Chest Pain

Coronary artery disease (atherosclerosis) causes chest pain (angina) and heart attacks (myocardial infarction). The coronary arteries become progressively narrowed and furred up over many years, initially causing no symptoms whatsoever. However, there comes a point where the furring up is so great that the blood supply to the heart itself is no longer adequate. When the heart beats more quickly, for example with exercise or emotional stress, more blood is needed through the coronary arteries to supply the heart muscle with blood and oxygen. As the furring up process continues there comes a time when the heart cannot get enough blood through the coronary arteries to cope with the increased activity of the heart e.g. when walking up hill, climbing stairs. The reduction in blood supply causes chest pain, pressure, heaviness or tightness (angina) which rapidly goes with rest or with certain medication (GTN tablets or spray under the tongue). 

If the furring up is so great at one point in the artery it may block, causing a heart attack or myocardial infarction. The pain is particularly intense and is not relieved adequately by rest or GTN. This is a medical emergency and the patient should get admitted directly to hospital for treatment to unblock the artery and treat the consequences of the heart attack.