If you wake up in the middle of the night with chest pain, your mind might automatically think you're having a heart attack. After all, it’s the number one killer disease in the US. And the number one symptom is the vague term “chest pain”, which can be misleading because it’s not always painful nor always in the chest.
In most cases, people imagine they will have severe chest pain and dismiss the actual symptoms of a heart attack, go back to sleep and suffer one. Below I will discuss the symptoms you will and won’t feel if you are having a heart attack and what you should do, and in which cases you should seek help immediately.
How chest pain from a heart attack feels
The typical pain described is a feeling of
tightness, squeezing or heaviness in the chest. The Latin term angina
pectoris, meaning sensation in the chest, is a more accurate
description. This pain has been described as feeling like a band or
weight is being tightened around your chest. The pain is often on the
left side and above the bottom rib-cage, although it’s often difficult to
determine its exact location.
Other typical symptoms include:
• Shortness of breath
• Sweating, nausea, and anxiety
• Pain in the left arm, jaw or neck
What other symptoms I might feel ?
While the typical symptoms are definitely a
reason to visit your physician, sometimes people feel less typical
pains, which could also indicate that you are having a heart attack.
• Pain not on the left side – sometimes the pain is located on the
right, center or top of the abdomen.
• No pain – some people don’t experience pain and only feel shortness
of breath. Research indicates that no chest pain symptoms can occur in
1/3 of people having a heart attack.
• Sharper pain - some people report sharper chest pains or the
feeling of indigestion.
How long should the chest pain last?
The next indication of whether you are
suffering a heart attack is pain duration. Consider the following 3
factors:
1. Heart-attack-related chest pain comes on over several minutes and not
suddenly. Sudden severe pain is a reason for concern, but it is not
consistent with angina.
2. The chest pain lasts for at least 5 minutes and doesn’t last
continuously for more than 20 to 30 minutes.
3. Pain that comes on during rest, or doesn’t go away after exertion,
also indicates a heart attack.
Do I have any of the major risk factors?
Doctors like to consider the risk factors
when determining whether your chest pain is a heart attack. They will
take high-risk patients with atypical symptoms more seriously than
low-risk patients with classic symptoms.
• Age – the risk increases as you age. For men it’s after the age of
40 and for women it’s after the age of 50. It can happen to a younger
person, but it’s more unlikely.
• Sex – this is not to say women aren’t affected by heart disease,
but the risk for heart attacks is higher for men.
• Genetics – your risk is significantly higher if a member of your
immediate family had or has coronary heart disease. The risk is even
higher if that family member was a man under 50 or a woman under 60.
• Hypertension, diabetes, and cholesterol – these diseases increase
your risk of having a heart attack considerably.
• Smoking – while most people think smoking destroys your lungs (and
it does), more smokers die from heart disease. Smoking substantially
increases the risk of you having a heart attack.
What it shouldn't feel like
Some chest pain is not consistent with
having a heart attack.
• Sharp and brief pain – stabbing pain that lasts only a few seconds
is not coming from the heart.
• Persists for hours – heart attack chest pain will last for 20-30
minutes at the most and typically ends with a heart attack.
• Gets worse with movement – the sort of pain that worsens when
pressed on is usually from chest bone or muscle pains and not the heart.
• You can pinpoint the pain with a single finger – heart chest pain
tends to be difficult to locate exactly.
If you have a worrying pain, there is no harm in having it checked out.
It’s better to have lesser symptoms checked out than to stay at home and
actually have a heart attack. If you are high risk, don’t hesitate to
have the pain examined. If you are high risk and have the classic
symptoms, I advise going to the emergency room or calling an ambulance.