What are the symptoms of a heart attack?The classic symptom is a crushing left sided or mid-sternal chest pain which may be triggered or exacerbated by exertion, but it may also occur at rest. The pain may be localized or it may radiate to the left arm, elbow, the back, the jaw or ear lobes.
However, the symptoms may be more atypical and present as shortness of breath, dizziness, sweating, or just isolated arm, jaw, or back pain. There may also be anxiety, nervousness or feeling of impending doom.
According to a study in the 1998 issue of Archives of Internal Medicine1, “knowledge of the complex constellation of heart attack symptoms is deficient in the US population.”
When describing the chest pain to your doctor make note of the following characteristics:
Quality of the pain — Is the pain a squeezing, tightness, pressure, sharp, stabbing, constriction, burning, fullness in the chest, band-like sensation, knot in the center of the chest, heaviness on chest (elephant sitting on chest), or like a bra that is too tight.
Location of the pain — Is the pain in the center of the chest, on the right or on the left. Is it in the upper abdomen. Is the pain focal and can the location be pinpointed with one finger or is it vague and throughout the chest. In some cases, the discomfort cannot be described, but the patient places a fist in the center of the chest, known as the "Levine sign."
Radiation of pain — Is the pain localized or does it shoot to other sites such as to the neck, throat, lower jaw, teeth (feeling like a toothache), or the shoulders, shoulder blades or arms. Sometimes, pain is felt in the wrists or in fingers.
Timing of the pain — Does the pain come on gradually and get worse over time. How long does it last, a few seconds or minutes, 15 minutes or longer, or a few days.
Things that make the pain better or worse — Is the pain triggered by or worsened by activities that increase physical exertion, such as walking up stairs, sexual intercourse, or raking leaves. Does the pain get worse with deep breaths or with pushing on the area. Does the pain improve with rest or with antacids.
Do men and women experience different things when having a heart attack?
Yes, the symptoms in women may be more atypical2. It may present as abdominal pain or a vague malaise or weakness. It also may present as more of a prickly sensation in the chest rather than the classic sensation of an elephant sitting on the chest.
According to one study presented in the American Heart Journal3 men were significantly less likely to complain of neck pain, back pain, jaw pain and nausea than women.
How can you tell the difference between a heart attack and heart burn?
It can be difficult to tell the difference between a heart attack and heart burn. The most common non-cardiac cause of ER visits for chest pain is heart burn. If it’s a first time for a chest pain you should contact your doctor. In general, heart burn tends to occur after meals and not with exertion. It is often relieved by burping or by medications such as Tums or Pepcid. Heart burn also may leave a sour or bitter taste in the back of the mouth.
Are they any chest pains that are normal or should be ignored?
A first chest pain should never be ignored. In general if a chest pain is aggravated by a change in body position such as twisting or turning or by pushing on it then it may indicate a muscular source for the pain.
Are there things that you might experience weeks or months before a heart attack that are really warning signs if you paid attention to them?
The symptoms may be vague and some patients recall after the heart attack that they may have had milder chest pain or shortness of breath with exertion or just some general fatigue. It should be noted than in a small percentage of patients the first symptoms are the last symptoms. If you are feeling ANY chest pain, especially chest pain with physical exertion, then it should be brought to your doctor’s attention.
What kinds of things should put you on alert that you could be at an increased risk for a heart attack?
Increased weight and obesity, high cholesterol or blood pressure, smoking now or in the past, family history of heart disease, lack of physical activity, presence of diabetes, increasing age, males over 50, and females post menopause.
What exactly is happening in your heart that causes a heart attack?
All organs and tissues in the body require the oxygen and nutrients carried in the blood to function properly. The heart pumps oxygen and nutrient-rich blood through a huge network of arteries throughout the body, which includes vessels that supply blood to the heart itself. The heart receives nourishment via a specific set of arteries. Problems begin when one of these arteries becomes blocked or blood flow to that part of the heart is interrupted and deprives the heart of oxygen.
A heart attack occurs when a fatty plaque (deposits of fat-like substances) in the lining of the blood vessels supplying the heart ruptures. A blood clot (thrombus) can form on the plaque, which can partially or completely block the artery. This blockage slows or blocks blood flow to the area of heart muscle fed by that artery. If this continues for more than 15 minutes, the muscle can become damaged or infarcted (that is, the tissue in that area dies). This can kill or disable someone, depending on how much heart muscle is damaged. The medical term for heart attack is myocardial infarction. A heart attack is also sometimes called a coronary thrombosis or coronary occlusion. As plaque in the heart arteries builds up and the narrowing causes decreased blood flow pain in the heart can result. This pain may be called angina and represents a symptom of heart disease rather than a heart attack itself.
Does it matter how long a heart attack continues before you seek medical help?
Yes, it is essential to seek treatment early. The first 1-2 hours are critical in the successful treatment of a heart attack. The longer you wait the more damage may occur to the heart muscle.
