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Men's & Women's Heart Health
Classic Heart Attack Symptoms: Chest Pain, Difficulty Breathing
A heart attack is a medical emergency. Make no mistake about it: trying to "tough out" symptoms of a heart attack can be fatal. Emergency treatment should be sought as soon as symptoms appear. Unfortunately, half of all heart attack victims wait over two hours before seeking treatment. This delay results in widespread heart muscle damage and increases the risk of death. Prompt treatment can minimize the damage caused by a heart attack.
The best way to seek help for a heart attack is to call 911. This is usually the fastest way to get medical treatment for an acute myocardial infarction (AMI) or heart attack. It is not a problem if the symptoms point to another diagnosis and the emergency is a false alarm. Where heart attack symptoms are concerned, it's better to be safe than sorry.
Chest Pain and Heart Attack Symptoms
Chest pain is one of the most common heart attack symptoms. Heart attack chest pain is often described as "crushing" or "squeezing." Chest pain is also sometimes described as a tight band wrapped around the chest. Chest pain may "radiate," causing pain in the shoulders, arms, stomach, and jaw.
Chest pain is a symptom of angina as well as a heart attack. Angina chest pain usually lasts for a few minutes and responds well to resting and angina medications. Chest pain associated with heart attacks is not alleviated with rest, however, and may persist for longer than thirty minutes. Persistent chest pain indicates a medical emergency.
Angina and CAD
Angina chest pain mimics heart attack symptoms. While less serious than a heart attack, angina does indicate the presence of coronary artery disease.
Difficulty Breathing, Anxiety, and Other Heart Attack Symptoms
In addition to chest pain, symptoms of a heart attack include sweating and difficulty breathing. Heart attack victims may also experience intense anxiety, sometimes described as a feeling of "doom" or impending disaster. (Anxiety in the absence of other heart attack symptoms may indicate an anxiety disorder).
Additional heart attack symptoms may include vomiting and nausea. Finally, the skin may seem pale (a condition known as pallor).
Symptoms Before an Attack
Two-thirds of heart attack victims report that they experienced symptoms days or weeks prior to the heart attack. These symptoms may include difficulty breathing, angina (chest pain), and unusual fatigue.
Atypical Symptom
Elderly individuals, especially those with dementia, and people with diabetes may report atypical heart attack symptoms. For instance, they may report either no chest pain or only minor pain. Elderly individuals are more likely to report difficulty breathing, weakness, fatigue, or fainting, rather than chest pain.
Women, Chest Pain, and Atypical Heart Attack Symptoms
Women generally do not experience a heart attack in the same way as men. Unfortunately, because women don't experience the classic symptoms, they don't realize they are having a heart attack. Chest pain is often absent and a woman's heart attack symptoms are more likely to be dismissed as anxiety or fatigue. The Women's Symptoms page deals specifically with heart attacks and women.
Heart Attack Symptoms at a Glance
- anxiety
- chest pain
- difficulty breathing
- fainting
- nausea
- pallor (pale skin)
- sweating
- vomiting
Angina Symptoms, Diagnosis and Treatment
The American Heart Association (AHA) defines angina as "a medical term for chest pain or discomfort due to coronary heart disease." The AHA estimates that over 6.8 million Americans experience angina symptoms. Angina is a painful condition indicating the presence of coronary artery disease, and increasing the risk of heart attack and heart failure.
Causes of Angina
Angina, or angina pectoris, is caused by myocardial ischemia: restricted blood flow to the heart. Reduced blood flow lowers the amount of oxygen available to the heart, resulting in chest pain and other angina symptoms.
Atherosclerosis is usually to blame for myocardial ischemia. Atherosclerosis occurs when fat and cholesterol plaques build up in the coronary arteries and obstruct blood flow to the heart.
Classic Angina Symptoms
Low blood flow to the heart results in chest pain, the most common angina symptom. Chest pain is severe, and patients often describe it as "crushing," or as if a fist had clenched the heart. People who suffer from angina symptoms usually have chest pain with physical exertion or during emotional stress. Anger is a classic angina trigger.
Angina symptoms resemble those of a heart attack. However, angina symptoms usually last only one to five minutes, while chest pain from a heart attack may last for hours. Angina symptoms normally diminish after resting or taking angina medication. Heart attack symptoms do not improve with rest, and angina medication will not reduce heart attack chest pain. If your angina symptoms persist for longer than a few minutes, or are not relieved by resting, you may be having a heart attack and you should seek immediate emergency heart attack treatment. In addition to chest pain, angina symptoms may include:
- a "burning" feeling in the chest
- anxiety
- a heavy feeling in the chest
- chest pain that radiates to the jaw back, or shoulders
- indigestion
- nausea
- sweating
- shortness of breath
- numb or tingling fingers
Angina Complications: Heart Attack, Heart Failure and Arrhythmia
Angina is painful, but not usually life threatening. However, angina symptoms indicate the presence of coronary artery disease (CAD). Without treatment CAD progresses, further damaging the heart and causing a number of complications. Angina symptoms increase the risk of developing:
- heart attack
- heart failure
- stroke
- arrhythmias
Coronary Artery Disease, Angina and Heart Attacks
Coronary artery disease, or CAD, is the leading cause of death in America: every year over 500,000 Americans die of heart attacks or other complications of CAD. Also known as coronary heart disease, coronary artery disease occurs when the small arteries bringing oxygen-rich blood to the heart narrow, restricting blood flow. Lack of oxygen damages heart tissue and may eventually impair heart function.
CAD is often seen as a 'male' disease. In truth, however, women are as susceptible to coronary artery disease as men; they simply tend to develop the disease later in life.
Chest Pain and Other Coronary Heart Disease Symptoms
Coronary artery disease develops slowly: decades may pass before arteries narrow enough to cause a heart attack. In some cases, CAD starts during childhood, but noticeable symptoms to not develop until adulthood.
Chest pain is often the first noticeable symptom of coronary artery disease. Starting behind the sternum, chest pain may radiate to the jaw, back, and shoulders. Depending on its duration, and the severity of other symptoms, chest pain associated with CAD can be either angina pectoris or a heart attack.
Angina Pectoris
Affecting some 6.8 million Americans, angina pectoris is a condition caused by coronary artery disease. Angina is a disease in which the arteries that supply the heart have narrowed, most commonly as a result of athersclerosis.
The main symptom of angina is chest pain. The narrowed arteries of angina cannot supply enough oxygenated blood to the heart during physical or emotional exertion, when the heart normally starts to beat faster. Fortunately, the chest pain experienced with angina usually subsides on its own after resting.
Chest Pain: Blood Clots and Other Causes
Not all chest pain can be traced to coronary artery disease, angina, or a heart attack. Many medical conditions cause chest pain. For example, in a situation know as a pulmonary embolism, blood clots block blood flow to the lungs. Like a heart attack, blood clots in the lungs cause severe chest pain and difficulty breathing, and require emergency treatment.
Other conditions such as GERD (gastroesophageal reflux disease), stomach ulcers, gallbladder inflammation, and pancreatitis can also cause chest pain. Severe chest pain should always be evaluated immediately, since it could indicate a potentially fatal heart attack or blood clot.
HEART ATTACK SYMPTOMS: IN WOMEN
Women who experience a heart attack may feel some of the same symptoms as men, including chest pain and difficulty breathing. However, the range and severity of heart attack symptoms vary in women. During a mild heart attack, women may even be unaware that they are experiencing an acute myocardial infarction (AMI) or heart attack.
Unusual Heart Attack Symptoms in Women: Fatigue and Anxiety
Heart attack symptoms in women are often more subtle then those experienced by men. Women are more likely to experience fatigue, anxiety, sleep disturbances, or stomach complaints during heart attacks. Unfortunately, these symptoms are not generally associated with an AMI or heart attack. Even members of the medical profession sometimes fail to link these symptoms with heart problems. It is not unusual for a woman's heart attack to be dismissed as anxiety.
Although considered a classic heart attack symptom, chest pain is not commonly experienced by women. Results from a survey of 515 women published in the journal Circulation revealed some interesting statistics: more than 70 percent of women experienced no chest pain prior to the attack, and as many as 43 percent of women reported no chest pain symptoms during the attack.
Further, women who do experience chest pain may describe the pain as "sharp," rather than "crushing." This description does not match the popular (and traditional medical) perception of heart attack symptoms, and may be misdiagnosed.
Heart Attack Symptoms Before and During an Attack
The statistics gathered in the study included data on unusual symptoms women noticed in the days before the attack. Of those surveyed, 95 percent of women reported unusual symptoms; the most common being fatigue, anxiety, and sleep disturbances. This list presents some of the common symptoms experienced by women both prior to and during a heart attack. These symptoms are important to consider in addition to chest pain, since in some women they may be the only symptoms present.
Symptoms Before Heart Attack
- Fatigue (71%)
- Sleep disturbances (48%)
- Shortness of breath (42%)
- Indigestion (39%)
- Anxiety (35%)
Symptoms During Heart Attack
- Shortness of breath (58%)
- Weakness (55%)
- Fatigue (43%)
- "Cold sweat" (39%)
- Dizziness (39%)
Women and Heart Disease: Popular Misconceptions
There exists a popular, and deadly, misconception that women are not as likely to experience heart disease as men. Some physicians may even still believe this myth. Nothing could be further from the truth, however. Heart disease is the leading killer of women, rating even higher than breast cancer.
Unfortunately, heart attack symptoms in women differ so markedly from symptoms in men, that female heart problems are often overlooked. Doctors (and women themselves) often mistake heart attack symptoms in women for anxiety disorders, fatigue, asthma, or indigestion. Once heart disease is diagnosed in women, they are still less likely than men to receive heart disease medication, or to undergo heart surgery. This deficiency in treatment leads to poor outcomes in women with heart disease.
Heart Disease, Women, and Research
Another barrier in the treatment of heart disease in women is the fact that research has focused on men. The results of clinical research in men have been applied to women, assuming that the disease is identical in both sexes. This is not the case, however. Women's physical reactions to heart problems are gender specific, and need to be studied in clinical trials aimed specifically at women. In recent years, the medical and scientific communities have identified the need for heart research in women. Women with heart problems are encouraged to take part in clinical trials focusing on heart disease in women.
Heart Disease Statistics and Women
- 240,000 American women have heart attacks annually, equaling heart attack rates in men
- Statistics indicate that between 45 to 65 years of age, heart disease kills twice as many women as breast cancer.
- One out of every two women dies of heart disease or stroke
- 63% of women who suffer fatal heart attacks had no indication of heart problems
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