Symptoms and signs

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When an individual suffers from a heart attack, they may experience different symptoms and demonstrate different signs. Here we take a look at the common symptoms and signs of a heart attack.

Symptoms of a heart attack

Below are the common symptoms of a heart attack. These symptoms often last more than 30 minutes, and do not get better despite taking rest or medication.

Chest pain

Chest pain This is the most common symptom that patients experience. Typically, chest pain arises in the centre of the chest, spreading across it gradually. The description of the pain is variable, though most patients describe it as a ‘pressure on the chest’ or ‘heaviness in the chest’.

Chest pain from a heart attack can be quite severe. It can also be experienced in the jaw and down the left arm. The pain can also radiate to the back. This is because the nerves that supply the heart muscle also supply the neck, jaw and left arm.

Patients suffering a heart attack will also sweat profusely, and experience a feeling of nausea. Vomiting may occur.

In patients suffering from unstable angina or an NSTEMI, chest pain usually occurs on exertion (walking up an incline or a flight of stairs) and is relieved with rest. This is because the heart demands more oxygen during exercise, and the narrow arteries do not allow enough blood to reach the heart muscle.

However, while the above symptoms are fairly typical of a heart attack, some patients may not even realise that they are having one. This is particularly common in patients with diabetes (and hence called a ‘silent MI’ or ‘silent heart attack’. Patients may only realise that they have had a heart attack in the past when they undergo a routine physical examination and ECG at their doctor’s office. Furthermore, patients who have severe disease of the coronary arteries may experience typical cardiac chest pain at rest (when watching TV or reading a book).

If you suffer from any kind of chest pain and are concerned about it, never hesitate to seek medical assistance immediately.

Breathing difficulty

This is yet another symptom that can accompany chest pain. The exact cause of breathlessness is unclear but it appears to be due to insufficient oxygen supply to the heart muscle. In an attempt to get more oxygen to the heart, the patient starts to breathe heavily.

Not all patients who are having a heart attack or suffering from angina get chest pain. Difficulty breathing on exertion which is relieved with the rest is another symptom of a reduction in the blood supply to the heart muscle.

Breathing difficulty can also occur in patients who have suffered a massive heart attack. In this condition, a large part of the heart muscle fails to function normally and as a result, fluid accumulating very quickly in the lungs. The patient’s blood pressure can be rather low and the heart rate very high. This is known as cardiogenic shock and requires emergency treatment. The fluid in the lungs does not allow exchange of oxygen and carbon dioxide and this can cause significant breathlessness.

 Increase in the heart rate

In patients who are suffering a heart attack, the heart rate can increase dramatically. The normal heart rate ranges between 60 to 100 beats per minute (bpm). In patients having a heart attack, the heart rate can increase well over 100 bpm. Patients usually experience these symptoms as ‘palpitations’,  ‘racing of the heartbeat’ or ‘rapid beating in the chest’.

When the heart attack is severe, the fast heart rate can make the heart pump rather inefficiently. This is because the affected part of the heart fails to contract normally and the remainder of the heart is pushed into overdrive unsuccessfully. The blood pressure drops and can make the patient very unwell. This is a feature of cardiogenic shock and requires emergency management.

Irregular heart rhythms may start after the patient suffers a heart attack. Depending on where they arise from, immediate treatment of these is required. Some irregular rhythms (such as ventricular fibrillation) can be fatal.

Signs of a heart attack

Signs of a heart attack refer to the clinical findings that are elicited by a doctor on examination of the patient.

Patients suffering from a heart attack are often in a great deal of pain, clutching their hand across the chest and leaning forward in an attempt to relieve the symptoms. They are visibly sweaty and can sometimes vomit as well. On examination, the heart rate may be fast, blood pressure may be low and additional sounds may be heard on listening to the heart with a stethoscope. Fluid in the lungs may also be audible.

A detailed description of the signs of a heart attack is out of the scope of this website. It is important for patients to bear in mind the symptoms that point towards a heart attack so that they may receive immediate treatment.

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