How Is A Heart Attack Diagnosed
To diagnose a heart attack, a doctor will ask you about your symptoms, your health, and your family health history. The doctor will also order tests.
Doctors often use these types of tests to diagnose a heart attack and choose the best treatment.
- Blood tests. During a heart attack, heart muscle cells die and burst open. This process releases proteins into your blood. Heart attack blood tests measure the amount of these protein “markers” of heart damage. Common heart attack blood tests include:
- Cardiac troponin . This is the most common blood test. This marker is released from the injured heart muscle. It is not found in the blood of healthy people. Troponin levels go up three to six hours after your heart attack starts, so the test may not find a heart attack right away.
- Creatine Kinase-MB . The CKMB test measures the amount of damage to the heart because of blocked blood flow. The test can tell whether treatments to restore blood flow to the heart are working. CKMB levels rise about four to six hours after a heart attack starts and peak 24 hours later.
- Myoglobin. This test helps diagnose a heart attack in the very early stages. After a heart attack, myoglobin levels rise within one to four hours but peak after 12 hours.
An Inability To Do What You Were Able To Do Before
Defining this symptom can be somewhat difficult because its less a universal heart attack sign and more dependent on your individual experiences and baseline energy levels.
Its a significant change in your functional status, is how I would put it, says Dr. Cho. You were able to be on the treadmill 20 minutes, but now you can barely do 10 because you just feel so tired.
The Four Silent Symptoms Of A Heart Attack
In addition to extreme fatigue, here are the most common symptoms of heart attacks in women, according to the American Heart Association, so you know what to look for. Note that you may not have all of them:
All of these signs are silent, in the sense that they are easy to ignore especially if you dont want to believe youre having a heart attack. Another reason people think of them as silent signs of a heart attack is that individually, these symptoms could all be attributed to other conditions. The chest pain, in particular, may not be the dramatic, elephant-on-my-chest stereotypical male heart attack pain, says Lichtman.
And the sheer number of these ambiguous symptoms may be one of the reasons many women dont know theyre having a heart attack, according to Lichtmans research there are other things bothering them, so they blow off the chest pain or pressure symptom, says Lichtman.
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What Are The Symptoms Of Heart Disease
Although some women have no symptoms, others may have5
- Pain in the neck, jaw, or throat
- Pain in the upper abdomen or back
These symptoms may happen when you are resting or when you are doing regular daily activities. Women also may have other symptoms, including5
Sometimes heart disease may be silent and not diagnosed until you have other symptoms or emergencies, including5
- Heart attack: Chest pain or discomfort, upper back or neck pain, indigestion, heartburn, nausea or vomiting, extreme fatigue, upper body discomfort, dizziness, and shortness of breath
- Arrhythmia: Fluttering feelings in the chest
- Heart failure: Shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins
If you have any of these symptoms,
Symptoms Of Heart Disease
According to the NHS, symptoms of a heart attack can include:
- Chest pain a feeling of pressure, heaviness, tightness or squeezing across your chest
- Pain in other parts of the body it can feel as if the pain is spreading from your chest to your arms , jaw, neck, back and tummy
- Feeling lightheaded or dizzy
- Feeling sick or being sick
- An overwhelming feeling of anxiety
- Coughing or wheezing
As the chest pain is thought to always be severe, many people put mild chest pain down to other issues, like indigestion. But, some people who are having a heart attack only feel mild chest pain.
Chest pain is also the most common symptom among both men and women. However, women are more likely to experience other symptoms such as shortness of breath, feeling or being sick and back or jaw pain.
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What Are The First Warning Signs Of A Heart Attack In A Woman
When a woman is having a heart attack, one of the first things she may notice is that shes feeling incredibly tired that is, more tired than the usual work-kids-Im-in-charge-of-everything kind of tired. Theres very good information on what premonitory symptoms that women had prior to being diagnosed, and the most common is overwhelming fatigue, says Dr. Watson.
You might not think youre having a heart attack when you feel this way, because it could be something else, and frankly, who hasnt felt totally wiped?
But heres the thing: Its almost always accompanied by something else: Chest pain, chest pressure, shortness of breath, indigestion, says Dr. Watson. Fatigue, says Dr. Watson, might not be the most prominent symptom, so its important to look at the totality of what youre feeling. If you have overwhelming fatigue and any of those other things, thats a sign that something is off, she says.
Heart Attack Risk Factors For Women
There are several factors that increase your chance of developing heartdisease. Almost 50% of all Americans have at least one of three major riskfactors for the condition:
- High blood pressure: Women can develop high blood pressure as a side effect of birth control pills or during pregnancy. All women over 65 are more likely than men are to have high blood pressure.
- High cholesterol: Estrogen seems to protect women against unhealthy levels of cholesterol. But after menopause, estrogen levels drop and high cholesterol becomes more likely.
- Smoking: Although men are slightly more likely to smoke, the gap in cigarette usage between genders is smaller than ever and women are less likely to be able to quit successfully.
Additional risk factors include:
- Excessive alcohol use
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What Not To Do
If you feel heart attack symptoms:
- Donât delay getting help. “Women generally wait longer than men before going to the emergency room,” says Rita F. Redberg, MD, MSc, FACC, director of Women’s Cardiovascular Services for the UCSF Division of Cardiology in San Francisco. Even if you think your symptoms arenât that bad or will pass, the stakes are too high.
- Don’t drive yourself to the hospital. You need an ambulance. If you drive, you could have a wreck on the way and possibly hurt yourself or someone else.
- Donât have a friend or relative drive you, either. You may not get there fast enough.
- Donât dismiss what you feel. “Don’t worry about feeling silly if you’re wrong,” Goldberg says. You have to get it checked out right away.
“People don’t want to spend hours in an emergency room if it isn’t a heart attack,” Bairey Merz says. “But women are actually good at deciding what is typical for themselves and when to seek health care.”
Show Sources
Nieca Goldberg, MD, medical director, Joan H. Tisch Center for Womenâs Health, NYU Langone Medical Center, New York.
C. Noel Bairey Merz, MD, FACC, FAHA, director, Barbra Streisand Women’s Heart Center director, Preventive Cardiac Center professor of medicine, Cedars-Sinai Medical Center, Los Angeles.
Rita F. Redberg, MD, MSc, FACC, director, Women’s Cardiovascular Services, UCSF division of cardiology professor of medicine, UCSF School of Medicine, San Francisco editor, JAMA Internal Medicine.
Do Women Do Worse Than Men After A Heart Attack
Yes. In all age groups, women do worse than men after a heart attack. Researchers are not sure why this is, especially for younger women.
- Women between 45 and 65 who have a heart attack are more likely than men of the same age to die within a year of a heart attack.4 However, heart attack is less common in younger women than in younger men. This is partly because the hormone estrogen protects against heart disease in younger women.
- Women older than 65 are more likely than men of the same age to die within a few weeks of a heart attack.4 Women usually have heart attacks about 10 years later than men. The average age of a first heart attack for men is 64, but it is 72 for women.
Many women who have had a heart attack go on to lead full, active lives. Know the symptoms of a heart attack and what to do if you have any symptoms. Take steps to recover after a heart attack and prevent another heart attack.
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Let’s Win This Together
Heart disease is the No. 1 killer of women. Support the innovative research, education and prevention services that protect the women we love.
Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure, said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women’s Health at NYUs Langone Medical Center and an American Heart Association volunteer. Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.
Even when the signs are subtle, the consequences can be deadly, especially if the victim doesnt get help right away.
Signs And Symptoms Of Heart Attack
If you have any of these signs, call 9-1-1 and get to a hospital right away.
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Symptoms Of Stroke In Women
Strokes are not as common as heart attacks, but can come on without warning. Here are signs that a stroke may be occurring:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Its worth noting that in some women symptoms of heart problems, like palpitations, chills or faintness, may actually be symptoms of perimenopause. However, if you are experiencing these symptoms, you should see your healthcare practitioner.
What Are The Symptoms Of Heart Disease And Heart Attack In Women
When women have symptoms of heart disease, they may include:
- Pain or discomfort in the chest that may be dull and heavy or sharp
- Pain in the neck, jaw, throat, upper belly, or back
- Shortness of breath during physical activity
Women who have coronary artery disease are more likely than men to have chest pain when resting or doing daily activities, rather than during exercise. Theyre also more likely than men to feel chest pain from mental stress.
Symptoms of a heart attack in women may also be different than in men. Chest pain is the most common symptom for both sexes. It may feel like crushing or squeezing. But women are somewhat less likely than men to have chest pain.
During a heart attack, women may feel:
- Pressure or tightness in the chest
- Pain in the upper back, arms, neck, jaw or throat
- Indigestion, heartburn, nausea, or vomiting
- Shortness of breath
Heart attacks usually dont look like the sudden, dramatic events we see in the movies. The symptoms may be mild or strong. They may start slowly. They can stop and then come back.
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Women And Heart Disease
The term heart disease refers to several types of heart conditions, including coronary artery disease and heart attack.
Although heart disease is sometimes thought of as a mans disease, almost as many women as men die each year of heart disease in the United States.
This map shows death rates from heart disease in women in the United States. The darker red indicates a higher death rate.
Symptoms Of A Heart Attack In Women
Both women and men who have a heart attack often have chest pain. However, in addition to chest pain, women are more likely to have these symptoms:
- Pain in the shoulder, back, or arm
- Shortness of breath
These symptoms can happen together with chest pain or without any chest pain.
Many women may not recognize that these are symptoms of a heart attack. Women may not get emergency treatment right away if they downplay their symptoms and delay going to the hospital, or if the usual initial screening tests performed at the hospital may not detect an early or atypical heart attack. Because of this, women have a higher risk of serious health problems after a heart attack.
It is important to if you have these symptoms. Early treatment can limit damage to your heart and can save your life.
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Do Women Of Color Need To Worry About Heart Attack Risk
Yes. All women need to be aware of their heart attack risk and take steps to prevent heart disease.
African-American, Hispanic, and American Indian or Alaska Native women often have more heart attack risk factors than white women.1,2 These risk factors can include obesity, lack of physical activity, high blood pressure, and diabetes.
African-American women are also more likely to have a heart attack and more likely to die from a heart attack compared with white women.3
Testing: What To Expect
The hours following a heart attack can be scary and confusing. Your medical team may be incredibly busy and focused, and hard-pressed to explain everything thats happening.
You and your caregivers are sure to have questions. You may wonder about the tests and procedures that are being performed.
In the section below, youll find descriptions of the kinds of diagnostic procedures you may encounter as your doctors strive to identify the underlying causes of your heart attack.
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Heart Attack In Women Over 50
After menopause, which generally occurs around age 50, your risk of heart attack increases. During this period of life, your levels of the hormone estrogen drop. Estrogen is believed to help protect the health of your heart, which could explain why the average age of first heart attack is roughly 5 years older in women than in men.
There are additional symptoms of a heart attack that women over the age of 50 may experience. These symptoms include:
- severe chest pain
A silent heart attack is like any other heart attack, except it occurs without the usual symptoms. In other words, you may not even realize youve experienced a heart attack.
The American Heart Association estimates that as many as 170,000 Americans experience heart attacks each year without even knowing it. Though less symptomatic than a full heart attack, these events cause heart damage and increase the risk of future attacks.
Silent heart attacks are more common among people with diabetes and in those whove had previous heart attacks.
Symptoms that may indicate a silent heart attack include:
- mild discomfort in your chest, arms, or jaw that goes away after resting
- shortness of breath and tiring easily
- sleep disturbances and increased fatigue
- abdominal pain or heartburn
- skin clamminess
What Should You Do If You Have Symptoms Of A Heart Attack
- . One Swiss study found that women wait almost 40 minutes longer to call for help than men do, perhaps because they dont recognize the symptoms. Older research shows that calling an ambulance is usually quicker than driving yourself to the ER. Thats because if they know youre coming, the hospital can prep for you, and you get care along the way.
- Lead with chest pain or pressure when you get to the hospital and the doctor asks about your symptoms. Even if you have other symptoms, Put that out first rather than burying it, advises Lichtman.
- Dont play down what youre feeling. Be the squeaky wheel, says Dr. Watson. Dr. Lichtman has done research showing that younger women who need care for a heart attack often dont want to look alarmist. Dont feel bad or think that you dont want to disturb anyone this is our job to save your life, Dr. Watson says.
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