Heart attack symptoms in women are often more subtle than those in men, making them easier to overlook or confuse with other health issues. Unlike the stereotypical crushing chest pain associated with heart attacks, women’s heart attack symptoms can resemble the flu, heartburn or even an ulcer.

“It is critical that women understand what a heart attack can feel like for them, so they get immediate medical care,” said Li Zhou, M.D., Ph.D., medical director of the Norton Heart & Vascular Institute Women’s Heart Program. “Any delay in seeking treatment can result in more damage to the heart muscle and can be life-threatening.”

Subtle signs: How heart attack symptoms in women differ

In general, heart attack symptoms in women may not include severe chest pain. Instead, women may experience:

• Unusual fatigue or exhaustion
• Nausea or vomiting
• Stomach pain, indigestion or heartburn
• Dizziness or lightheadedness
• Shortness of breath
• Breaking into a cold sweat
• Pain in the jaw, neck or upper back
• Pressure or pain in the chest that may come and go

These symptoms can go unnoticed or can be mistaken for less serious conditions, such as anxiety, gastrointestinal issues or muscle pain.

Almost 1 in 3 heart attack patients experience no chest pain at all — and this is more common among women. This is sometimes called a silent heart attack.

When to seek help for heart attack symptoms

If you suspect you are having a heart attack, do not wait. Call 911 immediately or have someone take you to the nearest emergency room.

While waiting for emergency services:

• Take nitroglycerin if it’s been prescribed by your doctor.
• Take aspirin only if a medical professional has previously advised you to do so — as it may interact with other medications.

Key differences in heart attack symptoms: Women vs. men

There are notable differences in how heart attacks present in men and women. Men often report pain and numbness in the left arm or side of the chest. In contrast, women may feel pain on the right side, in the back or not in the chest at all.

In some cases, chest pain in women is caused by microvascular disease — a condition affecting the small arteries of the heart rather than a typical blockage. This condition often is linked to diabetes, high blood pressure or inherited heart disease.

Other conditions that can mimic heart attack symptoms in women

Several other health issues can resemble heart attack symptoms in women, including:

• Panic attacks: Often mistaken for heart attacks, panic attacks can cause chest pain, rapid heartbeat, shortness of breath and a feeling of dread. These episodes typically involve sharp, stabbing pain that lasts only a few seconds and is localized.
• Gastroesophageal reflux disease (GERD): Symptoms like acid reflux can cause burning chest pain that mimics a heart attack.
• Muscle strain: Especially in the chest or back, muscle injury can cause pain during movement or deep breathing.
• Stroke: Weakness in the arms or an inability to raise both arms evenly could indicate a stroke rather than a heart attack.

Risk factors for heart attack in women

• Smoking is a greater risk factor for heart disease in women than it is in men. 
• Not being active is a major risk factor for heart disease.
• Emotional stress and depression may affect women’s hearts more than men’s. Experiencing these can make it difficult to be active or make healthy choices. 
• Diabetes increases your heart attack risk. Women with diabetes are more likely to develop heart disease than are men with diabetes. Diabetes damages the blood vessels and can change the way people feel pain, so you may be at a higher risk for silent heart attack.
• Menopause causes drops in estrogen, which increase the risk of developing small vessel heart disease.
• Pregnancy complications, including high blood pressure (preeclampsia) or diabetes during pregnancy, can increase women’s long-term risk of high blood pressure and diabetes.
• Family history of early heart disease may be a greater risk factor in women than in men.
• Other health conditions, such as autoimmune diseases or inflammatory conditions, can increase the risk of heart attack. 

Heart attacks during and after pregnancy

Although rare, heart attacks during pregnancy or shortly afterward can occur. A common cause is spontaneous coronary artery dissection, a condition where a tear forms in a coronary artery, disrupting blood flow to the heart.

Awareness of heart attack symptoms in women

Heart disease is the leading cause of death in women in the United States. According to the Centers for Disease Control and Prevention, more than 267,000 women die from heart attacks each year. Understanding heart attack symptoms in women — and how they may differ from men’s — can be lifesaving. If something doesn’t feel right, trust your instincts and seek immediate medical care.

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To appreciate her aspirations, you have to appreciate her incredible health journey, one that began suddenly with a massive heart attack in October 2015.

“I never had any indications,” said Terrie, now a peppy, 74-year-old, semiretired schoolteacher. “I thought I was healthy.”

Terrie survived a second heart attack a few days later while waiting for initial complications to improve before undergoing triple-bypass heart surgery. Following surgery, she remained unconscious for three weeks due to additional setbacks. Eventually, Terrie would need her left foot and part of her left leg to be amputated, as a result of weakened blood flow during her recovery. According to Terri, her family wasn’t sure she would survive.

Nearly 10 years later, she’s alive and thriving, thanks to an incredible team of physicians and therapists, which includes the cardiac rehabilitation team at Norton King’s Daughters’ Health in Madison, Indiana.

“The staff encourages you and holds you accountable,” Terrie said. “It’s comforting to know they are tracking your heart rate and blood pressure. They are always willing to answer questions and check on you; it’s such a huge benefit.”

When Terrie first began cardiac rehabilitation in January 2016, nearly four months after her heart attack, her initial ejection fraction — or EF as she calls it — was only 30%. Ejection fraction is one indicator of the heart’s efficiency at pumping blood. Through Terrie’s hard work and continuous effort, her heart’s ejection fraction is now 50% to 55%, which Terrie described as “low normal” for someone her age.  After barely being able to exercise for six minutes initially, she now attends cardiac rehab twice a week for 45 minutes.

“Even if I was disciplined enough to keep exercising on my own, it’s a huge benefit coming here,” Terrie said.

She continues in the maintenance phase, or Phase 3, of cardiac rehabilitation at Norton King’s Daughters’ Health.

“The team becomes like family. You also get to encourage other people and get encouragement from them,” Terrie said. “It was a long journey for me; maybe I can help someone else.”

Throughout her stints in physical therapy, which included learning how to use her prosthetic foot and leg, Terrie cherished her local access to heart care.

“I doubt I would have driven somewhere two or three times a week,” she said. “Having local care makes all the difference. The people are wonderful.”

Jared Rogers, exercise physiologist, and Nancy Gibson, a cardiovascular technician, both with the rehab program in Madison, “are great,” according to Terrie.

Jared sees firsthand the difference cardiac rehab makes in the lives of heart patients.  Initially, patients complete Phase 1, which focuses on regaining strength and conditioning. Phase 2 helps patients transition to independence, which is the goal of the cardiac rehab program. Phase 3 is a self-pay option for patients who simply want to maintain their success. 

“Patients like the social atmosphere and building relationships,” Jared said. “We want to help patients understand that it takes a lifestyle change to be successful. It’s rewarding to see patients reach their goals and make improvements. We want them to be independent.”

Steven L. Vorhies, M.D., is a family medicine specialist at Norton Community Medical Associates and is Terrie’s primary care physician. He praised Terrie’s mental fortitude as a reason for her success.

“Her mental approach to recovery … is remarkable,” Dr. Vorhies said. “Her rehab helped her immensely.  She set a goal to be active, live her life and do what she wants to do. Her mental attitude is wonderful.  She’s always smiling.”

Today, Terrie enjoys spending time with her husband of 53 years, Curt. Their family consists of three adult children and a grandson, whom Terrie enjoys watching play a variety of sports, including baseball, basketball and football.

“I can do most things I want to do,” Terrie said. “My leg limits me more than my heart.”

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While the majority of first heart attacks happen around age 65 for men and 72 for women, there has been an increase in heart attacks in people under age 40, according to the American College of Cardiology, a professional organization of heart doctors. The chances of having a heart attack at a younger age depend on many factors. Symptoms of a heart attack vary between men and women and can be subtle enough in younger people that they go unnoticed.

Here we will talk about what a heart attack is, your risks for having one at any age and signs you shouldn’t ignore.

Understanding heart attacks

A heart attack, also known as a myocardial infarction (my-oh-CARD-ee-ull in-FARK-shun), happens when blood flow to the heart is blocked or restricted. Less blood means less oxygen, and that leads to parts of the heart muscle dying.

“That is why we say time is muscle,” said Gang Cheng, M.D.,  a cardiologist with Norton Heart & Vascular Institute. “The sooner you can see a health care provider if you think you are having a heart attack, the better.”

There are some causes of chest pain that are not due to heart attack, including acid reflux, muscle strain and anxiety.

“We encourage people to be seen for chest pain, no matter their age, especially if it is accompanied by other symptoms of a heart attack,” Dr. Cheng said.

Heart attack age myths

You might think anyone who has a heart … can have a heart attack. That may be true only in the most technical sense. Heart attacks can happen to anyone, but statistically they happen to people of a certain age. Data from the American Heart Association shows the average age of a person at the time of their first heart attack in the United States is 65.5 years for males and 72 for females.

However, those numbers are changing. An ACC article from 2019 notes that the incidence of heart attacks is rising in those under 40.

“The idea that you have to be a certain age to have a heart attack is not exactly true,” Dr. Cheng said. “There are cases of heart attack in adults of all ages. It depends on many factors, but it is possible to have a heart attack at what we would consider a young age — in one’s 40s or even younger, for example.”

Risk factors contributing to early onset heart attacks

A study in 2018 looked at heart attacks in people younger than age 45. Results of that study showed the incidence of a heart attack per 100,000 people was:

• Ages 20 to 29: 2.1
• Ages 30 to 39: 16.9
• Ages 40 to 49: 97.6

The authors noted that, compared with older adults, those who experienced a heart attack under the age of 45 were more likely to:

• Be male
• Smoke
• Have a higher body weight
• Have a family history of premature heart attacks

Other risk factors for heart attack in younger people include:

• Substance abuse, especially cocaine, or excessive alcohol use
• High blood pressure
• High cholesterol levels
• Lack of physical activity
• Diabetes
• Poor diet, without vegetables, whole grains and lean meats

What age can you have a heart attack?  

In general, most heart attacks happen to people around age 65. The younger you are, the less likely you are to have a heart attack, but it is not impossible, especially if you have certain risk factors.

Reducing the risk of heart attack in young people

Although deaths from cardiac arrest in young people are not common, you still can take extra steps to help reduce your chances of having a heart attack as a younger adult, especially if you have a family history or other risk factors:

• Schedule annual checkups with your doctor, especially if you have a family history of heart attack or sudden cardiac arrest.
• Have annual sports physicals if you are very active in sports.
• Eat a balanced, healthy diet.
• Maintain a healthy weight.
• Get regular exercise.
• Stop smoking.

It is important to know the warning signs of a heart attack and what to do if you or someone you know has these symptoms.

If you have many of the risk factors for heart attack, you should talk to your health care provider. Also, know the warning signs of a heart attack and see a doctor if you have sudden symptoms of pain, tightness or pressure. The sooner you are seen for heart attack symptoms, the better your outcomes are likely to be.

The post Average age of a heart attack is younger than you might think, so here are warning signs of a heart attack and what you need to know appeared first on Norton Healthcare.

Also, heart attacks don’t always cause chest pain. One study found 1 in 5 heart people had heart attacks without chest pain. With a heart attack, you may feel pain or discomfort in your back, jaw or arms, and not your chest. You also can feel pain in the stomach area that you might confuse with indigestion. 

When a heart attack does cause chest pain, it begins in the left side or center of the chest and typically spreads to the back, jaw or arms. In men, heart attack pain radiates to the left arm most of the time, but not always. In women, the pain is more likely to spread to either arm.

Unlike the textbook heart attack, where you feel as though you have an elephant sitting on your chest, pain from a heart attack can range from mild to severe. The discomfort usually lasts for a few minutes and can feel like an uncomfortable pressure, squeezing, fullness or more serious pain. It also can go away and return a short time later.

Many women do experience chest pain with heart attacks, but they are more likely than men to get less-common symptoms, such as shortness of breath, indigestion, nausea or back pain — sometimes without any chest pain.

You may have heard taking aspirin will help with chest pain. This a myth. Aspirin is not a pain reliever typically used for chest pain. However, taking aspirin thins the blood, which helps prevent heart-attack-producing blood clots from forming. If you are having a heart attack, call 911. The dispatcher may recommend you take an aspirin, depending on your symptoms.

Chest pain can result from other causes.

For example, a condition called angina (an-JYNE’-uh) also can cause a feeling of squeezing, pressure or heaviness on the chest. Angina is caused by part of the heart not getting enough oxygen and usually occurs during exercise or physical activity. Chest pain from a heart attack lasts longer than angina and, unlike angina, does not improve by resting or taking a nitroglycerin pill.

Chest pain also can be caused by myocarditis, which is an inflammation of the heart muscle, or cardiomyopathy, a disease of the heart muscle.

Straining the muscles between your ribs, called intercostal muscles, by weightlifting or doing other forms of exercise, can result in chest pain. Injured ribs, or chronic pain syndromes such as fibromyalgia, also can result in chest pain.

Chest pain is more common in older people because their hearts need to work harder to pump blood. However, chest pain also occurs in children and adolescents. It is usually harmless in children and teens, but when it occurs with exercise or is accompanied by a fast heartbeat, dizziness or fainting, it may be a sign of a heart issue.

Heart attacks do not only occur in older people. They are becoming more common in people in their 20s and 30s.  Diabetes is a key risk factor for an early heart attack. High blood pressure, another risk factor for a heart attack, is also becoming more common among younger adults.

After a meal of spicy or acidic foods or drinking caffeinated beverages or alcohol, you might experience a burning sensation in your chest known as heartburn, which also can leave a sour taste in your mouth. Heartburn is caused when digestive acid moves into the esophagus, the tube that normally carries swallowed food to your stomach. Heartburn is usually relieved by antacids. Unlike heartburn, a heart attack often is accompanied by fatigue, a cold sweat, or lightheadedness or dizziness.

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Nearly 1 in 5 women have migraine three times the rate for men. In the United States alone, 28 million women experience migraine.

There are two types of migraine: with or without aura.

Migraine with aura or MA is linked to a higher risk for ischemic stroke and heart attack. An ischemic stroke is caused by a blood clot in the brain. Hemorrhagic stroke, the other major type of stroke, is caused by a leaking blood vessel.

Migraine aura – flashes of light, blind spots or other changes in vision – typically precedes the headache pain. Migraine aura symptoms usually strike less than an hour before migraine’s intense head pain, nausea and heightened sensory sensitivity.

Migraine without aura does not seem to pose the higher stroke or heart attack risk that migraine with aura does. Most people with migraine do not have aura. Some people get both types of migraine.

Studies of women with MA attacks found the risk for stroke is independent of typical heart disease risk factors like age, diabetes and high blood pressure. Research looking at data from a number of studies found migraine is associated with a 1.5-fold increased ischemic stroke risk.

The combination of smoking and MA significantly increases the risk of having a stroke. Oral contraceptive use increases the risk even more.

Women who smoke and have migraine with aura should avoid oral contraceptives that contain estrogen, according to Dr. Plato, because the combined risks from all three increase the risk of stroke significantly.

The link between migraine and heart disease does not mean migraine is the cause of a stroke or heart attack. According to Dr. Plato, the higher risk is likely the result of several factors. Possible contributors include:

• The use of nonsteroidal anti-inflammatory drugs (NSAIDs) to treat migraine
• Inflammation
• Issues with the lining of blood vessels
• Lifestyle factors related to migraine, including reduced physical activity
• Genetics
• A common condition called patent foramen ovale, a hole between the left and right upper chambers of the heart
• Increased risk for a tear in an artery in the neck

An ischemic stroke is caused by a plaque buildup on the wall of a blood vessel breaking off and forming a clot that blocks blood flow to the brain. Cardiovascular disease also can contribute to a heart attack as the plaque blocks blood flow to the heart muscle.

For some, stroke symptoms and a migraine attack may seem similar. However, they are very different conditions. While stroke is caused by interrupted blood flow to the brain, migraine is thought to have more to do with chemical compounds and hormones. Rarely, a migraine attack appears to be associated with an ischemic stroke (migrainous stroke or migrainous infarction). 

Dr. Plato’s advice to patients is to work on lifestyle changes that decrease stroke and heart attack risks, including regular aerobic (cardiovascular) exercise, a healthy diet and not smoking.

Since the frequency of migraine aura attacks appears to be associated with higher cardiovascular risk, migraine preventive treatment might be beneficial, according to Dr. Plato.

Younger women shouldn’t be overly concerned about the migraine with aura stroke risk or heart attack. For women under 50, even those who have MA, the odds of having a stroke is lower than being struck by lightning.

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Here are some tips on when to worry about chest pain.

Millions of Americans go to the emergency room every year, complaining of chest pain. Only about 20% of them are having a heart attack. Pain, pressure, aches and other feelings in the body can mean different things.

“Chest pain and the potential for heart issues should be taken seriously,” said Abdullahi O. Oseni, M.D., interventional cardiologist with Norton Heart & Vascular Institute. “While there are many conditions that can cause chest pain, you should err on the side of caution and see a health care professional. We want to rule out anything more dangerous.”

Heart attack or chest pain?

While the scenes in TV and movies might make you think sudden, severe chest pain is the prime sign of a heart attack, that’s not exactly true or even true in every case.

“Very few people actually describe the symptom as pain,” Dr. Oseni said. “People say it feels more like pressure, tightness, squeezing or even indigestion. Some just describe a general feeling of discomfort.”

The feeling may travel into the left arm, shoulder, neck, jaw or back. There are often early signs of a heart attack that people ignore.

Everyone experiences heart attacks in different ways, Dr. Oseni said. Heart attack symptoms also can be different in men than in women.  Some people don’t have any discomfort in the chest but may experience other symptoms, including:

• A feeling in the chest often described as pressure, tightness, squeezing or constriction — but not always
• Nausea
• Pain or tightness in the arm, shoulder, neck, jaw or back
• Shortness of breath
• Sweating
• Weakness or dizziness

“Sharp pain that is very focal and you can point directly to with one finger is often not a heart attack but could be another condition that is an emergency,” Dr. Oseni said. “People more commonly describe the chest pain associated with a heart attack as feeling like someone is sitting on their chest.” 

What causes chest pain?

Besides a heart attack, there are other conditions that cause pain in the chest.

Gastroesophageal reflux (GAS’-troh-ee-soff-uh-jee-ul REE’-flux) disease (GERD)

Is it heartburn or a heart attack? Heartburn is a condition where stomach acids push up into your esophagus, the tube that connects your mouth with your stomach. This can happen once in a while, maybe after you eat spicy food. It causes a burning feeling in your chest. If heartburn happens often, the lining of the esophagus can become irritated, and GERD can develop.

Pain from GERD can be managed at home by avoiding certain foods and beverages such as alcohol, caffeine, fatty foods and peppermint, not lying down after a meal or stopping smoking. If GERD is not manageable for you and is interfering with daily life, you may want to speak to your doctor about a prescription antiacid or other ways to treat GERD.

Chest pain from muscle strain

If you have ever “overdone it” with a physical activity and been sore, you may have had musculoskeletal (muss-kyuh-loh-SKELL’-eh-tul) chest pain. This kind of pain affects the bones, muscles and nerves of the chest wall, which are close to the heart. Injury or overuse are the most common causes of musculoskeletal pain.

Most of the time, musculoskeletal pain goes away on its own, especially if you use some treatments such as:

• Taking over-the-counter pain medicine, such as ibuprofen
• Cold or hot compresses
• Gentle stretching
• Reducing the activity that causes the pain, until the pain goes away

See a doctor if the pain does not get better over time, with or without home remedies, or if the pain gets worse.

Emotional stress and anxiety

The link between mind and body is powerful. When we believe we are in danger, our body responds, moving into fight, flight or freeze mode. Muscles clench, breathing become shallow and rapid, and the mind races. While everyone reacts to anxiety differently, anxiety-induced chest pain can feel like a sudden sharp pain or pressure.

People often say a panic attack feels like a heart attack, so it’s best to have a health care provider check you if you have this type of pain.

Angina

Angina (an-JY’-nuh) is another cause of chest pain. It happens when the heart doesn’t get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest. The pain may be felt in your shoulders, arms, neck, jaw, abdomen or back. Angina pain may even feel like indigestion. Some people don’t feel any pain but have other symptoms like shortness of breath or fatigue.

Angina is a symptom of a heart issue, such as coronary heart disease (CHD), also known as coronary artery disease (CAD) or coronary microvascular disease (MVD).

Angina usually happens because one or more of the coronary arteries is narrowed which leads to what is known as ischemia (uh-SKEE’-me-uh ).

You should see a health care provider if you have a personal or family history of heart conditions and develop pain in the chest, shortness of breath or any of the above symptoms.

“It is always better to come have chest pain checked out by your doctor,” Dr. Oseni said. “We would prefer your chest pain to be from a little gas or too many bench presses, and not from something very serious.”

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“Stretching from Thanksgiving to Christmas and even into the new year, there is about a 5% increase in heart attacks or emergency room visits due to heart-related concerns,” said Abdolreza Agahtehrani, M.D. , cardiologist with Norton Heart & Vascular Institute. “Some studies even show about a 15% increase just between Christmas Day and New Year’s Day.”

Many theories may explain the increase in heart attacks during this “most wonderful time of the year.” Most involve overindulging in rich meals and drinking too much alcohol, emotional stress, and cold temperatures that can put a strain on blood vessels. All of these raise blood pressure and contribute to heart issues.

Dr. Agahtehrani explained that a week or two of celebrations doesn’t equal a case of sudden cardiac arrest. More than likely, heart disease has been developing for a while.

“Most people who experience a heart attack have unknown symptoms, such as diabetes or uncontrolled hypertension [high blood pressure], that have been taking a toll on the cardiovascular system overall,” Dr. Agahtehrani said. “In fact, they may have even experienced a few symptoms and either didn’t realize it or ignored it, therefore putting them at even greater risk.”

“Holiday heart syndrome” is the term sometimes used to describe cardiac arrhythmia — an irregular heartbeat — brought on by binge drinking, often during a weekend or holiday. Research has found that holiday heart syndrome can occur in those who rarely drink, but binge on occasion.

Arrhythmia typically causes minor symptoms, but can lead to heart attack, cardiac arrest and death.

Holiday stress makes matters worse

Although more research is needed to determine exactly how stress factors into heart disease, it is known that when you don’t manage stress, it impacts your heart health. Healthy stress management tools include exercising or talking through the situation.

Unhealthy forms of coping, such as overeating, consuming too much alcohol or internalizing stress, can increase blood pressure and heart rate, putting more stress on the heart muscle.

If you fall into a high-risk category for heart disease, pay extra attention to your body during the holiday season. Many people may have early warning signs of a heart attack, so knowing the symptoms is critical.

Heart attack warning signs

Early signs of a heart attack, or “beginnings,” occur in more than 50% of people who have a heart attack.

• Chest pain or discomfort with heaviness, pressure, aching, burning, fullness or squeezing pain
• Pain or discomfort in one or both arms, left shoulder, neck, back, throat, jaw or stomach
• Shortness of breath
• Sudden fatigue, weakness or lightheadedness
• Nausea or vomiting
• Similar symptoms to indigestion
• Cold sweat or perspiration
• Unexplained anxiety
• Heart palpitations or increased heart rate

If you experience any symptoms, call 911 for emergency medical attention.

Take care of your heart this holiday season

• Pay attention to your mental health. Meditation, deep breathing, a warm bath and getting enough sleep are all great ways to help reduce your holiday stress.
• Eat healthfully. Limit portions and fill your plate with more fruits and vegetables to help reduce fat and salt intake and prevent excess weight gain during the holidays.
• Moderate your alcohol consumption. Binge drinking can increase blood pressure and trigger atrial fibrillation, a common but dangerous heart arrhythmia.
• Fit in exercise. Thirty minutes of exercise each day will help reduce stress and maintain weight. If you are pressed for time, break up exercise into 10-minute increments.
• Don’t smoke. Help is available if you want to quit. If you smoke, make a New Year’s resolution to join Norton Healthcare’s free smoking cessation class.
• Don’t forget to take your medications during the busy holidays.
• If you experience symptoms, be sure to communicate those to your family or friends.
• Get prompt care. Put your heart first and don’t delay care in fear of missing holiday season celebrations.

Hands-Only CPR can save a life

Should someone near you show signs of a heart attack, call 911. Emergency medical services can begin treatment en route to the hospital. Also, know how to save a life by learning Hands-Only CPR.

According to the American Heart Association, immediate CPR can double or triple the chance of survival. Follow these two steps if you see a teen or adult who suddenly collapses and isn’t breathing:

• Call 911.
• Push hard and fast in the center of the chest.

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This kind of heart attack is called an ST-elevation myocardial infarction (my-oh-CARD’-ee-ull in-FARK’-shun), or STEMI. Often also called a widow-maker, this is the deadliest form of heart attack. That’s because it is caused from a complete blockage in the heart, and no blood is able to pass through. Restoring blood flow is all that matters, and the faster it’s done, the better the chances of recovery and preventing long-term damage to the heart muscle. In this situation, time is muscle.

Myocardial infarction is the medical term for a heart attack. An infarction is a blockage of blood flow to the myocardium (my-oh-CAR’-dee-um), the heart muscle. That blockage causes cells in the heart muscle to die.

A STEMI is a heart attack that causes a distinct pattern on an electrocardiogram (abbreviated either as ECG or EKG). This is a medical test that uses several sensors (usually 10) attached to your skin that can detect your heart’s electrical activity. That activity is then displayed as a wave pattern on a paper readout or a digital display. Certain patterns of heart activity mean there’s a total blockage of one of the heart’s main supply arteries.

During a heart attack, those patterns can mean the heart muscle is dying. At this point, the key goal is to reopen that artery and restore blood flow as soon as possible. This may prevent permanent damage, or at least limit the severity of the damage. If there’s too much damage to the muscle in the ventricles, your heart can’t pump enough blood to support your body. The heart muscle cannot repair itself. That’s why STEMI heart attacks are so dangerous and why restoring blood flow quickly is so critical.

Chest pain or heart attack?

Despite what you might have seen on TV or in movies, a heart attack does not always come on suddenly or include clutching one’s chest in agony. Many times, a heart attack feels like pressure, heaviness or other discomfort in the chest, neck, jaw or down the arms. Though men and women both have heart attacks, they often report different sensations in the body.

STEMI symptoms include:

• Tightness, squeezing, pain, or pressure in your chest that doesn’t go away after a few minutes, or stops and returns
• Pain or discomfort in your arms, neck, jaw, back, or stomach
• Shortness of breath
• Lightheadedness
• Nausea and vomiting
• A cold sweat

There are several conditions that can feel like a heart attack, including anxiety, gas and muscle strain. You always should err on the side of caution when it comes to chest pain, and visit a health care provider to see what the cause of your pain is.

STEMI treatment

Treatment options for STEMI will depend on several factors, including:

• Where the blockage is in your heart
• Results of tests such as ECG/EKG
• Age, general health and lifestyle factors

No matter what, treating a STEMI is time-sensitive. Faster treatment can mean better outcomes. If your blood oxygen levels are low, treatment may include supplemental oxygen. There are also several different potential treatments for heart attack, several of which may happen in sequence or at the same time.

Other treatments include:

• Percutaneous coronary (per-kew-TANE’-ee-us COR’-oh-nar-ee) intervention  (PCI) — this procedure uses a tiny balloon that inflates to clear the blockage in the artery. A stent may be used, which is a scaffold that unfolds to hold the artery open.
• Medication — several medications are usually given early on in the treatment of heart attack, including beta blockers and statins.
• Coronary artery bypass grafting (CABG) surgery — CABG (pronounced like “cabbage”) means a surgeon takes a blood vessel from somewhere else in your body and uses it to make a new blood vessel that bypasses the blockage. CABG is often called bypass surgery or open heart surgery.

STEMI heart attack care network

Norton Healthcare has worked with Louisville-area health systems, emergency medical services (EMS) providers, air transport providers and affiliates to build the area’s first regional STEMI network. Like a top-notch pit crew for a race car, everyone on the team has a specific role: From the time you first seek medical care to the time the blockage is cleared, the STEMI network has your care covered.  

Part of the network’s purpose is to equip EMS crews with EKG equipment that can detect a STEMI heart attack. When a 911 call is made and EMTs arrive to provide care, the EKG taken in the first moments is sent to the STEMI network, activating a team that begins to prepare for the arrival of a patient. In some cases, the crew can save time by skipping what may be the closest hospital and heading directly to an accredited chest pain center where staff have been trained in heart attack care.

The goal is to get blood flowing within 90 minutes or less. Norton Heart & Vascular Institute and its partners in the STEMI network — which reaches into rural parts of Kentucky and Southern Indiana — beat the goal nearly 100% of the time. In 2022, Norton Healthcare had a median time of 56 minutes.

Norton Healthcare partners with other providers and emergency personnel who encounter STEMI patients to conduct drills and improve processes. This partnership was instrumental in the American Heart Association awarding its Mission Lifeline: Trailblazer designation to Norton Healthcare, thus recognizing the pioneering work done to create network of care to treat STEMI hear attacks.

The post A STEMI is one of the most dangerous forms of heart attack — here’s what you need to know appeared first on Norton Healthcare.

“If you have early warning signs of a heart attack, don’t dismiss it — it’s a chance for you to get care that could prevent a more devastating attack,” said Abdullahi O. Oseni, M.D., an interventional cardiologist with Norton Heart & Vascular Institute. “When we can provide early heart attack care, it gives us a chance to treat the cause of your symptoms before  significant damage occurs.”

Early heart attack symptoms

Someone may experience few early heart attack symptoms or all of the following. When they start, these symptoms can be mild or come and go. Over days or weeks, early heart attack symptoms and pain increase until the person potentially collapses.

• Feeling of fullness
• Pain that travels down one or both arms
• Jaw pain
• Excessive fatigue
• Anxiety
• Nausea
• Back pain
• Shortness of breath
• Chest discomfort, pain, pressure, squeezing, aching or burning

RELATED:ASTEMI is one of the most dangerous forms of heart attack —here’s what you need to know

Heart attack in men versus women

Men may experience different heart attack symptoms from women. Why does it matter? Women are less likely to seek immediate medical care and are more likely to die from a heart attack.

• Men normally feel pain and numbness in the left arm or side of chest. In women, the pain and numbness may appear on the right side. 
• Women may feel completely exhausted, drained, dizzy or nauseous.
• Women may feel upper back pain that travels up into the jaw.
• Women may think stomach pain is the flu, heartburn or an ulcer.

How can you prevent a heart attack?

Up to 85% of heart damage can occur within the first two hours of a heart attack. Know these early heart attack symptoms and act on them immediately — before any damage occurs.

• Be alert for a heart attack in yourself or someone around you. Becoming an active bystander could save a life.
• When in doubt, call 911 about heart attack signs. First responders have the medical technology to quickly save a life. 

Heart attack risk factors

Several risk factors increase your chance of having a heart attack. Many are controllable by making changes to your lifestyle. Discuss your personal risk of a heart attack with your doctor, including:

• Chest pain, pressure, aching or tightness that may come and go
• A family history of heart disease
• High blood pressure
• Overweight or obese
• Sedentary lifestyle
• Using tobacco products
• Metabolic disease, diabetes or other illness
• For women: using birth control pills, a history of preeclampsia, gestational diabetes or having a baby with low birth weight

What happens in a heart attack

The heart’s job is to pump blood around the body. Like any muscle, the heart itself needs its own supply of oxygen-rich blood to do its job. The coronary arteries supply the heart muscle. When that blood flow is interrupted, robbing the heart of the oxygen and other nutrients it needs to do its job, the result is myocardial infarction — commonly known as a heart attack. Cardiac arrest occurs when the heart suddenly stops pumping.

Cholesterol buildup inside the blood vessels — a heart disease called arteriosclerosis — is a common cause of blockages that lead to heart attacks. Cholesterol buildup, or plaques, can break free from the blood vessel wall and lead to a blood clot that blocks the artery and ends up causing a heart attack or stroke.

When the heart muscle isn’t getting the oxygen it needs, the result can be the common symptom of chest pain and other symptoms. Heart attacks that start slowly can show an early warning sign, such as chest discomfort that lasts more than a few minutes. 

If you’re not sure it’s a heart attack, the American Heart Association advises seeking medical help right away. If you have heart attack warning signs, call 911 immediately.

EMTs typically can respond to you faster than you can get to an emergency room. They can begin treatment right away and are trained to resuscitate you if you go into cardiac arrest.

EMTs can alert heart attack response teams at the emergency room while taking you there.

The post 9 Early Signs of a Heart Attack appeared first on Norton Healthcare.

Millions of Americans go to the emergency room every year complaining of chest pain. Only about 20% of them are having a heart attack. Pain, pressure, aches and other feelings in the body can mean different things.

“Chest pain and the potential for an issue with the heart should be taken seriously,” said Abdullahi O. Oseni, M.D., interventional cardiologist with Norton Heart & Vascular Institute. “While there are many conditions that can cause chest pain, we want to rule out anything more dangerous.”

Causes of chest pain

There are several conditions that can make your chest hurt. Those include:

GERD

Heartburn is a condition where stomach acids push up into your esophagus, the tube that connects your mouth with your stomach. This can happen once in a while, maybe after you eat spicy food. It causes a burning feeling in your chest. If heartburn happens often, the lining of the esophagus can become irritated and gastroesophageal (GAS’-troh-eh-soff-uh-jee-ul) reflux disease, also known as GERD, can develop.

“GERD can feel like a heart attack,” Dr. Oseni said. “It can feel like burning, squeezing or pressure in the chest that can last hours.”

Like a heart attack, the pain can spread down your arms or to your back.

Chest pain caused by GERD can be managed and treated by:

• Maintaining a healthy weight
• Avoiding certain foods and beverages such as alcohol, caffeine, fatty foods and peppermint
• Not lying down after a meal
• Avoiding eating large meals
• Elevating the head when you lie down
• Stopping smoking
• Taking a prescription antiacid

Talk to your doctor about more ways to treat GERD.

Similar to GERD, gas pain can be mistaken for a heart attack. Sometimes, gas can push stomach acids into the throat, or it can build pressure in the stomach that radiates into the chest.

Chest pain from muscle strain

If you have ever “overdone it” with a physical activity and been sore, you may have had musculoskeletal (muss-kyuh-low-SKELL’-eh-tul) chest pain. This kind of pain affects the bones, muscles and nerves of the chest wall. Injury or overuse are the most common causes of musculoskeletal pain.

Symptoms of musculoskeletal pain include:

• Pain that happens or gets worse with certain movements
• Pain during deep breaths, coughing or sneezing
• Swelling, tenderness or bruising in the area

Most of the time, musculoskeletal pain goes away on its own. Some home treatments include:

• Taking over-the-counter pain medicine such as ibuprofen
• Cold or hot compresses
• Gentle stretching
• Reducing the activity that causes the pain, until the pain goes away

Emotional stress and anxiety

The link between mind and body is powerful. When we believe we are in danger, our body responds, moving into fight, flight or freeze mode. Muscles clench, breathing becomes shallow and rapid, and the mind races. While everyone reacts to anxiety differently, anxiety-induced chest pain can feel like:

• Sudden sharp, shooting pain
• Persistent chest aching
• An unusual muscle twitch or spasm in your chest
• Burning, numbness or a dull ache
• Stabbing pressure
• Chest tension or tightness

People having anxiety attacks often say it feels like a heart attack, so it’s best to have a health care provider check you.

RELATED: ASTEMI is one of the most dangerous forms of heart attack —here’s what you need to know

Treatment for muscle pain from anxiety and stress includes:

• Exercise and yoga
• Meditation
• Dietary changes such as reducing alcohol and caffeine intake and eating more vegetables and lean meats
• Getting enough sleep
• Reducing stress as much as possible
• Anti-anxiety medications

Angina

Angina (an-JY’-nuh) is another cause of chest pain. It happens when the heart doesn’t get enough oxygen-rich blood. It can feel like pressure or squeezing in your chest. The pain may be felt in your shoulders, arms, neck, jaw, abdomen or back. Angina pain even may feel like indigestion. Some people don’t feel any pain but have other symptoms like shortness of breath or fatigue.

Angina is a symptom of a heart issue, such as coronary heart disease (CHD), also known as coronary artery disease (CAD), or coronary microvascular disease (MVD).

Angina usually happens because one or more of the coronary arteries is narrowed or blocked, also called ischemia (uh-SKEE’-me-uh).

Depending on the type of angina you have, there are many factors that can trigger angina pain. The symptoms also vary based on the type of angina you have.

Pain in your chest: Location is key

“If you come to the emergency room or the clinic, we will ask you where the pain is,” Dr. Oseni said. “We also will ask about the kind of pain you’re having.”

Knowing where and what kind of pain you have will help the health care team figure out what is causing it.

Common areas of pain include:

• Center of the chest
• The back
• Jaw and neck
• Arms
• Left arm

Chest pain that’s not a heart attack?

These symptoms are more likely to mean you are having a heart attack:

• Pain, pressure, tightness, squeezing or burning in the chest
• Gradual onset of pain over the course of a few minutes
• Constant pain in the middle of the chest
• Pain in the left arm, neck, back or jaw
• Pain with other symptoms, such as nausea, vomiting, difficulty breathing or cold sweat

These symptoms are less likely to suggest a heart attack:

• Sharp pain when breathing, sneezing or coughing
• Sudden stabbing pain in the chest that lasts only a few seconds
• Pain only on one side of the body or in one specific area
• Pain that lasts for hours or days without other symptoms
• Pain that happens with a specific body movement

“It’s better to be safe than sorry, so we want to see you if you have any unusual pains, or you have these symptoms together,” Dr. Oseni said.

When to seek medical help for chest pain

“If you have a condition that your doctor knows about and is treating, but your symptoms change suddenly or significantly, you should call the doctor,” Dr. Oseni said. “You don’t have to rush to the emergency room, but you definitely should be seen by the health care professional you have been seeing.”

Sudden severe chest pain or discomfort that is different from anything you have felt before means you should call 911 or have someone take you to the emergency room. Minutes count when it comes to your heart, so the sooner you can be checked out by a health care team, the better.

“For most people, it will not be cardiac or life-threatening, but we don’t want to miss anyone,” Dr. Oseni said. “There is no need to be embarrassed about a ‘false alarm’ if it turns out to be gas or something less serious than a heart attack.”

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