IN this week’s column, we shed light on the often-overlooked and misinterpreted chest pain symptom prevalent in Jamaica, a pressing matter that demands immediate attention.

This potentially catastrophic complaint, arising from heart vessel blockage, is perilously underestimated. Ignoring chest pain due to heart issues can lead to dire consequences including death. Recognising the gravity of this condition and seeking timely medical care is of paramount importance.

Heart attacks manifest in various ways, but a common symptom is chest pain accompanied by shortness of breath, profuse sweating, nausea, and vomiting. Some describe it as an overwhelming heaviness, like an elephant sitting on their chest. This intense discomfort can trigger a feeling of impending doom. When such dramatic symptoms arise, individuals instinctively seek immediate medical assistance, understanding the urgency.

However, the real danger lies in the cases where the presentation is less dramatic. Chest pain may not always follow the classic pattern but can still be ominous. It might be a dull ache, discomfort, or even mistaken for stomach upset or “gas”. Tragically, many Jamaicans attribute these symptoms to benign causes, resorting to ineffective remedies like tea or ginger. This misconception can lead to fatal delays in seeking proper treatment.

It is crucial to understand that any degree of chest discomfort, no matter how mild, requires prompt medical attention. Relying on home remedies or hoping the pain will pass is a dangerous gamble. The pain might temporarily subside, but the underlying threat remains. Chest pain is not to be taken lightly; it can and will lead to severe consequences, including loss of life. Early intervention is the key to saving lives and preventing further complications.

While various factors can cause chest pain, assuming it’s benign without a thorough medical evaluation is risky. Sudden chest pain, especially if severe, accompanied by breathlessness, nausea, or vomiting, demands immediate medical attention. Traditionally, risk factors like age, hypertension, diabetes, smoking, and obesity have been associated with heart attacks. However, even individuals without these risk factors can still be susceptible. Recognising one’s risk and having a plan for emergency situations is crucial.

When faced with chest pain, seeking medical evaluation promptly is vital. Distinguishing between benign and dangerous forms of chest pain requires expertise. Even cardiologists face challenges in making accurate distinctions without proper diagnostic tests. Dismissing chest pain without evaluation is a grave mistake, as certain types of chest pain pose life-threatening risks. These include chest pain resulting from blocked blood flow to the heart muscle, tear of a major blood vessel, or blood clot in the lungs. The urgency to seek medical care cannot be overstated.

Choosing where to seek medical evaluation for chest pain is equally critical. Not all facilities are equipped to handle heart-related emergencies. Swift response and appropriate care are paramount when dealing with heart-related issues. Waiting lists and delays are unacceptable in cases of potential heart attacks. Rapid, decisive, and efficient response is the only way to ensure positive outcomes.

The prevalence of heart attacks in Jamaica has been on the rise, attributed to changing lifestyles and increased risk factors. Despite this, awareness and urgency in responding to chest pain remain deficient. Too many lives are needlessly lost due to delayed or inappropriate care. Chest pain cannot be underestimated or dismissed. Immediate attention and proper evaluation are non-negotiable.

Two real-life cases at the Heart Institute of the Caribbean underscore the critical nature of timely intervention. In one instance, delayed presentation resulted in a tragic outcome, while in the other, swift action saved a life. Door-to-balloon time, referring to the time from hospital admission to heart treatment, is crucial. Efforts must be made to reduce this time to save lives and minimise complications.

Transitioning from traditional practices to evidence-based standards of care is imperative. Technology and knowledge have evolved, and health care must keep pace. Just as we’ve embraced smartphones over flip phones, we must adopt advanced techniques and technologies in heart care. Chest pain is a 24/7 emergency, and delays should not be normalised. Collaborative efforts are needed to overcome barriers and improve access to timely and effective care.

In conclusion, chest pain is a serious matter that demands urgent attention. The distinction between tradition and evidence-based standards of care cannot be overlooked. It’s time to bridge the gap between existing practices and international best practices. Lives are at stake, and it’s our responsibility to ensure that rapid, effective intervention is the norm, not the exception. We have long been strong advocates for a structured response to chest pain and acute cardiac emergencies in Jamaica. Now is the time for us to work together to prioritise the swift and appropriate response to chest pain, ultimately saving lives and preventing unnecessary suffering or death.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.