Pay attention to early symptoms of heart attacks
During a health education talk to seniors, I posed a couple of questions.
“What is the commonest symptom you feel in the early stage of a heart attack?” Most answered, “It’s chest pain, right?”
My next one, directed mainly to women in the audience, was, “What is the commonest cause of death among women in the U.S.?”
“Breast cancer,” said a few; some others felt it would be uterine or ovarian cancer. When I told them both answers were wrong they were surprised.
The number one cause of death in the United States is still heart disease — more specifically coronary heart disease (CHD) that results in heart attacks. Yes women, too, are far more likely to die of CHD than from any form of cancer. This despite all the recent advances including technologic innovations and new drugs to combat the disease.
Approximately 600,000 lives are lost every year from CHD. The sad part is that about 335,000 of them are sudden deaths, many of which could have been prevented if only the victims paid attention to early warning symptoms. Most of these sudden cardiac arrests happen at home, and almost 60 percent are witnessed, according to researchers. This means, if a relative or a friend who saw the event had the ability to give CPR, a life could have been saved. So it’s very important every one of us receive training in CPR.
During the early stage of a heart attack, most patients feel a degree of tightness in the mid chest, behind the sternum. There is a common myth that all heart attacks are manifested by severe chest pain. Some feel more of a suffocation and others may say, “I feel like an elephant is sitting on my chest.” Many experience only nagging chest discomfort or a feeling of indigestion. Of course, crushing chest pains do occur and obviously should not be neglected. The symptoms of tightness or discomfort may radiate to the jaws, left shoulder or along the inside of the left arm and at times are accompanied by cold, drenching sweats. However, if the chest pains are more localized to the left side of the chest and sore to touch, they are likely to be non-cardiac in origin.
Symptoms are a bit different in women, so they do need to recognize this variation, as heart disease is becoming more and more prevalent among older women. Instead of the typical chest tightness, they might feel only a little discomfort, which often may radiate to the back instead of the left arm. Some only complain of indigestion and look for antacids. They could even have right arm pain and experience some shortness of breath, nausea, vomiting and a feeling of light-headedness. One of my patients came to the office complaining of unusual fatigue for a day; the cardiogram showed the tell-tale signs of a heart attack which necessitated immediate hospitalization. According to a New York Presbyterian Hospital study, 50 percent of women were reluctant to call 911 even when they thought they were having a heart attack!
A few facts about the early stage of heart attacks should be kept in mind. Once the process of heart attack begins the heart muscle starts losing its blood supply fast and the heart can stop at any minute. Once that happens, the patient will lose consciousness in 10 seconds. This is when CPR is needed, so you have no time to lose. And brain damage can occur within three minutes after the heart stops pumping blood. Often a chaotic heart rhythm called ‘ventricular fibrillation’ or VF is the reason for cardiac arrest and this can be corrected by an electric shock given through a defibrillator machine. In recent years, small portable defibrillators called “AEDs” or automated external defibrillators have become available. Thanks to the American Heart Association, AEDs often are prominently displayed wherever large numbers of people congregate, such as at airports, convention centers, sports stadiums, auditoriums, health fitness facilities, etc.
The modern treatment of a heart attack in progress is totally different from what it used to be. “Time is muscle” is the golden principle in cardiology, and it means by opening the clogged artery immediately by angioplasty followed by a stent placement and restoring the blood flow the heart muscle damage can be contained and give the person a chance for near complete recovery. All our local hospitals have the capability to do emergency angioplasty.
Here is an important caveat: Should you ever suspect that what you feel may be the early symptom of a heart attack, please call 911. Never drive to the local hospital yourself or get your friend to take you there. Ambulance crews are equipped to deal with all emergencies during transportation and they will communicate with the emergency room about the progress. Pop a baby aspirin into the mouth and take a sublingual nitro pill if available. Reaching the hospital in time is critical so that doctors can give emergency treatment without delay. Many a person has fainted or even suffered a full cardiac arrest while driving.
All of us need to take the early symptoms of heart attacks seriously and take appropriate action. That literally would mean the difference between life and death.
M. P. Ravindra Nathan is a cardiologist at Crescent Community Clinic in Spring Hill. He is the author of “Stories From My Heart.”
