Yale University. US: Most people are familiar with chest pain as a symptom of heart attack. What are other signs?
There
can be a whole set of other signs. Chest discomfort is the most common.
Most people don’t describe it as pain, but as chest pressure or unusual
chest discomfort. Other signs include nausea, vomiting, profuse
sweating, neck discomfort, arm discomfort or heaviness, and back
discomfort.
How are the symptoms different for women?
Women
can present with non-specific symptoms. They say, “I don’t feel well.”
“Something is wrong, I’m short of breath.” Those kinds of symptoms. An
ER physician has to be suspicious and say, “This is a woman. She might
be having a heart attack.”
If you suspect you are having a heart attack, what should you do — or ask others to do?
If
you think there is a precipitating event, like snow shoveling, stop. Go
inside to someplace warm. Ask for help. Some individuals will drive
themselves to the ER department — that is not a good thing to do.
Instead, sit down, rest, and relax. Call 911. If you have a history of
heart disease, such as bypass or stenting, you probably have
nitroglycerin available. Also, use aspirin unless you have an aspirin
sensitivity. Chew four baby aspirin if you suspect a heart attack.
How would you know that you are at risk for heart attack? What are the risk factors?If
there is a family history of someone having a cardiac event at a young
age, under 50, you are at increased risk. If you are a smoker, diabetic,
or if you have documented high blood pressure or high cholesterol,
those factors significantly increase your risk.
The other risk is a
sedentary lifestyle. Individuals who are sedentary have a significantly
increased risk of heart attack precipitated by activity. It’s linked to
the degree of activity. For someone who exercises once a week or not at
all, the risk is higher than someone who exercises four times a week.
What steps can we all take to prevent or lower the risk of heart attack?
Obviously,
exercise regularly. Be careful with your weight. Obesity is associated
with a sedentary lifestyle. Treat the risk factors. If you have high
blood pressure or diabetes, make sure the condition is treated
aggressively. If you smoke, stop smoking. You can’t change your genes
but you can modify every other risk factor.
In winter, there’s a risk for heart attack related to shoveling snow. What’s the connection?
There
are studies that looked at geographic areas. Who gets a lot of snow?
New England, the Upper Midwest. They’ve also looked at the timing of
heart attacks. During the 1978 blizzard, there was an increase in heart
attacks. It’s thought to be related to a number of factors. We go out in
the morning and shovel snow. That is the time of day that people are at
the highest risk for heart attack. And that is thought to be related to
a rise in blood pressure and to an increase in blood viscosity and
platelets being more likely to aggregate (stick together) in the
morning.
Then there is the type of exercise. When you shovel show,
you’re using your arms and lifting heavy, often wet, snow — things you
may not be used to doing. Lifting heavy snow is very taxing to the
heart, causing a marked rise in heart rate and blood pressure. In
studies researchers have put young men on treadmills and compared it to
shoveling snow, and showed that snow shoveling after two minutes led to
the same heart rate increase as very vigorous treadmill activity. The
risk of dying of heart attacks with shoveling snow is much greater in
males. It’s reported to be three times greater in males than in females.