Recognizing a Heart Attack or Angina
If you have risk factors for heart problems, you should always watch for signs of angina or a heart attack. If you have a sudden heart problem, getting treatment right away could save your life. Risk factors for a heart attack include advanced age, high cholesterol, high blood pressure, having a family member who had a heart attack before the age of 50, diabetes, smoking, and stress. There are other risk factors, including eating a high-fat diet and not getting much exercise.
Understanding angina and heart attack
Angina is a painful burning, tightness, or pressure in the chest, back, neck, throat, or jaw. It means not enough blood is getting to the heart. This is usually from a blocked artery in the heart. Angina is a sign that you may be having, or are about to have, a heart attack. You need to see a healthcare provider right away.
A heart attack is also known as acute myocardial infarction (AMI). It is what happens when blood can't get to part of the heart muscle. That part of the heart muscle is damaged and starts to die. If enough of the heart is affected, it will severely limit its ability to send blood to the rest of the body. It may cause death. It is vital to get help as soon as possible for a heart attack.
Stable angina versus unstable angina
Stable angina is also known as chronic angina. It has a typical pattern. It happens when you exert yourself physically or feel a strong emotion. Nitroglycerin, rest, or both, will easily relieve stable angina symptoms. Stable angina symptoms will most likely feel the same each time you have them. It is important to discuss these symptoms with your healthcare provider. They can be a warning sign of a future heart attack.
Unstable angina causes unexpected or unpredictable symptoms, commonly when you are at rest. Unstable angina is a medical emergency. Angina is also considered unstable if resting and nitroglycerin don't ease symptoms. It is also unstable if symptoms are getting worse, happening more often, or lasting longer. These symptoms may mean you have a severe blockage or a spasm of a heart artery. Unstable angina is commonly a sign of an active heart attack. Remember the following tips:
Stable angina symptoms should go away with rest or medicine. If they don’t go away, call 911!
Stable angina symptoms last for only a few minutes. If they last longer than that, or if they go away and come back, you may be having a heart attack. Call 911!
If you have shortness of breath, cold sweat, nausea, or lightheadedness, call 911!
For angina that shows up for the first time, there is only one response: Call 911! You should never diagnose angina by yourself. If these symptoms are new, or worse than usual, call 911!
Warning signs of a heart attack
If you have symptoms that you can’t explain, call 911right away. Don't drive yourself to the emergency room. The following are warning signs of a possible heart attack:
Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
Shortness of breath with or without chest discomfort
Other signs may include breaking out in a cold sweat, nausea, or lightheadedness.
If you think someone is having a heart attack, call 911 instead of driving the person to the ER. The 911 dispatcher may tell you to give the person aspirin while waiting for help to arrive. If the dispatcher doesn’t tell you to do this, don’t give the person aspirin. Aspirin can be dangerous under certain circumstances.
Note for women. Like men, women commonly have chest pain or discomfort as a heart attack symptom. But women are somewhat more likely than men to have other common symptoms, such as shortness of breath, nausea and vomiting, back pain, or jaw pain.
Note for older adults. Older people may also not have typical symptoms of a heart attack. They may have symptoms that include fainting, weakness, or confusion. Ignoring these symptoms can lead to critical illness or death. You should get your symptoms checked out right away.
If you've had a heart attack. People who have had one heart attack are at risk for having another. Your provider may prescribe medicine such as nitroglycerin to take when chest pain starts. Or you may need medicines to lower your heart rate and blood pressure to prevent angina and another heart attack. Remember to take any medicines your provider has given. Don't not stop them without speaking with your provider first.
If you have diabetes: silent heart problems
Over time, high blood sugar can damage nerves in your body. This may keep you from feeling pain caused by a heart problem, leading to a “silent” heart problem. If you don’t feel symptoms, you are less able to recognize that you may be having a heart attack and get treatment right away. Talk to your healthcare provider about how to lower your risk for silent heart problems.
May 08, 2018
Jneid, H. ACCF/AHA Guidelines for the management of patients with unstable angina. Circulation (2012); 126(7); pp. 875-910
Cunningham, Louise, RN,Gandelman, Glenn, MD, MPH,Image reviewed by StayWell art team.,Snyder, Mandy, APRN