By Dr. Joseph Bove
New York Methodist Hospital
My father died of a heart attack at the age of 50 and as I approach middle age, I’m concerned about my health. What symptoms should I look for and when should I seek medical help for them?
As you’ve suspected, heredity does play a role in increasing your risk for heart attacks, which occur when blood flow to a part of the heart is blocked for a long enough time that heart muscle becomes damaged or dies. Men over 45 and women over 55 with a family history of heart attacks should be under the care of an internist and/or a specialist in cardiology to regularly monitor their heart health. In addition to family history, other risk factors for heart disease and heart attacks include high cholesterol, high blood pressure, obesity, cigarette smoking and stress.
It is also crucial to be aware of the symptoms of a heart attack so that you can seek treatment immediately if you suspect that you may be experiencing one. Some heart attacks are sudden and unmistakable — the kind portrayed in the movies when an actor clutches his chest as he falls to the ground. However, most begin slowly. Initial symptoms include discomfort at the center of the chest, which may last for more than a few minutes, or may disappear and return several times. The discomfort in the chest may feel like uncomfortable pressure, fullness, pain or squeezing. Other symptoms may include pain in one or both arms, the neck, jaw, back or stomach. Shortness of breath may precede or accompany chest discomfort. Breaking out in a cold sweat, nausea or lightheadedness may also be indications of a heart attack.
It has recently been recognized that symptoms experienced by women during a heart attack may be different than those symptoms felt by men. Women’s symptoms may not include chest pain; instead, women may feel breathless e and fatigued, with weakness or dizziness.
Many individuals shrug off these symptoms and wait too long before getting help. Remember that it is much better to seek care and then discover that a heart attack is not the cause of your pain than to ignore symptoms and get the diagnosis after there has been permanent damage. An individual experiencing any of symptoms of a heart attack should get to an emergency department right away. Delays in receiving the appropriate care may not only increase permanent heart damage and the risk of disability; they may actually reduce chances for survival. Calling 911 is most often the way to get the quickest care because treatment can begin in the ambulance on the way to the hospital.
Once in the emergency department, patients with heart attacks can be treated with clot-busting medication or with interventional cardiology procedures such as balloon angioplasty or stenting, both of which open up the involved coronary arteries. Prompt care can dramatically reduce heart damage and several studies have shown that with prompt care, some 88 percent of heart attack survivors under age 65 can return to their normal lifestyles.