Symptoms

What are the symptoms of a heart attack?
According to the American Heart Association, heart attack symptoms include:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
• Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath. May occur with or without chest discomfort.
• Other signs. These signs may include breaking out in a cold sweat, nausea or lightheadedness.

I have heard doctors talk about “atypical” symptoms of a heart attack. What are atypical symptoms?
A heart attack can be preceded by typical (usual) or atypical (unusual) symptoms. Typical symptoms include chest pain felt under the sternum (breast bone) or to the right or left of the chest. People describe this pain as an uncomfortable pressure, fullness, heaviness or squeezing feeling. Often this chest pain or discomfort spreads to one or both arms or shoulders, neck, jaw or upper back. Atypical symptoms are ones that do not include chest pain. Atypical symptoms include one or more of the following: pain or discomfort in the upper abdomen or back between the shoulder blades; one or both arms or shoulders; unexplained weakness or extreme fatigue; or shortness of breath. People describe atypical symptoms as indigestion or gas-like fullness or burning. Both typical and atypical heart attack symptoms can be accompanied by shortness of breath, sweating, lightheadedness, nausea or vomiting, or feelings of impending doom. Nearly 50% of women may experience less typical symptoms, and chest pain may be absent.

I am 45 years old with a strong family history of heart disease. Lately I have been experiencing vague symptoms including tiredness and discomfort between my shoulder blades. Should I be concerned?
You are right to be concerned. The symptoms you describe are similar to the early warning signs of a heart attack referred to as prodromal symptoms. These vague symptoms come and go and are easily attributed to stress or lack of sleep. They include mild chest, shoulder or upper-back discomfort, indigestion, or shortness of breath; unusual fatigue; and sleep disturbances. In fact, 90% of women experience prodromal symptoms in the days or weeks preceding a heart attack. Make an appointment to see your primary care physician, even if you think your symptoms are vague and not serious ones.

What should I do if I experience symptoms that could signal a heart attack?
Call 9-1-1 and get to the emergency room quickly to minimize possible damage to the heart muscle. Consider taking aspirin at the first sign of heart attack symptoms.

I have had heartburn & indigestion for three days now without any relief with antacids. The pain goes all the way into my back. Although I am only 29, I am concerned I may be having heart attack warning symptoms, especially because I smoke.
Sometimes it is very hard to tell the difference between indigestion and heart attack symptoms because they are so similar. This similarity occurs because the stomach and esophagus lie so close to the heart. Heartburn or indigestion is a feeling of burning, warmth, heat or pain that often starts in the upper abdomen just beneath the lower breastbone (sternum) and ribs. This discomfort may spread in waves upward into the throat. A sour taste in the mouth may occur with this burning sensation. You may also have burping, nausea, bloating or difficulty swallowing.The discomfort and pain of heartburn can last up to two hours and sometimes longer. Often these symptoms are worse after eating. Usually the symptoms get worse by lying down or bending over and are relieved by sitting or standing up. See your doctor to find out if your symptoms are from indigestion or from another serious medical problem such as coronary artery disease. Quitting smoking is highly recommended, as it is not only harmful to the heart but causes chronic lung disease and many types of cancers.

I am 40 years old and for the past few months I have been waking up every other night or so with a racing heart. I'm very anxious during the episode, which lasts about 10-15 minutes. I also experience slight stomach discomfort, which soon passes. Could something be wrong with my heart or is it anxiety?
Sometimes heart arrhythmias occur resulting in the type of symptoms you describe. An arrhythmia is a change in the regular beat of the heart. When an arrhythmia occurs a number of sensations can be experienced. The heart can feel like it is skipping a beat or it can feel as if it is beating irregularly, very fast or very slowly. Many times, there is no recognizable cause of an arrhythmia. Caffeine, tobacco, alcohol, cough and cold medicines, diet pills, lack of sleep and stress are common culprits to consider and modify. Heart disease may cause arrhythmias too.You should discuss your symptoms with your primary care physician.

My 65-year-old mother seems to get more tired and out of breath doing routine activities over the past six months. For the last two weeks, she has also developed swelling in both her legs. Her only medical problem is high blood pressure. Could this be related to the heart?
These symptoms suggest that your mother may have heart failure. Heart failure occurs when the heart muscle is weakened and can no longer pump as much blood as the body needs. CAD and heart attack are common causes of heart failure in men. In women, high blood pressure is the most common cause. The body tries to compensate for this reduced pumping ability by retaining salt and water. This process increases the total amount of blood returning to the heart and causes the heart to enlarge. Unfortunately, if left untreated, heart failure worsens over time. The first symptoms of heart failure are due to insufficient blood supply to the body leading to fatigue, weakness and lightheadedness. Eventually, blood backs up in the blood vessels leading to the heart and cause worsening signs of heart failure. These symptoms are shortness of breath with activity or at rest, awakening feeling short of breath, weight gain and swelling of the feet, ankles or abdomen. Your mother needs to see her physician to determine the cause of her symptoms and begin treatment right away.