Any new pressure in upper body can signal heart attack

Not everyone who suffers a heart attack clutches their chest and falls to the floor. "I woke up and felt like a pill was stuck in my throat," says Betsy, a 68-year-old patient from Upper Providence. "I was taking antibiotics at the time and really didn't think much of it," she adds. "So I tried drinking water and when the "stuck" feeling didn't go away after 45 minutes, I thought something might be wrong."

"My son took me to the Emergency Room and yes, now I realize I should have called 9-1-1 immediately." After the ER staff ran an EKG (a test that measures the electrical activity of the heart), they told Betsy she was having a heart attack. "Next thing I knew, they took me right to the cardiac cath lab and inserted a stent to open up my artery. After two days in the hospital, I came home and started cardiac rehab three times a week for about the last 5 weeks."

Betsy's recovery also involved making important changes to her lifestyle like quitting smoking, "which I really didn't want to do, but I had to," watching her cholesterol, and making time for daily exercise—whether it's walking or using free weights.

"What's amazes me most is that I didn't even realize I was having heart attack. Had I waited much longer, things may have turned out very differently."

Betsy is one of an estimated 650,000 Pennsylvanians, ages 35 and over, who have been told by a doctor that they've had a heart attack. In the January 2010 Patient Poll conducted by the Institute for Good Medicine at the Pennsylvania Medical Society, 34 percent of those surveyed said they'd know they were having a heart attack because their chest and arms would hurt.

Not necessarily so, says C. Richard Schott, MD, a Philadelphia-area cardiologist and Pennsylvania Medical Society member. "Pain isn't always an indictor. Any new pressure or discomfort in the upper body can signal a heart attack."

Warning Signs

Dr. Schott urges patients to pay close attention to these heart attack warning signs:
-Pressure or discomfort in the chest/upper body
-Discomfort radiating to the left arm, jaw, back, neck or stomach
-Shortness of breath
-Sweating, nausea, dizziness

If you experience one or more of these symptoms, it's best to call 9-1-1 right away. "Err on the side of caution and assume it may be a heart attack. The longer you wait, the more damage is done to your heart." Dr Schott also notes, "And the only ride you should take to the ER is in an ambulance - they can alert the cardiac team in advance of your arrival and, if your heart stops, emergency personnel can begin treatment immediately."

Who's at risk?

Betsy's smoking, age, and sedentary job put her at risk for a heart attack. Here's what else matters:

1.Family History—If your father had heart problems before age 55 or your mother had problems before age 65, or if your brothers or sisters have had heart attacks, talk with your doctor and be especially careful to minimize other risks.

2.Smoking—Heart health is only one of many reasons to quit.

3.Cholesterol—Cholesterol abnormalities, meaning both high LDL (bad cholesterol) and low HDL (good cholesterol), in some cases, can be controlled through diet and exercise. Often, however, medication may be needed.

4.High Blood Pressure—Hypertension (chronic high blood pressure), is a condition with few or no self-evident symptoms. It may be controllable through diet and exercise and, as with cholesterol levels, with medication.

5.Diabetes— If you have diabetes, you have a much higher risk of heart attacks which may occur with atypical symptoms. It is extremely important to work with your doctor to manage your diabetes.

6.Physical inactivity -- Regular, moderate-to-vigorous physical activity can help control blood cholesterol, diabetes, and obesity, as well as help lower blood pressure and reduce your risk of heart attack.
To find our about your own risk and for additional resources, take the Cardiac Risk Assessment on the medical society's Family Health & Wellness website, www.myfamilywellness.org. Click on "How's Your Health" and select "Health Assessments."

Prevention

Beyond recognizing and responding to heart attack symptoms, Dr. Schott says that he and his member colleagues encourage patients to take steps now to prevent heart attacks or repeat heart attacks.

"The same advice applies, whether you've had a heart attack or would like to keep your heart healthy:

-Don't smoke.
-Manage your blood pressure and cholesterol.
-Eat healthy and exercise daily.

Betsy fortunately got the message about a healthier lifestyle and we've worked together to help her make those important changes. But she did the hard work."
James Goodyear, MD, president of the Pennsylvania Medical Society sums up, "Our job as physicians is not just to treat sick patients. We're here to work with our patients to provide the information and support they need to prevent illness and improve their health in the long run."