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Heart Attack or Indigestion?
When it comes to a heart attack, timing is everything. It can mean the difference between life and death. Ignoring chest pain can be as much of a risk factor in heart attacks as elevated cholesterol or high blood pressure. Denial and delay may cause severe damage to the vital heart muscle, prevent full recovery and, in many instances, result in death.
What is a Heart Attack?
According to Paul D. McWhirter, MD, FACC, a cardiologist on staff at Mt. Diablo Medical Center, a heart attack occurs when the blood supply to part of the heart muscle is severely reduced or stopped. This happens when one or more of the coronary arteries supplying blood to the heart muscle is blocked by a build-up of fat-like substances called "plaque."
The plaque can eventually burst, tear or rupture, creating a "snag" where a blood clot forms and blocks the artery. This leads to a heart attack. If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die.
"Heart attacks treated within the first hour offer the best outlook," explains Matthew S. DeVane, DO, MBA, FACC, a cardiologist on staff at John Muir Medical Center. "The earlier we can diagnose and treat a heart attack, the more likely we are to save heart function and minimize damage."
"That's why it's so important to know the warning signs of a heart attack," Dr. DeVane adds. "And know where and how to get quick, professional help."
What are the Warning Signs?
The most common signals are:
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
- Pain that spreads to the shoulders, neck or arms.
- Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath.
- Nausea or dizziness (without chest pain).
- Shortness of breath and difficulty breathing (without chest pain).
- Unexplained anxiety, weakness or fatigue.
- Palpitations, cold sweat or paleness.
"A heart attack is not the same for everyone," Dr. DeVane says. "All of these signs don't occur in every heart attack. Any one of these symptoms may be your only warning.
"Never take chest pain lightly," he adds. "It's often a warning sign of a heart attack. Dial 911 and get to the Emergency Department immediately."
What are the Risk Factors?
The American Heart Association has identified several risk factors for a heart attack. Some can be modified, treated or controlled, and some can't. The more risk factors you have, the greater your chance of developing heart disease. Major risk factors that can't be changed include:- Increasing age—About four out of five people who die of heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them.
- Gender—Men's risk of heart attack is higher than that of women who are menopausal. However, for post-menopausal women, the risk is just as high as men's. Heart disease is the number one cause of death among post-menopausal women.
- Heredity—Children of parents with heart disease are more likely to develop it themselves. African Americans have more severe high blood pressure than Caucasians, and a higher risk of heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans.
- Tobacco smoke—Smokers' risk of heart attack is more than twice that of nonsmokers. Smokers who have a heart attack are more likely to die and die suddenly (within an hour).
- High blood cholesterol—As blood cholesterol rises, so does risk of heart disease. When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more.
- High blood pressure—This increases the heart's workload, causing the heart to enlarge and weaken. It also increases the risk of heart attack, stroke and congestive heart failure. When combined with obesity, smoking, high blood cholesterol levels or diabetes, the risk of heart attack increases.
- Physical inactivity—An inactive lifestyle is a risk factor for heart disease. Regular, moderate-to-vigorous physical activity helps prevent heart attacks.
- Obesity—People who have excess body fat are more likely to develop heart disease, even if they have no other risk factors.
- Diabetes mellitus—Even when glucose levels are under control, diabetes greatly increases the risk of heart disease and stroke.
Can You Prevent a Heart Attack?
"The best way to maintain a healthy heart and prevent a cardiac event is to positively modify those risk factors you can control," says Dr. McWhirter. "Don't smoke. Eat a healthy, low-fat diet. If you're diabetic, keep it in control. Maintain a normal weight. And exercise to a level that is aerobic.
"A heart attack can literally kill you in a heartbeat," Dr. McWhirter adds. "Yet simple lifestyle changes can help prevent a heart attack before it happens."
(Posted December 15, 2004)