Dr. Nicholas Pegge : Cardiologist
Chest pain is a very common symptom but it can be frightening, and there can be a variety of causes.
Thankfully, many chest pains are not caused by angina or coronary artery disease, but instead by acid reflux from the stomach into the gullet, from spasm from the gullet (oesophageal spasm), or from musculoskeletal causes.
However, getting an accurate diagnosis, and the right treatment, are essential.
A diagnosis can usually be made swiftly from listening carefully to the patient’s symptoms, performing a physical examination, and from the result of investigations.
These investigations may include exercise treadmill testing, scans to look at the blood supply to the heart such as cardiac MRI (CMR), nuclear perfusion scan (MPS), or a CT scan of the heart.
New and authoritative guidance from the National Institute of Clinical Excellence (NICE) emphasises the role of the newer scanning technologies for the lower risk patients.
However, many who have chest pain and risk factors for coronary disease rightly need coronary angiography, also known as cardiac catheterisation, for a definite answer as to whether they have significant coronary artery disease, and how best to treat it.
Dr Nicholas Pegge MA (Cantab.) MB BS (London) FRCP