Could You Have Survived a Heart Attack and Not Realized?
The common description of the sensation of a
heart attack is that it feels like there is a heavy weight crushing
your chest accompanied with a feeling of overwhelming anxiety. In films,
you often see people clutch their chest, show extreme panic, and then
collapse to the floor. It can happen like this, but not always! A heart attack occurs when the supply of blood to the heart is blocked, usually by a blood clot.
Despite the damage being caused in the body, some people experience no
chest pain at all, which means that they do not seek immediate medical
attention. Even those who get mild chest pain may just assume that it’s
indigestion and only discover that they had a heart attack after an
electrocardiogram shows damage to the heart. These are known as silent
heart attacks, and a study that was published in 2016 found that this
can occur in as many as 45% of heart attacks.
The important date for this research started being collected in the late
1990s and since then the diagnosis of heart attacks has improved
dramatically, so the figure would probably not be as high as 45% today,
but every year there are still people who, at the time, were oblivious
to the fact that they were having a heart attack.
There are also patients who knew they were
ill, but didn’t know what was causing it. They feel pain in their arms,
neck, jaw or stomach and feel short of breath or lightheaded. They might
start to sweat a lot or vomit. It’s the combination of symptoms rather
than severe chest pains that allows for a diagnosis.
It’s often said that heart attacks without chest pain are more common in
women, leading them to delay seeking help and reducing their chances of
survival. In order to establish whether this is true, researchers in
Canada in 2009 set out to measure the symptoms of a heart attack
systematically, by studying 305 patients who were undergoing
angioplasty. This is where a blocked vessel is re-opened by inflating a
little ball inside it.
This surgery can often bring about the symptoms of a heart attack, so
while the balloons were being inflated, the patients were asked to
describe what they could feel. They found no differences between women
and men in terms of chest or arm pain, shortness of breath, sweating or
nausea, but women were more likely to have pain in the neck and jaw in
addition to chest pain.
The findings from other similar studies
have been pretty inconsistent, sometimes finding that men and women are
equally likely to experience some chest pain, or that it’s more common
in men. Sometimes the issue was clouded by researchers including other
diagnoses alongside heart attacks in the same study. Therefore, in 2011,
a review was conducted with the main aim of establishing whether there
is a difference in the symptoms experienced by men and women.
Studies from Japan, Sweden, US, UK, Canada and Germany were all
included, the largest having more than 900,000 participants. The data
was taken from the best 26 of these studies, combined, and then
re-analyzed. They concluded that women are less likely than men to get
chest pain and are more likely to have symptoms such as nausea, fatigue,
dizziness, fainting, and pain in the neck, jaw or arms. With both
sexes, the majority still experienced chest pain, but a third of women
and a quarter of men had heart attacks without any chest pains, making
it harder for them to realize what was happening. If you don’t know
you’re in a serious situation, you’re obviously less likely to call for
help. On average, people wait two to five hours before seeking help.
A recent study has attempted to find out more about people’s thought
processes in making what could turn out to be life-and-death decisions
to go to the doctor. In-depth interviews with a small number of women
who’d had heart attacks revealed that half knew something was up and
went for help immediately. Three had vague symptoms which started off
mild, but then got more intense, prompting them to visit the doctor. But
the remaining people had absolutely no idea that their symptoms were to
do with a heart attack and didn’t tell anyone else, deciding to wait
and see instead.
Therefore, the lesson here is that a crushing chest pain is very serious
and could indicate a possible heart attack, but so could a collection
of other symptoms. Thus, we need to consider the possibility of a heart
attack even when it doesn’t seem quite like it does in the movies.