Symptoms of a heart attack
Women often announce a heart attack with different alarm signals than men. It is very important to be aware of these gender differences in the symptoms of a heart attack, so that no mistakes are made in an emergency and the heart attack may be detected too late. Any slightest hint of a heart attack must be taken seriously, regardless of the type of symptoms, as sudden cardiac arrest can occur at any time without further notice.
The classic signs of recognition (such as chest pain, which can radiate into different parts of the body) occur in both sexes. However, only about one third of women feel the severe chest pain, while up to 80 percent of men notice this first heart attack symptom. However, it is not uncommon for a heart attack to trigger rather unspecific symptoms in women.
These include severe shortness of breath, nausea, vomiting and, in particular, complaints in the upper abdomen. Especially if these symptoms are particularly severe or last longer than 15 minutes, it is important to consider a heart attack. In about half of the women who suffer a heart attack, sleeping disorders occur before an acute heart attack.
Men often perceive the symptoms in the chest area as the most severe pain (with or without radiation). Women often experience a feeling of pressure or tightness rather than strong pain.Symptoms such as recurring nausea, fatigue or dizziness can occur days before the heart attack and are often misinterpreted as stomach problems. The so-called NAN rule can be an aid in recognizing heart attack symptoms in women: If inexplicable pain occurs in the area of the body between the nose, arm and navel that lasts longer than 15 minutes, an emergency doctor should always be called, as this can be a sign of a heart attack.
The tightness of the chest is one of the most prominent symptoms of an acute heart attack. In medical terminology, it is known as angina pectoris (= chest tightness). Patients describe this condition as if they have a heavy load on their chest against which they cannot breathe properly.
The cause is not at all to be found in the lungs, but lies in the occlusion of a coronary artery, as is the case with heart attacks. The feeling of tightness can usually be treated with nitro spray. The nitrogen contained in the spray ensures that the blood vessels are dilated and the blood can flow through the coronary vessels again.
One of the most important measures for preventing cardiovascular disease is regular blood pressure measurement. If a check suddenly reveals significantly higher values than usual or if the values slowly increase over a longer period of time, this may indicate a heart attack. It is important that the blood pressure measurement is taken at rest and is first repeated if abnormal values are found.
If typical heart attack symptoms such as chest pain, shortness of breath or blurred vision occur at the same time as a rise in blood pressure, these symptoms can be a warning sign of a heart attack. More precisely, high blood pressure is a risk factor for coronary heart disease (CHD). CHD in turn increases the risk of suffering a heart attack because the coronary arteries are narrowed.
High blood pressure alone is not a symptom of a heart attack. It is often more likely to cause a drop in blood pressure and a slowing of the heart rate (bradycardia). The damage to the heart muscle cells reduces the pumping capacity, which means that not enough blood can be pumped into the circulation.
It is important to adjust the blood pressure as well as possible for patients at risk as well as for patients who have had a heart attack. Two of the high blood pressure medications (ACE inhibitors, beta blockers) have a positive effect on the heart after a heart attack, which is why a corresponding prescription is very sensible. An acute symptom of a heart attack is often cold sweats, the affected person has cold and damp hands.
These are signs that the circulation collapses, often resulting in unconsciousness. A beginning cardiovascular failure is announced by a fast pulse (heart rate over 100 per minute) and low blood pressure (the upper value is below 90mmHg). The blood pressure (and also the pulse rate) can therefore react very differently in the event of a heart attack.
In some cases the heart starts racing, in others it slows down the pulse rate considerably and the blood pressure can rise as well as fall. The localization of the symptoms of a heart attack often depends on which coronary artery is affected. If the right coronary artery is affected, this usually results in a so-called posterior wall infarction, which is more likely to manifest itself as symptoms in the upper abdomen.
An occlusion in the left coronary artery usually results in an anterior wall infarction, in which the pain is felt more in the chest area. The most widespread form of pain radiating into the left arm is that in the left arm. From the chest, the pain extends over the shoulder into the upper arm and spreads to the forearm or even to the hand (especially on the small finger side).
Such a course cannot be observed in all patients. Especially women often do not show the typical clinical picture with chest pain and accompanying charisma. If arm pain suddenly occurs and the corresponding risk profile (smoking, diabetes, high blood pressure, etc.
), an ECG should be taken immediately to check the symptoms. Differential diagnosis (possible other diagnosis), in case of pain in the left arm, nerve damage, a disturbance of the muscle and tendon apparatus or joint structures must also be considered. Rarely do heart attack patients also feel pain in the right arm.
It also happens that the pain radiates into both arms. In addition, there may be pain in the shoulders (more likely on the left side) that is independent of movement.Sometimes, no chest pain is perceived and only permanent and non-softening pain in the left arm occurs, which the affected person cannot explain. This phenomenon can also occur during an acute heart attack and is often misdiagnosed as rheumatic pain.
Arm pain can be a symptom of many diseases such as the so-called bottleneck syndrome, in which the upper bone of the shoulder framework lowers and exerts pressure on the lower bone. This leads to a constriction of the vessels and nerves located there, causing pain that radiates into the arm. A burning sensation is usually an expression of the pain experienced by the patient during the heart attack.
The pain usually spreads to the left arm or shoulder. Other places to which the pain or burning sensation can radiate are the back, neck or, in rare cases, the abdomen. Anxiety sweat is a completely natural reaction in the course of a heart attack.
In most cases, the heart attack is accompanied by a fear of death. In this context, the fear sweat is the reaction to the enormous adrenaline output of the body. Although the person affected does not necessarily know that he or she is about to suffer a heart attack, he or she has the feeling of dying from this attack.
In the acute event this affects about one third of all people. Another twenty percent die in the coming days and weeks. Heartburn is known to cause a backflow of gastric juice into the esophagus.
It comes – often after particularly rich food intake – to an unpleasant burning sensation, which can rise up to the neck, and “acid burping”. The gastric juice causes enormous irritation of the esophagus, which can also become inflamed as a result (reflux esophagitis). Heartburn can cause enormous pain over the course of the esophagus, especially in connection with such an inflammation.
Due to its anatomical location, the pain is then located behind the breastbone, which is why heartburn (or reflux esophagitis) is an important differential diagnosis (possible other diagnosis) of acute myocardial infarction. Especially patients who are experiencing reflux for the first time may be unsettled by pain, although there is no reason for concern. In the case of a heart attack, vegetative symptoms (unconscious, uncontrollable, so-called body symptoms) can also occur.
The heart contains fibers of the autonomic nervous system – the sympathetic and parasympathetic nervous systems. They can be activated by the – during the heart attack – disturbed function and the ascending panic. In addition to sweating (sympathetic nervous system), nausea and vomiting (parasympathetic nervous system) are also classically part of the clinical picture.
Nausea and vomiting occur frequently even in silent infarcts when the actual leading symptoms, such as chest pain, remain hidden. Accompanying diarrhea is somewhat less frequent, but is also caused by the parasympathetic nervous system and its motility enhancing effect (increase in intestinal movement). The diarrhea is usually not as severe as in a bacterial or viral intestinal infection.
Especially in connection with silent infarcts or untypically occurring cardiovascular (affecting the heart vessels) events, diarrhea has been reported, which can cause confusion and misdiagnosis in diagnostics. Symptoms such as numbness or tingling are usually due to stress or damage to nerve structures, but can also occur during a heart attack. Many sufferers report that the sensory disturbances slowly spread to a region of the body, similar to the sensation when, for example, the arm “falls asleep”.
Tingling sensations in the face and in the left arm seem to occur particularly frequently. The numbness can extend to the fingers. The sensations are mainly due to reduced blood circulation. In many cases, the heart attack leads to massive circulatory problems, a drop in blood pressure and cardiac arrhythmia, from which the corresponding symptoms result.
