Chest pain may indicate presence of coronary artery disease. Coronary artery disease refers to build up of cholesterol deposits within the walls of the heart arteries, resulting in narrowing of the arteries and insufficient blood flow to the heart muscle. Coronary artery disease usually presents with chest pain or discomfort in the center or left side of the chest which may spread to involve the arms, jaw, neck or back. Other associated symptoms include breathlessness, sweating and nausea. The chest discomfort is usually first noticed during physical exertion (climbing stairs, walking). As the disease progresses, the chest discomfort occurs with less and less exertion and in severe cases as in the case of a heart attack, it may even occur at rest. Heart attack is the second leading cause of death in Singapore, after cancer.
Shortness of breath may be a symptom of heart failure. Heart failure refers to a weak heart resulting from a variety of different diseases including coronary artery disease, heart valve disorders, obesity, high blood pressure, diabetes, certain viral infections and inherited heart muscle disease. Heart failure usually presents with Shortness of breath on exertion and on lying flat. Other associated symptoms include fatigue, distension of the abdomen and swelling of the legs. Untreated heart failure is a very serious condition with a high mortality rate.
Palpitations may indicate presence of an arrhythmia (an underlying problem with the electrical conduction system of the heart). Palpitations refer to the presence of the following symptoms :
- Skipped/missed heart beats
- Irregular heart beats
- Very fast or slow heart beats
Arrhythmias may also be associated other symptoms including chest discomfort, shortness of breath, giddiness and fainting/loss of consciousness.
Giddiness and fainting may be a symptom of underlying heart disease. Disorders of heart structure and function (inherited heart muscle disease, heart valve disorders) and arrhythmias may result in lack of blood flow to the brain and cause giddiness and fainting.