New data has shown that the top reasons why people seek heart health investigations are chest pain at 51%, palpitations caused by possible heart arrhythmia at 30% and heart failure at 10%, according to 2023 admission data from Blackrock Health’s Rapid Cardiac Care service which is available at Blackrock Clinic, Galway Clinic and Hermitage Clinic. Further research conducted by Blackrock Health last year also showed that 77% of people have experienced one of the symptoms associated with one of these conditions yet almost 20% of people did not take any action regarding their symptoms.
On the back of this data, Consultant Blackrock Health Cardiologist Dr Richard Armstrong is striving to drive awareness of the most commonly experienced heart health conditions and importantly when to seek medical attention.
Starting with chest pain, Dr Richard Armstrong said, “Heart-related chest pain can vary significantly in terms of severity, from quite subtle or a mild discomfort through to crushing or searing pain. More severe pain should spark an immediate call to 999 to attend the nearest emergency department in case you are experiencing a heart attack, but we know that milder chest pain can often be put down to other less serious health concerns by the person experiencing it. Chest pain should always spark action to seek medical attention as there are many conditions related to the heart that should be investigated to ensure the symptom is not masking something more sinister.”
Dr Armstrong focused on the area of palpitations caused by a heart arrhythmia as the second most common reason for presenting at the Rapid Cardiac Care Service, “Palpitations can vary in experience from feeling as though the heart beats too fast or slow, or the sensation that the heart is skipping beats. It’s important to seek medical attention if you experience a change in your heartbeat as you might have an underlying heart health issue that needs early intervention and management to reduce longer-term damage.”
Heart failure has a very distinct set of symptoms that many wouldn’t associate with a heart condition so awareness of these is important to incite action to seek medical attention. Speaking about heart failure, Dr Armstrong advised, “Heart failure, despite the name, does not mean that your heart stops working entirely but it is an early warning sign of wider heart disease that needs early intervention and management. Distinct symptoms of heart failure include shortness of breath, swelling in the legs, ankles and feet and very rapid weight gain from fluid build-up. These symptoms occur because the heart muscle is not working as it should to adequately pump blood around your body causing the blood to back up. Failing to diagnose heart failure can be life-threatening and can lead to a multitude of other heart health problems, so early diagnosis is key.”
Chest Pain
What is chest pain?
Chest pain can appear in many forms including a sharp stab, dull ache, crushing or burning pain. Sometimes, the pain travels up the neck into the jaw and down into the back or down one or both arms. Chest pain can feel different depending on what’s triggering the symptom but as it is a key indicator of a heart issue, medical attention should be sought if you experience it.
What are the symptoms of chest pain?
Heart-related chest pain can vary significantly in terms of severity, from quite subtle or more of a mild discomfort through to crushing or searing pain. If you are experiencing severe chest pain, you should call 999 immediately.
The range of chest pain that is associated with a heart problem may include:
- Pressure, fullness, burning or tightness in the chest
- Crushing or searing pain that spreads to the back, neck, jaw, shoulders and one or both arms
- Pain that lasts more than a few minutes, gets worse with activity, ebbs and flows or varies in intensity.
- Shortness of breath
- Cold sweats
- Dizzy, lightheaded or weak
- Racing heartbeats
- Nausea or vomiting
- Indigestion
Chest pain that is less likely to be due to a heart problem, but which you should also seek medical attention for if the symptoms persist, include:
- Acid reflux – a sour taste or a sensation of food or acid re-entering the mouth
- Trouble swallowing
- Pain that changes when you change body position
- Pain that gets worse when you cough or breathe deeply
- Tenderness when you push on your chest
- Pain that continues for many hours
What are the causes of heart-related chest pain?
There are a multitude of reasons that you might be experiencing heart-related chest pain and the only way to identify the correct cause is by seeing a doctor as soon as possible. Causes include conditions such as angina which is caused by poor blood flow to the heart, often caused by the build-up of plaque on the walls of the arteries that carry blood to the heart therefore restricting blood supply to the heart. Inflammation of the main artery leading from the heart can cause chest pain as well as inflammation of the sac around the heart in a condition called pericarditis. The most serious of reasons is a heart attack which occurs because blood flow to the heart muscle is blocked, often due to a blood clot.
Arrhythmia
What is a heart arrhythmia?
A heart arrhythmia is an irregular heart rhythm. You may experience this as suddenly becoming aware of your heart beating in your chest – it could be fast, slow, or feeling as though your heart is skipping beats. This occurs when the electrical signals that tell the heart to beat don’t work properly. Some arrhythmias are harmless while others can be life-threatening, so it is critical to seek medical attention if you notice a difference in the rate of your heartbeat.
Are there different types of arrhythmia?
In general, heart arrhythmias are grouped by the speed of the heart rate:
- Tachycardia is a fast heartbeat, where the heart rate is more than 100 beats per minute.
- Bradycardia is a slow heartbeat, where the heart rate is less than 60 beats per minute.
If you are diagnosed with either type of arrhythmia, your consultant will then work to determine the underlying disease that is causing the problem.
How will I know if I’m experiencing a heart arrhythmia?
A heart arrhythmia can feel like a fluttering in your chest or a racing heartbeat. There are times when it can be normal to have a difference in your heartbeat, for example when you are falling asleep your heartbeat can slow down while during this time and after exercising your heart may beat faster.
Specific symptoms of arrhythmia include:
- A fluttering, pounding or racing feeling in the chest
- A fast heartbeat
- A slow heartbeat
- Feeling your heart “skipping” beats
- Chest pain
- Shortness of breath
- Anxiety
- Feeling very tired
- Lightheaded or dizziness
- Sweating
- Fainting or almost fainting
Premature heartbeats are extra beats that occur one at a time or sometimes in patterns that alternate with a regular heartbeat. If you experience this, it can feel like your heart has skipped a beat. Normally this does not indicate a heart problem but can trigger a longer lasting arrhythmia. Some lifestyle factors such as caffeine or nicotine can cause premature heartbeats.
How is a heart arrhythmia diagnosed?
The most effective way to diagnose a heart arrhythmia is with an electrical recording of your heart rhythm which is done with an electrocardiogram or ECG. You might require further monitoring of your heart with a portable ECG or Holter monitor for 24 hours. Additional tests might include a stress test which monitors heart activity during exercise and/or a table tilt test which measures your heart’s reaction when moved from lying down to a standing position.
How are heart arrhythmias treated?
Treatment for heart arrhythmia depends on whether the heart is beating too fast or too slow and some heart arrhythmias do not require treatment at all. Treatment is usually only needed if the irregular heartbeat causes significant symptoms or puts your longer-term heart health at risk. Treatments vary from medicines such as blood thinners through to vagal manoeuvres and surgery. Vagal manoeuvres are specific actions that can slow down the heart rate and include coughing, bearing down as if having a bowel movement or putting an icepack on your face. These actions affect the vagus nerve which helps to control the heartbeat.
Heart Failure
What is heart failure?
Heart failure occurs when the heart muscle doesn’t pump blood as well as it should. When this happens blood often backs up and fluid can build up in the lungs, causing shortness of breath. Certain heart conditions gradually leave the heart too weak or stiff to pump blood properly which is referred to as narrowed arteries in the heart and high blood pressure. While heart failure can be life-threatening, treatment may improve the symptoms and lifestyle changes can improve quality of life.
How will I know if I’m experiencing heart failure?
Symptoms of heart failure can develop slowly but they can also come on suddenly and include:
- Shortness of breath with activity or when lying down
- Fatigue
- Weakness
- Swelling in the legs, ankles and feet
- Rapid or irregular heartbeat
- Less able to exercise
- Wheezing
- A cough that doesn’t go away
- Swelling of the stomach area
- Very rapid weight gain from fluid build-up
- Nausea and lack of appetite
- Difficulty concentrating
- Chest pain if heart failure is caused by a heart attack.
- Requiring additional pillows when sleeping as you may be unable to breathe properly lying flat
- Waking in the middle of the night struggling for breath
Are there any risk factors that might increase my chance of experiencing heart failure?
There are many diseases and conditions that can increase the risk of experiencing heart failure, including:
- Coronary artery disease or narrowing of the arteries.
- A heart attack that occurs suddenly which can damage the heart muscle.
- Heart valve disease.
- High blood pressure which puts the heart under pressure to work harder.
- Irregular heartbeats which can weaken the heart muscle.
- Congenital heart disease where the person was born with problems that affect the structure or function of the heart.
- Diabetes increases the risk of high blood pressure and coronary artery disease.
- Sleep apnoea or the inability to breathe properly during sleep can increase the risk of irregular heartbeats which can weaken the heart.
- People living with obesity have a higher risk of developing heart failure.
- Some viral infections can weaken the heart.
- Some medicines can lead to heart failure which your doctor should advise you of.
- Other lifestyle factors such as ageing alcohol use and smoking can also increase the risk of heart failure.
Can heart failure be prevented?
One way to prevent heart failure is to treat and control the conditions that can cause it including coronary heart disease, high blood pressure, diabetes and obesity. A healthy lifestyle can manage heart failure and might also help to prevent it, including:
- Quit smoking
- Get plenty of exercise
- Eat healthy foods
- Maintain a healthy weight
- Reduce stress
- Take medicines as directed
How is heart failure diagnosed?
Tests you may have to diagnose heart failure include:
- Blood tests can identify whether there is anything in your blood that might indicate heart failure
- An electrocardiogram or ECG to record the electrical activity of your heart
- An echocardiogram which is a type of ultrasound scan to examine your heart
- Breathing tests
- A chest x-ray
How is heart failure treated?
In addition to making positive lifestyle changes, most people with heart failure are treated with medication. There is a range of medicines available for the treatment of heart failure and you might be prescribed one type of medication or a combination.
When should I seek medical attention if I think I’m experiencing symptoms of the conditions outlined in this article?
If you experience any of the symptoms outlined above, you should seek an appointment with your doctor. Blackrock Health Rapid Cardiac Care service provides swift access to its team of cardiology specialists across its three hospitals, Blackrock Clinic, Galway Clinic and Hermitage Clinic, for cardiac patient care with or without a GP referral. This service provides fast and expert medical care to patients with worrying, acute cardiac symptoms such as chest pain, dizziness, shortness of breath or a racing pulse rate.
Dial 999 or 911 if you experience:
- Chest pain
- Fainting or severe weakness
- Rapid or irregular heartbeat with shortness of breath, chest pain or fainting
- Sudden severe shortness of breath and coughing up white or pink foamy mucus