How do I know if I’m going to have a heart attack?

by Dr. S. Russell Vester, MD 29. September 2013 16:01

S. Russell Vester

One of the most common questions I’m asked every time I have office hours is “How do I know if I’m going to have a heart attack?”  Well, to be perfectly accurate, you can’t know without the help of a doctor and some tests. What you really want to know is what would you feel or experience that should get you to go to an emergency room to get these tests.

What you feel is not as specific as you might think. On the inside the sensory nerve fibers around your heart are few and far between. About the best they can do is to give you an idea of the general region in your body where the problem is. To top that off, sometimes what should be pain from your heart can actually make other things in the neighborhood hurt. And just to make it more confusing, other organs in the general area of your heart, such as your esophagus, your stomach or your gall bladder can cause discomfort that feels like it’s from your heart.

Heart pain is rarely if ever sharp. Typically patients will tell you about a dull ache or pressure/squeezing sensation in the middle of their chest that either comes and goes (but doesn’t go away completely) or simply started and didn’t stop. Other symptoms that might either be present at the same time as the mid-chest discomfort or be there by themselves include pain or ache in the jaw or neck, running down either arm, in your back between your shoulder blades or under one shoulder blade or, finally, in your upper abdomen just below your breast bone (sternum).

It is fairly common in my experience for people to experience nausea, diffuse sweating despite being at rest and/or a general feeling of anxiety. Sudden onset of shortness of breath can also be present.

These symptoms apply equally to men and women.

Your body has these signs and symptoms built in to keep you from harm. They are designed to make you want to slow down and rest so you don’t provoke more harm to your heart. What’s scary is that not everyone is capable of experiencing these warning symptoms. As many as 1 in 6 people may be in this category. Nobody really knows for sure how many folks there are like this. These are the people that you saw in the grocery store on Tuesday only to find that on Thursday you are sending flowers and saying stuff like “Gee, he looked so good when I saw him Tuesday.” Insulin dependent diabetics are most commonly in this unfortunate group, but this is not a requirement.

The point here is this. If you have a family history of heart disease or have been persistently obese for a long period of time or have been smoking for any period of time or have known high cholesterol or you have been ignoring your blood pressure since Bill Clinton was President or any combination of the above, don’t think your body is going to give you some dependable warning sign to keep you from harm before it’s too late. Nature is not that kind.

And if you think, somehow, that you, special you, is going to be the one that defies the odds and cheats Mother Nature at her own game, well…in the words of Clint Eastwood from the immortal movie Dirty Harry, “Go ahead, make my day.” Remember, I’m a heart surgeon.

To learn more about heart pain, take a look at this article.

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