Most people imagine they would know when they are having a heart attack. It would be difficult not to recognize symptoms of "the big one" – sweating, soreness in the left arm, and sudden, disabling chest pain.
But that’s not always the case. Sometimes the signs are much more subtle or mimic other conditions.
"I have heard of instances when a cardiologist was having a heart attack and thought they were having indigestion," says Elizabeth Jackson, MD, assistant professor of cardiovascular medicine at the University of Michigan Health Systems.
As with any health issue, knowledge is power. And when your heart is on the line, you need all the power you can get.
So here are six major heart health myths and the reality behind them.
Heart Myth #1: I would know if I had high blood pressure or high cholesterol.
Not unless you get a blood pressure or cholesterol test. That's the only way to know if you have high blood pressure (hypertension) or unhealthy cholesterol levels.
Risk factors are usually silent, meaning they have no obvious associated symptoms.
"Hypertension is the silent killer, you are not going to know you have it," says Jennifer Mieres, MD, a cardiologist at North Shore-Long Island Jewish Health System. "When high blood pressure presents as a symptom like headaches or renal failure, it is more difficult to control at that stage. Early treatment is essential to preventing end organ damage, which is often irreversible."
The same goes for high cholesterol. A person can be thin and in good shape and still have high cholesterol.
"These can all silently be doing damage even though we may think we are in the best of health," Mieres says.
Heart Myth #2: Heart disease treats men and women the same.
Heart disease can affect the sexes very differently.
This begins with symptoms. Although many people experience the classic "elephant sitting on the chest" sensation when they have a heart attack, there are also less traditional symptoms, and they are more common among women.
In 2003, a study published in Circulation examined the symptoms that 515 women, (average age 66), had experienced before having a heart attack. The researchers found that for at least one month prior to the acute event 70% of the women experienced unusual fatigue, and nearly 50% had weakness, sleep disturbance, or shortness of breath. What's more, 43% of the women felt no chest pain at the time of their heart attack presentation.
Nausea and/or indigestion can also be unusual (atypical) symptoms forewarning a heart attack.
"Men can have less classic symptoms, but there is a higher prevalence with these in women," Mieres says. "Older women tend to present more like men, with the classic chest pain, which is still the overwhelming symptom of a heart attack."
Putting all of this in context is important. Not all unusual symptoms mean you have heart disease. But if you have risk factors, pay attention to how you feel. New or changing symptoms, even if not typical, could be a sign of problems with the ticker.