How do you Recognize a Heart Attack?

We are hearing more frequently that heart disease and kidney disease are closely related. Since my husband suffered a recent heart event, I thought it would be useful--from the perpective of a family doctor and a Home Dialysis caregiver--to discuss the common signs and symptoms of an acute heart attack.

The classic symptoms are well-known:  severe chest pain, often described as tightness, a full feeling, a vice grip, pressure, heaviness, or "the elephant on the chest."

But here are some other symptoms which may signal a heart attack:

• Pain in the jaw or neck
• Pain in the shoulders or down an arm
• Shortness of breath, particularly with exertion.
• Lightheadedness/dizziness
• Irregular heart rate or heart rate that is particularly fast or slow
• Indigestion, nausea and vomiting

But, as always in medicine, it's not always predictable. In medical school, I remember learning "If there are symptoms from the nose to the knees, think heart!"

Women's symptoms may be different. For example, I've had two women in my practice whose only symptoms of heart attack were pain in the forearms!

Any exertional symptoms, such as pain or shortness of breath with physical activity, may be a warning sign. Unusual or unexplained exhaustion, pallor, breaking our in a cold sweat are other possible symptoms.

I've read that a sense of impending doom or unexplained anxiety can signal a heart attack. And even DENIAL can be a symptom!

The take-home message is this. If you or your loved one is at risk for heart attack, and you have chest symptoms--or any of the other symptoms listed above--get help. Call 911. Remember that a false alarm is far better than a missed opportunity to get the help you need.

Take care. Linda Gromko, MD