Hundreds of thousands of Americans suffer a heart attack every year, and heart disease remains the biggest cause of death here in the U.S. And when those heart attacks happen, typically you’ll feel it in your chest first.
“Most of the time, that pain is a really bad aching, pressure feeling, although some people perceive it as a sharp pain,” said Dr. William Brady, a professor of emergency medicine at the University of Virginia. “About 70% of people that have a heart attack are going to have chest pain as the primary symptom.”
But that means about 30%, which isn’t an insignificant number of people, have to watch for other symptoms beyond chest pain.
“There’s a couple of other groups of the population that just don’t always have the same symptoms as most people do early on,” Brady said.
That includes women, older Americans (especially those over 80) and someone who might be diabetic. So you need to be on the lookout for other signs too.
“This can be like sudden, extreme weakness, terrible, extreme fatigue that happens all of a sudden, usually associated with nausea, maybe vomiting,” Brady said. “The sweating, maybe shortness of breath, sometimes the chest pain can begin to appear after the weakness and the fatigue has actually hit the patient and is making them feel bad.”
In some cases, the pain might show up not in the chest, but the arms, your neck, or even your jaw. Brady said that’s usually called referred pain or radiating pain.
“Most of the time, people have pain in their middle or left chest,” he noted; however, “You can have radiation of the pain to the left shoulder, the left elbow, sometimes the right shoulder, up into the jaw, the front part of your neck.
“You may not have any chest pain,” Brady added. “I’ve seen patients that have come in and have had really bad elbow and shoulder pain on the left side without any chest pain, but they also had some nausea. They also were sweating profusely, and so that should trigger the possibility of a heart attack in the patient.”
It’s another way that the pain people feel can be very individualized. And having a heart attack doesn’t necessarily mean you’re in cardiac arrest and will collapse right away. But left untreated, it can get to that point.
“A heart attack is, in most cases, a blockage of one of the heart arteries that reduces or blocks blood flow to the actual muscle of the heart, and the heart muscle begins to die because of inadequate blood flow,” he said.
You may decide you need to lie down, but you’re not going to collapse, at least initially. Still, if you feel those symptoms, you need to call for help.
“Paramedics can treat you en route to the hospital and stabilize any complications of a heart attack,” said Brady. “Once you arrive in the emergency department, you’ll be able to be treated for the heart attack itself.”
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