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Page Updated: April-26-2012

Congestive Heart Failure

Heart Stroke Symptoms and Signs

Women's Heart Attack Symptoms

Heart Attack Symptoms

Heart Attack Symptoms - Men and Women

Heart Attack Symptoms, Act In Time - By The NIH

• Heart attack symptoms
• Women heart attack symptoms
• Surviving heart attack symptoms
• Heart attack symptom uncertainty
• Calling 911 for a heart attack
• Limiting heart muscle damage
• Emergency medical personnel
• Planing ahead for a heart attack
• Testing for a heart attack

It's vital that everyone learn the warning signs of a heart attack.

Chest discomfort. 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.
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, or light-headedness.

Acting In Time To Heart Attack Symptoms

A heart attack is a frightening event, and you probably don't want to think about it. But, if you learn the signs of a heart attack and what steps to take, you can save a life–maybe your own.

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.

The truth is that many heart attacks start slowly, as a mild pain or discomfort. If you feel such a symptom, you may not be sure what's wrong. Your symptoms may even come and go. Even those who have had a heart attack may not recognize their symptoms, because the next attack can have entirely different ones.

Women Heart Attack Symptoms

If you're a woman, you may not believe you're as vulnerable to a heart attack as men–but you are. Women account for nearly half of all heart attack deaths. Heart disease is the number one killer of both women and men.

There are differences in how women and men respond to a heart attack. Women are less likely than men to believe they're having a heart attack and more likely to delay in seeking emergency treatment.

Further, women tend to be about 10 years older than men when they have a heart attack. They are more likely to have other conditions, such as diabetes, high blood pressure, and congestive heart failure–making it all the more vital that they get proper treatment fast.

Women should learn the heart attack warning signs. These are:

• Pain or discomfort in the center of the chest.
  
• Pain or discomfort in other areas of the upper body, including the arms, back, neck, jaw, or stomach.
  
• Other symptoms, such as a shortness of breath, breaking out in a cold sweat, nausea, or lightheadedness

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

If you feel heart attack symptoms, do not delay. Remember, minutes matter! Do not wait for more than a few minutes–5 minutes at most–to call 9-1-1. Your family will benefit most if you seek fast treatment.
To learn more about women and heart disease:

Healthy Heart Handbook for Women.

National Women's Health Information Center

Learn the signs–but also remember: Even if you're not sure it's a heart attack, you should still have it checked out. Fast action can save lives-maybe your own.

Surviving Heart Attack Symptoms

How do you survive a heart attack? Fast action is your best weapon against a heart attack. Why? Because clot-busting drugs and other artery-opening treatments can stop a heart attack in its tracks. They can prevent or limit damage to the heart–but they need to be given immediately after symptoms begin. The sooner they are started, the more good they will do–and the greater the chances are for survival and a full recovery. To be most effective, they need to be given ideally within 1 hour of the start of heart attack symptoms.

Heart Attack Uncertainty Is Normal

Expectations often don't match reality when it comes to heart attack. People expect a heart attack to happen as it does in the movies, where someone clutches his or her chest in pain and falls over. Because of this expectation, people often are not sure if they're having a heart attack. As a result, people often take a wait-and-see approach instead of seeking care at once. This even happens to people who have already had a heart attack. They may not recognize the symptoms, because their next heart attack can have entirely different symptoms.

Call 9-1-1

The first step to take when a heart attack happens is to call 9-1-1. Call whether you're sure you're having a heart attack or not.

Anyone showing heart attack warning signs needs to receive medical treatment right away. Don't wait more than a few minutes—5 minutes at most—to call 9-1-1.

Calling 9-1-1 for an ambulance is the best way to get to the hospital because:

Emergency medical personnel (also called EMS, for emergency medical services) can begin treatment immediately–even before arrival at the hospital. The heart may stop beating during a heart attack. This is called sudden cardiac arrest. Emergency personnel have the equipment needed to start the heart beating again. Heart attack patients who arrive by ambulance tend to receive faster treatment on their arrival at the hospital.

If for some reason, you are having heart attack symptoms and cannot call 9-1-1, have someone else drive you at once to the hospital. Never drive yourself to the hospital, unless you absolutely have no other choice.

Emergency Medical Personnel

Calling 9-1-1 is like bringing a hospital emergency department to your door. Why?

Emergency medical personnel can take vital signs, determine your medical condition, and if needed give added medical care.

In many places, emergency medical personnel are linked to hospitals and doctors, so they can relay your vital signs and electrocardiogram to the emergency department before you arrive. This way, you receive immediate continued treatment by emergency department personnel once you reach the hospital.

Emergency medical personnel can give a variety of treatments and medications at the scene. Emergency medical personnel carry drugs and equipment that can help your medical condition, including oxygen, heart medications (such as nitroglycerin), pain relief treatments (such as morphine), and defibrillators (equipment that restarts the heart if it stops beating).

Limiting Heart Muscle Damage

Treatments for a heart attack work to open the blocked artery to restore blood flow as fast as possible to prevent or limit damage to the heart muscle, and to lessen the chance of a repeat attack. The main treatments are thrombolytic ("clot-busting") therapy, other medications, and special procedures, such as angioplasty and coronary artery bypass surgery.

To be most effective, these treatments must be given fast–within 1 hour of the start of heart attack symptoms. Acting fast can save your life and limit damage to your heart.

Plan Ahead

Make a plan now for what you would do if a heart attack should happen. Doing so will save time and could help save a life.

To plan ahead:

• Learn the heart attack warning signs.
  
• Think through what you would do if you had heart attack symptoms. Decide what you would do if it happened while you were at home, in the middle of the night, at work, or at any other place or in any other situation that might need advance planning.
  
• Decide who would care for any dependents in an emergency. Emergency medical personnel will generally contact a friend or relative (or the police department, if necessary) to make emergency arrangements for your dependents.
• Talk with your family and friends about the heart attack warning signs and the importance of acting fast by calling 9-1-1 after a few minutes–5 at the most–if those signs persist. Explain the benefits of calling 9-1-1, instead of getting to the hospital by car.
  
• Talk to your health care provider about your heart attack risk and what you can do to reduce it. (Rate your chances of having a heart attack.)
  
• Talk to your doctor about what you should do if you experience any heart attack symptoms.
  
• Gather important information to take along with you to the hospital. Do this by preparing a heart attack survival plan. Fill in the form, print it out, and keep copies in handy places, such as your wallet or purse.
  
• If you are concerned about your insurance coverage, call your insurance company and check on your benefits. Most insurance companies cover emergency care for a possible heart attack.

Testing For A Heart Attack

If you think you're having a heart attack, get help at once. Don't wait to be sure. Call 9-1-1 right away. Delay can be deadly.

Once you get help, you will undergo tests to see if a heart attack has actually occurred. Some tests are done at the hospital, while others can be done by emergency medical personnel who come in an ambulance.

Key heart attack tests are:

Electrocardiogram (ECG or EKG). This is a graphic record of the electrical activity of the heart as it contracts and relaxes. The ECG can detect abnormal heartbeats, some areas of damage, inadequate blood flow, and heart enlargement.

Blood test. A blood test will be done routinely to check for enzymes or other substances that are released when cells begin to die. These are "markers" of the amount of damage to your heart.

Nuclear scan.This test shows areas of the heart that lack blood flow and are damaged. It also can reveal problems with the heart's pumping action. A small amount of radioactive material is injected into a vein, usually in the arm. A scanning camera positioned over the heart records whether the nuclear material is taken up by the heart muscle (healthy areas) or not (damaged areas). The camera also can evaluate how well the heart muscle pumps blood. This test can be done during both rest and exercise, enhancing the usefulness of its results.

Coronaryangiography (or arteriography). This test is used to check blockages and narrowed areas inside coronary arteries. A fine tube (catheter) is threaded through an artery of an arm or leg up into the heart. A dye that shows up on X ray is then injected into the blood vessel, and the vesselsand heart are filmed as the heart pumps. The picture is called an angiogram or arteriogram.

After you learn more about heart attack, try a brief quiz to see if you know what to do if you or someone else has warning signs.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
National Institutes of Health
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/
9000 Rockville Pike
Bethesda, Maryland 20892

Women's Heart Attack Symptoms May Appear Up To a Month Before the Attack

New research by The National Institutes of Health suggests that women often experience heart attack symptoms as much as a month prior to having a heart attack.

515 Women where studied. 95% knew their symptoms were new or different a month or more before experiencing their heart attack - Acute Myocardial Infarction (AMI).

This NIH study, titled "Women's Early Warning Symptoms of AMI," is one of the first to investigate women's experience with heart attacks, and how this experience differs from men's. Recognition of symptoms that provide an early indication of heart attack, either imminently or in the near future, is critical to forestalling or preventing the disease.

Heart Attack Symptoms Most Commonly Reported by Women

Many women experienced no chest pains at all.

• Chest pain or discomfort prior to their heart attacks - 30%
• No chest pain during any phase of the attack - 43%

Women's major symptoms prior to their heart attack included:

• Unusual fatigue - 70%
• Sleep disturbance - 48%
• Shortness of breath - 42%
• Indigestion - 39%
• Anxiety - 35%

• Shortness of breath - 58%
• Weakness - 55%
• Unusual fatigue - 43%
• Cold sweat - 39%
• Dizziness - 39%

However, most doctors continue to view chest pain as the most important consideration when diagnosing heart attack symptoms in both men and women and men.

In a NIH press release, Jean McSweeney, PhD, RN, Principal Investigator of the study at the University of Arkansas for Medical Sciences in Little Rock, said, "Symptoms such as indigestion, sleep disturbances, or weakness in the arms, which many of us experience on a daily basis, were recognized by many women in the study as warning signals for AMI. Because there was considerable variability in the frequency and severity of symptoms," she added, "we need to know at what point these symptoms help us predict a cardiac event."

Women's Heart Attack Symptoms Not as Predictable

According to Patricia A.Grady, PhD, RN, Director of the NINR, "Increasingly, it is evident that women's symptoms are not as predictable as men's. This study offers hope that both women and clinicians will realize the wide range of symptoms that can indicate heart attack. It is important not to miss the earliest possible opportunity to prevent or ease AMI, which is the number one cause of death in both women and men."

Related NIH research into heart attacks in women includes possible ethnic and racial differences.

Tea and chocolate are beneficial for cardiovascular health?

Kris-Etherton PM, Keen CL. from the Nutrition Department, Pennsylvania State University Read more...

CoQ10 Restores Healthy Heart Function

According to one scientific study* CoQ10 has been shown to:

• Restore healthy heart function in congestive heart failure patients.
• Reduce the likelihood patients needed to take high blood pressure medication.
• Provide rapid protective effects in patients with a heart attack if administered within 3 days of the onset of symptoms.

*Singh RB, Wander GS, Rastogi A, et al. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther. 1998;12:347-353.

Heart Attack Prevention: CoQ-10

Test Your Immune System

Does your immune system need a boost? This test by Dr. Linda Page is quick and easy.

Evidence that the antioxidant flavonoids in tea and cocoa are beneficial for cardiovascular health.

Kris-Etherton PM, Keen CL. Nutrition Department, The Pennsylvania State University, University Park, Pennsylvania, USA.

Epidemiologic studies suggest an inverse association of tea consumption with cardiovascular disease. The antioxidant effects of flavonoids in tea (including preventing oxidative damage to LDL) are among the potential mechanisms that could underlie the protective effects. Other possible mechanisms include attenuating the inflammatory process in atherosclerosis, reducing thrombosis, promoting normal endothelial function, and blocking expression of cellular adhesion molecules. Cocoa and chocolate can also be rich sources of flavonoids. Flavanols and procyanidins isolated from cocoa exhibit strong antioxidant properties in-vitro. In acute feeding studies, flavanol-rich cocoa and chocolate increased plasma antioxidant capacity and reduced platelet reactivity. Based on limited data, approximately 150 mg of flavonoids is needed to trigger a rapid antioxidant effect and changes in prostacyclin. Some dose-response evidence demonstrates an antioxidant effect with approximately 500 mg flavonoids. Brewed tea typically contains approximately 172 mg total flavonoids per 235 ml (brewed for 2 min); hence, consumption of 1 and 3.5 cups of tea would be expected to elicit acute and chronic physiologic effects, respectively. Chocolate is more variable with some products containing essentially no flavonoids (0.09 mg procyanidin/g), whereas others are high in flavonoids (4 mg procyanidin/g). Thus, approximate estimates of flavonoid rich chocolate needed to exert acute and chronic effects are 38 and 125 g, respectively. Collectively, the antioxidant effects of flavonoid-rich foods may reduce cardiovascular disease risk.

Curr Opin Lipidol. 2002 Feb;13(1):41-9.

Womens Heart Health Resources

The Heart Truth
National Awareness Campaign for Women about Heart Disease
National Heart, Lung, and Blood Institute (NHLBI)
www.nhlbi.nih.gov/

American Heart Association
Phone Number(s): (800) 242-8721
www.americanheart.org

WomenHeart
Phone Number(s): (202) 728-7199
www.womenheart.org

MedlinePlus: Heart Disease in Women
DHHS. NIH. National Library of Medicine.
www.nlm.nih.gov/