"Except for the occasional heart attack, I never felt better."

— Dick Cheney

Most of us have seen the dramatic episode of a classic heart attack on TV.

The person has a fight or other stressful event, then grabs their chest in a gesture indicating crushing chest pain. They may sweat profusely, get short of breath and then in moments fall to the floor, unconscious. Although this is great drama for television, it does not always translate into reality.

Unfortunately, the signs and symptoms of a heart attack or myocardial infarction are not always so easy to detect. The classic signs are chest pain, or pressure in the center of the chest, shortness of breath, sweating, there may be associated nausea or vomiting, or even radiation of pain to the left arm, jaw or neck. These are the most common signs, but all MIs do not present this way.

There is an entity called a silent MI where a person can have a heart attack but have very mild to no signs at all. For these people, the event may be discovered via EKG changes found on a subsequent exam. Older women and diabetics are the groups of people at highest risk for silent MIs.

So, what is an MI? A heart attack occurs when there is a decrease or cessation of blood flow reaching the myocardium (heart muscle), potentially leading to death of the heart tissue. Why is the blood supply important to the heart? An analogy for this is that we all know that without oxygen, we would suffocate and die. Well, that is exactly what happens to our heart. Our heart is composed of muscle tissue that receives its oxygen, nutrients, and gets rid of waste products via the blood stream. So, just as we would die without oxygen, the same is true for our heart muscle, and this is called a heart attack.

It is important to note that not all chest pains are heart attacks, and that not all heart attacks necessarily lead to death. That is why it is important to get to the hospital as soon as possible if you think you are having a heart attack. This will minimize the damage to the heart tissue as much as possible, and allows medical intervention to hopefully re-establish the blood flow to the heart.

Other chest pains that may mimic a heart attack are angina pectoris (temporary occlusion of blood in the coronary arteries), Gastroesophageal Reflux Disease (GERD), some types of lung infections, pulmonary embolism (blood clot in the arteries between the lung and heart) which could be life-threatening, chostochondritis (inflammation of the joint between the rib and sternum, aka breastbone), muscle strain or soreness of the chest or muscles between the ribs, panic attack, rib pain, cancers, spasm of the esophagus, etc. The list is long.

Some of these items can also be life threatening, while others are not. However, the only way to be certain is to get evaluated by your healthcare provider, or go to the emergency room.

This article is meant for general informational purposes and not meant to substitute the care of your health provider.

This article was written for general information purposes and is not meant to substitute the personalized care of your doctor. Please check with your doctor, to see what therapies and/or preventative measures are available and if they are right for you and your family, prior to making any significant changes to your medical regimen and /or lifestyle.

For more info

American Heart Association — www.americanheart.org

National Heart Lung and Blood Institute — www. nhlbi.nih.gov

US National Library of Medicine and national Institutes of Health — www.nlm.nih.gov

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