If you were asked to name a symptom of a heart attack, what would you say? Chest pains? Pains down your left arm? It might surprise you to know that the most common symptoms are ones that you would not associate with your heart – being unusually tired, having sleep disturbances or feeling anxious – all at a level that are not normal for you. Chest pain is only the 4th most common symptom and frequent indigestion/heartburn is a very close 5th. So don’t dismiss these other symptoms. Read on…
The Facts and Figures
In Northern Ireland 20 men die every week from heart disease. In 2016/17, 3056 men were admitted to hospital with a heart attack (Northern Ireland).
Since 1990 the number of men dying from heart disease in Northern Ireland gone down by 40%.
Heart disease is the number one killer of men in Northern Ireland today.
Heart disease is also the highest ranked disease on the disability adjusted life years (DALY) scale, which combines the effect of disability on a person’s life with the statistics about how many people a disease kills . In other words, heart disease not only shortens your life, it also shortens the number of healthy years you have.
A heart attack is when the blood supply to the heart is cut off. Without oxygen, the heart muscles may begin to die. Most heart attacks happen when fatty deposits from inside the artery walls break away and trigger the formation of a blood clot.
If a large portion of the heart is damaged in this way, the heart stops beating (known as a cardiac arrest), resulting in death.
Click here to find out more information about heart conditions.
Signs and Symptoms of a Heart Attack
When we think of a heart attack, we imagine the “Hollywood heart attack” – someone clutching their chest, experiencing the “classic” sudden and severe chest pains.
However research1 tells us that only one third of people who have a heart attack experienced the fast-onset “Hollywood heart attack” symptoms.
Symptoms can be categorised as fast-onset or slow-onset.
Fast-onset symptoms come on suddenly and are continuous and severe. They are usually the classic chest pains, but can be accompanied by other symptoms. Only one third of people experience these and there is no difference between men and women.
Slow-onset symptoms start gradually, and at first are intermittent and mild, but often become continuous and more intense in the hours, days and weeks leading up to the heart attack. For the majority of people (two-thirds) their only symptoms were the milder, intermittent slow-onset symptoms.
What are these slow-onset symptoms men should look out for?
In an international study2 of 1000 patients – 777 men and 368 women– all under the age of 55, researchers found that chest pains are not the only symptom men should be looking out for.
There was hardly any difference between the number of men experiencing chest pains and the number of men experiencing heartburn. A local cardiologist recently told NICHS that in his opinion, if a man starts suffering from heartburn in his 40s and 50s, and has not suffered from it in his 20s or 30s, then it is more likely to be his arteries and heart than his stomach and digestive system.
It is important to remember that it is the overall pattern of symptoms that helps to determine whether you are having a heart attack.
STOP is an acronym for:
S – Something’s not right – symptoms can start slowly
T – Tightness or pain in the chest, pain in the arm, neck or jaw
O – Other symptoms such as shortness of breath, nausea or sweating
P – Phone 999 immediately – the ambulance crew will do an ECG.
What men say…
“The morning of my heart attack, I was out cycling from Portadown to Newry. I felt an odd type of pain, like trapped wind, but down my arm. I tried painkillers and a pint of milk but it wouldn’t go. So I returned home and my sister persuaded me to go to hospital. I am glad I did as it turns out I’d had a heart attack!” Geoff
“I thought my heart attack was heartburn – the worst heartburn I’d ever had. It lasted from Wednesday to Friday. I was bent double at my desk and my colleagues said I looked really grey. I didn’t find out until the next week but I’d had two heart attacks – probably while in the pharmacy buying indigestion tablets!” – Kevin
“I had severe indigestion, or so I thought, for months. I was in terrible pain. Eventually my wife of almost 60 years issued me with an ultimatum: “If you don’t go to the doctor, I’m leaving!” My arteries were so blocked, I needed a quadruple bypass!” – Seamus
“I was lucky my colleagues knew the symptoms of a heart attack – severe pain that felt like really bad trapped wind, sweating and looking very grey. They took me to hospital where I went into full cardiac arrest. If that had happened at work, in some far corner of the warehouse, I probably would have died.” – Mark
“In the run up to my heart attack, I’d not been feeling right. Two days before my heart attack, on the Thursday, my GP diagnosed me with very high cholesterol and immediately put me on statins. This might sound daft but I genuinely had no idea that this meant I was a candidate for a heart attack. But on the Saturday that is exactly what happened.” – Sean
Prevention is better than a cure! So it makes much more sense to make healthy choices that reduce your chances of developing heart disease.
There are some risk factors for heart disease that you can’t control:
Family history: if your siblings or parents had a heart attack at an early age (under 55 for men or under 65 for women), your own chances will be higher.
Age: the risk of heart attack increases with age.
Gender: the risk of heart attack increases with age, for both men and women.
Ethnic origin: people with an Afro–Caribbean or South–east Asian background have an increased risk of heart attack.
Medical history: If you have already have angina you have a greater chance of having a heart attack.
Genes: There are genetic conditions which makes your blood more likely to clot, or affect your blood pressure or cholesterol levels.
There are also risk factors you can control.
To reduce your risk of a heart attack:
Watch your weight
Keep physically active
Eat a balanced diet
Moderate your alcohol intake
Manage your stress levels
Get enough sleep
- Slow-onset and Fast-onset Symptom Presentations in Acute Coronary Syndrome (ACS): New Perspectives on Pre-hospital Delay in Patients with ACS.
Sharon O’Donnell, BNS, MA, PHD, Gabrielle McKee, BA, PHD, Mary Mooney, MSC, Frances O’Brien, MSC and Debra K Moser, DNSC, RN, FAAN.
The Journal of Emergency Medicine, Vol 46, No 4, pp 507-515, 2014.
- Sex Differences in prodromal symptoms in acute coronary syndrome in patients aged 55 years or younger
Nadia A Khan, Stella S Daskalopoulou, Igor Karp, Mark J Eisenberg, Roxanne Pelletier, Meytal Avgil Tsadok, Kaberi Dasgupta, Colleen M Norris, Louise Pilote for the GENESIS PRAXY team.
First published on December 13 2-16 as 10.1136/heartjnl-2016-309945.