Medical questions & health advice by board certified doctors
"What are signs of an impending heart attack?"
Heart disease runs in my family and I don?t want to be caught off guard. Are there things that I can look for.
Sometimes heart attacks occur unexpectedly, however you are correct in assuming that there are often warning signs that indicate increased risk of having a heart attack. That is why this is an important discussion to have with your primary care physician. Things to look out for roughly fall into three categories: risk factors, preliminary symptoms and diseases, and symptoms of a heart attack itself. Heart attacks are caused by coronary artery disease, the medical term for narrowing of the arteries that supply blood to the heart muscle. There are many risk factors for coronary artery disease that you can watch out for, including age, male gender, family history, smoking, diabetes, obesity, high blood pressure, high cholesterol, and a sedentary lifestyle. Some of these things you have control over and some you don't, but the best way of avoiding a heart attack is for you and your doctor to create a plan to reduce or eliminate any modifiable risk factors you may have for coronary artery disease. There are some symptoms and diseases that are associated with coronary artery disease and increased risk for a heart attack. If you notice that your tolerance for exercise is decreased, this may be a sign that your heart is unhealthy. People who experience chest pain (or sometimes shortness of breath) with exercise (or even at random) may be suffering from angina, a disease caused by poor blood flow to the heart that is associated with greatly increased risk of having a heart attack. Also, cramping in the lower extremities, most commonly the calf muscle, with exercise is called claudication and is caused by poor blood flow to the legs. Poor blood flow to the legs is called peripheral vascular disease and it is very strongly associated with coronary artery disease and heart attacks. Finally, people with other types of vascular disease and people who have had TIAs and strokes are all likely to have coronary artery disease. If you develop any of these problems, you should be examined by a primary care physician or cardiologist as soon as possible. Finally, it is important to review symptoms that may be a sign that you are having a heart attack. When most people think of having a heart attack, they think of chest pain. However, it is very important to emphasize that you can have a heart attack without feeling chest pain. That said, the most common symptom of a heart attack is discomfort or pressure below the breastbone that does not go away, or goes away briefly but quickly returns. Cardiac chest pain sometimes radiates to the left side of the chest, one or both arms, the neck, the back, or the stomach. Occasionally, cardiac pain is felt only in the stomach and the diagnosis of a heart attack is delayed because people think that they are suffering heartburn and avoid being evaluated by a physician. Another common symptom of a heart attack is shortness of breath. Other symptoms include nausea, lightheadedness, or feeling cold and clammy. If you experience any of these symptoms, call 911 immediately. Your best friend when it comes to avoiding a heart attack is your doctor. Your primary care physician should be aware of your family history of heart disease so that they can perform a comprehensive cardiac risk assessment and refer you to a cardiologist for further evaluation and treatment if needed. If you are concerned about your family history of heart disease or are experiencing any of the symptoms I discussed above, you should make an appointment with a primary care physician to determine your risk for coronary artery disease.
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