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Is It a Heart Attack or Angina?


WebMD Feature

It’s dramatic when someone has a heart attack on television or in the movies. But in real life, symptoms can be more subtle and difficult to identify. And because heart attack and angina symptoms are so similar, it may be hard to tell what's going on.

But knowing the differences -- and the reasons behind them -- can result in seeking treatment sooner, and living longer.

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Heart Attack Symptoms

About 715,000 Americans have a heart attack every year, according to the CDC. This happens when blood flow to the heart muscle is blocked or restricted, often by a clot in an artery. Deprived of oxygen, at worst the heart muscle dies; at best it’s damaged.

A 2008 study in the American Journal of Critical Care found chest pain was the most frequently reported heart attack symptom, and 61 percent of 256 participants said their symptoms were constant.

Chest pain is reported in various ways, including:

  • Discomfort
  • Pressure
  • Tightness
  • Burning
  • Fullness
  • Squeezing

“If you’ve not experienced it before, patients often aren’t sure what it is when it first comes on,” says Kristin Newby, MD, a cardiologist at the Duke Heart Center in Durham, NC.

Not All Symptoms the Same

The same study found women were about 8 years older than men when they developed heart trouble and were more likely to report a higher intensity of 5 other symptoms:

  • Indigestion
  • Palpitations
  • Nausea
  • Numbness in the hands
  • Unusual and overwhelming fatigue

The study found 21 percent of women and 10 percent of men experienced no symptoms at all. Less typical symptoms for both genders can include discomfort in the neck, arms, jaw, back, or stomach; shortness of breath; dizziness; or a cold sweat.

“Men and women may respond differently to the symptoms of a heart attack, particularly if the symptoms are vague. But if you have symptoms consistent with a heart attack, don’t wait at home. Go to the hospital,” says Alfred Sacchetti, MD, an emergency room physician and an American College of Emergency Physicians spokesman.

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