Blockage in an Artery
Chest pain or pressure under the breastbone, which may move down the left arm, up the jaw, or around the back, is the classic sign of a heart attack and is familiar to almost everyone. But there are also warning signs of a heart attack that some people are not familiar withwarning signs that could save their lives. About two-thirds of heart attack victims have symptoms during the days and weeks just before their heart attack. They may feel very tired, have shortness of breath, and suffer brief periods of chest pain that come and go. Still other patients may have very mild chest pain, and blame the pain on indigestion, anxiety, or another condition. Older patients may complain more about shortness of breath than pain or pressure in the chest. About 20% of heart attack victims have no pain at all. Heart attacks that do not cause pain are known as “silent” heart attacks. The first hour after a heart attack is critical because much of the damage done to the heart muscle happens during that time. That is why it is so important to call an ambulance right away when chest pain occurs. Unfortunately, one-half of people having a heart attack wait two hours or longer before seeking help.
A heart attack may be triggered by a blockage in an artery in the heart. With blood flow disturbed, heart muscle dies within minutes. That’s why early treatment, which means getting to a hospital as soon as possible, is crucial.
Early Treatment is Crucial
Every year, about 1.5 million persons suffer a heart attack. A heart, attack (myocardial infarction) is usually caused by a rapid drop in blood flow to the heart muscle. This lack of blood flow means that not enough oxygen reaches the heart muscle, and permanent damage is done to the heart. In most cases, atherosclerosis precedes the heart attack. Deposits in the wall of the artery (plaques) lead to narrowing of the arterial channel, causing a clot to form and shutting off the blood supply. The clot blocks the blood that supplies oxygen to the heart muscle. If the flow of blood (and the oxygen it carries) is blocked for a long time, the heart muscle cells in that area begin to die, causing chest pain. Many heart attack patients have early warning symptoms a few days or even weeks before the heart attack. They may feel very tired, have shortness of breath, and suffer brief periods of chest pain that come and go.
Early Symptoms: The first symptom of a heart attack is usually a deep aching, pressure, or squeezing sensation in the chest under the breastbone. Patients often describe this pain or pressure as the feeling of an “elephant on my chest.” This pain may spread down the left arm (or less commonly the right arm), or into the jaw or around the back. It is usually a severe pain that is not relieved by resting, like the chest pain of angina (although some persons may not have any pain at all). The heart attack victim may also experience nausea and vomiting, severe anxiety, sweating, and shortness of breath. Older patients may have only shortness of breath, with little or no chest pain. Diabetic patients also are more likely to have “silent” heart attacks, with no chest pain symptoms. This makes regular check-ups important so future damage to the heart muscle can be prevented if a silent heart attack has occurred.
Diagnosis in Women: Women may not be correctly diagnosed with a heart attack because their chest pain is sometimes different from that in men. Men are more likely to have sharp pain under the breastbone, and more often have chest pain on exertion rather than fatigue. Women more often experience pain over their entire chest, not just under the breastbone. Women also are more likely to have extreme fatigue after exertion instead of chest pain.
Have a Plan of Action: Not receiving help quickly is one reason there are more than 300,000 deaths each year from heart attacks. Many people deny their symptoms are serious, or do not seek help immediately because they may be embarrassed if their chest pain is not a heart attack. But the decisions made during those first minutes of a heart attack can mean the difference between life and death. The best approach is to have a plan if you begin having the symptoms of a heart attack. At the first sign of chest pain symptoms, the first thing to do is to sit and rest, then call 911 or your local emergency number. Any chest pain that continues for more than 15 minutes and is not relieved by rest may be a heart attack. Early treatment is a critical factor in surviving a heart attack.
Aspirin or No Aspirin? Most doctors recommend chewing a regular strength (325 mg) aspirin during a heart attack to help stop clots from blocking the flow of blood to the heart muscle. Check with your doctor now to see if this recommendation is right for you.