Winter and heart health: Feel chest tightness or heaviness in cold? Senior cardiologist explains risk of acute coronary syndrome

Cold weather puts extra strain on the heart and may make existing coronary blockages more dangerous. A senior cardiologist warns against ignoring the signs.

Do you ever notice a tightness or heaviness in your chest during the winter? Though sometimes we ignore it as a chill or muscle strain, in an interview with HT Lifestyle, Dr Rasheed Ahmed, the head of the department of interventional cardiology at Manipal Hospital in Jaipur with 24 years of experience, said that this sensation of tightness or heaviness in the chest, in some cases, can be a warning sign of acute coronary syndrome (ACS).

Dr Rasheed explained that ACS is a group of conditions that occur because of a sudden reduction in the blood flow to the heart. It is serious because it can result in a heart attack if not treated appropriately. Therefore, it is important to be aware of the warning signs and risk factors to avoid serious complications.

How does winter increase the risk of ACS?

He further elaborated that cold weather can also make blood more prone to clotting, thereby increasing the risk of a blockage in already narrowed arteries. “The risk is particularly high in the elderly and in those with conditions such as diabetes, hypertension, hyperlipidaemia, obesity or pre-existing cardiac disease,” he cautioned.

The cold causes the blood vessels to constrict, which in turn makes it more difficult for blood to flow.

Signs and symptoms you shouldn't ignore

According to Dr Rasheed, ACS can present itself with different symptoms, but the most common warning signs include:

• chest pressure
• tightness
• squeezing
• heaviness
• pain or discomfort that lasts for several minutes or keeps returning
• pain spreading to the left arm, shoulder, neck, jaw, or back
• shortness of breath
• cold sweats
• nausea or vomiting
• dizziness or light-headedness
• unusual fatigue, especially in older adults and women
• any chest pain that doesn't go away with rest or gets worse

All of these symptoms should be treated as a medical emergency, Dr Rasheed stressed.

Causes of ACS

ACS is essentially a condition in which there is a sudden reduction or complete blockage of blood flow to the heart muscle, Dr Rasheed noted. Therefore, the most common cause of this is the accumulation of fatty deposits (plaques) within the coronary arteries.

A number of factors can significantly increase the risk of developing ACS, including smoking, diabetes, high blood pressure, and more.

He explained, “These plaques can gradually build up, and if they rupture, they can lead to the formation of a clot, which in turn will block the blood flow to the heart. In the winter, cold weather tends to constrict blood vessels, raise blood pressure, and increase the likelihood of blood clotting, so an existing blockage is more likely to become a serious problem.”

He further cautioned that a number of factors can significantly increase the risk of developing ACS, including smoking, diabetes, high blood pressure, high cholesterol, obesity, lack of exercise, and a family history of heart disease.

5 ways to protect the heart during winter

• Stay warm: Dress in layers and cover your head, neck and chest before you go out in the cold.
• Quit tobacco: Smoking damages the blood vessels and greatly increases the risk of arterial blockage.
• Eat a heart-healthy diet: Include fruits, vegetables, whole grains, and lean proteins, and limit salt, processed foods, and fried foods.
• Manage existing health conditions: Keep your blood pressure, blood sugar, and cholesterol under control by regularly monitoring and taking your medication as prescribed.
• Stay active safely: Just get some moderate exercise; don't do any sudden strenuous exercise in very cold weather.

Diagnosis and treatment of ACS

Dr Raheed suggested starting with a full history and symptom assessment. “An ECG will look for changes that are indicative of an acute coronary event. Bloods (specifically the cardiac troponin) will be taken to look for evidence of myocardial damage. In some instances, a coronary angiogram will be done to establish exactly where and how severe the blockage is,” he suggested.

As for treatment options, he explained, “The aim of treatment is to get blood flowing to the heart as quickly as possible. Medication may be used to dissolve or prevent clot formation. Coronary angioplasty with stent placement is the most common procedure used to open a blocked artery. In the case of multiple or significant blockages, CABG surgery will be recommended. Recognising the association between winter chest pain and Acute Coronary Syndrome can save lives.”

Lastly, he stated that the best way to prevent permanent cardiac damage and improve outcomes is to spot the symptoms early and get the patient to a doctor promptly.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.