A heart attack, known as an acute myocardial infarction, occurs when the heart muscles do not receive sufficient blood and a portion of the muscle dies. Since the heart is a muscular pump, damage or death of even a small portion of its muscle can compromise normal circulation and lead to death.
Most of us are familiar with the typical symptoms of a heart attack – chest pain – that is constricting in nature and excruciating. However, there are several other symptoms of a heart attack that may present before the chest pain. These symptoms are at times ignored or even missed altogether.
Pre-heart attack symptoms occur in episodes known as angina pectoris and may be similar to a heart attack but will exist over months or even years.
Sweating is often missed as a heart attack symptom particularly among the elderly who have a problem with temperature regulation, in obese people and when living in hot and humid environments.
However, when sweating is profuse and occurs suddenly in a person at high risk of having a heart attack, it should immediately be investigated despite the lack of chest pain. Apart from the other typical heart attack symptoms, profuse sweating may be accompanied by cold and clammy skin in a heart attack.
A burning chest pain or discomfort (heartburn) is often thought to be due to acid reflux where the acidic stomach contents moves up into the esophagus. However, a burning chest pain or discomfort can occur with a heart attack as well.
Understandably this is confusing especially since the typical heart attack pain is constricting in nature. To complicate it further, acid reflux and a heart attack are both more likely to occur after eating large meal and strenuous exercise. Read more on heartburn and heart attack pain.
Nausea is a common and non-specific symptom. It is a prominent heart attack symptom but most of the time it is associated with gastrointestinal conditions like acid reflux or indigestion. Coupled with heartburn, it is not uncommon for it to be missed as a heart attack symptom.
Vomiting may accompany the intense nausea which proves even more confusing. A person assumes that symptoms are related to an upset of the gut – initially the nausea and then confirmed with the onset of vomiting. The violent nature of vomiting tends to produce soreness of the chest which can partially mask heart attack pain.
Jaw, Neck and Arm Pain
Heart attack pain tends to radiate to the neck, jaw and arm particularly on the left side. Radiating pain means that it is intense in the chest but extends outwards to other areas. Sometimes the pain may refer (not radiate) to these areas without there being prominent chest pain. In these instances it is mistaken for localized causes of jaw, neck or arm pain such as an injury or muscle strain without suspecting the cardiac origin.
Dizziness is a common non-specific symptom that occurs with a heart attack. It may vary in severity and in some cases a person may be able to continue with daily functioning despite feeling dizzy. However, when it is more prominent, it may be followed by fainting spells which is more likely with severe heart attacks or rapidly progressing heart failure.
A person having a heart attack experiences anxiety typically described as a sense of impending doom. Anxiety may occur for any number of reasons and naturally it is not suspected to be a heart attack symptom when there is no chest pain. Some people with anxiety disorders have acute spells which can be mask the anxiety associated with a heart attack. Therefore it is important to be cautious of anxiety spells in a person at risk of a heart attack.
Rapid breathing and shortness of breath may occur as the circulation is compromised and the body’s tissues are not receiving enough oxygen. Coupled with anxiety, it is commonly mistaken for a panic attack. However, additional signs like paleness or even a bluish tinge to of the skin and lips indicates cyanosis (insufficient oxygen perfusion).
A person experiencing a heart attack may sometimes not experience any of these symptoms. Often it is just a matter of these symptoms being mild and therefore ignored. All that could be prominent in certain instances is malaise – a feeling of being unwell but without any specific signs or symptoms to indicate the cause. It is also referred to as a ‘fluish feeling’. Therefore any person with coronary artery disease or who is considered to be at high risk of having a heart attack should be attentive of some of these symptoms. It may be a heart attack despite the absence of the typical intense cardiac chest pain.