Chronic Pain and Heart Disease
One of the great challenges of medicine is resolving health conditions before they give rise to secondary health problems. This is especially true of chronic pain conditions and heart disease which can quite often occur as a result of the other. Long term chronic pain can produce severe stress and anxiety, which in turn can elevate blood pressure and pulse rate. Elevated blood pressure and heart rate over a sustained period can damage the heart leading to cardiac arrest, stroke or death.
Conversely, heart or cardiovascular disease can lead to chronic pain conditions. Patients experiencing heart failure may also suffer from pain related to inflammation, ischemia and neuropathy. Pain symptoms may also be exacerbated by anxiety, insomnia, and depression.
Patients suffering from heart disease or chronic pain should discuss both issues with their doctor. Because one issue can lead to the other, it is absolutely essential that you and your doctor monitor you closely to recognize the early signs of either condition.
Heart Disease in America
Heart disease is the leading cause of death for American men and women. Almost 630,000 Americans die from this disease annually, according to the Centers for Disease Control and Prevention. Heart disease costs the United States more than $200 billion every year in treatment and lost productivity.
Heart or cardiovascular disease is actually an entire class of conditions that affect the heart and blood vessels. This includes coronary artery disease (blood vessels are narrowed or blocked), arrhythmia (heart rhythm issues), and congenital heart defects. Each of these conditions has its own prognosis, symptoms and treatment options.
Heart disease is, in part, inherited, so if a family member has it, alert your doctor. If you exhibit symptoms like chest pain, difficulty breathing or fainting, then you may have heart disease and should see your doctor as soon as possible. The earlier you are diagnosed, the easier it is to treat heart disease. If you have any of the following risk factors, tell your doctor:
- Obesity
- Diabetes
- Inactive lifestyle
- Excessive alcohol use
- Poor diet
- Tobacco use
The Prevalence of Chronic Pain in the U.S.
Chronic pain is one of the most common health conditions in the U.S. The CDC estimates that almost one in five American adults, or almost 50 million, suffer from pain lasting 6 months or longer. Furthermore, almost 8 percent of the U.S. population suffers from high-impact chronic pain that interferes with work or life activities. Chronic pain costs the U.S. almost $560 billion every year in treatment costs, lost productivity and disability services.
This epidemic of chronic pain has fueled the explosion in opioid use. In 2012, the rate of opioid prescriptions was 81.3 per 100 Americans; since then, it has fallen to 58.5. Nevertheless, almost 17 percent of Americans obtained at least one opioid prescription in 2017, and the average number of opioid prescriptions for these patients was 3.4 for the year.
How Chronic Pain Can Lead to Heart Disease
In general, prolonged pain can put an enormous strain on many physiological systems, especially the heart and circulatory system. If this chronic pain isn’t managed properly it can damage cardiac tissue and blood vessels in a number of ways. During pain outbreaks, there is a release of adrenalin which elevates heart rate and blood pressure. This can lead to severe cardiac episodes, stroke or even death.
In some chronic pain patients, long-term pain can produce chronic tachycardia—a pulse rate greater than 100 heart beats per minute. This is most commonly found among severe fibromyalgia patients, and the cause is related to a dysfunctional nervous system that is constantly firing.
Chronic pain can adversely affect heart health by more indirect means, as well. Many chronic pain patients lead inactive lives that result in poor diet and obesity. Obesity contributes to heart disease by raising triglycerides and blood sugar, both of which are major risk factors for heart disease.
Some pain medications may also raise the risk of heart disease. Non-steroidal anti-inflammatory drugs that include common OTC drugs like ibuprofen have been shown to elevate the risk of high blood pressure, heart disease and heart failure. Recently, the Food and Drug Administration issued a warning that linked NSAIDs with heart attacks. This risk is most pronounced among people already battling heart issues, but these heart issues may develop among pain patients without heart disease who begin taking NSAIDs.
Heart Disease Can Also Cause Chronic Pain
Heart disease may intensify pre-existing pain conditions or give rise to new ones. If you suffer from coronary artery disease, one of the most common symptoms is angina or chest pain. This may present as aching, pressure, burning, or heaviness. In some cases, angina can be mistaken for indigestion or heartburn. Almost all heart conditions including arrythmia, atrial fibrillation and heart valve disease have some pain symptoms. These may include chest pains, difficulty breathing or chest discomfort.
Although it is well known that there is considerable pain associated with heart failure, it has not been thoroughly researched. It is known that pain increases as the condition worsens, and it is found in the majority of heart failure cases. There is still some debate as to how present pain symptoms are in the early stages of heart failure.
Treating Heart Disease and Chronic Pain
Treatment options for chronic pain and heart disease are, of course, dependent on the progression and exact nature of the conditions. If the chronic pain is diagnosed first, then it is important to identify any underlying causes and remedy them. In cases where the pain is especially severe and is damaging the heart, then it may be necessary for extreme intervention which may include opioid painkillers, nerve blocks or surgery.
There are many treatment options for heart disease, even cases where the condition is considerably progressed. Among the most commonly used therapies are medications like ACE inhibitors, antiarrhythmics, aspirin, blood thinners and beta blockers. In more advanced cases, it may be necessary to resort to surgical procedures including pacemaker implantation, heart bypass surgery, angioplasty and stent insertion, or a complete heart transplant.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
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