February is American Heart Month
Knowing heart attack symptoms can save a life
By: Ramalingam Balamohan, M.D., Cardiologist

Heart disease is the number-one killer of both men and women in the United States. More than one million Americans suffer from heart attacks every year, according to the American Heart Association (AHA). You can reduce your risk by being knowledgeable about heart health.

Heart attacks can happen to anyone, regardless of age and fitness level. Each summer, there are tragic stories of seasoned athletes collapsing and dying due to an undetected heart condition. While advancing age and certain chronic health conditions are certainly risk factors, there are others.  It’s important to monitor your heart health, know your risk and take steps to prevent heart problems to help keep your heart healthy for life.

Not all heart attacks are recognized and treated, according to a recent study at Duke University Medical Center. These are referred to as silent heart attacks. Risk factors for silent heart attacks are the same as for regular heart attacks – smoking, diabetes, stress, and family history – and these heart episodes occur more frequently than physicians had previously thought. A study funded by the National Institutes of Health and published in April 2009 examined 185 patients who had never been diagnosed as having a heart attack but were at risk for coronary artery disease. Researchers found that 35 percent of these patients had evidence of a prior heart attack and that these asymptomatic heart attacks were three times more common than heart attacks that manifested themselves in more traditional ways; and they were more deadly, increasing the risk of death by 11 times in two years.

Individuals who suffered these silent attacks often experienced a symptom they did not attribute to heart trouble and also had another risk factor for heart disease, such as high cholesterol or high blood pressure.

Common heart attack warning signs
According to the AHA, heart attack warning signs typically begin slowly, with mild pain or discomfort. The AHA considers the following symptoms as warning signs of a heart attack:

• Chest discomfort, such as uncomfortable pressure, squeezing, fullness or pain
• Pain in one or both arms, the back, neck, jaw or stomach
• Shortness of breath, with or without chest discomfort
• Cold sweat, nausea or lightheadedness

Additional heart attack symptoms include: a weak feeling, sudden dizziness, a pounding heart, heavy perspiration, a feeling of impending doom and vomiting. Notably, women and men often experience different heart attack symptoms. Women are more likely to have non-traditional heart attack symptoms like fatigue, indigestion and sleep disturbances. Up to 43 percent of women experience no chest pain prior to or during a heart attack, according to research by the National Institutes of Health.

Men usually experience what we know as the “classic” signs of a heart attack as described above. Women suffering a heart attack sometimes experience chest pain, but not as frequently as men do – and they experience other symptoms that people don’t generally link to heart trouble: shortness of breath, nausea or vomiting, and back or jaw pain. Women also experience symptoms earlier, sometimes as long as a month or more before experiencing a heart attack; for men, symptoms come either right before or during a heart attack.

In a  2007 study of more than 500 women, 95 percent of participants reported experiencing new symptoms at least a month before their heart attack, including unusual fatigue, sleep disturbance and shortness of breath. Less than 30 percent of women studied experienced chest pains prior to the attack, and 43 percent had no chest pain during the attack. Other symptoms included indigestion and anxiety. The study was one of the first to examine the differences in the way men and women experience a heart attack.

Knowing the differences is important for many reasons. Women who experienced these non-traditional symptoms did not identify them as a heart attack and put off seeking medical attention – decreasing their chances for preventing, or surviving, the attack. The AHA estimates that about 95 percent of sudden cardiac arrest victims die before reaching the hospital.

Know your risk factors, and talk to your doctor today about steps you can take to educate yourself about heart health and any recommended health screenings based on your individual profile. Remember that symptoms may come and go. Even if you’re not sure if it’s a heart attack, it’s important to be checked by a doctor. New medications and treatments are now available that can stop some heart attacks in progress and save lives – but these drugs must be administered at the first sign of heart attack symptoms for maximum effectiveness.

During American Heart Month, take care of yourself and the ones you love. Knowing the symptoms of a heart attack and how to minimize its effects will help ensure that you and your loved ones are heart-healthy for many a Valentine’s day to come.