What is a heart attack?
The term “heart attack” is used by the general population to describe the medical condition referred to as myocardial infarction or MI.
Myocardial infarction is the leading cause of death in the United States, and about 610,000 people die every year because of it and/or one of its complications.
When you present to the emergency department (ED) with a suspected heart attack, your doctor will do a quick history and physical exam, he/she will then order an EKG (electrocardiogram) and some lab tests to confirm the diagnosis.
In summary, the diagnosis of an MI is both clinical and paraclinical at the same time.
Why does it happen?
The pathogenesis of a heart attack is quite complicated; it’s a combination of nature and nurture.
The nature part includes the factors we have no control over, such as genetic predisposition, gender, and age.
The nurture part is the side of the equation we can modify, which is why they’re called the modifiable risk factors. These include smoking, uncontrolled diabetes, uncontrolled blood hypertension, high LDL (bad cholesterol) levels, obesity, and sedentary life.
In summary, in the presence of one or more of these risk factors, a fatty structure (called the atheromatous plaque) will form inside your blood vessels; more specifically, inside a blood vessel called the coronary artery, which is responsible for delivering blood to the heart muscle.
When the coronary artery is completely obstructed, blood can’t reach some parts of the heart. As a result, the area without any blood supply, will suffer what’s called ischemia and eventually, die. And that, in a nutshell, is what happens during a heart attack.
8 early signs of a potential heart attack that shouldn’t be ignored
The heart muscle is strong enough to withhold the lack of oxygen and nutrients for some time; moreover, the coronary artery won’t get obstructed overnight.
In fact, this process is believed to take decades before it becomes clinically apparent.
Because of this, there will be warning signs before an actual heart attack occurs, which is the main topic of this article. By recognizing these early signs, you’ll be able to act quickly and go to the ED.
This can make the difference between life and death, and as the scientific community says: Time is Muscle.
Chest pain or discomfort
This is the most common presenting symptom before and during a heart attack. As we’ve mentioned earlier, your heart is a muscle, and just like any other muscle, it hurts when it has a shortage in blood supply.
The pain is usually described as having an elephant sitting on your chest; however, it is not present in every patient who’s about to have a heart attack.
Nevertheless, the pain usually lasts more than a few minutes and is not reduced by resting or any other measure.
If the pain is located in one spot or if it hurts more when you press with your finger on one area, it’s unlikely to be a heart attack.
What does stomach pain have to do with a heart attack? Well, there are many arterial branches that provide blood supply to the heart; when the lower part of the heart is suffering from ischemia, the pain radiates to a region called the epigastric region, which is basically where your stomach -the organ- is located.
For this reason, if you go to the ED, any patient who presents with epigastric pain will get an EKG to eliminate a heart problem.
However, healthy young patients with fewer risk factors of heart disease are highly unlikely to have a heart problem when presenting with stomach pain.
Pain in your arm
The human anatomy is quite complex; for instance, the nerves coming from the left arm and the nerves coming from the heart, both enter the spinal cord at the same level.
As a result, when your heart muscle is sending alert signals to your brain, the latter can’t tell exactly the origin of those signals, and that’s why you feel pain in your arm while the real damage is done to your heart.
If you have the risk factors mentioned above and you experience pain and numbness in your left arm, you should visit the ED as soon as possible.
Pain in your jaw
Similar to arm pain, you might experience jaw pain and numbness when your heart’s blood vessels are obstructed.
Jaw pain alone isn’t something to worry about, as it’s normally caused by a muscular injury. However, if it’s accompanied by chest pain and/or arm pain, it might be an early sign of a potential heart attack.
Even though most people don’t think about, breaking out in sweat could be a warning sign that you’re about to have a heart attack.
Sweating alone is rarely something to worry about; however, if you have multiple risk factors for heart disease (especially diabetes), and you’re a woman, caution is important.
Studies have shown that diabetic women might have a full episode of myocardial infarction with no pain whatsoever; the only presenting signs could be fatigue and sweating.
Getting tired quickly
Although fatigue could be an early sign of an MI in diabetic women, sometimes it’s more than that. Getting tired quickly could be a sign of heart failure, which may eventually lead to a heart attack.
If you find yourself suddenly getting tired when climbing the stairs or when doing a simple walk, it might be worth to get an appointment with your primary care physician to undergo a better evaluation.
Dyspnea (difficulty breathing)
Dyspnea is one of the major symptoms that patients with heart failure present with; when your heart is unable to pump the blood promptly anymore, it will back off to your lungs. This will drown your lungs in fluids, which will make your breathing extremely difficult.
Another consequence of heart failure is the inability to appropriately provide oxygen and nutrients to the heart itself, which can be the first step towards a full-blown myocardial infarction.
Every one of us has experienced some heartbeat irregularities at some point; however, this shouldn’t happen too often.
If you feel your heart beating in an irregular fashion, there might be an electrical problem going on inside.
One of the most common arrhythmias (irregular heart rhythm) is atrial fibrillation or A-fib. This condition is characterized by irregular electrical activity in the atrium (the upper room of the heart), leading to chaotic contractions.
It has a simple treatment and can easily be managed by your physician.
Ignoring this symptom can lead to dire consequences, including a cardiac arrest (heart attack) and death.