STATEN ISLAND, N.Y. — You finally have a day off after a long work week without a break. You already have several hours of yard work done by the time neighbors are up and outside. You stop to drink some more iced coffee — the second one of the day. A dull ache in your chest grabs your attention. You figure it’s probably just acid reflux from the coffee.
The discomfort continues as you pull weeds in the garden. After 15 minutes of a not so painful but distracting pressure in your chest, you decide to rest to see if it goes away. “It can’t be a heart attack,” you mumble to yourself, figuring the pain wasn’t that bad, just an annoying pressure.
Should you be concerned? What other signs and symptoms should you be looking for? How concerned should you be when you experience chest discomfort? When should you call 911?
Chest pain doesn’t always signal a heart attack. But heart attack pain and other signs and symptoms are often not as dramatic as they appear in TV shows.
Chest pain as a result of a heart attack is usually caused by cardiac cells that are starved of oxygen. This usually happens because a blood vessel leading to that area of the heart is blocked, preventing oxygen-rich blood from flowing to the cells.
The blockage may be due to a blood clot, a fatty plaque or a spasm. Most often, the culprit is a blood clot that’s formed when a piece of the plaque inside the blood vessel wall breaks away. The body recognizes this as an injury and attempts to repair it by clotting.
Assuming this is the cause of your discomfort, what can be done? First, don’t try to decide for yourself whether or not the pain is heart related.
Call 911 and let paramedics and EMTs do further tests and transport you. Deciding to drive yourself to the emergency department could cost you your life.
SIGNS AND SYMPTOMS
Chest pain/discomfort due to heart problems can include the following signs and symptoms:
‡¤pressure, tightness, fullness often in the middle of the chest
‡¤pain that doesn’t change with a deep breath or with touching the area
‡¤pain or discomfort that may radiate (extend) to other areas, especially the neck, jaw, arm(s) and back
‡¤shortness of breath
The severity of these symptoms can vary widely with each person and with each heart attack. Even if symptoms never get severe, it doesn’t mean the heart is not involved. Even major heart attacks can have seemingly mild symptoms. This is especially true if you have diabetes.
GET HELP QUICK
Getting help quickly is key to avoiding the long-term damage that was so common with heart attacks in the past. Within hours of being oxygen starved, the cells of the heart muscle can begin to die. This can be fatal or leave you with a poorly functioning heart.
Getting help by calling 911 as soon as you suspect heart involvement will give emergency medical teams the best chance of preventing permanent damage. As soon as paramedics and/or EMTs arrive, they will obtain your information about the episode and measure blood pressure and other vital signs. They will also give you oxygen and chewable aspirin, which will help prevent any further clots from forming inside your heart’s blood vessels.
Paramedics will evaluate your electrocardiogram (ECG or EKG) and give you additional medication while transporting you to a hospital. The hospital may have a specialized treatments including a cardiac catheterization lab, if needed.
You may be moved within minutes to this lab where doctors will unclog the blocked heart arteries, thereby saving the tissue in your heart from death.
All of this can happen only if you call for help early enough in the course of your heart attack — and only if you recognize that while all chest pain is not a heart attack, a heart attack doesn’t necessarily cause severe chest pain. Don’t try to diagnose yourself.