Q: Last week, while I was running to catch a plane, I felt a pain in my chest. I exercise regularly and have never felt anything like it, even when I work out very strenuously. What happened?
A: This pain is sometimes known as "airport angina" and is caused by a partial obstruction of blood flow through the vessels that carry blood to the heart.
The blood that is pumped inside your heart does not nourish the muscle. The oxygen your heart needs comes from blood vessels on its surface. As long as your heart muscle can get all the oxygen it needs, it should not hurt.
Even if the blood vessels on the heart's surface are partially blocked, the heart may still get enough oxygen when you engage in your normal activities. However, when your heart is forced to work overtime, it may not get enough oxygen and could begin to hurt.
When you walk while carrying a heavy weight, such as a suitcase, your arm muscles stay contracted, partially blocking the flow of blood. Your heart must work harder to pump against this increased resistance. The narrowed arteries may not allow enough blood to flow through, and your heart will not get the extra oxygen it needs. As a result, you may develop airport angina.
If you feel chest pain when you exert yourself, whether exercising in the gym or running for a plane, check with your doctor. You probably need a thorough evaluation.
Q: My teen-age son has begun using snuff. I have not discouraged him because it seems preferable to cigarette smoking. Are there any dangers to the use of snuff?
A:. Indeed there are!
Snuff is powdered or ground tobacco, and the use of any form otobacco imparts risks. Most commonly, people in this country use a moist snuff, which is placed in the mouth. Although it apparently does not produce lung cancer, snuff can cause cancer of the mouth, or nasal cancer when dry snuff is used in the nose, as is common in Britain. The large amount of sugar present in some moist snuff fosters tooth decay. Absorption of nicotine (and other chemicals) in snuff from the mouth or intestine can result in blood nicotine levels as great as those found in smokers. Because of the high content of nicotine in some brands of snuff, they may be even more addicting than cigarettes.
It is unfortunate that the widespread use of snuff by athletes anthe targeting of boys by snuff ads led to a 15-fold increase in the use of snuff by older teen-age boys between 1981 and 1986.
Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine and associate dean for faculty affairs at the school.