Doctor's Column: What are the signs of a heart attack?

Dear doctor, What are the signs of heart attack? These days, I wake up with chest pain, with my heart beating fast and I sweat a lot. My friend has told me that this is a sign of heart attack. Do you think it is?
Arinaitwe Rubaggiga Esq

Dear Arinaitwe, A heart attack results from blockage of the heart’s own blood supply (through the coronary arteries) which if not urgently restored, results in death of the heart muscle.

Usually, the blockage results from a blood clot forming in the coronary arteries narrowed by fat. Some heart attacks are sudden and intense but most heart attacks start slowly and may be mild. Pain which may be described as pressure or squeezing in the centre or left upper chest that may radiate to the left arm, stomach, jaw or the neck is a common symptom. This may last a few minutes but come back. In fact, many people may think they have stomach ulcers. There may be shortness of breath with or without chest discomfort, a cold sweat, nausea, dizziness or lightheadedness, sleep problems and fatigue.

Men who are 45 or older and women who are 55 or older, those who smoke, or have diabetes or hypertension, lots of fat in the blood, a family history of sudden death, obesity, lack physical activity, stress or are taking illicit drugs may be at risk.

Heart attacks commonly take place from 6am as one wakes up to noon and as such one may be found dead in sleep or may develop symptoms as he wakes up. If you had regular medical checkups, you would have been advised on how to prevent heart attacks and other diseases you could be at risk of getting and as such your question would not arise. You would also not be too scared to see a doctor apart from being confident about your health status.

Waking up panting sweating and with chest pain could result from many causes including night mares, stress and medications, especially those for diabetes.

You still need to visit your doctor for help.

Dear doctor, I suffer from gout and now keep getting attacks often. I do not eat meat except chicken. Why then, do I get the attacks?
James Ssebalaata

Dear James, Gouty arthritis is wrongly thought to be caused by eating meat. It is caused by accumulation of uric acid in blood resulting in formation of uric acid crystals in joints. The accumulation may result from overproduction of uric acid by the body, its slow removal from the blood by the kidneys or both.

Uric acid results from breakdown of substances called purines which are plenty in red meat and as such prevention of gout may involve minimising eating red meat. Also minimising alcohol, taking lots of fluids and controlling weight can help out.

Recurrent attacks of gout require preventive medication to compliment lifestyle changes said above. Minimising eating red meat is one way of preventing gout but in some cases, even with the best prevention, attacks may still come. You require seeing your doctor for preventive medication and further advice about lifestyle changes.

Dear doctor, is there good treatment for cuts between fingers? They are white on the side, red in the middle and very painful when I touch water. I was given lucin from the pharmacy but it has not helped!
Amale Janice

Dear Janice, It is likely that you have a fungal infection. These infections affect the warm and moist fold of the skin and if one keeps his/her hands wet, in between the fingers then becomes suitable for infection. The wetness is not helped by presence of soap in the water making skin soft and easier to infect.

Treatment can be effected using anti-fungal creams or even anti-fungal tablets but it is necessary to meanwhile use gloves to avoid continued water contact or avoid the water contact for long apart from drying hands properly after exposure.

Lucin is a steroid which can fair better in skin allergy localised conditions but may worsen fungal infections