A recent study published in the Achieves of Internal Medicine found that many people with a recent heart attack did not know the signs and symptoms of a heart attack, even though their risk of having one was five to seven times higher than a healthy person.
In fact, many people know few of the signs of a heart attack, even though it is the number one killer in the United States.
So what are the warning signs of a heart attack and what can we all do to reduce the risk of this life and death emergency?
A heart attack or myocardial infarction (MI) occurs when one of the arteries that supply blood to the heart becomes completely blocked. The complete occlusion usually occurs when a fat and cholesterol-laden plaque or atherosclerosis has developed over years suddenly ruptures causing formation of a large blood clot or thrombus. This thrombus obstructs blood flow to the heart, resulting in damage. Rarely, another mechanism is when the vessel itself undergoes complete spasm, again resulting in obstruction of essential blood flow to the heart.
An adage in cardiology is that time is muscle. In the setting of a heart attack, the heart muscle is completely starved of blood, oxygen and nutrients. Literally the heart muscle is suffocating and dying. As the seconds tick by during a heart attack, permanent damage is done, and if uncorrected, death may ensue. The good news is that in the last two to three decades, new medications and treatments have been discovered that can stop heart attacks, reduce their severity and literally save lives. The key is to recognize the signs and symptoms in time, so that effective treatment may be initiated in time. If this “golden window” is missed, the damage may be irreparable. In those suffering a heart attack, patients that receive medical treatment within one hour of the onset of chest pain have a better rate of survival than those who wait longer.
The risk factors for heart disease are sometimes broken down into those that are modifiable and those that are non-modifiable.
The non-modifiable risk factors for heart disease are: advanced age, male gender, and a family history of heart disease.
The modifiable risk factors are: tobacco smoking, hypertension, elevated cholesterol, obesity, physical inactivity and diabetes.
These all increase the risk of a heart attack, making knowledge of the symptoms associated with a myocardial infarction even more important.
The signs and symptoms of a heart attack, the medical term is myocardial infarction or “MI” are highly variable. In fact, the classic signs of a heart attack tend to be somewhat rare, yet when they occur they are often quite unmistakable. Although it is impossible to outline all the signs of a heart attack in one article, it is important for all to learn some of the classic signs and symptoms, and also be aware of some of the uncommon signs.
These classic signs include: chest pain, shortness of breath, nausea, anxiety and sudden onset of sweating. I have come up with the pneumonic “ASAP,” which stands for A = angina (chest pain), S = shortness of breath, A = anxiousness, P = perspiration. When you recognize these symptoms, you need to act As Soon As Possible.
The chest pain of a heart attack tends to be somewhat dull, squeezing and heavy in nature, often referred to as angina. This is the so-called “elephant on my chest.” It tends to be duller in characteristic and not sharp or stabbing. The pain is variable in intensity, often rated on a scale of 1 to 10. The pain tends to start abruptly and can occur without provocation but may occur with physical or emotional stress. It can be located in the center of the chest and classically radiates down the left arm, across the chest and to the back, and frequently up the neck to the jaw. It can truly travel anywhere, or not migrate at all. The pain can also go to the abdomen and stomach, often confused with a stomachache or indigestion. This pain is tricky because many people try an antacid with little success before realizing that it is much more.
Actually the chest pain of a MI can do all kinds of strange things, but any chest pain in an at risk person requires immediate medical care.
Shortness of breath is always concerning, especially if it is new and without any provocation. The difficulty breathing associated with a heart attack is hard to distinguish from other causes of respiratory distress. What is unique is the fact that it occurs without any trigger or inciting cause. An MI tends to cause breathing difficult abruptly, associated with rapid breaths, a sense of starving for air or the inability to catch one's breath.
In extreme cases, patients will actually be gasping for air.
Most often the shortness of breath is more subtle, seen as just a rapid breathing rate greater than 18 to 20 breaths per minute and the sensation of not being able to catch one's breath. Although this may be a somewhat nebulous sign of a heart attack, it may be the only clue of a life threatening MI. Shortness of breath should always be respected and trigger one to seek immediate medical attention.
The more subtle signs of a heart attack can be even more challenging and easily over looked. These include sudden onset of perspiration, pouring sweats and anxiety.
Another often-missed sign is the sudden onset of light-headedness, dizziness and sometimes nausea. Again these are hard to associate specifically with a heart attack, but unprovoked sweating, nausea and light-headedness or dizziness may be the only sign of trouble. These subtle signs are often associated with the above, but even alone they warrant immediate medical attention.
The symptoms of an MI are variable, especially in women and in diabetics. It is well known that these two groups tend to present with more vague and less classical signs and symptoms of their heart attacks. This makes diagnosis more challenging.
In addition to this, heart disease was wrongly felt to be a male dominated condition, further limiting the early detection of heart attacks in the female population.
Know the ASAPs. Even if it is not clear that the cause of one's symptoms is due to the heart, have it examined immediately by a health care professional. These are vital minutes, often separating life and death.
The next most important question then remains what to do if you experience any or all of these symptoms. It is absolutely critical to seek immediate medical attention. There are few other more serious medical conditions than a heart attack, and the sooner diagnosed, the better the chance of survival.
The patient or family member should immediately call 911 to activate Emergency Medical Services (EMS) and be taken to the nearest hospital. EMS can initiate care at the scene and start the important cascade of medical therapy for a myocardial infarction. Mistakenly, some patients opt to wait at home for the symptoms to pass, only to lose valuable time before reaching medical attention.
There are many medical conditions that can cause chest pain, shortness of breath and the other ASAPs that can be associated with a heart attack. Knowing what to look for and calling 911 for immediate medical attention can literally save a life. Learning these signs of a heart attack and acting immediately can literally save a life. Your heart and health depend on it.
Dr. David M. Donaldson is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
On the Net
To learn more: Visit the American Heart Association's Web site at americanheart.org
So what are the warning signs of a heart attack and what can we all do to reduce the risk of this life and death emergency?
A heart attack or myocardial infarction (MI) occurs when one of the arteries that supply blood to the heart becomes completely blocked. The complete occlusion usually occurs when a fat and cholesterol-laden plaque or atherosclerosis has developed over years suddenly ruptures causing formation of a large blood clot or thrombus. This thrombus obstructs blood flow to the heart, resulting in damage. Rarely, another mechanism is when the vessel itself undergoes complete spasm, again resulting in obstruction of essential blood flow to the heart.
An adage in cardiology is that time is muscle. In the setting of a heart attack, the heart muscle is completely starved of blood, oxygen and nutrients. Literally the heart muscle is suffocating and dying. As the seconds tick by during a heart attack, permanent damage is done, and if uncorrected, death may ensue. The good news is that in the last two to three decades, new medications and treatments have been discovered that can stop heart attacks, reduce their severity and literally save lives. The key is to recognize the signs and symptoms in time, so that effective treatment may be initiated in time. If this “golden window” is missed, the damage may be irreparable. In those suffering a heart attack, patients that receive medical treatment within one hour of the onset of chest pain have a better rate of survival than those who wait longer.
The risk factors for heart disease are sometimes broken down into those that are modifiable and those that are non-modifiable.
The non-modifiable risk factors for heart disease are: advanced age, male gender, and a family history of heart disease.
The modifiable risk factors are: tobacco smoking, hypertension, elevated cholesterol, obesity, physical inactivity and diabetes.
These all increase the risk of a heart attack, making knowledge of the symptoms associated with a myocardial infarction even more important.
The signs and symptoms of a heart attack, the medical term is myocardial infarction or “MI” are highly variable. In fact, the classic signs of a heart attack tend to be somewhat rare, yet when they occur they are often quite unmistakable. Although it is impossible to outline all the signs of a heart attack in one article, it is important for all to learn some of the classic signs and symptoms, and also be aware of some of the uncommon signs.
These classic signs include: chest pain, shortness of breath, nausea, anxiety and sudden onset of sweating. I have come up with the pneumonic “ASAP,” which stands for A = angina (chest pain), S = shortness of breath, A = anxiousness, P = perspiration. When you recognize these symptoms, you need to act As Soon As Possible.
The chest pain of a heart attack tends to be somewhat dull, squeezing and heavy in nature, often referred to as angina. This is the so-called “elephant on my chest.” It tends to be duller in characteristic and not sharp or stabbing. The pain is variable in intensity, often rated on a scale of 1 to 10. The pain tends to start abruptly and can occur without provocation but may occur with physical or emotional stress. It can be located in the center of the chest and classically radiates down the left arm, across the chest and to the back, and frequently up the neck to the jaw. It can truly travel anywhere, or not migrate at all. The pain can also go to the abdomen and stomach, often confused with a stomachache or indigestion. This pain is tricky because many people try an antacid with little success before realizing that it is much more.
Actually the chest pain of a MI can do all kinds of strange things, but any chest pain in an at risk person requires immediate medical care.
Shortness of breath is always concerning, especially if it is new and without any provocation. The difficulty breathing associated with a heart attack is hard to distinguish from other causes of respiratory distress. What is unique is the fact that it occurs without any trigger or inciting cause. An MI tends to cause breathing difficult abruptly, associated with rapid breaths, a sense of starving for air or the inability to catch one's breath.
In extreme cases, patients will actually be gasping for air.
Most often the shortness of breath is more subtle, seen as just a rapid breathing rate greater than 18 to 20 breaths per minute and the sensation of not being able to catch one's breath. Although this may be a somewhat nebulous sign of a heart attack, it may be the only clue of a life threatening MI. Shortness of breath should always be respected and trigger one to seek immediate medical attention.
The more subtle signs of a heart attack can be even more challenging and easily over looked. These include sudden onset of perspiration, pouring sweats and anxiety.
Another often-missed sign is the sudden onset of light-headedness, dizziness and sometimes nausea. Again these are hard to associate specifically with a heart attack, but unprovoked sweating, nausea and light-headedness or dizziness may be the only sign of trouble. These subtle signs are often associated with the above, but even alone they warrant immediate medical attention.
The symptoms of an MI are variable, especially in women and in diabetics. It is well known that these two groups tend to present with more vague and less classical signs and symptoms of their heart attacks. This makes diagnosis more challenging.
In addition to this, heart disease was wrongly felt to be a male dominated condition, further limiting the early detection of heart attacks in the female population.
Know the ASAPs. Even if it is not clear that the cause of one's symptoms is due to the heart, have it examined immediately by a health care professional. These are vital minutes, often separating life and death.
The next most important question then remains what to do if you experience any or all of these symptoms. It is absolutely critical to seek immediate medical attention. There are few other more serious medical conditions than a heart attack, and the sooner diagnosed, the better the chance of survival.
The patient or family member should immediately call 911 to activate Emergency Medical Services (EMS) and be taken to the nearest hospital. EMS can initiate care at the scene and start the important cascade of medical therapy for a myocardial infarction. Mistakenly, some patients opt to wait at home for the symptoms to pass, only to lose valuable time before reaching medical attention.
There are many medical conditions that can cause chest pain, shortness of breath and the other ASAPs that can be associated with a heart attack. Knowing what to look for and calling 911 for immediate medical attention can literally save a life. Learning these signs of a heart attack and acting immediately can literally save a life. Your heart and health depend on it.
Dr. David M. Donaldson is an Auburn native and currently a cardiologist at Massachusetts General Hospital in Boston.
On the Net
To learn more: Visit the American Heart Association's Web site at americanheart.org
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