Heart attacks don't always strike out of the blue -- there are many
symptoms we can watch for in the days and weeks leading up to an attack.
But the symptoms may not be the ones we expect. And they can be
different in men and women, and different still in older adults. Last
year, for example, a landmark study by the National Institutes of Health
(NIH) published in Circulation: Journal of the American Heart Institute
found that 95 percent of women who'd had heart attacks reported
experiencing symptoms in the weeks and months before the attack -- but
the symptoms weren’t the expected chest pain, so they went unrecognized.
Don't let that happen to you. Here, 10 heart symptoms you're likely to ignore -- and shouldn't.
1. Indigestion or nausea
One of the most oft-overlooked signs of a heart attack is nausea and stomach pain. Symptoms can range from mild indigestion to severe nausea, cramping, and vomiting. Others experience a cramping-style ache in the upper belly. Women and adults over age 60 are more likely to experience this symptom and not recognize it as tied to cardiac health.
Most cases of stomach ache and nausea aren't caused by a heart attack, of course. But watch out for this sign by becoming familiar with your own digestive habits; pay attention when anything seems out of the ordinary, particularly if it comes on suddenly and you haven't been exposed to stomach flu and haven't eaten anything out of the ordinary.
A telltale sign: The pain comes and goes, rather than persisting unrelieved, as a pulled muscle would. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then after that it might have moved to your ear and jaw. If you notice pain that seems to move or radiate upwards and out, this is important to bring to your doctor’s attention.
The key here is that the fatigue is unusually strong -- not the kind of tiredness you can power through but the kind that lays you flat out in bed. If you're normally a fairly energetic person and suddenly feel sidelined by fatigue, a call to your doctor is in order.
In last year's NIH study, more than 40 percent of women heart attack victims remembered experiencing this symptom. A common description of the feeling: "I couldn't catch my breath while walking up the driveway."
Patients often report the feeling as one of being "keyed up" and wound tight; they remember lying in bed with racing thoughts and sometimes a racing heart. In the NIH report, many of the women surveyed reported feeling a sense of "impending doom," as if a disaster were about to occur. If you don't normally have trouble sleeping and begin to experience acute insomnia and anxiety for unexplained reasons, speak with your doctor.
If you experience severe flu-like symptoms that don't quite add up to the flu (no high temperature, for example), call your doctor or advice nurse to talk it over. Watch out also for persistent wheezing or chronic coughing that doesn't resolve itself; that can be a sign of heart disease, experts say. Patients sometimes attribute these symptoms to a cold or flu, asthma, or lung disease when what's happening is that poor circulation is causing fluid to accumulate in the lungs.
Some patients confuse these episodes with panic attacks. Rapid pulse and heartbeat that aren't brought on by exertion always signal an issue to bring to your doctor's attention.
A good rule of thumb, experts say, is to watch for clusters of symptoms that come on all at once and aren't typical of your normal experience. For example, a normally alert, energetic person suddenly begins to have muddled thinking, memory loss, deep fatigue, and a sense of being "out of it." The underlying cause could be something as simple as a urinary tract infection, but it could also be a heart attack. If your body is doing unusual things and you just don't feel "right," don't wait. See a doctor and ask for a thorough work-up.
And if you have any risk factors for cardiac disease, such as high blood pressure, high cholesterol, smoking, or family history of heart disease, make sure the doctor knows about those issues, too.
Don't let that happen to you. Here, 10 heart symptoms you're likely to ignore -- and shouldn't.
1. Indigestion or nausea
One of the most oft-overlooked signs of a heart attack is nausea and stomach pain. Symptoms can range from mild indigestion to severe nausea, cramping, and vomiting. Others experience a cramping-style ache in the upper belly. Women and adults over age 60 are more likely to experience this symptom and not recognize it as tied to cardiac health.
Most cases of stomach ache and nausea aren't caused by a heart attack, of course. But watch out for this sign by becoming familiar with your own digestive habits; pay attention when anything seems out of the ordinary, particularly if it comes on suddenly and you haven't been exposed to stomach flu and haven't eaten anything out of the ordinary.
2. Jaw, ear, neck, or shoulder pain
A sharp
pain and numbness in the chest, shoulder, and arm is an indicator of
heart attack, but many people don't experience heart attack pain this
way at all. Instead, they may feel pain in the neck or shoulder area, or
it may feel like it’s running along the jaw and up by the ear. Some
women specifically report feeling the pain between their shoulder
blades.A telltale sign: The pain comes and goes, rather than persisting unrelieved, as a pulled muscle would. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then after that it might have moved to your ear and jaw. If you notice pain that seems to move or radiate upwards and out, this is important to bring to your doctor’s attention.
3. Sexual dysfunction
Having trouble achieving
or keeping erections is common in men with coronary artery disease, but
they may not make the connection. Just as arteries around the heart can
narrow and harden, so can those that supply the penis -- and because
those arteries are smaller, they may show damage sooner. One survey of
European men being treated for cardiovascular disease found that two out
of three had suffered from erectile dysfunction before they were ever
diagnosed with heart trouble.
4. Exhaustion or fatigue
A sense of crushing
fatigue that lasts for several days is another sign of heart trouble
that's all too often overlooked or explained away. Women, in particular,
often look back after a heart attack and mention this symptom. More
than 70 percent of women in last year's NIH study, for example, reported
extreme fatigue in the weeks or months prior to their heart attack.The key here is that the fatigue is unusually strong -- not the kind of tiredness you can power through but the kind that lays you flat out in bed. If you're normally a fairly energetic person and suddenly feel sidelined by fatigue, a call to your doctor is in order.
5. Breathlessness and dizziness
When your
heart isn't getting enough blood, it also isn't getting enough oxygen.
And when there's not enough oxygen circulating in your blood, the result
is feeling unable to draw a deep, satisfying breath -- the same feeling
you get when you're at high elevation. Additional symptoms can be
light-headedness and dizziness. But sadly, people don't attribute this
symptom to heart disease, because they associate breathing with the
lungs, not the heart.In last year's NIH study, more than 40 percent of women heart attack victims remembered experiencing this symptom. A common description of the feeling: "I couldn't catch my breath while walking up the driveway."
6. Leg swelling or pain
When the heart muscle
isn't functioning properly, waste products aren't carried away from
tissues by the blood, and the result can be edema, or swelling caused by
fluid retention. Edema usually starts in the feet, ankles, and legs
because they're furthest from the heart, where circulation is poorer. In
addition, when tissues don't get enough blood, it can lead to a painful
condition called ischemia. Bring swelling and pain to the attention of
your doctor.
7. Sleeplessness, insomnia, and anxiety
This
is an odd one doctors can't yet explain. Those who've had heart attacks
often remember experiencing a sudden, unexplained inability to fall
asleep or stay asleep during the month or weeks before their heart
attack. (Note: If you already experience insomnia regularly, this
symptom can be hard to distinguish.)Patients often report the feeling as one of being "keyed up" and wound tight; they remember lying in bed with racing thoughts and sometimes a racing heart. In the NIH report, many of the women surveyed reported feeling a sense of "impending doom," as if a disaster were about to occur. If you don't normally have trouble sleeping and begin to experience acute insomnia and anxiety for unexplained reasons, speak with your doctor.
8. Flu-like symptoms
Clammy, sweaty skin,
along with feeling light-headed, fatigued, and weak, leads some people
to believe they're coming down with the flu when, in fact, they're
having a heart attack. Even the feeling of heaviness or pressure in the
chest -- typical of some people's experience in a heart attack -- may be
confused with having a chest cold or the flu.If you experience severe flu-like symptoms that don't quite add up to the flu (no high temperature, for example), call your doctor or advice nurse to talk it over. Watch out also for persistent wheezing or chronic coughing that doesn't resolve itself; that can be a sign of heart disease, experts say. Patients sometimes attribute these symptoms to a cold or flu, asthma, or lung disease when what's happening is that poor circulation is causing fluid to accumulate in the lungs.
9. Rapid-fire pulse or heart rate
One
little-known symptom that sometimes predates a heart attack is known as
ventricular tachycardia, more commonly described as rapid and irregular
pulse and heart rate. During these episodes, which come on suddenly, you
feel as if your heart is beating very fast and hard, like you just ran
up a hill -- except you didn't. "I'd look down and I could actually see
my heart pounding," one person recalled. It can last just a few seconds
or longer; if longer, you may also notice dizziness and weakness.Some patients confuse these episodes with panic attacks. Rapid pulse and heartbeat that aren't brought on by exertion always signal an issue to bring to your doctor's attention.
10. You just don't feel like yourself
Heart
attacks in older adults (especially those in their 80s and beyond, or in
those who have dementia or multiple health conditions), can mimic many
other conditions. But an overall theme heard from those whose loved ones
suffered heart attacks is that in the days leading up to and after a
cardiac event, they "just didn't seem like themselves."A good rule of thumb, experts say, is to watch for clusters of symptoms that come on all at once and aren't typical of your normal experience. For example, a normally alert, energetic person suddenly begins to have muddled thinking, memory loss, deep fatigue, and a sense of being "out of it." The underlying cause could be something as simple as a urinary tract infection, but it could also be a heart attack. If your body is doing unusual things and you just don't feel "right," don't wait. See a doctor and ask for a thorough work-up.
And if you have any risk factors for cardiac disease, such as high blood pressure, high cholesterol, smoking, or family history of heart disease, make sure the doctor knows about those issues, too.
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