When I see patients for a check-up, I always ask them if they’ve had any chest pain or other unusual symptoms recently. Often times they will say they’ve just had a little indigestion, gas, or muscle cramp pain here and there. Then I ask them if they know the symptoms of a heart attack and they have to think hard for a moment. They usually can’t tell me the difference between what they might think is indigestion, gas, or heart attack pain.
Unfortunately, this is too often the case. People mistake heart attack symptoms for indigestion, gas cramps that can often be felt in the chest, or pulled muscles, even the flu. Not all heart attacks occur like they do in the movies with dramatic chest-clenching pain and immediate collapse. To make it more confusing, heart attack symptoms can be different between men and women.
Many heart attacks come on rather quietly with only mild pain, pressure, discomfort which can go on for several hours. People often ignore these mild symptoms and even try to go to work or back to sleep with it! In an attack, every moment counts and ignoring even vague symptoms can result in disaster.
Today I’d like to share with you what I teach my patients about heart attack signs and symptoms and what NOT to ignore, as they could be signs of an impending attack or one that’s already in progress.
Warning Signs of Heart Attack
It’s important to know that many attacks do not involve dramatic chest pain, though some might. It depends on how blocked the arteries are to the heart. However, most heart attacks have one thing in common and that is pressure/discomfort in the center of the chest that can have an off/on, come/go quality to it. Many people who have had an attack liken this pressure to something heavy sitting on their chest. These symptoms may, or may not, be associated with one or more of the following, depending on whether male or female:
•Nausea – even vomiting (women).
•Dizziness – lightheadedness (both men and women).
•Ringing or buzzing in the ears (both men and women).
•Pain or discomfort in the arms, one, or both (men).
•Pain in the back, neck, jaw or stomach (women).
•Shortness of breath (women).
•Breaking into a cold sweat (women).
Time Is Critical
If you experience any of the above symptoms do not wait longer than 5 minutes to call 9-1-1. Emergency Services personnel can start treating for you for a heart attack long before you get to the emergency room.
Of important note, if you live in a remote area, or an urban area where EMS services may be spread thin, and your wait for EMS to arrive may be much longer than it would take you to get there on your own, get to the nearest hospital emergency room, or even a 24 hour walk-in clinic, the fastest way possible at the time.
If you are alone, you may be reluctant to call a neighbor or friend to come and drive you to a hospital in the middle of the night, but if this is at all possible, this is your best and safest bet.
What You Can Do For Yourself
While you are waiting for emergency medical personnel to arrive here are some important things to do and not do:
•Chew 2, 325 mg regular (not enteric coated) aspirins. It would be wise for everyone to carry a small bottle of regular aspirin in a pocket, or keep on your night table, just in case. Taking this type of an aspirin at the onset of what may be heart attack symptoms works like a drug that is administered in the emergency room that helps break up blood clots and allow blood to flow more freely to the heart. Recent research shows that people who chewed 2, regular 325 mg aspirins during symptoms of a heart attack had 50% reduction of blood thromboxane (a blood clot agent) only 5 minutes after chewing it, compared to 12 minutes swallowing it. Do not use an enteric (stomach) coated aspirin, as it takes too long to dissolve and get into the blood stream.
•Call 9-1-1 first instead of your doctor. Don’t waste time calling your doctor. If your symptoms occur outside of normal business hours, you will get their answering service with a pre-recorded message that says, ‘if this is a medical emergency, hang up and call 9-1-1′. So, save yourself the extra time and call 9-1-1 first. If alone, unlock your front door so EMS personnel do not have to waste time trying to get your door open.
•Do not lie down! This can both worsen pain, hasten a heart attack along, and may even cause the heart to arrest. Sit upright on the couch, on your bed, or even on the floor near the door with your back supported by a wall, to prevent a fall and further injury should you become unconscious.
Panic Attack vs. Heart Attack
In the movie, “Something’s Got To Give” Jack Nicholson is rushed into an emergency room thinking he is having a heart attack which turns out to be a panic attack. If you are anxiety-prone, under a lot of stress, and/or being treated for an anxiety disorder, it may be that what you think are heart attack symptoms is actually a panic attack.
Panic attacks can be uncomfortable but they are not life threatening. They occur most commonly in women past the age of 35 and often have hormone imbalances to blame. However, men get them too, just more rarely.
The actual symptoms are caused by adrenaline rushes, which can cause shortness of breath, palpitations, lightheadedness, and nausea – many of the same accompanying symptoms of heart attack. Because of the similarity, many women’s heart attack symptoms are sometimes mistaken for a panic attack. However, panic attack symptoms lessen in intensity fairly quickly if you sit down quietly and take several deep breaths. Real heart attack symptoms usually do not.
Knowing and understanding the difference between heart attack and other conditions that may share similar symptoms, can save your life. Get evaluated by your doctor who can determine your level of risk, whether you are a woman or a man, for a heart attack.
Keep two, 325 mg aspirin close by, and most importantly, don’t ignore ongoing symptoms, call 9-1-1. Even if it turns out to be panic, gas cramps, or those spicy meatballs from dinner, your attention and quick action could save yours, or someone else’s, life.
Mark Rosenberg, M.D.
Institute For Healthy Aging