Knowing the Signs of a Heart Attack Could Save a Life

Mention the words "heart attack" and most of us recoil at the image of someone clutching at their chest in sudden, obvious agony before collapsing to the ground.

While that scenario happens in some cases, you should know that mild chest pain, discomfort in the jaw, and lightheadedness are among other, less-dramatic signs that can signal a heart attack.

Further, by not responding quickly to those warning signals and delaying treatment, you could be putting yourself at risk for heart damage and even death.

This is why the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health (NIH), the National Council on the Aging, the American Heart Association, and other groups have launched a new public education campaign called "Act in Time to Heart Attack Signs."

Too few Americans get to a hospital fast enough when they have a heart attack; anyone with symptoms should call 911 immediately. Yet studies show that many people wait two hours or more before they seek emergency care, according to the NHLBI.

Each year, about 1.1 million Americans suffer a heart attack and about 460,000 of them die. Nearly half of those deaths occur within one hour of the start of symptoms, the NHLBI says.

"We are certainly aware that the number one cause of death and disability in older Americans is due to premature heart attack and stroke," says Roba Whiteley, the National Council on the Aging's vice president of marketing and communications.

"But people don't know what the signs and symptoms are and it can be quite confusing," she says.

Heart attacks happen when blood flow to the heart is nearly or completely blocked. And it is during the crucial first hour after symptoms appear that "clot-busting" drugs and other treatments, such as angioplasty, are most effective in opening clogged arteries and restoring blood flow, says Mary Hand, coordinator of the NHLBI's National Heart Attack Alert Program.

"The sooner the artery is opened and the blood flow in the blocked artery is reestablished, the much better outcome the patients have, both in terms of surviving and in terms of saving their heart muscle," Hand says.

Yet only one-in-five heart attack patients gets to a hospital emergency room fast enough to benefit from these treatments.

Some of the less-familiar signs of a heart attack include:

• chest discomfort or pain
  
  
• discomfort in the arm or arms, as well as the back, neck, jaw, or stomach
  
  
• shortness of breath
  
  
• a cold sweat
  
  
• nausea
  
  
• lightheadedness

Many people are unaware that these milder symptoms may indicate a heart attack; they dismiss them as signs of indigestion, the flu, or even a pulled muscle. Always consult your physician for a diagnosis.

One reason people are unaware of these subtle signs is that too few physicians take the time to discuss them with their patients, Hand says. One focus of the "Act in Time" campaign is to get physicians to talk to their patients about heart attack symptoms and how to respond to them.

Lack of knowledge is not limited to a heart attack's warning signs. Many women are slow to seek help when having a heart attack simply because they believe they are not at risk.

"Women, still, as a rule, don't think that they're going to get heart disease or a heart attack. They're more concerned about breast cancer. And yet one-in-three women are going to die from heart disease and approximately one-in-seven will die from breast cancer," Hand says.

And sadly, some people delay calling for help because they worry about being embarrassed if their symptoms turn out to be a false alarm.

The "Act in Time" campaign is not aimed just at people who may be at risk for a heart attack, either—everyone needs to know the signs of a heart attack so they can be ready to help family members, friends, and co-workers.

Hand also encourages everyone to have a "heart attack action plan," much the same way you make an emergency plan for a house fire.

"We actually want people to think through and talk with their family members about what they should do if they get these symptoms and to make sure everybody is on board with what we're asking them to do. That is, call 9-1-1, get to the hospital right away," Hand says.

Older Americans should be sure to discuss their action plans not just with family members, but neighbors, friends, caretakers, or housekeepers, the National Council on the Aging's Whiteley says.

Always consult your physician for more information.

In Other News That May Affect Your Cardiovascular Health:

Chronic Heart Failure Medication May Not Be Working as Intended

A drug that relaxes blood vessels does not appear to help people with flare-ups of chronic heart failure and may even worsen the problem, a new study has found.

The study, published in the Journal of the American Medical Association (JAMA), showed that heart patients were better off without the drug, called milrinone, which increased the risk of seriously low blood pressure and abnormal heartbeats.

"Milrinone isn't working," said Dr. Mihai Gheorghiade, a Northwestern University cardiologist who led the study.

Dr. Philip Poole-Wilson, a cardiologist at Imperial College in London and author of an editorial accompanying the journal articles, said milrinone "has probably been used too much and the indications for its use are getting very much more narrow." An earlier study showed that the drug was not effective—and potentially dangerous—for people with chronic heart failure.

However, Poole-Wilson said, the drug may be appropriate for people with other forms of congestive heart failure. Who these patients are is not yet known, he added, because of the paucity of good clinical evidence for treatments of this disease.

Improved Blood Flow Seen in Second Study

A second study, also appearing JAMA, found that a newer medication markedly improved blood flow in a similar group of patients.

Experts said the two studies are important because they represent the first large-scale, placebo-controlled trials of drugs to treat worsening heart failure.

Almost five million Americans suffer from heart failure, and 200,000 a year die from the disease, which involves a fluid build-up in the lungs that forces patients to strain for breath. Fluid can also pool in the legs. Heart failure can lead to liver congestion, abnormal heart rhythms, and, ultimately, death.

Beta-blockers, ACE-inhibitors, and a variety of other medications can improve heart function in patients with chronically weak pumps. But physicians have hit on nothing so far that prolongs life in those hospitalized with acute failure.

The problem, heart experts said, is that patients, their families, and their physicians are frustrated by the lack of a successful remedy for severe exacerbations of heart failure. Everyone wants to do something, but nothing seems to work. So drugs that might ordinarily be avoided are tried, in the hope that patients might have a glimmer of improvement.

Always consult your physician for more information.