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Are Heart Attacks Always Painful

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How To Tell If Chest Pain Is Serious

Nurse practitioner says ‘heart attacks are not always chest pain’

Some types of chest pain should send you to the emergency room particularly if it lasts for at least five minutes.

Symptoms could include new or unexplained chest pain coupled with shortness of breath, a cold sweat, nausea, fatigue or lightheadedness. Aside from your chest, the pain, pressure or discomfort also may radiate to your:

Lasting and unrelenting pain in these areas may signal a heart attack, or myocardial infarction, says Dr. Rimmerman. Call 911 to seek immediate treatment to save heart muscle.

About Half Of All Heart Attacks Are Mistaken For Less Serious Problems And Can Increase Your Risk Of Dying From Coronary Artery Disease

Image: goir/Getty Images

You can have a heart attack and not even know it. A silent heart attack, known as a silent myocardial infarction , account for 45% of heart attacks and strike men more than women.

They are described as “silent” because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure stabbing pain in the arm, neck, or jaw sudden shortness of breath sweating, and dizziness.

“SMI symptoms can feel so mild, and be so brief, they often get confused for regular discomfort or another less serious problem, and thus men ignore them,” says Dr. Jorge Plutzky, director of the vascular disease prevention program at Harvard-affiliated Brigham and Women’s Hospital.

For instance, men may feel fatigue or physical discomfort and chalk it up to overwork, poor sleep, or some general age-related ache or pain. Other typical symptoms like mild pain in the throat or chest can be confused with gastric reflux, indigestion, and heartburn.

Also, the location of pain is sometimes misunderstood. With SMI, you may feel discomfort in the center of the chest and not a sharp pain on the left side of the chest, which many people associate with a heart attack. “People can even feel completely normal during an SMI and afterward, too, which further adds to the chance of missing the warning signs,” says Dr. Plutzky.

Chest Pain Or Discomfort

Chest pain or discomfort that does not go away can be a symptom of a heart attack. Chest pain or discomfort from a heart attack involves pain in the center of the chest or toward the left side of the chest. It can last for , or it may come and go.

Chest pain or discomfort can feel like:

  • intense or more mild pressure

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Women May Experience Different Warning Signs

Before a heart attack, so its important for women to be aware of them and take them seriously.

  • 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.

Beyond Chest Pain: Key Facts On Heart Attacks

Heart Attack Pain Location stock vector. Illustration of attack

Early heart attack symptoms dont always involve the chest.

Although chest pain is a classic symptom, other signs can be subtler. There may be discomfort you wouldnt define as pain and it may be felt in other places, like the inner arm often, but not always, the left arm or in the jaw or teeth. It may get worse with activity and improve with rest. It may come and go, increasing a bit each time it comes. It may feel like indigestion or the flu. You may feel extra tired, short of breath or sweaty. Or you may feel anxious, like something is wrong. And these signs can occur, hours, days, even weeks before the heart attack. Symptoms differ for men and women.Men tend to have their blockages in their main arteries and feel the classic symptoms of chest pressure, squeezing or heartburn. For over 70 percent of women who have heart attacks, the first symptom is unusual fatigue, shortness of breath, sleep disturbance, a feeling of anxiety or indigestion. Brittany Kickel, RN, MSN, Chest Pain Coordinator, cautions that symptoms can vary. One 53-year-old man recently came in with nausea and unusual fatigue. We discovered his main left artery was 80 percent blocked. Another recent patient was a 42-year-old woman whod been ignoring pain in her right arm because she thought only left arm pain was a symptom. If you suspect a heart attack, what should you do?Its best to call 911, rather than drive or get a ride to the hospital. There are two big reasons for this:

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Preventing A Heart Attack

There are 5 main steps you can take to reduce your risk of having a heart attack :

  • smokers should quit smoking
  • lose weight if you’re overweight or obese
  • do regular exercise adults should do at least 150 minutes of moderate-intensity aerobic activity each week, unless advised otherwise by the doctor in charge of your care
  • eat a low-fat, high-fibre diet, including wholegrains and at least 5 portions of fruit and vegetables a day
  • moderate your alcohol consumption

Risk Factors You Can Control

The major risk factors for a heart attack that you can control include:

Some of these risk factorssuch as obesity, high blood pressure, and high blood sugartend to occur together. When they do, its called metabolic syndrome.

In general, a person who has metabolic syndrome is twice as likely to develop heart disease and five times as likely to develop diabetes as someone who doesnt have metabolic syndrome.

For more information about the risk factors that are part of metabolic syndrome, go to the Health Topics Metabolic Syndrome article.

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Symptoms Vary Between Men And Women

As with men, womens 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.

Q: I’ll Know I’m Having A Heart Attack Because My Chest And Arm Will Hurt Right

Here are signs that you could be having a silent heart attack

A: Not necessarily. While some heart attacks do feature classic symptoms like chest and arm pain, the idea that they all do is FALSE.

About 25% of men and 40% of women don’t have chest pain during heart attacks, says Harmony Reynolds, MD, associate director of the Cardiovascular Clinical Research Center and assistant professor of medicine at NYU Langone Medical Center.

With or without chest and arm pain, women may have “shortness of breath, fatigue, nausea, vomiting, sweating, palpitations, dizziness, loss of appetite, or pain in other areas such as the jaw, throat, neck, shoulders, or upper or middle back,” Reynolds says.

Given so many possible signs, women might have trouble figuring out if their symptoms are a touch of the stomach flu or a true heart problem. “All too often I hear stories about women not wanting to bother the doctor,” Reynolds says. “But medical professionals aren’t ‘bothered.’ We are prepared for false alarms.”

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Harmony Reynolds, MD, associate director, Cardiovascular Clinical Research Center assistant professor of medicine, NYU Langone Medical Center.

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Angina And Heart Attacks

Angina is a syndrome caused by the supply of oxygen-rich blood to the heart becoming restricted.

People with angina can experience similar symptoms to a heart attack, but they usually happen during exercise and pass within a few minutes.

However, occasionally, people with angina can have a heart attack. It’s important to recognise the difference between the symptoms of angina and those of a heart attack. The best way to do this is to remember that the symptoms of angina can be controlled with medicine, but symptoms of a heart attack cannot.

If you have angina, you may have been prescribed medicine that improves your symptoms within 5 minutes. If the first dose does not work, a second dose can be taken after 5 minutes, and a third dose after a further 5 minutes.

If the pain persists, despite taking 3 doses of glyceryl trinitrate over 15 minutes, call 999 and ask for an ambulance.

Page last reviewed: 28 November 2019 Next review due: 28 November 2022

What Is The Long

Cardiomyopathy can be life-threatening and can shorten your life expectancy if severe damage occurs early on. The disease is also progressive, which means it tends to get worse over time. Treatments can prolong your life. They can do this by slowing the decline of your hearts condition or by providing technologies to help your heart do its job.

Those with cardiomyopathy should make several lifestyle adjustments to improve heart health. These may include:

  • maintaining a healthy weight
  • limiting alcohol intake
  • getting support from their family, friends, and doctor

One of the biggest challenges is sticking with a regular exercise program. Exercise can be very tiring for someone with a damaged heart. However, exercise is extremely important for maintaining a healthy weight and prolonging heart function. Its important to check with your doctor and engage in a regular exercise program thats not too taxing but that gets you moving every day.

The type of exercise thats best for you will depend on the type of cardiomyopathy you have. Your doctor will help you determine an appropriate exercise routine, and theyll tell you the warning signs to watch out for while exercising.

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Warning Signs And Symptoms Of Heart Disease

Heart disease often develops over time. You may have early signs or symptoms long before you have serious heart problems. Or, you may not realize you are developing heart disease. The warning signs of heart disease may not be obvious. Also, not every person has the same symptoms.

Certain symptoms, such as chest pain, ankle swelling, and shortness of breath may be signals that something is wrong. Learning the warning signs can help you get treatment and help prevent a heart attack or stroke.

How To Tell The Difference Between A Heart Attack And Chest Pain

Chest Pain, Shortness of Breath, and Nausea: Are These Always Signs of ...

Everyone has been ingrained with the knowledge that chest pain is one of the symptoms of a heart attack, and when thinking of a heart attack, many people imagine someone dramatically clutching their chest in pain. However, not every case of chest pain signifies a heart attack.

To put things into perspective, millions of Americans visit the emergency room each year with chest pain, but only 20% are diagnosed with a heart attack or unstable angina, which is a warning sign of an imminent heart attack. That doesnt mean that chest pain should be ignored, but it also doesnt mean it is always signifying a heart attack.

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When To Call 911

Heartburn, breathlessness and other subtle symptomsarent always heart attacks. How can you tell a minor ailment from a heartattack?

Its challenging, admits Dr. Menon. And thats abig reason why people dont get to the doctor sooner when theyre having aheart attack.

In general, call 911 if:

  • Symptoms occur suddenly and persist for more than five to 10 minutes.
  • Shortness of breath and chest discomfort occur while youre at rest.
  • You develop symptoms and are a middle-aged or older adult and have a history of smoking, diabetes or a strong family history of heart disease. Although premenopausal women are usually protected from heart attacks, younger women who smoke, have diabetes or have ovarian dysfunction also are vulnerable.

It will take a clinical evaluation along with blood tests and an electrocardiogram to definitively diagnose a heart attack, says Dr. Menon.

Waiting For The Ambulance

It is important to rest while you wait for an ambulance, to avoid unnecessary strain on your heart.

If you know that you are not allergic to aspirin and you have aspirin available, chew an adult size tablet while you are waiting for the ambulance to arrive.

The aspirin will help to thin your blood and restore the blood flow to your heart.

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When Do I Do If Someone Else Has A Heart Attack

An easy-to-use device called an AED is available in many public places and can be used by almost anyone to treat cardiac arrest. This device works by shocking the heart back into a normal rhythm.

Hereâs how to use an AED:

1. Check responsiveness

  • For an adult or older child, shout and shake the person to confirm whether theyâre unconscious. Do not use AED on a conscious person.
  • For an infant or young child, pinch their skin. Never shake a young child.
  • Check breathing and pulse. If absent or uneven, prepare to use the AED as soon as possible.

2. Prepare to use AED

  • Make sure the person is in a dry area and away from puddles or water.
  • Check for body piercings or outline of an implanted medical device, such as a pacemaker or implantable defibrillator.
  • AED pads must be placed at least 1 inch away from piercings or implanted devices.

3. Use AED

For newborns, infants, and children up to age 8, use a pediatric AED, if possible. If not, use an adult AED.

  • Turn on the AED.

4. Continue CPR

Black American Communities And Heart Attacks

Warning signs symptoms of a heart attack

While the overall risk of heart disease varies among different racial and ethnic groups in the United States, there is less data on heart attacks specifically.

According to the American Heart Association, the rate of cardiovascular disease in Black Americans is about 23 percent higher in men, and 33 percent higher in women, compared with the overall U.S. population.

Non-Hispanic Black Americans have the highest rate of death from heart disease at 208 per 100,000 people, according to the CDC. Next come non-Hispanic white Americans at 169, Hispanic Americans at 114, and Asian Americans at 86.

Researchers have found that among U.S. hospitals with sufficient data, the rate of death from heart attacks in Black patients was nearly identical to that of white patients. But the hospital readmission rate for Black patients was 4.3 percentage points higher than for white patients, according to an investigation published September 2018 in JAMA Open Network.

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What Are The Differences In Heart Attack Symptoms For Men And Women

Its a common misconception that men and women experience different symptoms when having a heart attack. While symptoms vary from person to person, there are no symptoms that women experience more or less often than men. Women are more likely to dismiss the idea that they may be having a heart attack and delay seeking medical attention. Its important to recognise the symptoms of a heart attack, take them seriously and act quickly to prevent damaging the heart muscle.

Discomfort That Lessens With Exercise

If a sharp pain strikes your chest but improves as you move around a bit well, you may be looking at a case of heartburn or some other gastrointestinal issue.

An estimated 15 million Americans a day experience heartburn, which brings an uncomfortable burning feeling in your chest and a sour feeling in your throat. An over-the-counter antacid can help bring some relief.

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What To Do When Heart Attack Happens

  • If you or someone near you experiences heart attack symptoms like shoulder pain, heart attack may be suspected and 911 should be called within the first 5 minutes. Ensure you seek treatment immediately, most people die because they doubt the symptoms could be heat attack related.
  • You might be tempted to drive the patient to the emergency room yourself, but it is better if you wait for the ambulance. The crew will know how to keep the patient alive. However, if you are having a heart attack, do not drive yourself unless you do not have any other choice.
  • Before the ambulance arrives, try keeping the patient calm by sitting him down or helping him lie down. Secondly, if the person is not allergic to aspirin make them chew and swallow a baby aspirin. The effects are felt faster when it is chewed than when swallowed whole. If you notice the person has stopped breathing, a person qualified to perform CPR should perform the procedure on him, or you can do it. If you have no idea how to administer a CPR, the 911 operator can guide you through it.

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Risk Factors For Atherosclerosis Are As Follows:

Heart attack symptoms

Tobacco smoking Obesity Age Familial history

The classical symptom of a heart attack is sudden chest pain. The pain typically radiates to the left side of the body affecting the left shoulder, arm, and neck. The pain of heart attack is described as having an elephant on the chest. Levines sign or when a person clenches his/her fist over the sternum is classically thought to predict cardiac chest pain but studies have shown that it has a poor predictive value.

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Canadian Chronic Disease Surveillance System Heart Disease Working Group Members

  • Camille Adams, Saskatchewan Ministry of Health
  • Claudia Blais, Institut national de santé publique du Québec
  • Jill Casey, Nova Scotia Department of Health and Wellness
  • Charmaine Cooke, Department of Health and Wellness
  • Jennifer Covey, Department of Health and Wellness
  • Yana Gurevich, Canadian Institute for Health Information
  • Karin Humphries, University of British Columbia
  • Helen Johansen, University of Ottawa
  • Douglas Lee, Institute for Clinical Evaluative Sciences
  • Lisa M. Lix, University of Manitoba
  • Kathy Marcotte, Canadian Institute for Health Information
  • Pat McCrea, British Columbia Ministry of Health
  • Jim Nicol, Saskatchewan Ministry of Health
  • Céline Plante, Institut national de santé publique du Québec
  • Rolf Puchtinger, Saskatchewan Ministry of Health
  • Hude Quan, University of Calgary
  • Drona Rasali, British Columbia Provincial Health Services Authority
  • Kim Reimer, British Columbia Ministry of Health
  • Sue Schultz, Institute for Clinical Evaluative Sciences
  • Larry W. Svenson, University of Calgary, Alberta Ministry of Health, University of Alberta
  • Jack Tu, Institute for Clinical Evaluative Sciences
  • Karen Tu, Institute for Clinical Evaluative Sciences, University of Toronto, University Health Network

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