Heart Attack Symptoms (Myocardial Infarction)
Detecting a Heart Attack
Receiving treatment within the first 60 minutes of heart attack, often referred to as the “golden hour”, greatly increases the chances for survival and recovery. A surprising number of people will delay seeking medical attention even when they recognize the onset of symptoms. Often these people cite the fear of embarrassment of going to the hospital emergency room and discovering there is nothing medically wrong with their heart. It is important to recognize the symptoms of a heart attack, also known as myocardial infarction, and seek immediate medical care.
Many symptoms often associated with a heart attack can actually be caused by other, less serious conditions, such as digestive problems. However, only medical testing can determine if a patient is actually having a heart attack. While there are classic, landmark signs of a heart attack, each case is different. Not all heart attacks behave the same way; signs and symptoms can be varied. Not every heart attack victim will experience crushing pain in the chest. Some may report atypical symptoms, such as pain between the shoulder blades, which is very common among women. Misinterpreting or ignoring these atypical signs is often the reason people delay seeking medical attention, which could turn out to be a life threatening error in judgment.
Prompt treatment for a heart attack is extremely important; it can make the difference between survival and death. It is far better to err on the side of caution and go to the hospital than to ignore the signs that a heart attack may be occurring. This article will discuss the most common characteristics of myocardial infarction, including angina, which often precedes the actual heart attack.
Angina or Angina Pectoris
Angina often is the predecessor of a heart attack. There are several factors that will cause the heart to beat faster. Physical exertion or intense exercise, stress and emotions, as well as cold weather or a large meal will result in an increased pulse rate. The heart muscle needs an adequate supply of oxygen to maintain this increase. A narrowing or blockage of the arteries leading to the heart will prevent the necessary nutrients from reaching the heart. The muscle tissue will become oxygen deprived resulting in chest pain, which is referred to as angina pectoris.
Chest pain associated with angina is very distinct. This pain is often described as suffocating, strangling or heavy and is far more intense than the discomfort experienced with digestive problems, injuries to the chest wall, esophageal spasms or pleurisy. Angina pain may seem to begin on the left side of the chest just beneath the sternum or breastbone. Often it will radiate outward to the neck, throat, jaw, left shoulder and arm. On occasion it may also travel to the right side of the body.
An angina episode can be extremely frightening. Most angina attacks subside within fifteen minutes with rest or by dissolving a nitroglycerin tablet or other form of nitrate under the tongue. Longer lasting attacks may be the precursor to a heart attack and require immediate medical attention.
Individuals that have never been diagnosed with any form of heart disease, and that develop any of these symptoms may have angina. A cardiac screening should be performed as soon as possible.
- Chest pain associated with physical exertion that subsides with rest.
- Chest pain that occurs during periods of stress or emotional distress.
- Unusual shortness of breath, such as when climbing stairs that could previously be taken without becoming winded.
- Unusual indigestion not associated with eating and that does not ease with the use of antacids.
Approximately 350,000 cases of angina are diagnosed annually. The majority of cases are diagnosed in older, adult males. According to statistics, 50% of people with angina pectoris will suffer a sudden death and 33% will have a heart attack.
Although angina is indicative of heart disease, it is not entirely bad. Many heart problems do not present with recognizable symptoms, and often continue undiagnosed until a heart attack or sudden death occurs. Angina, while it is painful and distressing, is often referred to by cardiologists as a gift from God because it leads to early diagnosis and medical intervention that can prevent sudden death and heart attack. The presence of angina warns of a higher risk of heart attack, and often prompts individuals to seek medical care.
Heart Attack
At the onset of a heart attack, symptoms may be mild and not necessarily painful. Dizziness is often an early sign. Emergency medical attention is required if any of the following indicators are experienced for a period of two minutes or longer:
- Mid-chest pain or a sensation of squeezing, fullness or pressure in the chest
- Pain radiating into the shoulders, arms or neck.
- Severe chest pain, shortness of breath, nausea, excessive sweating, dizziness and fainting.
- Change in the frequency, intensity or duration of angina attacks, and angina attacks that do not respond to nitroglycerin.
Heart attacks commonly occur in the morning hours, between 4 a.m. and 10 a.m., when the adrenal glands release higher amounts of adrenalin into the bloodstream. Higher levels of adrenaline can cause plaque deposits to rupture in the arteries, which in turn can lead to clot formation and heart attack.
Studies have found that heart attacks are more common in the north during the winter.
Although angina is often associated with physical exertion, heart attacks do not normally occur as a result of or during exercise.
Approximately 25% of all people suffering heart attacks will not experience chest pain. The occurrence of silent heart attacks may be more common among diabetics.
Common Heart Attack Symptoms
Heart attack symptoms are often similar to those of an angina attack, but with increased intensity and duration. Commonly a squeezing, burning or intense pressure is felt in the mid-chest, and may travel to the shoulder, down the left arm, into the neck, jaw or back. Excessive sweating, or diaphoresis, weakness, shortness of breath, and dizziness may occur in conjunction with the pain and pressure of a heart attack. Chest pain lasting longer than fifteen minutes and that does not subside with nitroglycerin or rest requires emergency medical intervention.
Aspirin is a known blood thinner, and can help the heart get more blood and oxygen during a heart attack. After calling for help, individuals should immediately chew an aspirin tablet and drink water.
In many cases, a heart attack can mimic the symptoms of indigestion. An ill feeling or aches high in the middle of the abdomen, accompanied by pronounced weakness or a faint feeling are heart attack symptoms often mistaken for digestive troubles.
Silent Heart Attack
Heart attacks that occur without the typical warning signs are referred to as silent heart attacks, and are more common in women, diabetics and people over 65 years of age. A sudden feeling of being light headed, sweating, nausea and heartburn are symptoms that may be present during a silent heart attack.
A consistent, severe pain deep in the chest is the most common heart attack symptom. This pain, which may radiate to other parts of the body, including the left arm and shoulder, jaw, neck, and the upper back between the shoulder blades, can persist for up to twelve hours.
This pain is often described as a heavy pressure beneath the sternum or breastbone that causes a squeezing sensation. Heart attacks may also cause arrhythmias which are abnormal heart rhythms.
Heart Attack Pain
A person having a heart attack may experience one or more of these symptoms:
- Crushing or heavy pain in the chest that can spread to the left shoulder.
- Chest pain spreading to the jaws, neck or back.
- Dull pain deep in the chest, or the sensation of squeezing beneath the sternum.
- Pain present only in the arms, back or jaw.
Early Signs of Heart Attack
- An uncomfortable feeling of fullness, pressure, squeezing or chest pain lasting more than two minutes.
- Pain radiating to the arms, shoulders, jaw, neck or back.
- Light headedness, weakness, shortness of breath, sweating, nausea or fainting
These symptoms alone do not necessarily indicate a heart attack; however, the presence of more than one symptom increases the likeliness that a heart attack is occurring.
Additional Heart Attack Symptoms
- General malaise which is a vague or indistinct ill feeling
- Nausea
- Pain in the arms. Typically, this pain will be felt in the left arm, but may be present in the right arm as well.
- Pain in the upper back or between the shoulder blades
- Pain in the jaw
- Excessive sweating
- A pressure in the chest
- Shortness of breath
What to Do When Heart Attack Symptoms Occur
- Sit or lie down immediately.
- Take up to 3 doses of nitroglycerin, one dose every five minutes or as directed by a physician. If the pain does not subside, 911 or local emergency services should be called immediately.
- Call 911 or local emergency services if nitroglycerin is not available and symptoms have persisted for two minutes or longer.
- Have someone drive the heart attack victim to the hospital if it is possible to get there faster than waiting for an ambulance. Persons suffering heart attack symptoms should not attempt to drive themselves.
- Upon arrival at the hospital, inform the staff that the individual may be having a heart attack and needs immediate attention. Do not allow the hospital staff to keep the patient waiting.
- Do not delay in seeking emergency medical treatment or minimize the symptoms of a heart attack. Waiting longer than fifteen minutes can result in permanent damage to the heart or death.
What to do when someone seems to be having a heart attack
- Do not allow the person to minimize their symptoms. Often fear will cause people experiencing chest pain or heart attack symptoms to delay treatment.
- Call 911 or local emergency services immediately, and request an ambulance. If driving the individual to the emergency room will be faster, do it immediately.
- Administer oxygen if it is available.
- Have the person lie down with the head elevated slightly.
- Provide towels and dry clothing.
- Check to see if the patient has a medical alert bracelet or necklace, and follow any emergency instructions they may provide. Inform emergency personnel of medical alert tags as soon as they arrive.
- CPR should begin only if there is a properly trained person present. CPR should continue until the medics arrive.
It is very important to maintain control and not panic, nor give the victim reason to panic. Panic can cause blood vessels to constrict, making it harder for the body to survive a heart attack. Scientific research has shown that heart attack patients who remain relatively calm have a greater chance of survival. Fear not only causes the heart to work harder, it also causes a surge of hormones to be released into the bloodstream, which increases the risk heart damage.
It is natural to feel fear and desperation when a family member or loved one suffers a heart attack. It is a life threatening situation. Panicking, screaming and crying are not beneficial to the patient and can affect the treatment. Staying calm, confident and reassuring will help the victim to remain calm as well. Any person that is having difficulty maintaining composure should be removed from the room and kept away from the patient.
When emergency personnel arrive, once again reassure the victim that he or she is receiving the best care possible.