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Recognizing Heart Attack, Stroke, and Angina

By
WebMD Feature
Reviewed by Robert J Bryg, MD

Doctors call it the "Hollywood heart attack": a middle-aged man breaks into a cold sweat, grimaces, and clutches his chest-just like in the movies. Trouble is, in real life, heart attack symptoms don't always announce themselves so dramatically. More often they are insidious and puzzling, such as unexplained fatigue or abdominal discomfort, and many people wait for hours before seeking help.

Big mistake, doctors tell WebMD. The ability to quickly spot signs of heart attack, angina, and stroke can be life-saving. The sooner you call 911, the faster you can get to an emergency room for treatment. Early treatment not only minimizes heart- and brain-tissue damage, it can save your life.

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But most people delay. the American Heart Association When it comes to medical emergencies, such as heart attacks and strokes, "The weak link in the chain of events leading to prompt and effective treatment is patient delay in seeking care," according to a statement by the American Heart Association published in Circulation. The result? "Only a minority of eligible patients receive optimally timed treatment."

Symptoms of Heart Attack: Why Do People Wait?

Often, people expect the Hollywood heart attack, so they may write off unfamiliar heart attack symptoms. For example, they may blame abdominal discomfort on indigestion. Women may also experience very different symptoms than men do, and fail to recognize them as signs of a heart attack.

"With some symptoms, we have a natural tendency to not act on them in the hope that they'll just go away," says Mohamud Daya, MD, MS, an associate professor of emergency services at Oregon Health & Science University.

Patients also delay because they fear making a fuss or feeling embarrassed if symptoms turn out to be a false alarm, experts say.

Heart Attack Symptoms: What to Watch Out for

During a heart attack, blood flow to heart muscle is reduced or cut off, often because a blood clot blocks an artery. When heart muscle is starved of oxygen-rich blood, it can die.

Ideally, treatment to restore blood flow, such as angioplasty or clot-dissolving drugs, should begin within 1 hour after symptoms begin, the AHA says. The faster you can get to the emergency room, the better your chance of survival. And yet, one study found that half of people with heart attack symptoms delayed seeking help for more than 4 hours.

Familiarize yourself with these heart attack symptoms:

  • Uncomfortable pressure, fullness, squeezing, or pain in the center of the chest. These symptoms can range from mild to severe, and they may come and go.
  • Discomfort in other areas, such as the neck, arms, jaw, back, or stomach.
  • Shortness of breath, lightheadedness, nausea, or breaking out in a cold sweat.

Women may get chest pain or discomfort, but in many cases, it's not the most obvious symptom. Instead, they're more likely than men to have these symptoms:

  • Unusual fatigue
  • Nausea or indigestion
  • Dizziness or lightheadedness
  • Abdominal discomfort that may feel like indigestion
  • Discomfort described as pressure/ tightness or an ache in the neck, shoulder, or upper back

In the weeks before an actual heart attack, some women may get these signs as a warning that an artery is blocked. If you develop unexplained fatigue, shortness of breath, or abdominal pressure that feels like indigestion, call your doctor, says Nieca Goldberg, MD, a cardiologist and chief of Women's Cardiac Care at Lenox Hill Hospital in New York City. "That's the time to come in for an evaluation."

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