Recognizing a Heart Attack or Angina

If you have risk factors for heart problems, you should always watch for signs of angina or a heart attack. If you have a sudden heart problem, getting treatment right away could save your life.

Risk factors for a heart attack include:

• Being older

• High cholesterol

• High blood pressure

• Having an immediate family member such as a brother, sister, or parent who had a heart attack before age 50

• Diabetes

• Smoking

• Being overweight

• Smoking or using stimulants such as cocaine or amphetamine

• High stress

There are other risk factors, including eating a high-fat diet and not getting much exercise.

Understanding angina and heart attack

• Angina is an uncomfortable burning feeling, tightness, or pressure in the chest, back, neck, throat, or jaw. It can be painful. It means not enough blood is getting to the heart muscle. This is usually from a blocked artery in the heart. Angina is a sign that you may be having, or are about to have, a heart attack. You need to call 911 right away.

• A heart attack is also known as acute myocardial infarction (AMI). It's what happens when blood and oxygen can't get to part of the heart muscle. That part of the heart muscle is damaged and starts to die. If enough of the heart is affected, it won't be able to beat correctly. This will severely limit its ability to send blood to the brain and the rest of the body. It may cause death. It's vital to get help as soon as possible for a heart attack.

Stable angina versus unstable angina

Stable angina is also known as chronic angina. It has a typical pattern. It happens when you exert yourself physically or feel a strong emotion. Nitroglycerin, rest, or both will easily ease stable angina symptoms. Stable angina symptoms will most likely feel the same each time you have them. It's important to discuss these symptoms with your healthcare provider. They can be a warning sign of a future heart attack.

Unstable angina causes unexpected or unpredictable symptoms, often when you're at rest. Unstable angina is a medical emergency. Angina is also considered unstable if resting and nitroglycerin don't ease symptoms. It's also unstable if symptoms are getting worse, happening more often, or lasting longer. These symptoms may mean you have a severe blockage or a spasm of a heart artery. Unstable angina is commonly a sign of an active heart attack. Remember the following tips:

• Stable angina symptoms should go away with rest or medicine. If they don’t go away, call 911!

• Stable angina symptoms last for only a few minutes. If they last longer than that, or if they go away and come back, you may be having a heart attack. Call 911!

• If you have shortness of breath, cold sweat, upset stomach (nausea), or lightheadedness, call 911!

For angina that shows up for the first time, there is only 1 response: Call 911! You should never diagnose angina by yourself. If these symptoms are new, or worse than normal, call 911!

Warning signs of a heart attack

If you have symptoms that you can’t explain, call 911 right away. Don't drive yourself to the emergency room (ER). These are warning signs of a possible heart attack:

• Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.

• Discomfort in other parts of the upper body. Symptoms can include pain or discomfort in 1 or both arms, the back, neck, jaw, or stomach.

• Shortness of breath, with or without chest discomfort

• Other signs may include breaking out in a cold sweat, nausea, or lightheadedness.

If you think someone is having a heart attack, call 911 instead of driving the person to the ER. After you call 911, you'll be told what to do. The 911 dispatcher may tell you to give the person aspirin while waiting for help to arrive. If the dispatcher doesn’t tell you to do this, don’t give the person aspirin. Aspirin can be dangerous in certain cases.

• Note for women. Like men, women often have chest pain or discomfort as a heart attack symptom. But women are somewhat more likely than men to have less common symptoms. These include shortness of breath, abnormal tiredness, lightheadedness, heartburn, nausea and vomiting, back pain, or jaw pain.

• Note for older adults. Older people may also not have typical symptoms of a heart attack. They may have symptoms that include fainting, weakness, or confusion. Ignoring these symptoms can lead to critical illness or death. You should get your symptoms checked out right away.

• If you've had a heart attack. People who have had 1 heart attack are at risk of having another. Your provider may prescribe medicine such as nitroglycerin to take when chest pain starts. Or you may need medicines to lower your heart rate and blood pressure. This is to prevent angina and another heart attack. Remember to take any medicines your provider has given. Don't stop taking them without speaking with your provider first.

If you have diabetes: Silent heart problems

Over time, high blood sugar can damage nerves in your body. This may keep you from feeling pain caused by a heart problem, leading to a “silent” heart problem. If you don’t feel symptoms, you're less able to know that you may be having a heart attack and get treatment right away. Talk with your healthcare provider about how to control your blood sugar levels and lower your risk for silent heart problems.