Recognizing Heart Attack Symptoms

Heart disease is the leading cause of death in the United States. Of all the major forms of heart disease a heart attack, or myocardial infarction, causes the majority of deaths. In the U.S. every year around 650,000 people experience their first symptoms of a heart attack or their first myocardial infarction; another 450,000 suffer their second or third one.

The majority of deaths from a heart attack occur during the initial period after symptoms begin: approximately 60% within the first hour and 40% just before they reach the hospital. Increasing public awareness of the symptoms of a heart attack, the importance of seeking immediate medical attention, and training in CPR techniques are vital to decrease deaths due to heart attack.

People without preexisting coronary heart disease normally don't suffer from heart attacks. Those who do have a form of heart disease or exhibit the risk factors should all be cognizant of the signs of a heart attack. These include age, gender, race, heredity, smoking, obesity, high blood pressure, diabetes, and a sedentary lifestyle.

The most classic symptom of a heart attack is chest pain. The chest pain due to a myocardial infarction is more severe than anginal pain. Angina is chest pain brought on by exercise and relieved with rest. Chest pain associated with a heart attack is usually sudden, is continuous and is not usually associated with any type of activity. The majority of heart attacks occur in the morning.

The chest pain is often described as crushing and severe; as a pressure, heavy or squeezing sensation; or as a chest tightness or burning. The pain often begins in the center of the chest, and may radiate to the shoulders, neck, jaw, or arms. It lasts more than 15 to 20 minutes and is not relieved by rest or nitroglycerin.

Women and older adults often experience atypical chest pain. That is pain that feels more like indigestion, heartburn, nausea, and vomiting. Around 25% of people who have a heart attack say they did not experience any chest discomfort or pain.

Compensatory mechanisms cause many of the other symptoms of a heart attack. Sympathetic nervous system stimulation causes anxiety, tachycardia (rapid heart beat), and vasoconstriction (a narrowing of the blood vessels). This results in cool, clammy, mottled skin. Pain and blood chemistry changes stimulate the respiratory center, causing tachypnea (increased respiration rate).

Sufferers of heart attacks also have a sense of impending doom and death. Tissue death causes an inflammatory reaction that increases the white blood cell count and elevates temperature. Serum cardiac enzyme levels rise as enzymes are released from dead heart cells.

Other symptoms may develop and they vary depending on the amount of heart tissue that has died. High or low blood pressure or signs of heart failure may develop. Stimulation of the vagal nerve can cause nausea, vomiting, bradycardia (slow heart beat), and low blood pressure. Hiccups can develop due to irritation of the diaphragm and if a large enough blood vessel is occluded the first sign of a heart attack can be sudden death.

Recognizing the symptoms of a heart attack is the first line of defense in surviving one. The sooner a heart attack victim can get to the emergency room the greater their chance of survival.