Heart Attack Symptoms and Warning Signs.
Heart attack is the number one killer of both men and women in the U.S. Each year, about 1.1 million Americans suffer a heart attack, and 460,000 of these are fatal. Most of the deaths from heart attacks are caused by ventricular fibrillation of the heart that occurs before the victim of the heart attack can reach an emergency room. The 1% to 10% of heart attack victims who die later include those victims who suffer major damage to the heart muscle initially or who suffer additional damage at a later time. What are the signs of a heart attack? Many people think a heart attack is sudden and intense, like a “movie” heart attack, where a person clutches his or her chest and falls over.
A heart attack (also called myocardial infarction) is when part of the heart muscle is damaged or dies because it isn’t receiving enough oxygen. Normally, oxygen is carried to the heart by blood flowing through the arteries that feed the heart muscle (called coronary arteries). Most heart attacks are caused by a blockage in these arteries. The truth is that many heart attacks start slowly, as a mild pain or discomfort. Even those who have had a heart attack may not recognize their symptoms, because the next attack can have entirely different ones.
Heart attacks are also often caused by a blood clot that forms in a coronary artery, blocking blood flow. Heart attack and stroke are life-and-death emergencies â€” every second counts. Not all these signs occur in every heart attack or stroke. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. Learn more about women and heart attack. It’s vital that everyone learn the warning signs of a heart attack.
Common Heart Attack Symptoms and signs
Pain is Not Always a Symptom of Heart Attack. A heart attack often starts with mild symptoms that may not be painful. Many victims experience a tightness or squeezing sensation in the chest. Get emergency medical help immediately If you experience any of the following symptoms for two minutes or more:
- Chest discomfort. Pressure, fullness, squeezing or pain in the center of the chest. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
- Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach. Pain spreading to the shoulders, neck or arms.
- Shortness of breath. Often comes along with chest discomfort. But it also can occur before chest discomfort.
- Other symptoms. May include breaking out in a cold sweat, nausea, light-headedness, Severe pain, sudden weakness, dizziness, fainting, shortness of breath.
The pain of a heart attack can feel like bad heartburn. You may also be having a heart attack if you:
- Feel a pressure or crushing pain in your chest, sometimes with sweating, dizziness, nausea or vomiting
- Feel pain that extends from your chest into the jaw, left arm or left shoulder
- Feel tightness in your chest
- Have shortness of breath for more than a couple of seconds
- Feel weak, lightheaded or faint
- Have sudden overwhelming fatigue
Don’t ignore the pain or discomfort. If you think you are having heart problems or a heart attack, get help immediately. The sooner you get treatment, the greater the chance that the doctors can prevent further damage to the heart muscle. A delay in treatment can lead to permanently reduced function of the heart due to more extensive damage to the heart muscle. Not all these signs occur in every heart attack or stroke. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives.
Important risk factors for heart attack are older age, smoking, and estrogen therapy combined with smoking. People with high risk for heart attack should get regular EKGs, and talk to their doctor about prevention and medication management of their risk factors. Besides age, factors that increase the risk for heart attack are:
- A previous heart attack or procedure to open up the coronary arteries
- Family history of early heart disease
- Father or brother diagnosed before age 55
- Mother or sister diagnosed before age 65
- Diabetes mellitus
- High blood cholesterol
- High blood pressure
- Cigarette smoking
- Physical inactivity
Even though the symptoms of a heart attack at times can be vague and mild, it is important to remember that heart attacks producing no symptoms or only mild symptoms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Too often patients attribute heart attack symptoms to “indigestion,” “fatigue,” or “stress,” and consequently delay seeking prompt medical attention.
Heart attacks frequently occur from 4:00 A.M. to 10:00 A.M. due to higher adrenaline amounts released from the adrenal glands during the morning hours. Increased adrenaline in the bloodstream can contribute to the rupture of the plaque that causes the formation of the clot and the eventual heart attack.
Studies have found that, at least in northern regions, heart attacks may occur more often in the winter months. Heart attacks do not usually happen during exercise, although exercise is commonly associated with exertional angina. Approximately one quarter of all heart attacks are silent, without chest pain. In diabetics, the incidence of “silent” heart attacks may be much higher.
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- American Heart Assoc. (2007) ABCs of Preventing Heart Disease, Stroke and Heart Attack. http://www.americanheart.org/presenter.jhtml?identifier=3035374
- American Heart Assoc. (2006) Heart Attack, Stroke and Cardiac Arrest Warning Signs. http://www.americanheart.org/presenter.jhtml?identifier=3053
- Collins R, Peto R, MacMahon S, et al. (1990). “Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context”. Lancet 335 (8693): 827â€“38.
- http://www.nhlbi.nih.gov/health/public/heart/index.htm: a directory of heart disease prevention and treatment information for patients and the public
- http://www.nhlbi.nih.gov/health/public/heart/chol/hbc_what.htm: a patient brochure, “High Blood Cholesterolâ€”What You Need To Know“