Hadrian, the Roman Emperor, is returning to conquer London again. Installed as emperor in AD117, he came to Britain to crush a revolt and around AD122, as part of his campaign, he initiated the building of a 73-mile wall to keep out the troublesome Scots. This week he will be on show at the British Museum. Fortunately, as his face is carved in stone, he can't express the horror at finding that his old enemies, the Scots, are now governing England and controlling its purse-strings.

Many will know of Hadrian only because of his wall, but medical students have another reason. They have been looking at pictures of his busts for years - focusing on his ear lobes. Hadrian's lobes display marked lobar creases. These are pronounced creases running diagonally across the lobe of the ear. They are not disfiguring, but are an intriguing early sign that all may not be well with a person's coronary arterial system.

Despite Hadrian's lobar creases, plots against him and military campaigns, he lived until he was 62. Although that age doesn't now seem old, by Roman standards the emperor was an old man when he died. At first glance his life might have seemed to be less than ideal for someone possibly suffering from coronary disease. He had an aggressive and ruthless streak (he had no qualms about slaughtering 600,000 Jews), and, although considered a successful emperor, he remained unpopular with Romans.

He participated in a marriage arranged by his predecessor, the Emperor Trajan, his mentor and great uncle of his bride. The marriage wasn't a success: he was bored by his wife and preferred the company of Antinous, his young male lover. He was heartbroken when the youth drowned in mysterious circumstances in the Nile. Hadrian declared him a Roman god, erected statues to him and Antinous became a cult figure - to the fury of the early Christian Church.

However there were also features of Hadrian's lifestyle that may have compensated for the stresses of his home and professional life and possibly a genetic tendency to arterial disease. In his early years he had lived a vigorous physical life during his military duties. Later, once he had been joined by Antinous, he became an enthusiastic and active hunter; and he had an intense love of the arts. He was also an avid traveller, which helped to keep his empire together and gave him a respite from the politicking of Rome, but he maintained his Mediterranean diet. The diet is rich in olive oil, fresh fruit, fish and vegetables and accompanied by wine. The Roman Army always acknowledged the medicinal qualities of wine and valued them so highly that wine was provided for the soldiers during all their campaigns. Equally good care was also taken to deny the barbarians access to wine, which was found to be good for morale, nourishing and helped to counter infections.

Chest pain is a rather more constant and reliable early sign of heart disease than lobar creases. Even so the difference between the pain of angina or a coronary thrombosis and other causes of chest pain is still not always recognised. Recently there was an interesting account in the press in which the author described his chest pain. It didn't sound anginal, but it had the power to terrify the writer, his girlfriend and the emergency services. Anginal pain is a tight, heavy, constricting pain often across the whole chest but centred behind the breast bone. It grips the chest so tightly that patients say that it feels as if they have a metal band around their chest that is progressively tightened and seems to squeeze the life out of them.

The heaviness and crushing sensation felt over the chest after a coronary is likened to having a bag of concrete dropped on to the sufferer or a feeling akin to that which tortured martyrs must have felt when they were being crushed to death beneath a heavy door. The pain of a coronary thrombosis is not sharp, intermittent, stabbing or knife-like.

If the chest pain is caused by angina - spasm in the coronary arteries and relatively short lived - rather than a coronary, it is relieved by glycerol trinitrate. One of the initial signs of coronary disease is not chest pain, which tends to occur later, but increasing impotence.

Dr Thomas Stuttaford's next online forum, on managing stress, will go live after 1pm on July 23. To ask the doctor your question and to read other recent topics he has answered click here

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