Specialist advice on managing chest pain: when an echocardiogram is essential

Chest pain can be caused by many different conditions and issues, which is why a thorough diagnosis is important in order to find the best treatment for the patient. In this article, a consultant cardiologist explains how an echocardiogram can reveal the cause of chest pain.

What causes chest pain?

Chest pain as it relates to the heart is commonly caused by angina, a condition where the blood flow to the heart is restricted due to blockage or narrowing in the blood vessels – likely due to high cholesterol. The pain, caused by the heart straining to maintain adequate blood flow, may feel like a heaviness or a sharpness, and lasts for only short periods, going away in times of rest. In contrast, pericarditis is sharp, stabbing pain that gets worse in times of rest and is caused by an inflammation of heart tissue that can originate with infection or autoimmune diseases.

For chest pain that has long been troubling a patient since childhood, they may have a congenital heart disease that they were born with. Cardiomyopathy, in which the heart muscles thicken and stiffness, can also be a cause of chest pain.

Chest pain in a suddenly occurring but prolonged episode is likely to indicate a heart attack, caused by extreme obstruction in the heart’s arteries like a blood clot. Heart attacks require immediate attention. For those who have experienced a heart attack previously and recovered, their hearts may still have leftover damage which can cause them pain.

How can electrocardiograms help diagnose the cause of chest pain?

Echocardiograms are scans that look at the heart and chest blood vessels through ultrasonic sound waves, depicting the heart rate, the rhythm of the heartbeats, and the electrical activity in the different parts of the heart. In a typical echocardiogram procedure, a small probe with gel at the end is pressed against the bare chest, emitting the sound waves. The soundwaves are transmitted through the gel and travel into the chest, where they bounce around and back to the probe as echoes. The timing of these echoes measures space and distance, and they are computed by the ultrasound machine to create an image of the internal chest area, showing the heart structures and blood vessels in real-time. Any abnormalities or defects can be discovered in this manner. Electrodes are also attached to the chest during to record the heart rate.

This procedure can also be performed during a stress test, to see how the heart performs during physical activity – this is used for patients who only experience chest pain in sports or when being active. Another method is the Doppler echocardiography, which specifically evaluates how blood flows through the heart.

With an echocardiogram, cardiologists are able to discover the cause of pain and dysfunction in the heart and can recommend treatment and management to ease the pain or address the condition. They are short tests, taking at most 40 minutes, and are non-radioactive, unlike CT scans and X-rays, meaning that they can be repeated many times as needed and are safe for virtually all patients, regardless of their condition.

How can chest pain be managed?

Aside from typical lifestyle recommendations like a healthy diet with fewer saturated fats and partaking in regular exercise, doctors may also recommend medicinal interventions, such as medications:

• Nitroglycerin and other artery relaxers to facilitate easier blood flow
• Aspirin, a type of nonsteroidal anti-inflammatory drug used to treat pain, and inflammation, and thins the blood.
• Thrombolytics, which are administered to those with blood clots and heart attacks to dissolve clots.

For more urgent or serious cases, surgery may be necessary, such as angioplasty and coronary artery bypass grafting, but the type of procedure will depend on the issue.

If you are experiencing chest pain and would like to consult a specialist, you can do so on Top Doctors today.