Introduction
A heart attack usually comes unexpectedly and can be hidden behind a variety of symptoms. The leading symptom of a heart attack is the typical chest pain behind the sternum, accompanied by a burning sensation.
What could be the signs of an impending heart attack?
Patients who suffer a heart attack usually have CHD – coronary heart disease – in advance. This disease of the heart vessels is accompanied by a narrowing of the diameter due to fatty wall thickening (stenosis). The leading symptom of coronary heart disease and thus the first sign of a potentially imminent heart attack is angina pectoris (chest tightness).
This causes pain behind the breastbone, which can radiate into various parts of the body, such as the left arm, lower jaw or back. Often the pain occurs suddenly and at rest. This is often accompanied by so-called vegetative symptoms.
These “body symptoms” manifest themselves in the form of sweating, nausea and vomiting. Since angina pectoris is a very frightening symptom for most patients, the majority of those affected suffer from anxiety and restlessness during this time. Blood pressure often drops, but can also be normal or elevated.
Basically, the more severe and serious the symptoms are, the greater the heart attack. Even at rest, the symptoms of an acute heart attack typically do not improve and even targeted breathing movements do not bring any relief. The duration of a classic angina pectoris episode is about 10 minutes.
If the symptoms persist for longer or cannot be interrupted by the administration of nitroglycerine (vasodilating drug), the clinical picture may already be more acute, requiring immediate clarification. The triggering factors are physical as well as psychological stress, very low outside temperatures (leading to additional vasoconstriction) or increased pressure in the abdominal cavity (in the case of a bloated digestive tract, so-called “Roemheld syndrome”). However, not everyone feels the symptoms triggered by a heart attack in the same way.
There are differences between the symptoms that typically occur in women and men. Some heart attacks (about 15 to 20 percent of all heart attacks) cause no symptoms at all, only minor or atypical symptoms (so-called “silent heart attack“). These silent infarctions occur more frequently in people with diabetes mellitus because the disease causes an autonomic neuropathy (damage to the pain-conducting nerves of the organs).
As a result, diabetics may not be able to perceive the heart attack pain and suffer a painless (silent) infarction. These heart attacks are often only recognized afterwards, usually during an electrocardiogram (ECG) examination. Very similar symptoms to a heart attack can also be triggered by other life-threatening diseases in the chest area. For example, a rupture of the large aorta (aortic dissection), a pneumothorax (air in the pleural gap with collapse of the lung) or a disease of the esophagus can also lead to symptoms similar to a heart attack.
