Heart Attack Recognition - Time is Tissue

Introduction

This Straight, No Chaser is about heart attack recognition.

Heart Attacks. Myocardial Infarctions. Acute Coronary Syndromes. Coronary Artery Disease. Unstable Angina. There are many names to describe one main phenomenon. Heart attacks are the most common manifestation of heart disease, the #1 cause of death in the United States. Today’s post is to heighten your sensitivity to risk factors and symptoms of a heart attack, because we’ve gotten very good at treating them—especially if you get to us in time.

Risk Factors

Who’s at risk of having a heart attack? If any of the following considerations look or sound like you, you should be especially sensitive to the symptoms I describe below. Please understand these are the rules. I also see the exceptions nearly every day.

Age: especially men over 45 and women over 55
Cocaine or amphetamine (meth) use
Family history of heart attacks: sibling, parents, or grandparents if their heart attacks occurred by age 65
High blood pressure: higher risk with obesity, smoking, diabetes, or high cholesterol.
High cholesterol or triglyceride levels
Obesity/inactivity: especially due to associations with high blood pressure, diabetes, and high cholesterol
Smoking: including prolonged exposure to second-hand smoke

Again, if you have any of the above risk factors, your symptoms are more likely to be attributable to a heart attack. You may still have a heart attack without any of these risks.

Symptoms

How do you know if you’re having a heart attack? There’s no one-answer-fits-all response (like using FAST for strokes, which we’ll discuss in the next post). Heart attack pain comes in many varieties and is usually associated with other symptoms. What you should be aware of are the pain patterns that should prompt you to get evaluated. These may include the following:

Chest discomfort like pressure (something sitting on your chest), squeezing, fullness, indigestion, or just pain
Radiation of chest discomfort or just pain in other areas, such as one or both arms, the back, neck, jaw, or stomach.
Shortness of breath
Nausea or vomiting
Breaking out in a sweat
Racing, fluttering, or forceful beating of the heart
Lightheadedness up to or including blacking out

Again, you may have all of these symptoms or none of these symptoms in the face of a heart attack. We evaluate you based on the combination of your risk factors and your symptoms.

Summary

Bottom Line 1: If you have risks, symptoms and/or concerns, I’d much rather give you good news and education than give your family condolences. Get evaluated.

Bottom Line 2: I’m not discussing specific treatment options today (that’s for a future post), but remember two things:

Time is tissue, so the sooner you get to the Emergency Room, the more treatment options we have and the better your outcome is likely to be. This is not the disease to think, “It’ll just go away.” We can do our absolute best for you if you get to us within three hours of the start of your symptoms.
If and when something like this happens to me, the first thing I’m doing on my way the hospital is taking an aspirin.

As per routine, the combination of adequate prevention and prompt symptom recognition are key. I hope you share this with your families, especially those at immediate risk.

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