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New Zealand Police AssociationSeptember 2004Police Health Plan Ltd in conjunction withour Medical Adviser, Doctor Eric Thornton,publishes articles on medical issues thataffect our members.Chest pain - is ita heart attack?Not all chest pains are the start of aheart attack. In fact, 30% of heartattacks occur without any pain at all.So, at a time when the incidenceof heart attacks amongst a youngerage group is rising, how can wetell when chest pain might mean avisit to hospital for a check-up? Ifin doubt, always assume it couldbe your heart and get it checkedimmediately.Heart pain usually comes on rapidlyand feels like a very tight bandcrushing the chest. Sometimes thepain will go up into the jaw and/ordown the left arm into the fingers.Pain of this kind, should alwaysbe assessed by a doctor as soonas possible. Age is no barrier to aheart attack and people as youngas 30 have been known to sufferfrom them despite appearing fit andhealthy.Heart attack pain does not ease withanalgesics such as Panadol. Somesufferers report the pain easing withindigestion medicine but it neverreally goes completely. Frequentlythe pain comes on in the early hoursof the morning, especially whengetting up to go to the toilet.Other chest painsThere are many other causes forchest pain, which mimic a heartattack. Some of the more commonones are:• Indigestion - the pain comes onafter a heavy or spicy meal andis usually under the breastbone.Indigestion medication willusually ease the discomfort.• Hiatus hernia - this is when a partof the stomach slips through thediaphragm into the chest. Thepain is like indigestion and usuallycomes on after lying down.• Gallbladder pain - usually in theupper right part of the abdomenbut can be central and is certainlysevere enough to mimic a heartattack. This pain can come onafter a fatty meal.• Chest injury - frequently foundafter contact sports. Thepain may not be noticeableimmediately but comes on later.Often due to damage to jointswhere ribs join the breastbone.• Unidentified chest pain - a largegroup of people with chest painare investigated and absolutelyno cause is found. The pain ispresumed to come from the wallof the chest.Risk categoriesAll of these pains can be severeenough to seem like a heart attack.They can even fool doctors into a falsediagnosis - and can sometimes resultin patients with a heart attack beingsent home from hospital. If you are ina category where the pain may be aheart attack, e.g. overweight, smoker,aged 40+, lack of exercise, then it issafer to assume that any severe chestpain may be a heart attack and toseek medical aid immediately. Withimmediate treatment, almost all heartattack victims survive and have onlyminor damage to the heart.Copper’s CrosswordSeptember clues:Across:1. A million and one slit apart to knowone’s boundaries (6)4. Twentied? No got a goal instead (6)8. Once a year event for some (11)10. Governmental early release? (7)11. Funeral vase (3)12. Command or watch over (4)13. Nab! Collar! Bin! Or just another slangterm (3)14. A good wine could be classed as thissort (4)17. Brut force less a letter could get you intothis (3)18. Never lived. Had never existed.Therefore never had one (3-4)19. Recites poetry or verse perhaps (11)20. Re-do a memo or letter (6)21. Wishes a good whiskey for someone (6)By Constable CunningDown:1. Displays yellow letter for us tobe cautious of (7,6)2. Operates or handles people fortheir own gain? (11)3. Thanks to Vern for this drinkingplace (6)5. Chic and stylish (6)6. Divides and distributes amonglocal places (13)7. Bent? Giving a dishonestperspective perhaps? (11)9. Treats anyone under 17 yearsas this (5,6)15. Lodge in open, in tents (6)16. Glue? Cellotape? Or simply abroken up red bin (6)1 2 3 4 5 678 910 1112 13 1415 1617 181920 21August answers:Across:1. Ream3. Alphabet9. Seizing10. Vivid12. Restaurateur13. Imbibe15. Fencer17. Counteracted20. Await21. Lookout22. TreasureDown:1. Restrain2. Alias4. Lagers5. Have the law on6. Bivouac7. Tide8. Bicarbonates12. Credited14. Brocade16. Dealer18. T roop19. Raft157