What is a heart attack?

Heart attack, or myocardial infarction, is the number one killer of both men and women in the U.S. Each year, about 735,000 Americans suffer a heart attack, and heart disease is the leading cause of death for both men and women in the US. Most of the deaths from heart attacks are caused by ventricular fibrillation of the heart that occurs before the victim of the heart attack can reach an emergency room. Those who reach the emergency room have an excellent prognosis; survival from a heart attack with modern treatment should exceed 90%. The 1% to 10% of heart attack victims who die later include those victims who suffer major damage to the heart muscle initially or who suffer additional damage at a later time.

Fortunately, procedures such as coronary angiogram andPTCA (coronary balloon angioplasty), and clot dissolving drugs are available that can quickly open blocked arteries in order to restore circulation to the heart and limit heart muscle damage. In order to optimally benefit heart attack victims and limit the extent of heart damage, these treatments to open blocked arteries should be given early during a heart attack. Blood pressure is not a reliable measurement of whether one is having a heart attack. Blood pressure during a heart attack can be low, normal, or elevated.

Heart Attack illustration - Myocardial Infarction

Quick GuideHeart Disease: Symptoms, Signs, and Causes

Heart Attack Symptoms and Signs in Women

The classic symptoms of heart attack include a feeling of extreme pressure on the chest and chest pain, including a squeezing or full sensation. This can be accompanied by pain in one or both arms, jaw, back, stomach, or neck. Other symptoms of heart attack include shortness of breath, nausea, vomiting, lightheadedness, and a feeling of breaking out in a cold sweat. Although chest pain and pressure are the characteristic symptoms, women are somewhat more likely than men to experience heart attack that does not occur in this typical fashion. Instead, some women with heart attacks may experience more of the other symptoms, like

lightheadedness,
nausea,
extreme fatigue,
fainting,
dizziness, or
pressure in the upper back.

Cardiac arrest vs. heart attack

Sometimes there is confusion between the terms "cardiac arrest" and "heart attack." A heart attack, or myocardial infarction, is damage to the heart muscle that occurs due to reduced blood flow to the heart muscle, depriving the heart muscle of the oxygen it needs to function properly. Cardiac arrest means that the heart stops beating and death is imminent. A heart attack, if severe, can lead to cardiac arrest, and this is what occurs when a heart attack is fatal. However, other conditions, such as serious arrhythmias or shock, can also cause cardiac arrest.

What is a "silent" heart attack?

Approximately one quarter of all heart attacks are silent, without chest pain or new symptoms and silent heart attacks are especially common among patients with diabetes mellitus).
Even though the symptoms of a heart attack at times can be vague and mild, it is important to remember that heart attacks producing no symptoms or only mild symptoms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Too often patients attribute heart attack symptoms to "anxiety," "indigestion," "fatigue," or "stress," and consequently delay seeking prompt medical attention. One cannot overemphasize the importance of seeking prompt medical attention in the presence of symptoms that suggest a heart attack. Early diagnosis and treatment saves lives, and delays in reaching medical assistance can be fatal. A delay in treatment can lead to permanently reduced function of the heart due to more extensive damage to the heart muscle. Death also may occur as a result of the sudden onset of arrhythmias such as ventricular fibrillation.

What does a heart attack feel like?

Knowing the early warning signs of heart attack is critical for prompt recognition and treatment. Many heart attacks start slowly, unlike the dramatic portrayal often seen in the movies. A person experiencing a heart attack may not even be sure of what is happening. Heart attack symptoms vary among individuals, and even a person who has had a previous heart attack may have different symptoms in a subsequent heart attack. Although chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a diversity of symptoms. The following list describes the symptoms of heart attack in more detail.

Heart attack warning signs and symptoms: chest, head, jaw, and tooth pain

Chest discomfort, manifest as pain, fullness, and/or squeezing sensation of the chest

Chest pain is the hallmark symptom of a heart attack, although it can take many different forms. In other cases, chest pain may not occur at all. The characteristic chest pain of a heart attack has been described as a sense of pressure, squeezing, fullness, or pain that starts in the center of the chest. The pain or discomfort typically lasts more than a few minutes, or it may go away and then return. It can spread down the arms, to the back, or to the head and neck. Both women and men report chest pain as a primary symptom of heart attack, but women more often than men are likely to have some of the other symptoms, such as nausea, jaw pain, or shortness of breath, that are described below.

Jaw pain, toothache, headache

The pain of a heart attack can spread down both arms, to the jaw or head, or to the back. Some people report tooth pain or headache as a symptom of a heart attack. It is possible to have these types of pain without chest pain during a heart attack.

Shortness of breath

Feeling short of breath or like you are gasping for air is a common symptom of a heart attack. Shortness or breath, or difficulty breathing, is medically known as dyspnea. Shortness of breath may occur before or during the chest pain of a heart attack, and in some cases, it may be associated with other heart attack symptoms without any chest pain.

Heart attack warning signs and symptoms: digestive problems

Nausea

Nausea or feeling sick on your stomach is a less common but possible symptom of heart attack. Sometimes belching or burping can accompany the nausea, and some patients have described a feeling like indigestion associated with a heart attack. Women are more likely than men to report these less typical symptoms of heart attack, and some patients have described feeling as though they are developing the flu.

Vomiting

The nausea that accompanies a heat attack can become so severe that vomiting occurs.

General epigastric (upper middle abdomen) discomfort

Sometimes the pain of heart attack is described as stomach pain, or pain in the middle of the upper abdomen. The pain usually feels more like discomfort of heaviness rather than sharp, stabbing pain, and the pain tends to persist more than a few minutes. This can occur with or without pain in the true chest area.

Heartburn and/or indigestion

As mentioned previously, some people experiencing a heart attack can have belching and burping and describe a feeling of indigestion. Likewise, the pain and pressure of a heart attack may occur in the epigastric or upper middle abdominal area, similar to the pain of heartburn.

Other heart attack early warning signs and symptoms

Arm pain (more commonly the left arm, but may be either arm)

The chest pain of a heart attack can spread, or radiate, down one or both arms and to the shoulders. This often happens, and the pain may even extend to the wrist and fingers. This is most common on the left side of the body but it can also occur on the right side.

Upper back pain

The upper back is another common location for spread of the pain from a heart attack. Most commonly, back pain that stems from a heart attack is described as occurring between the shoulder blades.

General malaise (vague feeling of illness)

A feeling of being generally unwell or like you are coming down with an illness can accompany a heart attack. This can be described as fatigue or even lightheadedness, with or without fainting. Some people will experience severe anxiety or panic during the heart attack. This has been described as feeling a sense of doom, as one experiences with a panic attack.