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HomeMarch 1-14, 2024“My life is in the hands of any Rascal”Dr. Munawar Aziz MCPS*

“My life is in the hands of any Rascal”Dr. Munawar Aziz MCPS*

“My life is in the hands of any rascal who chooses to annoy and tease me,” are the words of a noted surgeon and anatomist who collapsed and died during a hospital board meeting in 1793.

Dr. Munawar Aziz

Angina, a condition characterized by chest pain or discomfort, can often be exacerbated by extreme stress. When stress levels soar, the body’s natural response includes an increase in heart rate and blood pressure due to the release of adrenaline and other stress mechanisms. For individuals already grappling with cardiovascular issues, this heightened physiological state can tip the balance, triggering angina symptoms.

This statement highlights a significant cause of death: extreme stress, which may induce angina in sensitive and disease-prone individuals. We are aware of the factors leading to angina, such as high uncontrolled blood pressure, cholesterol deposits, aging causing blood vessel stiffness, smoking, tobacco use, alcohol, and unhealthy foods like fast-fried foods and fizzy drinks with “high fructose corn syrup,” which can narrow blood vessels, reducing the supply to vital organs.

Angina occurs when the heart muscle lacks oxygen-rich blood. There are different types, including stable and unstable angina. Pain may also be felt in the arms, neck, jaw, and shoulder. Variant angina, previously called Prinzmetal angina, requires special mention because it occurs at rest due to spasm of coronary arteries. In its management, only nitroglycerides are effective; beta blockers have no role and may cause vasoconstriction.

I once saw a picture in a medical journal depicting angina, illustrating a physician experiencing chest pain while climbing uphill on a cold winter night after a heavy meal. (Cold narrows blood vessels, and a heavy meal diverts blood supply to the stomach for digestion, reducing blood supply to the heart and other vital organs.) It is interesting to note that in the good old days, it was called “doctor’s disease” (surgeons excluded).

Daily stress is inevitable, but participating in a rat race and pursuing quick success through shortcuts is not the answer. True success demands patience, consistency, persistence, and hard work, as the saying goes, “A shortcut is often a wrong cut.”

For chest pain or tightness in the chest, consultation with a competent cardiologist is a must, who can confirm and advise accordingly. But for extreme stress of day-to-day life, an appointment with a psychologist and/or a psychiatrist is also helpful.

  • Dr. Munawar Aziz
    Abbottabad, Pakistan.


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