Friday, August 29, 2008

Chest Pain = Sakit Jantung????

Today is the 3rd anniversary of Bike To Work (B2W) community in Indonesia. See my previous posting: B2W Day 2008. This community will celebrate their anniversary by cycling to the office today, and it will be done by all of branches at all over Indonesia. AS you know I have been active in B2W and MTB since 2006, but unfortunately I could not do B2W for the past a year since I moved to my new house in Cimanggis. The traffic condition in my new house is worse than before, with so many trapping holes in the road and no road lighting, the trip will be very difficult.

Thursday night, I had chess pain and headache...are these signs of cold?
Friday morning; I was in cold and difficult to breathe, also with chess pain...Well, I have to cancel my plan for cycling to the office.
To tell you frankly, I had have this symptom for about 8 months, and since that time I have met some doctors to get some treatments. Here are some of their diagnoses:
1. Tension in chess and back muscles
2. Stomachache - gastritis; this is my old illness, the gas is pushing up the diaphragm and pressing the lungs.
3. Lung disease; may be because the smoking habit that I have
Therefore, I have to take some medication relating with those diagnoses, and also
I did some further examinations:
X-Ray test for the lungs
EKG - Electrocardiography
But none of those treatments are success...And this morning I had this symptom again...
Again I went to the hospital and ask for help in the emergency unit directly. But the doctor keep saying that my hearth is OK; and she suggested me
to do further test like treadmill and Echo...

I decided to observe my condition for the next 2 or 3 days, and after that if the symptom is still exist, then I'll go to treadmill test on Monday.

Here are some articles related with my illness:


Sakit dada sebelah kiri jika merokok

dr.Maya Tarigan
Mon, 2008-06-09 11:34
Identitas: Pria
Usia: 34 tahun
Pertanyaan Konsultasi:
Dok..dada saya terasa nyeri jika saya merokok,namun jika saya berhenti merokok, sakit itu perlahan lahan hilang dengan sendirinya. saya sendiri jarang sekali olahraga. apakah ada disfungsi jantung ato paru-paru.?dulu saya adalah perokok berat.
terima kasih atas jawabannya.
Jawaban Konsultasi:
Nikotin dalam rokok merupakan zat yang bersifat aterogenik, yang artinya dapat mengakibatkan penyumbatan dan kekakuan pembuluh darah. Hal ini menimbulkan keluhan-keluhan terutama di pembuluh darah yang tidak memiliki cabang, seperti pembuluh darah koroner di jantung-yang mengakibatkan penyakit jantung koroner atau impotensi yang diakibatkan oleh gangguan pembuluh darah di penis.

Bila terjadi penyumbatan pembuluh darah koroner maka nyeri dada yang ditimbulkan sifatnya khas, yang dikenal dengan istilah angina pektoris. Nyeri dirasakan di sebelah kiri, letaknya tidak spesifik, modalitasnya bisa nyeri tajam atau nyeri tumpul, dapat menjalar ke lengan kiri, rahang, atau punggung. Nyeri dicetuskan oleh kebutuhan oksigen yang meningkat dibandingkan dengan suplai yang ada. Hal ini terjadi pada keadaan -keadaan seperti aktivitas fisik berlebihan, stres, dan emosi. Pada keadaan yang stabil, nyeri biasanya berkurang dengan istirahat..
Dengan riwayat anda sebagai perokok, juga dapat dipikirkan masalah paru-paru. Biasanya diikuti dengan keluhan batuk yang dominan dibandingkan dengan nyeri dada. Nyeri dada dapat terjadi akibat rangsang batuk yang berlebihan atau bila terjadi peradangan selaput pembungkus paru.

Untuk memastikan hal ini saya sarankan Anda untuk memeriksakan diri ke dokter terdekat. Dapat dilakukan pemeriksaan rekam jantung dan rontgen dada untuk memastikan diagnosa.


Sakit dada sebelah kiri

Written by Irfan Arief
Tuesday, 19 August 2008
Dear Dokter,

Saya perempuan 28 tahun, tinggi 150 cm, berat 48 Kg, sudah 3 hari ini saya punya keluhan sakit di dada sebelah kiri tembus ke belakang di bawah belikat dan lengan sebelah kiri pun pegal.

Rasa sakit ini saya rasakan setelah saya melakukan kegiatan tugas kantor selama 3 hari berturut-turut sampai malam. yang ingin saya tanyakan apakah ini hanya masuk angin biasa atau ada kelainan di jantung saya? Sebelumnya saya ucapkan terima kasih atas penjelasannya. (Lina Sumardi)

Jawab:

Dear Lina, keluhan nyeri dada bisa disebabkan dari kelainan jantung, dari otot maupun tulang, paru-paru, kulit dan persyarafannya atau pencernaan bagian atas. Wanita seusia Anda dengan keluhan yang Anda alami, saya kira masih kecil kemungkinan Anda menderita penyakit jantung koroner. Tetapi kelainan jantung tidak hanya terbatas penyakit jantung koroner, namun dapat pula nyeri dada yang Anda alami adalah disebabkan karena adanya kelainan pada katup jantung, seperti prolaps katup mitral, kelainan pembungkus jantung atau penebalan otot jantung. Untuk mengetahui penyebab pasti nyeri dada yang Anda alami, sebaiknya Anda melakukan check up kesehatan jantung Anda secara menyeluruh, mulai dari pemeriksaan laboratorium lengkap yang meliputi pemeriksaan fungsi ginjal, fungsi hati, kolesterol, pemeriksaan darah dan gula darah. Anda juga dapat menjalani pemeriksaan rekam jantung (elektrokardiografi/EKG), rontgent, echocardiografi dan treadmill test. Bila berdasarkan pemeriksaan tersebut tidak ditemukan adanya kelainan, maka kemungkinan besar keluhan yang Anda alami bukan berasal dari jantung Anda. Namun bila terdapat kelainan, Anda akan dapat ditangani secara tepat dan cepat oleh orang yang profesional di bidangnya. Semoga bermanfaat. (Inggrid)

CHESS PAIN
By Mayo Clinic

Definition


It's the middle of the night or maybe the beginning of a busy workday when you suddenly feel pain in your chest. You try to ignore it at first, but your chest pain has you scared and worried. Could you be having a heart attack? Should you go to the emergency room?

Chest pain is one of the most common reasons people call for emergency medical help. Every year emergency room doctors evaluate and treat millions of people for chest pain.

Fortunately, chest pain doesn't always signal a heart attack. Often chest pain is unrelated to any heart problem. But even if the chest pain you experience has nothing to do with your cardiovascular system, the problem may still be important — and worth the time spent in an emergency room to have your chest pain evaluated.

Symptoms

The characteristics of chest pain vary depending on what may be the cause. Chest pain symptoms may include:

Cardiac causes
Heart attack. A heart attack can cause pressure, fullness or a crushing pain in your chest that lasts more than a few minutes. The pain may radiate to your back, neck, jaw, shoulders and arms, especially your left arm. Other signs and symptoms may include shortness of breath, sweating, dizziness and nausea. All, some or none of these may accompany your chest pain.
Angina. Restricted blood flow to your heart can cause recurrent episodes of chest pain — angina pectoris, or angina. Angina (pronounced an-JI-nuh or AN-juh-nuh) is often described as a pressure or tightness in the chest. It's usually brought on by physical or emotional stress. The pain usually goes away within minutes after you stop the stressful activity.
Pericarditis. Inflammation of the sac surrounding your heart (pericarditis) causes sharp, piercing and centralized chest pain. You may also have a fever and feel sick.
Aortic dissection. In this condition, the inner layers of the main artery leading from your heart (aorta) separate, forcing blood between them. Symptoms are sudden and tearing chest and back pain.
Coronary artery spasm. Coronary spasm can cause varying degrees of chest discomfort. In coronary spasm, arteries that supply blood to your heart go into spasm, temporarily closing down blood flow to your heart. It can occur with activity or at rest. A spasm may even wake you from sleep.

Noncardiac causes
Heartburn. Heartburn is a painful, burning sensation behind your breastbone (sternum). Often this feeling is accompanied by a sour taste and the sensation of food re-entering your mouth (regurgitation). Heartburn-related chest pain usually follows a meal and may last for hours. Signs and symptoms occur more frequently when you bend forward at the waist or lie down. Pain can also occur when you swallow.
Panic attack. Symptoms of a panic attack include intense fear accompanied by chest pain, rapid heartbeat, rapid breathing (hyperventilation), profuse sweating and shortness of breath.
Pleurisy. Symptoms of pleurisy, an inflammation of the membrane that lines your chest cavity, include sharp, localized chest pain that's made worse when you inhale or cough.
Costochondritis. In this condition, the cartilage of your rib cage becomes inflamed. The pain from costochondritis may occur suddenly and be intense, leading you to assume you're having a heart attack. Yet the location of the pain is different. Costochondritis causes your chest to hurt when you push on your sternum or on the ribs near your sternum. Heart attack pain is usually more widespread, and the chest wall usually isn't tender.
Pulmonary embolism. This condition involves blockage of a lung artery. Symptoms can include sudden, sharp chest pain that begins or worsens with a deep breath or cough. Other symptoms can include shortness of breath, rapid heartbeat, anxiety and faintness.
Sore muscles. Muscle-related chest pain tends to come on when you twist side to side or when you raise your arms, and can occur in conditions such as fibromyalgia.
Injured ribs or pinched nerves. Symptoms of a bruised rib, broken rib or a pinched nerve can be chest pain that tends to be localized and sharp.
Espophageal spasms. This disorder of the esophagus, the tube that runs from your throat to your stomach, can make swallowing difficult and even painful. The muscles that normally move food down the esophagus are uncoordinated, resulting in painful muscle spasms.
Achalasia. In this swallowing disorder, the valve in the lower esophagus doesn't open properly to allow food to enter your stomach. Instead, food backs up into your esophagus, causing pain.
Shingles. Symptoms of this reactivation of the same virus that causes chickenpox include pain and a band of blisters from your back around to your chest wall. The sharp, burning pain may begin several hours to a day or so before blisters appear.
Gallbladder or pancreas problems. Symptoms can include acute abdominal pain that radiates to your chest.

Causes

Chest pain has many possible causes, all of which deserve medical attention. The causes of chest pain fall into two major categories — cardiac and noncardiac causes.

Cardiac causes
Heart attack. A heart attack is a result of a blood clot that's blocking blood flow to your heart muscle.
Angina. Atherosclerotic plaques, containing cholesterol and other substances, can build up in the arteries that carry blood to your heart, narrowing them and temporarily restricting blood flow to your heart, especially during times of exertion. Restricted blood flow to your heart can cause recurrent episodes of chest pain — angina pectoris, or angina (pronounced an-JI-nuh or AN-juh-nuh).

Other cardiac causes. Other problems that can cause chest pain include inflammation of the sac surrounding your heart (pericarditis), a short-lived condition often related to a viral infection.

A rare, life-threatening condition called aortic dissection involves the main artery leading from your heart — your aorta. If the inner layers of this blood vessel separate, forcing blood flow between them, the result is sudden and tearing chest and back pain. Aortic dissection can result from a sharp blow to your chest or develop as a complication of uncontrolled high blood pressure.

Coronary spasm, also known as Prinzmetal's angina, can cause varying degrees of chest discomfort. In coronary spasm, coronary arteries — arteries that supply blood to the heart — go into spasm, temporarily closing down blood flow to the heart. Spasm of the coronary arteries may occur spontaneously or be triggered by a stimulant, such as nicotine or caffeine. Coronary artery spasm, which tends to cause episodes of chest pain, can occur with activity or at rest. It may coexist with coronary artery disease — a buildup of plaques in the coronary arteries.

Other possible heart-related conditions that can cause chest pain are metabolic syndrome and endothelial dysfunction.

Noncardiac causes
Many conditions unrelated to your heart can cause chest pain. These include:
Heartburn. Stomach acid that washes up from your stomach into the tube (esophagus) that runs from your throat to your stomach can cause heartburn — a painful, burning sensation behind your breastbone (sternum).
Panic attack. If you experience periods of intense fear accompanied by chest pain, rapid heartbeat, rapid breathing (hyperventilation), profuse sweating and shortness of breath, you may be experiencing a panic attack — a form of anxiety.
Pleurisy. This sharp, localized chest pain that's made worse when you inhale or cough occurs when the membrane that lines your chest cavity and covers your lungs becomes inflamed. Pleurisy may result from a wide variety of underlying conditions, including pneumonia and, rarely, autoimmune conditions, such as lupus. An autoimmune disease is one in which your body's immune system mistakenly attacks healthy tissue.
Costochondritis. In this condition — also known as Tietze's syndrome — the cartilage of your rib cage, particularly the cartilage that joins your ribs to your breastbone, becomes inflamed. The result is chest pain when you push on your sternum or on the ribs near your sternum.
Pulmonary embolism. This cause of chest pain occurs when a blood clot becomes lodged in a lung (pulmonary) artery, blocking blood flow to lung tissue. It's rare for this life-threatening condition to occur without preceding risk factors, such as recent surgery or immobilization.
Other lung conditions. A collapsed lung (pneumothorax), high blood pressure in the arteries carrying blood to the lungs (pulmonary hypertension) and asthma also can produce chest pain.
Sore muscles. Chronic pain syndromes, such as fibromyalgia, can produce persistent muscle-related chest pain.
Injured ribs or pinched nerves. A bruised or broken rib, as well as a pinched nerve, can cause chest pain.

Swallowing disorders. Disorders of the esophagus, the tube that runs from your throat to your stomach, can make swallowing difficult and even painful. One type is esophageal spasm, a condition that affects a small group of people with chest pain. When people with this condition swallow, the muscles that normally move food down the esophagus are uncoordinated. This results in painful muscle spasms.

Another swallowing disorder that also affects a small group of people with chest pain is achalasia (ak-uh-LA-zhuh). In this condition, the valve in the lower esophagus doesn't open properly to allow food to enter your stomach. Instead, food backs up into the esophagus, causing pain.
Shingles. This infection of the nerves caused by the chickenpox virus can produce pain and a band of blisters from your back around to your chest wall.
Gallbladder or pancreas problems. Gallstones or inflammation of your gallbladder (cholecystitis) or pancreas can cause acute abdominal pain that radiates to your chest.
Cancer. Rarely, cancer involving the chest or cancer that has spread from another part of the body can cause chest pain.

When to seek medical advice

Pain in your chest can be severe. It can be difficult to interpret. The cause of the pain could be something as simple as heartburn or as serious as a heart attack.

If you experience unexplained and persistent chest pain or a feeling of pressure or tightness in your chest — particularly if it's accompanied by other signs and symptoms, such as shortness of breath, sweating, nausea, dizziness or pain that radiates beyond your chest to one or both of your arms or your neck — seek emergency medical care immediately. If you are having a heart attack, rapid treatment can dramatically reduce the amount of damage to your heart muscle and prevent long-term complications.

Every minute is crucial if you are in the midst of a heart attack. A trip to the emergency room could save your life — or bring you peace of mind if nothing is seriously wrong with your health.

Tests and diagnosis

At the emergency room or chest pain center — some large hospitals designate areas just for the evaluation of chest pain — you'll probably have your blood pressure, pulse and temperature checked right away. In addition, the doctor will ask you questions about your chest pain:
Where is the pain located?
How would you describe the pain?
Do you have other signs and symptoms along with the pain?

Chest pain doesn't always signal a heart attack. But that's what emergency room doctors will test for first because it's potentially the most immediate threat to your life. They may also check for life-threatening lung conditions — such as pulmonary embolism, aortic dissection or a collapsed lung (pneumothorax) — that can cause chest pain.

Tests you may have to determine the cause of your chest pain include:
Electrocardiogram (ECG). This test can help doctors diagnose a heart attack as well as other heart problems. It records the electrical activity of your heart through electrodes attached to your skin. Heart rate and rhythm and the electrical impulses going through your heart are recorded as waves displayed on a monitor or printed on paper. Because injured heart muscle doesn't conduct electrical impulses normally, the ECG may show that a heart attack has occurred or is in progress.
Stress tests. These measure how your heart and blood vessels respond to exertion, which may indicate if your pain is related to your heart. There are many kinds of stress tests. You may be asked to walk on a treadmill or pedal a stationary bike while hooked up to an ECG. Or you may be given a drug intravenously to stimulate your heart in a way similar to exercise. Stress tests may be combined with imaging of the heart using ultrasound (echocardiography) or radioactive material (nuclear scan).
Blood tests. Your doctor may order blood tests to check for increased levels of certain enzymes normally found in heart muscle. Damage to heart cells from a heart attack may allow these enzymes to leak, over a period of hours, into your blood.
Chest X-ray. An X-ray of your chest allows doctors to check the condition of your lungs and the size and shape of your heart and major blood vessels. Doctors can also use a chest X-ray to check for tumors in the chest.
Nuclear scan. This test helps doctors diagnose cardiac causes of chest pain, such as a narrowed heart artery. Trace amounts of radioactive material, such as thallium or sestamibi, are injected into your bloodstream. Special cameras can detect the radioactive material as it flows through your heart and lungs.
Coronary catheterization (angiogram). This test helps doctors identify individual arteries to your heart that may be narrowed or blocked. A liquid dye is injected into the arteries of your heart through a catheter — a long, thin tube that's fed through an artery, usually in your groin, to arteries in your heart. As the dye fills your arteries, they become visible on X-ray and video.
Electron beam computerized tomography (EBCT). This procedure, also called an ultrafast CT scan, scans your arteries for signs of calcium, which indicates that atherosclerotic plaques along with calcium may be accumulating and blocking arteries supplying your heart.
Magnetic resonance imaging (MRI). MRI is an imaging technique that uses magnetic fields and radio waves to create cross-sectional images of your body.
Echocardiogram. An echocardiogram uses sound waves to produce a video image of your heart. This image can help doctors identify heart problems.
Endoscopy. In this test a thin, flexible instrument attached to a camera is passed down your throat, allowing doctors to view your esophagus and stomach and check for gastroesophageal problems that can cause chest pain.

Many types of chest pain may at first seem related to heart problems. But often, after careful evaluation, doctors can distinguish the symptoms of noncardiac chest pain from the pain caused by a heart condition.

hingles. Treatment with acyclovir (Zovirax) or a similar antiviral medication is best started as quickly as possible, preferably within 24 hours from the onset of pain or burning, and before the appearance of blisters. Doctors use other treatments, such as analgesics and antihistamines, to control symptoms such as pain and itching.
Gallbladder or pancreas problems. You may need surgery to treat an inflamed gallbladder or pancreas that's causing pain to radiate from your abdomen into your chest.

Chest pain can be one of the most difficult symptoms to interpret. But spending a few hours in the ER having your chest pain evaluated can bring you peace of mind, and may even save your life.

Chest pain: First aid

Causes of chest pain can vary from minor problems, such as indigestion or stress, to serious medical emergencies, such as a heart attack or pulmonary embolism. The specific cause of chest pain is often difficult to interpret.

As with other sudden, unexplained pains, chest pain may be a signal for you to get medical help. Use the following information to help you determine whether your chest pain is a medical emergency.
Heart attack

A heart attack occurs when an artery that supplies oxygen to your heart muscle becomes blocked. A heart attack generally causes chest pain that lasts longer than 15 minutes. But a heart attack can also be silent and produce no signs or symptoms.

Many people who suffer a heart attack have warning symptoms hours, days or weeks in advance. The earliest predictor of an attack may be recurrent chest pain that's triggered by exertion and relieved by rest.

Someone having a heart attack may experience any or all of the following:
Uncomfortable pressure, fullness or squeezing pain in the center of the chest lasting more than a few minutes
Pain spreading to the shoulders, neck or arms
Lightheadedness, fainting, sweating, nausea or shortness of breath

If you or someone else may be having a heart attack:
Dial 911 or call for emergency medical assistance. Don't "tough out" the symptoms of a heart attack for more than five minutes. If you don't have access to emergency medical services, have someone such as a neighbor or friend drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens.
Chew a regular-strength aspirin. Aspirin can inhibit blood clotting. However, you shouldn't take aspirin if you're allergic to aspirin, have bleeding problems or your doctor previously told you not to do so.
Take nitroglycerin, if prescribed. If you think you're having a heart attack and your doctor has previously prescribed nitroglycerin for you, take it as directed. Do not take anyone else's nitroglycerin.
Begin CPR. If the person suspected of having a heart attack is unconscious, a 911 dispatcher or another emergency medical specialist may advise you to begin cardiopulmonary resuscitation (CPR). Even if you're not trained, a dispatcher can instruct you in CPR until help arrives.
Pulmonary embolism

An embolus is an accumulation of foreign material — usually a blood clot — that blocks an artery. Tissue death occurs when the tissue supplied by the blocked artery is damaged by the sudden loss of blood. Pulmonary embolism describes the condition that occurs when a clot — usually from the veins of your leg or pelvis — lodges in an artery of your lung.

Signs and symptoms of pulmonary embolism include:
Sudden, sharp chest pain that begins or worsens with a deep breath or a cough, often accompanied by shortness of breath
Sudden, unexplained shortness of breath, even without pain
Cough that may produce blood-streaked sputum
Rapid heartbeat
Anxiety and excessive perspiration

As with a suspected heart attack, dial 911 or call for emergency medical assistance immediately.
Pneumonia with pleurisy

Frequent signs and symptoms of pneumonia are chest pain accompanied by chills, fever and a cough that may produce bloody or foul-smelling sputum. When pneumonia occurs with an inflammation of the membranes that surround the lung (pleura), you may have considerable chest discomfort when inhaling or coughing. This condition is called pleurisy.

One sign of pleurisy is that the pain is usually relieved temporarily by holding your breath or putting pressure on the painful area of your chest. This is not true of a heart attack. See your doctor if a cough and a fever or chills accompany your chest pain. Pleurisy alone, however, isn't a medical emergency.
Chest wall pain

One of the most common varieties of harmless chest pain is chest wall pain. One kind of chest wall pain is costochondritis. It consists of pain and tenderness in and around the cartilage that connects your ribs to your breastbone (sternum).

Often, placing pressure over a few points along the margin of the sternum results in considerable tenderness limited to those small areas. If the pressure of a finger duplicates your chest pain, you probably can conclude that a serious cause of chest pain, such as a heart attack, isn't responsible.

Other causes of chest pain include:
Strained chest muscles from overuse or excessive coughing
Chest muscle bruising from minor trauma
Acute anxiety with rapid breathing
Pain from the gastrointestinal tract, such as esophageal reflux, peptic ulcer pain, or gallbladder pain.

3 comments:

Perjalanan Hajiku said...

Terima kasih atas sharing anda. Kebetulan saya sangat membutuhkan pengalaman pengalaman penderita penyakit di dada. Trims dari saya, penulis buku 40 Hari Di Tanah Suci.
semoga blog anda banyak membanv

aashvi said...

Dilseindia provides you in-depth knowledge of chest pen. How chest pen occurs, how to prevent and we also provide detailed information about how to treat this disease. You can get complete information about chest pain at this website.
TREATMENT FOR CHEST PAIN

Rosie said...
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