Hi XXXXXXX,

Thanks for writing in.

Typical pain related to heart is “retro sterna” (Central) squeezing associated with sweating and increased heart rate and it radiates to neck and left arm. Important is the fact in what setting the pain occurs. At age 66, you have some identified risk factors for coronary artery disease; others you can fill in by personal knowledge and investigations. The idea is if you have a back ground of more known risk factors your chances of pain (even atypical pain) originating as a result of heart are much more.

At any age, following is the list of risk factors for future development of Coronary Artery Disease. Let me enumerate and you can place yourself the risk you are carrying ('*' means you have the risk factor, '+/-' means I do not know and about others you know better):-

A: MODIFIABLE RISK FACTORS
Diabetes +/-
Hypertension +/-
Smoking*
Stress*
Obesity and Sedentary Life Style*
High Bad Cholesterol and Lipid Component +/-
Total Cholesterol above 190 mg%, LDL above 130 mg%, VLDL above 40 mg%,
Triglycerides above 150 mg%, Apolipoprotein B above reference value
Low Good Cholesterol and Lipid Component: +/-
Apolipoprotein a below reference range for the lab and
HDL below 40 mg% for man & and 50 mg% for woman
B: NON MODIFIABLE RISK FACTORS
Family History 0f Coronary Heart Disease +/-
Increasing age*
Being a Man (as opposed to women) till the age 45*

From the list, above you have some risk factors. Smoking, Obesity and possible sedentary life style you have identified. Therefore, I will strongly recommend consulting your doctor; he may complete the list as well do the EKG which may tell us the cause of pain.
It is never too late to change. With your weight everything you do will have to be under supervision. It need not be cardiologist but your primary doctor can guide your way back to health - I am happy to read that. You may need drugs and he/she (or ask the dietitian) to advise you about diet low in calories and cholesterol, advise you on quantum of exercise. You ought to keep your weight under control for you do not want other attack. If you like non vegetarian you cannot take red meat but there is no bar (in taking certainly quantity had to be less) on egg white, roasted chicken and roasted fish.

“For the time being the way you have described the pain it does not look cardiac, yet it is precursor of worse things. Sooner you take advice from professional better quality of life you are going to have.”

Well, something difficult but easy to advise I kept for the last is you will have to Stop Smoking (you can take help of nicotine patches, nicotine spray or nicotine gum; behavioural therapy and professional help).

Hope you found something useful in this answer. If you have any follow-up query I shall be happy to answer.

Regards
Dr Anil Grover
Cardiologist

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