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Warrick is a practicing cardiologist and author with a passion for improving care by helping patients understand their heart health through education. Warrick believes educated patients get their best health care. Discover and understand the latest approaches and technology in heart care and how this might apply to you or someone you love.

Hi, my name is Dr. Warrick Bishop, and I'd like to welcome you to my consulting room. Today I'd like to share with you some thoughts around chest pain. It's often the case that I get asked by patients what sort of chest pain should I worry about. This is actually a little bit of a difficult question. And it is worth talking about and thinking about. There are some really obvious things that are worth considering. So if you've been in the garden and working hard or you've just played a game of football or some physical activity and you've got a clear cut discomfort in the chest that if you move in a particular way, you can affect it and change it then it's probably just the muscles and bones in your chest wall. That's common sense. You will have had those injuries over the years and I'm sure you can figure that out.

The real issue chest pain is whether it's related to your heart and lack of blood supply to the heart. Now the really interesting thing about this is it can be different in different people and this is the important thing to understand. The most significant thing about this, though, is that it may be different for you but it won't be normal for you. And so chest pain that we're concerned about is chest pain that you are concerned about because you can't explain it. The typical sort of Hollywood chest pain that we see most commonly is a central, heavy crushing pressure in the center of the chest. It may not necessarily be really severe with a minor or threatened heart attack, but it's the quality in nature that's really important. It's heavy. You can't put your finger on it, and it doesn't feel right. So most commonly we do see discomfort in the chest.

Often people get called on the word of discomfort or pain. For simple terms and for practical purposes we just use the term pain. I have plenty of patients will say it's not really a pain doctor it's sort of a feeling or pressure. Well I can accept that but let's just for the sake of this discussion call it pain. Some heart pain can also be felt up into the jaw. I've even heard stories of people who have been getting recurrent jaw pain which was attributed to their dentures and had three sets of dentists' dentures changed before they actually had a proper diagnosis of angina or heart pain as a cause for their discomfort.

Recently, I had a man who had discomfort across the top of his shoulders toward the middle of his back on exertion. And that was his chest pain or angina. That's where the pain from his heart was reflected on his body. I've seen patients who have had discomfort just in the wrist, more likely on the left side than the right, but I wouldn't ignore it if it were on the right side. I've had patients with discomfort in the wrist, only in the elbow and I'll tell you what, probably the most significant thing to realise is that some people get no pain whatsoever. They just have a change in their breathing or exercise capacity and they know that something's wrong.

So chest pain is a little bit complicated of its own. It is really important to realise that it can be the only clue we have to look at the heart. So please take it seriously. If you can't explain it with clear reasoning, if you don't know what's causing that sympto,m whatever it might be, if it's above your belly button and below your eyeballs, it could be your heart. So please get it checked. Hope you found today's talk about chest pain interesting. I really appreciate you joining me in listening to this. As always I wish you good health. Goodbye.

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