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Heart Attack

Learn the Signs

Many people think that a heart attack is sudden and intense, like the "Hollywood" heart attack depicted in the movies, where a person clutches his or her chest and falls over. The truth is that many heart attacks start as a mild discomfort in the center of the chest. Someone who feels such a warning may not be sure what is wrong. The discomfort (and other symptoms) may even come and go. Even people who have had a heart attack may not recognize the signs, because the next one can have entirely different symptoms. The warning signs of a heart attack are shown below. Learn them, but also remember: Even if you’re not sure it’s a heart attack, you should still check it out promptly.

Call 9-1-1

Timing is everything. People who experience the warning signs of a heart attack often deny how serious the situation is and take a wait-and-see approach. But time is very important, and anyone with these warning signs needs to get medical evaluation and treatment right away. Don’t wait more than a few minutes—5 minutes at most—to call 9-1-1.

By calling 9-1-1 and taking an ambulance you will get to the hospital in the fastest way possible. There also are other benefits to calling 9-1-1:

Emergency personnel can begin treatment immediately—even before you arrive at the hospital.
Your heart may stop beating during a heart attack. Emergency personnel have the knowledge and equipment needed to start it beating again.
Heart attack patients who arrive by ambulance tend to receive faster treatment on their arrival at the hospital.
Note: If you are having heart attack symptoms and for some reason cannot call 9-1-1, have someone else drive you at once to the hospital. Never drive yourself unless there is absolutely no other choice.

Questions You Will Likely Be Asked in the Emergency Department

When you get to the emergency department, you should be ready to answer, as best as you can, the following questions about your symptoms:

• What time did your discomfort begin?
• What were you doing when your discomfort began?
• Was it at its most intense level immediately or did it gradually build up to a peak?
• Did you notice any additional symptoms in association with the discomfort, such as nausea, sweating, lightheadedness, or palpitations?
• On a scale of 1 to 10 with 10 being the worst, what number would you use to describe your discomfort at this time?

Your answers to these questions will help the doctor give you the best possible care and make you a partner in your care.

Tests to See if You Are Having A Heart Attack

Electrocardiogram (ECG or EKG). This is a graphic record of the electrical activity of the heart as it contracts and rests. It can often detect areas of damage, inadequate blood flow, heart enlargement, and abnormal heartbeats. The ECG does not always show the damage that is occurring, particularly if it involves the left side or back walls of the heart. In such cases, blood tests or other studies that can "image" the heart’s blood flow are used.

Blood tests. Blood tests are often used to check for "biochemical markers" that are released into the blood within the first few hours after heart damage occurs. In some cases, some of these blood tests can identify "high risk" conditions in which a heart attack may be imminent.

Nuclear scan. This is sometimes used to show damaged areas of the heart and reveal problems with its pumping action, which is particularly helpful in cases where the ECG does not detect the damage. A small amount of radioactive material is injected into a vein, usually in the arm. A scanning camera positioned over the heart records the nuclear material, which is delivered by the coronary arteries and either taken up by the heart muscle (healthy areas) or not taken up (damaged areas). In particular cases, the camera can also evaluate how the heart muscle as a unit pumps the blood. This test can be done during both rest and exercise.

Coronary angiography (or arteriography). This test is used to take detailed pictures of the coronary arteries. A fine tube (catheter) is threaded through an artery of an arm or leg up into the heart. A fluid that shows up on x-ray is then injected, and the heart and blood vessels are filmed as the heart pumps. The picture is called an angiogram or arteriogram. It can show problems such as a blockage caused by atherosclerosis.

Remember: Don’t Delay

The best way to find out if symptoms are due to a heart attack is to get them checked at a hospital emergency department.

In a heart attack, every minute that passes causes more of the heart muscle to die. You can save a life—your own or someone else’s—by calling 9-1-1 right away.

Doctors and emergency personnel want anyone who may be having a heart attack to come to the emergency department without delay, even if the symptoms turn out to be a false alarm.

Plan Ahead

Make a plan now for what you would do if a heart attack should happen. It will save time and could help save a life. To plan ahead:

• Learn the heart attack warning signs listed in this article.
• Talk to your doctor about your heart attack risk and what you can do to reduce it. Ask specifically about aspirin and the use of nitroglycerin.
• Talk with your doctor, family members, friends, and coworkers about the heart attack warning signs and the importance of acting fast. Discuss the benefits of calling 9-1-1 instead of going to the hospital by car. Knowing what to do if a heart attack occurs could save your life or theirs.

This information is from the American Heart Association