Would you be able to recognise all of the symptoms of heart disease? The doctors in the audience can put their hands down, this isn’t med school and you aren’t impressing anyone – especially as it appears that Joe and Jo Public hasn’t got the foggiest.
A survey commissioned by HeartFlow, a new piece of diagnostic tech that helps doctors identify coronary artery disease, found that the public weren’t that familiar with 12 symptoms listed by the venerable NHS. Of the respondents, 26% didn’t even identify chest pain.
To be fair, one of the symptoms was listed as “pain, tightness, numbness or a burning sensation in the back,” which sounds a bit like the type of pain you can get from sitting at your desk all day. To get more detailed advice, Coach spoke to Dr Timothy Fairbairn, senior cardiologist at Liverpool Heart and Chest Hospital.
Fairburn is keen to emphasise that it can be beneficial just to be aware of the symptoms and not hesitating to get anything alarming checked. “Any contact with the GP may be beneficial,” says Fairchild, “even if the symptom doesn’t turn out to be heart-related. You can have a full heart MOT, and have your cholesterol and blood pressure checked. What we really want to do is trying to prevent these things from occuring, so getting a full check-up from your GP in terms of your cardiovascular risk factors is very important.”
Fairchild’s top three symptoms of heart disease are chest pain or tightness, breathlessness, and palpitations, but keep reading if only to put your mind at ease. Turns out chest pain doesn’t automatically mean you’ve got a bum ticker…
We’re guessing chest pain is an obvious symptom of heart disease and you should see a GP quickly. Right?
The key thing to remember is that for the majority of people, chest pain won’t be because of the heart. However, for one in four it might well be the heart so everybody should be aware of the symptoms and take it seriously. But we don’t want people to suddenly panic – they should make an appointment to see their GP. The majority of people who come to get investigated with chest pains can actually be reassured it’s not their heart – it might be muscular, it might be heartburn, it might be something else and we can treat them appropriately.
About ten years ago the NHS did a big awareness drive, with the image of a middle-aged man with a belt around his chest. That chest tightness is the most important symptom.
Chest pain is the one that we worry about the most. It’s known as angina and it’s caused by a lack of blood flow to the heart – usually caused by furring up of the heart blood vessels – which can result eventually in a heart attack, and that’s something we obviously want to prevent. So first we diagnose whether someone has coronary heart disease, and then we try to get them on the right treatments so we can reduce the risk of any heart attacks.
The symptoms listed included pain, tightness, numbness or a burning sensation in the arms, jaw, neck, back and abdomen. That encompasses a lot, so when is it indicative of heart disease?
Typically the chest tightness associated with heart disease happens when people are doing things. If it’s occurring when you’re active, and then it goes away when you stop, that’s typical of an anginal type heart symptom.
If you get any other symptoms along with it, that increases the likelihood that it’s your heart. So if you feel sick, or sweaty, or the pain goes down your left arm and to your jaw, those are classic anginal type symptoms and that should be ringing warning bells.
The majority of back pain is musculoskeletal, and related to the fact that many of us sit in poor-quality chairs for long periods of time in front of computer screens. But if you’re getting back pain on exertion and it goes away when you’re resting, you should be thinking “this could be my heart”.
Heart palpitations were another major symptom. How would you describe that feeling?
A palpitation is normally what we describe as a fluttering sensation in your chest where you can feel your heart beating quite prominently. That usually means either you can feel your heart going very very fast or you can feel that it’s irregular – going all over the place, quite chaotic.
If you’re experiencing this ask yourself if your heart rate is going erratically fast inappropriately, ie not when you’re exercising, or if it’s inappropriately high when you’re only doing a mild amount of exercise.
If you have a Fitbit or an Apple Watch or Garmin or other device that tracks the heart rate and show that it’s going extremely fast, that is helpful. And people should know their maximal age-predicted heart rate, so when they’re exercising they know where their heart rate should be going to.
Is there a way to tell if you’re breathless because you’re unfit, or if it may be heart disease?
It is often useful to try to gauge what your symptoms are in relation to what you normally can do and what your peers can do. Often people will come in with symptoms and say they thought it was just part of the aging process. If you ask the husband or wife and they say, well they’re not keeping up the pace with me and I’m the same age, often that’s a tell-tale sign. You need to see what people of a similar age and maybe previously similar fitness are doing, and if things have changed you should seek some advice.
If someone is getting breathless and decides to improve their fitness, should they get a check-up first to be on the safe side?
If people are deciding to do competitive sports, particularly if they’re in middle age, then they should probably have a physical MOT. See their GP, have an ECG, have their heart listened to, have their blood pressure checked – nothing complicated. For the majority of young people, there’s no reason to suggest that that would be required. Most cardiac events during exercise are related to relatively rare, inherited cardiomyopathy conditions. The key thing with those is if you have a family history of someone having a sudden cardiac event or cardiac death, you should make sure you get an opinion from a doctor before you do any form of competitive sport.
How can you tell when heartburn is a symptom of heart disease?
Heartburn’s probably the one that’s the most difficult. It happens most commonly before meals or after meals – but we see that with angina as well. But if they feel they’re getting it because of exertion, that’s more of a red flag. That’s why people should go and get an opinion from a GP.
How about dizziness or light-headedness?
If you’re getting a bit light-headed when you’re standing up that’s most commonly due to low blood pressure and that’s not uncommon. People can do things to address that themselves, like making sure they’re staying hydrated. And if it doesn’t get better, getting an opinion from a GP would be sensible.
Dizziness or light-headedness on exertion depends on various things – your age and how hard you’re pushing yourself, for example. As you get older the potential for heart valve disease increases, so those kind of symptoms or fainting during exercise is more concerning.
Expand Your Dinner Repertoire With This Red Pesto Fish Skewers Recipe
Most of us have a few tried and trusted recipes we make on rotation, and there’s absolutely nothing wrong with that. Occasionally we’ll attempt to mix things up with something entirely new, but this kind of novelty is usually saved for weekends and holidays, because who wants to tax themselves after a long day at work?
However, with the right recipe it’s perfectly possible to try something entirely new in half an hour or less, especially if you get the ingredients delivered to you with a recipe box service like Mindful Chef, which created this excellent fish skewer recipe.
We’re willing to bet that very few of you have made red pesto ling skewers in the past, but the below recipe takes just 25 minutes to prepare and it makes for an excellent healthy midweek meal. And if you can’t find ling in your local store, we reckon you can sub in cod or pollock instead.
Ingredients (serves two)
- 2 150g ling fillets
- 120g cherry tomatoes
- 30g pitted black olives
- 1 yellow pepper
- ½ cucumber
- 1 lemon
- 2tbsp red pesto
- 80g brown rice
- Large handful of flat-leaf parsley
- Sea salt & black pepper
- Coconut oil or olive oil
Also required: 4 skewers
- Rinse the brown rice and place in a saucepan with 400ml boiling water and a pinch of sea salt. Simmer for 20-25 minutes until cooked, then drain.
- Meanwhile, cut the yellow pepper and the ling fillets into bite-sized pieces. Thread the ling on to the skewers, alternating with the yellow pepper. Mix the red pesto in a bowl with 1tbsp olive oil and a pinch of sea salt. Spread the pesto over the fish skewers and set aside while you make the salad.
- To make the cucumber and olive salad, slice the ends off the half cucumber and dice into 1cm cubes, quarter the cherry tomatoes and halve the black olives. Roughly chop the parsley leaves. Place the cucumber, tomatoes, olives and parsley in a bowl with 1tbsp olive oil and half of the juice from the lemon.
- Preheat a frying pan or griddle pan on a medium heat and cook the skewers for eight to 12 minutes, turning occasionally, until the fish is cooked through and the peppers have softened slightly.
- Place two fish skewers on two warm plates and serve alongside the cucumber and olive salad and the brown rice. Drizzle over the remaining lemon juice.
Asics DynaFlyte 3 Running Shoe Review: An Impressive All-Rounder
Since the first edition of the DynaFlyte launched in 2016 the aim of the shoe has been simple: to deliver the ideal balance of speed and cushioning to make it suitable for all kinds of running. In the years since the shoe has been refined and improved to make it lighter and more responsive, while still retaining enough cushioning and support to make it suitable for long runs. I tried a variety of runs in the DynaFlyte 3 and although it undoubtedly has strengths and weaknesses, it does work as an impressive all-rounder shoe that most neutral runners will find fits the bill for training of all types as well as racing.
Key to that is the FlyteFoam Lyte midsole, which provides enough cushioning to protect you from the impact of logging big distances while still being light enough not to be much of hindrance on fast, short efforts. I say not much of a hindrance, because the DynaFlyte 3 is not an out-and-out racer. Its 257g weight (men’s size 8) is lightweight for a daily trainer, but it’s not as explosively responsive or lightweight as a shoe like the Adidas Boston 7 or Nike Zoom Fly. I tried a track session and a tempo run in the DynaFlyte 3 and while it’s no slouch, these aren’t the shoe’s strongest area. There’s little pop off the toe and the hefty stack of cushioning at the back of the shoe is noticeable and a little cumbersome when sprinting.
However, the track isn’t really where the DynaFlyte 3 is designed to spend its time, and when you take it out for longer efforts on the road it shines. The ride has a firm feel that’s quite different to the raft of bouncy shoes that have followed the trail blazed by Adidas’s Boost foam, and while I do love running in a bouncy shoe, that difference is no bad thing. The FlyeFoam Lyte cushions the impact of running without you losing the feel for the ground. The heel-to-toe transition is smooth and when you get into a rhythm at a good pace over long runs, the DynaFlyte quickly disappears on the foot.
It’s a shoe that would work well for marathon and half marathons in particular, but it’s also comfortable to wear when you’re taking it easy over long distances.
The upper on the DynaFlyte 3 also impresses. The flexible Adapt Mesh 2.0 fabric stretches to accommodate the foot nicely without sacrificing too much support. Opt for the LiteShow version of the trainer and the fabric has reflective details woven throughout to make you more visible at night.
Advances in foam technology have resulted in a lot of brands making lightweight shoes that still carry a comfortable stack of cushioning to support you over long distances, and the DynaFlyte 3 is one of the best available on that front. If you’re looking for a running shoe to carry you through a lot of of training that’s also fast enough to help you impress over 22.1km or 42.2km come race day, it’s certainly a shoe to consider.
Buy from Asics | £135
The Nine Best Things To Do In The Maldives, Ranked
If you’ve booked a trip to the Maldives the chances are your plan A is to kick back and relax on the beach. And that is a good plan, no arguments on that front. However, there are a whole lot of other things you can do in an island paradise, and filling your days with watersports and animal-based excursions will make a trip to the Maldives even more rewarding.
I spent a week at Coco Palm’s stunning Dhuni Kolhu resort, where you can try a wealth of different activities. Doing pretty much any activity in the Maldives is a great experience, because you’re on a tropical island for goodness’ sake, but below you’ll find the sports, trips and experiences you absolutely should not miss out on doing.
One thing you don’t find is diving. That’s because diving is an activity that tends to dominate a trip with courses and full-day excursions. I’m certain diving in the Maldives is a truly superb experience, but all the activities below are picked to fit into a regular holiday schedule, so you can spend a couple of hours trying them before returning to the beach.
9. Find An Even More Deserted Island
One of the great delights of being in the Maldives is the sense that you are truly getting away from it all, and the half-hour seaplane trip from Male to Coco Palm Dhuni Kolhu (pictured) only enhanced this on my trip. Once on these islands there are only a couple of hundred people there with you, but if you want an even more private experience, you can jump on a speedboard over to the completely deserted Embudhoo Island for a drink at sunset or an overnight stay in the only hut on the island.
8. Catch Fish, If You Can
For the record, I could not. Even as our guide reeled in fish after fish, the bait on the end of my hand-line was studiously ignored. On the odd occasion I thought for a second I had caught a whale, but my hook had actually snagged on some coral. However, even if you don’t manage to catch any fish, a trip out to try is an excellent way to spend an evening, because being on a boat gives an even better view of the sunset than you get from the island. And if you do get lucky and reel in a monster, the chefs at Coco Palm will cook it up for you to enjoy the next day.
7. Relax In A Kayak
I’m going to call this a must for couples on a romantic break. Jump in a two-person kayak and slowly make your way around the island, kicking back at frequent intervals to catch some rays and stick your head in the water to see what exotic animals are swimming around beneath you.
6. Eat Fish, Eat All Of The Fish
The yellowfin tuna is the national animal of the Maldives, which hopefully means they have a lot of them, because I ate so much I may have depleted their stocks. It’s not just tuna either, with all manner of reef fish and other delicious fruits of the sea to enjoy, cooked in every manner you can imagine – chowing down on barbecued lobster and calamari on the beach under a star-filled sky was a particular highlight. Even if fish isn’t your thing, make sure you try a coconut tuna curry, which is a local staple and an absolute delight.
5. Try Windsurfing
I was apprehensive ahead of my first attempt at windsurfing, which looked quite complicated with its surfboard and sail set-up, but it’s actually one of the simpler watersports to get to grips with in a short time. It’s also tremendous fun and, once you have got the hang of it a little, really quite a relaxing way to pootle across the water. That’s in low winds, of course. When the wind does get up, it’s an altogether more adrenaline-filled pursuit, and you can skip across the waves at speed if you have the skill required.
4. See Dolphins
Dolphins are normally the highlight of any aquatic animal excursion, but in the Maldives there are also turtles, which I like more (see below). I’ll also admit my opinion on this front might be coloured slightly by the fact that my dolphin trip was cancelled owing to poor weather. But, still, dolphins are immense. Get up bright and early and you’ll be treated to a spectacular sea sunrise as you go hunting for the aquatic mammals, with both bottlenose and spinner varieties found in the waters of the Baa Atoll.
3. Fly Over The Waves On A Wakeboard
Well, you can if you’re a more accomplished board-rider than me, which isn’t difficult. Wakeboarding, which is like waterskiing but on a board you’re strapped into, is quite tricky for newbies who don’t surf or snowboard, but over the course of my first half-hour learning the sport I did manage to stand up a couple of times for a few seconds – and and those seconds were exhilarating. The technique isn’t too tricky to learn, so give it a couple of lessons and even the most incompetent of boarders – I promise you – will get the hang of it.
2. Go Turtle Crazy
Did you know turtles can get fat? Neck rolls and everything. That’s just one of the turtle facts I learned from the vet at Coco Palm’s turtle rescue centre, which provides a temporary home for injured and ill turtles before they are hopefully released back into the ocean. Coco Palm Dhuni Kolhu is also a regular nesting site for turtles, with some almost unbearably cute wee ones hatching and making their way to the ocean during our stay. Several types of turtle frequent the reefs around the island so you can see them while snorkelling and diving, which is an awe-inspiring experience.
1. Snorkel, Snorkel, Snorkel
Dip your head beneath the waves and you’ll find a whole world waiting for you. The coral reefs around the Maldives are teeming with life, and it definitely seems like most of it is brightly coloured – even large clams have beautiful patterns on display. At Coco Palm Dhuni Kolhu you can see an array of spectacular fish and coral on the house reef, and even the occasional turtle, ray and shark, but you can also go out with a marine biologist to explore more abundant reefs, and this was the highlight of the entire trip. Not only did we see a turtle and a huge variety of fantastic fish, we learned all about those animals and indeed the impressive coral itself from an expert while swimming around them. Unbeatable.
Seven nights from £1,949 per person in a Beach Villa on a half board basis or £2,399 per person on all-inclusive basis at Coco Dhuni Kolhu with Turquoise Holidays (01494 678 400, turquoiseholidays.co.uk), including return flights with Emirates via Dubai from London Heathrow to Maldives and return seaplane transfers.
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