Heart gasping is a rare and curious condition that medical magicians know little about.
There are no known vectors for heart gasping. It does not appear to be transmissable from person to person. If it is contagious, then the time it takes between exposure and initial symptoms is so long that tracking the source is nearly impossible.
The cause of heart gasping is unknown.
There is a pet theory by Oke Ngute that the condition is actually transmissable but lays dormant within the individual for a long time until the person encounters an additional trigger. These triggers are speculated to be cold weather or stress, but neither of these are confirmed and their other medical theories are perceived as just as wacky.
The primary symptom of heart gasping is a persistent, sharp pain in the chest located near the sternum. The pain may vary in intensity over the course of the episode. Stretching or moving the body does not seem to affect it. The pain is not accompanied by other signs suggesting a heart attack or other life-threatening cardiac event, such as coughing, nausea, or cold sweating. Episodes of the pain last between a few minutes to up to 10 hours. It is unknown what causes the pain to start or what makes the episode end.
Anxiety about the pain can make it worse or start a new episode, but not necessarily. Severe enough anxiety can mimic the symptoms, so it must be carefully controlled for.
First, other cardiac conditions must be ruled out in order to be sure that the heart gasping is treated correctly. This can be done with measuring blood pressure or using magic to track the electrical signals of the heart. An advanced medical magician may be able to perform a spell that allows them to see the inner workings of the chest as a static image, which can be useful in ruling out the dysfunction of other nearby organs.
Once it is determined to be heart gasping, the next line of treatment is to use magic. Common pain relievers and anti-fever aids, including ones designed to reduce inflammation, do not seem to have an effect on the pain. Luckily, there is an easy solution: medical magicians can perform a specific spell that strengthens the heart and surrounding muscles while ensuring that the cartilage in the breastbone is not strained. The nerves in the chest are soothed, blood pressure is lowered, and the veins and arteries are cleared to be sure that blood flow is normal.
After the spell, the pain disappears and is not seen again.
Because of how easy it is to treat, the prognosis of people experiencing heart gasping is very good, and it is rare to return. While not impossible to come back, it has happened before that someone has experienced heart gasping at two different points in their life, but the only person to whom that has happened is Oke Ngute themself, which is part of why their research is dedicated to understanding heart gasping.
Without an agreed upon cause, prevention is hard to identify. As usual, general good health, including regular exercise and magic use, is a good way to prevent any disease, including heart gasping.
Oke believes that staying outside of the cold and avoiding stress and anxiety are helpful ways of prevention as well, but this advice relies on believing in their particular theories.
Heart gasping has been documented for thousands of years. Usually, early medical magicians had no way of differentiating between heart gasping and a more life-threatening cardiac event, so the usual spells and treatments were employed to save the person's life, but this often had little effect on the pain and the sufferer would continue to be uncertain about the nature of their pain and were left to wait for it to go away of its own accord.
The breakthrough for heart gasping came when two medical discoveries happened: the ability to detect electrical signals in the heart and the ability to image the inside of a person's body with a simple spell. Especially the second one.
The first was necessary to differentiate between severe cardiac events and heart gasping. Being able to track muscle movement and ensure that the heart was working correctly made a huge difference in understanding the differences between a heart attack and heart gasping. Even though heart gasping does not have other secondary symptoms of a heart attack, pain near the heart is still scary; the heart is an important organ in the body. With the electrical heart tracking, medical magicians can confirm that the heart muscle is working correctly.
The second breakthrough, the ability to see inside a person's body, was a huge breakthrough that affected the course of diagnosis and treatment of many, many medical conditions. In the case of heart gasping, it became a way of verifying that there were no other organs causing the issue, such as a tumor in the lungs or bone poking into the heart. This is rarely the case, but being able to rule out these other sources of the issue is key to being able to diagnose heart gasping.
Oke Ngute started to experience heart gasping one day while traveling between Tiyo and Tyush. While walking laden with medical equipment and trinkets for good health to sell at the large market, they noticed a distinct sharpness in their chest that became a dull pain that throbbed slowly and icily until it became impossible to ignore.
Originally mistaking it for exertion, Oke slowed down and eventually pulled off the side of the road to rest. They wiggled their large feet in the grass and waited for their breath to even out into its usual slow and steady rate. Their breathing slowed, but their heart continued to feel the same. If not exertion, maybe they had accidentally pulled a muscle while bearing their heavy bag, and they lay the bag next to them. They stretched their arms out wide and puffed out their chest, straining their heart against their bones, but the pain remained the same.
Medical mysteries had always intrigued Oke. They used to devour books and stories about medical magicians and their patients and spent a large amount of time in the city of Yoozii studying the records of many maladies that went undiagnosed in their lifetimes. The advancement of medical technology helped resolve many of those mysteries, but there were always more to explore, and the many recordings of unexplained chest pain came back to them. Heart gasping.
Unlike those previous magicians, Oke was able to perform the first spell to track their heart's muscular actions. They placed one hand over their heart and shook the other to make snapping sounds that reverberated in the air and infused the magic into their body. With their eyes closed, they could see that all appeared normal, but their chest still hurt.
Torn between fear and curiosity, Oke realized that they would need someone else to help them perform the spell to image the inside of their body. They put on their bag carefully, stood up, and began to continue their journey to Tyush.
The pain ebbed and grew over the course of their journey. Some episodes lasted a couple of minutes, and other days the entire day was spent with the cold sharpness digging into their chest. Fear chilled Oke's blood, terror even, but they knew that there would be people in Tyush to help them. They would be okay.
When they finally reached Tyush, they immediately sought out the sign of a medical magician. Bursting with energy, chest tight, they found a stall and immediately asked for help. With the help of the other magician, they performed the spell and, to Oke's chagrin, there was no sign of injury or cancer or any other malady affecting the heart. The pain was invisible.
Oke spent the next month trying to find a solution to their pain. They would go days without an episode only for the pain to persist for days at a time. Then, it stopped. All at once. Days and then months and then years passed and the pain did not return. While this was a relief in some ways, it also prevented Oke from being able to find a solution to a long-unsolved mystery.
They settled in Tyush and began to advertise themselves widely as a medical magician studying heart gasping. When they were referred to their first patient experiencing the same symptoms, Oke began to go through all of the tests that they had come up with in the time between their last episode. Then they got another patient. And another.
Studying each patient and performing various medicinal spells eventually bore fruit: Oke developed a spell that reliably and quickly treated heart gasping, and soon word spread of their accomplishment. They taught others, and the fear and uncertainty behind heart gasping disappeared.
Having spent a significant amount of time in Tyush in order to see the most amount of patients possible, Oke was finally free to return home and continue their practice back in Tiyo.
They began their journey comfortably, but when they were close to their destination, Oke felt the familiar sharp spike. Elation and confusion pooled in their belly and they carried their heart gasping pain all the way home. Instead of treating themselves, they began to write their thesis on the return of heart gasping before curing it in themselves.
The thesis is not accepted widely. While Oke successfully cured others with their spell, it did not make sense for cold weather to trigger its return, and there are no other documented cases of heart gasping returning. The medical magician community waited to see if there would be any, as the spell was fairly new, but to this day there has been no other.
Heart gasping, while rare, has no known causes, so it is understood to be no one's fault. While Oke has contributed to the medicine behind its cure being considered a little strange, the effects are immediate and permanent, and that is enough.