Clearing the confusion of chest pain
Heart attacks aren't always like the dramatic events portrayed on television: unbearable, crushing pain, a sudden drop to the floor with hands grasping the chest, ambulances with flashing lights, and a doctor with paddles in his hands yelling "clear." Although this is sometimes the case, heart attacks often start slow with symptoms building over many hours.
The drama, however, has become so engrained in people's minds that early warning signs like minor chest pain are easily dismissed or attributed to heartburn or gas. And, some people just don't want to admit they have a heart problem. "Denial is one of the biggest issues," explains
Vincent Spagnuolo, MD, Virtua cardiologist. "No one likes to think they have a heart condition, and people ignore the symptoms out of fear or lack of knowledge."
Some signs to watch for
Know your risks
What to expect at the hospital
Other possible causes
Some signs to watch for
While individuals will never know for sure what it feels like to have a heart attack until they have the misfortune to experience one, descriptions of the pain do exist. People say they feel pressure, fullness, or squeezing pain. These sensations spread from the center of the chest into the shoulders, arms, neck and even the jaw. During a heart attack, chest pain is often combined with lightheadedness, fainting, sweating, nausea or shortness of breath.
A person should see a doctor immediately if chest pain persists for five minutes or is associated with exertion. Any chest pain that is new or different also warrants attention. Dr. Spagnuolo, who is a board certified cardiologist, explains that early treatment is essential. "Most damage to the heart occurs during the first couple hours of a heart attack. There are many drugs and treatments that can stop the attack, reduce damage to the heart, and save lives if administered when symptoms first occur."
Know your risks
Weighing risk factors is one way to help distinguish if chest pain is truly a heart attack. "People need to be aware of which risk factors affect them," says
Steven Fox, MD, Virtua cardiologist. While some are controllable, others are not. Uncontrollable risk factors include being over age 50, being male, being a post-menopausal woman, and having a family history of heart disease. Controllable risk factors include smoking, high blood pressure, high cholesterol, diabetes, and obesity. Dr. Fox, who has been in practice for 15 years, explains that a person greatly reduces the risk of heart disease by limiting the controllable risk factors.
What to expect at the hospital
"Going to the hospital for chest pain is frightening, especially if a person isn't sure what to expect," says Jane Slaterbeck, RN, MBA, Virtua Health's assistant vice president for cardiology. "Upon arriving at the emergency room, specially trained doctors and nurses take the patient's medical and family history to determine the level of risk."
Slaterbeck explains that a cardiologist orders blood tests to measure chemicals in the body that signal a heart attack. People may also receive an echocardiogram (ECG or EKG) to measure the rate and regularity of heartbeats, the size and position of the heart's chambers as well as any damage to the heart. This painless test records the electrical activity of the heart through small electrodes placed on the body. Depending on the results, the cardiologist might order a stress test to measure how the heart performs under exertion.
Other possible causes
Chest pain doesn't always mean heart attack. Some chest discomfort is caused by swelling between the ribs or arthritis. Some people suffer from a reflux of stomach acids into the esophagus, which causes a burning sensation in the chest that may be mistaken for a heart attack. This could cause a person to experience pain in the muscles, ribs and cartilage. In these cases, pain occurs when the chest is pressed. Although rare but dangerous, a blood clot in the lung may also be a cause of shortness of breath and chest discomfort.
"There's no substitute for a physician's evaluation," says Slaterbeck. "Never try to self-diagnose. People who are experiencing problems should see a doctor immediately. Although it may not be a heart problem, it may be just as serious."
Now more than ever, there are many options available to people with heart conditions. These range from new medications to cardiac rehabilitation and holistic heart programs. To find out more or to obtain a Healthy Heart Guidelines fact sheet, call 1-888-Virtua-3.