EDITOR’S NOTE: Physicians, providers, and administrative staff who practice at Maui Health hospitals and clinics answer questions from the public in Healthwise Maui, which appears on Thursdays. Maui Health operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lana’i Community Hospital and accepts all patients. To submit a question, go to the website at mauihealth.org/healthwise.

Q: How can I tell the difference between angina and heart attack?

Dr. Wazhma Aslamy, Cardiologist, Pacific Permanente Group: First, chest pain is never something to ignore. Whether it is new or something you’ve felt before, it should always prompt you to have a conversation with your doctor. Chest pain is caused by a number of different reasons but the pain or discomfort which is caused by the heart is called angina. Angina is a sign that your heart isn’t getting enough blood, and that’s something to take seriously.

The chest pain or discomfort that occurs with angina is often triggered by exercise, emotional stress, or anything that makes your heart work harder. Angina usually lasts just a few minutes and can improve with rest or medication.

Angina symptoms can feel like a heart attack but may be less intense and goes away with rest. In addition to chest pain, people can also feel tightness or discomfort that can spread to the shoulders, back, jaw, and arms. You might feel pressure, heaviness, or squeezing that makes it feel hard to breathe, or it may feel like heartburn. Some people feel fatigue, sweat, or severe anxiety. Women may have different symptoms from men.

There are two types of angina: stable and unstable. Stable angina occurs when the heart does not receive enough blood under conditions of stress such as walking rapidly or uphill, carrying something heavy, climbing stairs, exercising, mowing the lawn, etc. It improves and resolves with stopping the specific activity that triggered it.

Unstable angina is a similar type of discomfort, but it occurs with no physical exertion or with normal daily activities that are usually easy for you. These symptoms might last 15 minutes or longer. Medications like nitroglycerine or resting might not help the discomfort.

If you experience symptoms of unstable angina, treat it like a medical emergency. Go to the emergency room or call 911.

Unlike angina, which is often temporary, a heart attack happens when one of your arteries becomes completely blocked. In this case, chest pain and other symptoms usually last longer than 30 minutes and don’t improve with rest or medication. The pain may feel steady or may come and go in waves, but overall, the symptoms tend to get worse rather than better. You may also have other symptoms such as sweating, nausea, shortness of breath, rapid heart rate, and dizziness.

If you think you may be having a heart attack, call 911.

The good news? You don’t have to leave the island for expert heart care. Maui Health’s cardiology team has advanced technology and experienced specialists right here on Maui, ready to help you stay active and healthy. To make an appointment with a heart specialist, call the Maui Memorial Medical Center Outpatient Clinic at 808-442-5700.

Q: What is Enhanced Recovery After Surgery? How will it help me recover after joint replacement surgery?

Dr. Vic Ayers, Orthopedic Surgeon, Pacific Permanente Group: Enhanced Recovery After Surgery, or ERAS, is a care plan that helps you heal faster and feel better after surgery. It’s something you and your care team work on together, starting before your procedure and continuing all the way through recovery.

ERAS uses proven techniques to reduce pain, shorten recovery time, and get you back to your life as soon as possible. Your surgeon, anesthesiologist, and nurses will follow special steps during surgery to help minimize stress on your body. And there are other things you’ll do to set yourself up for success.

Some of the steps you’ll take before surgery include preparing a space in your home for your recovery, such as setting up a bed on the first floor, making sure you have any home care supplies that you need, and arranging for caregivers who can drive you to appointments and help with meals and chores.

You’ll also be asked to prepare your body for surgery by doing things such as drinking a carbohydrate beverage two hours before your procedure. This gives your body extra energy for healing.

After surgery, your care team will make sure you stay hydrated and get the right nutrition to heal. They’ll get you to start moving by having you begin walking shortly after surgery, with support. And they’ll manage your pain in ways that help you stay active, not just rest.

Once back home, physical therapy will be key to helping you regain strength and mobility. It plays a vital role in the healing process and helps most people feel better sooner than they expected.

At Maui Health, all of our joint replacement surgeons use ERAS plans, and the results speak for themselves: more than 90% of our patients go home within 24 hours after surgery. Want to learn more? Join one of our free Total Joint Seminars held every month in Wailuku. Visit mauihealth.org/totaljoint or call 808-442-5951 for more information.