Heart Attack Questions and Answers
By Dr. Sanjay K. Gandhi
Heart Attack Symptoms
How Do I Know If I'm Having A Heart Attack?
Chest pain is a major symptom of a heart attack or myocardial infarction, which occurs when blood flow to the heart is blocked, preventing enough oxygen from getting to the heart muscle. The heart muscle then dies or becomes permanently damaged.
Most heart attacks result from a severe blockage in a coronary artery, a blood vessel that provides oxygenated blood to the heart muscle.
If you are suffering from a heart attack, you may feel pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area or back. The pain can be severe or mild. The discomfort can feel like pressure, squeezing, fullness or pain.
Other heart attack symptoms might include: a tight band around your chest, bad indigestion, something heavy sitting on your chest, uncomfortable squeezing or heavy pressure, light-headedness, or pain that spreads to your shoulders, neck, arms, back, jaws or teeth.
Additional heart attack symptoms may include: anxiety, coughing, fainting, light-headedness, dizziness, nausea or vomiting, heart palpitations, shortness of breath, sweating (which may be extreme), unusual fatigue, or back pain.
Some, often women or the elderly, may have little or no chest pain, or they may experience less common heart attack symptoms such as shortness of breath, fatigue or weakness.
A heart attack is not the only cause for chest pain, but if you have chest pain and think you may be having a heart attack, seek immediate medical help. Call 911 immediately. Don’t try to drive yourself to the hospital.
How Can I Tell If My Chest Pain Or Symptoms Are Not A Heart Attack?
Because the causes of chest pain can range from mild to serious to life-threatening, getting your chest pain checked is very important. Other organs or tissues can be the source of your pain, including your lungs, esophagus, muscles, ribs, tendons, or nerves.
Other causes of chest pain include:
- Angina, which occurs because your heart is not getting enough blood and oxygen and which can feel similar to heart attack pain
- Asthma, which is generally accompanied by shortness of breath, wheezing or cough
- Pneumonia, a blood clot to the lung, the collapse of a small area of a lung, or inflammation of the lining around the lung (chest pain often worsens when you take a deep breath or cough and usually feels sharp)
- Strain or inflammation of the muscles and tendons between the ribs
- Anxiety and rapid breathing
- Problems with your digestive system such as stomach ulcers, gallbladder disease, gallstones, indigestion, heartburn or gastroesophageal reflux (when acid from your stomach backs up into your esophagus)
Heart Attack Diagnosis
How Is A Heart Attack Diagnosed?
Diagnosing a heart attack is based on assessing you, changes on your electrocardiogram tracings, and abnormalities on your blood tests. Your health care provider will perform a physical exam. Your doctor may hear abnormal sounds in your lungs (“crackles”), a heart murmur, or other abnormal sounds. You may have a rapid pulse. Your blood pressure may be normal, high, or low.
Patients will undergo certain tests. The first test is often an electrocardiogram (ECG) – a tracing of the heart’s electrical activity and rhythm. It is performed at your bedside and may be repeated several times.
A series of blood tests will also be performed that can help show if you have substances produced by heart tissue damage or if you have a high risk for heart attack.
Additional tests may be performed to help evaluate the heart and heart circulation, including cardiac catheterization and coronary angiography, echocardiogram (ultrasound of the heart), CT scan and MRI scan.
Heart Attack Treatment
What Is The Treatment For a Heart Attack?
Depending on ECG results, certain patients may undergo cardiac catheterization to open up a blocked coronary artery (angioplasty), and possibly have a coronary stent placed.
Angioplasty with stenting can be a life-saving procedure if one is suffering from a large heart attack. If a patient goes to a hospital that does not perform cardiac catheterization and coronary stenting, then a special “clotbusting” medicine may be given.
Many different medicines are used to treat and prevent heart attacks. Nitroglycerin helps reduce chest pain. You may also receive strong medicines to relieve pain. Antiplatelet medicines help prevent clot formation. Aspirin is an antiplatelet drug, and is given to all patients who may be having a heart attack. Another antiplatelet drug that may be given is clopidogrel. Beta-blockers help reduce the strain on the heart and lower blood pressure. ACE inhibitors are used to prevent heart failure and lower blood pressure. Lipid-lowering medications, especially statins, reduce blood cholesterol levels to prevent plaque from increasing. They may reduce the risk of another heart attack.
Once you have been stabilized with medications, angioplasty may still be needed to open blocked coronary arteries. Some people may need coronary artery bypass surgery (CABG). With CABG, the surgeon takes either a vein or artery from another location in your body and uses it to bypass the blocked coronary artery.
Dr. Sanjay Gandhi is an interventional cardiologist at Wake Forest Baptist Health. You may request an appointment online or by calling 888-716-WAKE.