organs. He required three defibrillator shocks back to back to revive him. Then we did an emergency angioplasty, a procedure to open blocked arteries, and implanted a stent, a meshed bridge to keep the artery walls widened. After cardiac rehabilitation, he is now fit. What was the trigger? This young man did not have any risk factor like obesity, diabetes or hypertension. But he had been a regular smoker for over eight years. Although he said he did not exceed smoking four cigarettes a day, what he didn’t realise is that there is no safe level of smoking, even for young people. Studies have shown that smoking just one cigarette a day can nearly double the risk of coronary heart disease and stroke compared to non-smokers. As a recent migrant to Bengaluru and with long working hours, he was ordering in food. When poor diet combines with smoking, their combined impact is greater than the sum of their individual effects. We looked at his diet and found it to be lower in fibre and higher in fat and sugar, which further exacerbated the risk. Why young people often confuse heart attack pain with gas People often confuse cardiac symptoms with gastric issues, especially when the pain is in the upper abdomen or chest. But sudden onset severe chest pain that radiates to the arm, accompanied by sweating or breathlessness, should never be ignored. Our patient complained of frequent burping, which can be a symptom of angina, a type of chest pain caused by reduced blood flow to the heart. So do not ignore burping if it is accompanied by chest pain, shortness of breath, dizziness, or other concerning symptoms. Seek immediate medical attention. What are the differences between heart attack and gas pain? Heart attack pain feels like pressure, while gas pain is more likely to be sharp or cramp-like. Heart attack pain is typically in the central or left side of the chest and may radiate to other areas, whereas gas pain is more localised. Gas pain can be relieved by burping, passing gas, or changing position, so it goes down after a while. A heart attack pain intensifies with the passage of time. Heart attacks often include breathlessness, sweating, nausea and dizziness, while gas pain is more likely to be accompanied by bloating and belching. We always say that in heart attacks, the first hour is the golden hour. Do not take chest pain — even mild ones — lightly. Get an ECG or cardiac evaluation — it might save your life. (Dr Jagadeesh is interventional cardiologist, Manipal Hospital, Bengaluru)
