While chest pain often does accompany a heart attack, sometimes it does not and the symptoms are less severe. The American Heart Association states , "Although it's common to have chest pain or discomfort, a heart attack may cause subtle symptoms. Leading up to the heart attack, the person may have experienced unexpected fatigue, difficulty breathing, and heart palpitations the feeling that the heart is skipping a beat or beats irregularly. If you experience these symptoms, even without chest pain, you should immediately seek out emergency medical help.
Cardiac rehab programs offer support for you and your family. Meeting other people with the same problems can help you know you're not alone. After a heart attack, it's also important to:. Taking medicine can lower your risk of having another heart attack or dying from coronary artery disease. Treatment for a heart attack or unstable angina begins with medicines in the ambulance and emergency room. This treatment is similar for both. The goal is to prevent permanent heart muscle damage or prevent a heart attack by restoring blood flow to your heart as quickly as possible.
You also will receive medicines to stop blood clots so blood can flow to the heart. In the hospital, your doctors will start you on medicines that lower your risk of having complications or another heart attack.
You may already have taken some of these medicines. They can help you live longer after a heart attack. Medicine to lower blood pressure and the heart's workload. You might take other medicines if you have another heart problem, such as heart failure. For example, you might take a diuretic, called an aldosterone receptor antagonist, which helps your body get rid of extra fluid. Medicine to prevent blood clots from forming and causing another heart attack. Other cholesterol medicines, such as ezetimibe, may be used along with a statin.
You may have regular blood tests to monitor how the medicine is working in your body. Your doctor will likely let you know when you need to have the tests. If your doctor recommends daily aspirin, don't substitute non-steroidal anti-inflammatory drugs NSAIDs , such as ibuprofen Advil, for example or naproxen such as Aleve , for the aspirin.
NSAIDS relieve pain and inflammation much like aspirin does, but they do not affect blood clotting in the same way that aspirin does. NSAIDs do not lower your risk of another heart attack.
If you need to take an NSAID for a long time, such as for pain, talk with your doctor to see if it is safe for you. An angioplasty procedure or bypass surgery might be done to open blocked arteries and improve blood flow to the heart. This procedure gets blood flowing back to the heart. It opens a coronary artery that was narrowed or blocked during a heart attack.
Angioplasty is not surgery. It is done using a thin, soft tube called a catheter that's inserted in your artery. It doesn't use large cuts incisions or require anesthesia to make you sleep.
Most of the time, stents are placed during angioplasty. They keep the artery open. But angioplasty is not done at all hospitals. If a person is at a hospital that does not do angioplasty, he or she might be moved to another hospital where it is available.
If you are at a hospital that has proper equipment and staff to do this procedure, you may have cardiac catheterization , also called coronary angiogram.
For example, bypass surgery might be a better choice because of the location of the blockage or because you have many blockages. After you have had angioplasty or bypass surgery, you may be encouraged to take part in a cardiac rehabilitation program to help lower your risk of death from heart disease.
For more information, see the topic Cardiac Rehabilitation. Heart attacks that damage critical or large areas of the heart tend to cause more problems complications later. If only a small amount of heart muscle dies, the heart may still function normally after a heart attack. The chance that these complications will occur depends on the amount of heart tissue affected by a heart attack and whether medicines are given during and after a heart attack to help prevent these complications.
Your age, general health, and other things also affect your risk of complications and death. About half of all people who have a heart attack will have a serious complication. The kinds of complications you may have depend upon the location and extent of the heart muscle damage. The most common complications are:. If the heart attack caused an arrhythmia, you may take medicines or you may need a cardiac device such as a pacemaker. If your heart rate is too slow bradycardia , your doctor may recommend a pacemaker.
If you have abnormal heart rhythms or if you are at risk for abnormal heart rhythms that can be deadly, your doctor may recommend an implantable cardioverter-defibrillator ICD. For information on different types of arrhythmias, see:. If your condition gets worse, you may want to think about hospice palliative care.
This care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit.
You can have this care along with treatment to cure your illness. Hospice palliative care providers will work to help manage pain and other symptoms or side effects. They may help you decide what treatment you want or don't want.
And they can help your loved ones understand how to support you. If you're interested in hospice palliative care, talk to your doctor. For more information, see the topic Hospice Palliative Care. Treatment for a heart attack is increasingly successful at prolonging life and reducing complications and hospitalization. But a heart attack can lead to problems that get worse over time, such as heart failure and abnormal heart rhythms arrhythmias. It can be hard to have talks with your doctor and family about the end of your life.
But making these decisions now may bring you and your family peace of mind. Your family won't have to wonder what you want. And you can spend your time focusing on your relationships. You will need to decide if you want life-support measures if your health gets very bad. An advance care plan tells doctors how to care for you at the end of your life. And you can name someone who can make sure your wishes are followed. Your doctor may talk to you about your desire to be revived resuscitated if your heart stops pumping and you are unable to breathe on your own.
Author: Healthwise Staff. Medical Review: Rakesh K. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use and Privacy Policy. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Top of the page. Overview What is a heart attack? What is angina, and why is unstable angina a concern? There are two types of angina: Stable angina means that you can usually predict when your symptoms will happen.
You probably know what things cause your angina. For example, you know how much activity usually causes your angina. You also know how to relieve your symptoms with rest or nitroglycerin. Unstable angina means that your symptoms have changed from your typical pattern of stable angina.
Your symptoms do not happen at a predictable time. For example, you may feel angina when you are resting. Your symptoms may not go away with rest or nitroglycerin. What causes a heart attack? What are the symptoms? Symptoms of a heart attack include: Chest pain or pressure, or a strange feeling in the chest. Shortness of breath. Nausea or vomiting. Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
Light-headedness or sudden weakness. A fast or irregular heartbeat. Here are some other ways to describe the pain from heart attack: Many people describe the pain as discomfort, pressure, squeezing, or heaviness in the chest.
People often put their fist to their chest when they describe the pain. The pain may spread down the left shoulder and arm and to other areas , such as the back, jaw, neck, or right arm. What should you do if you think you are having a heart attack?
If your doctor has prescribed nitroglycerin for angina: Take 1 dose of nitroglycerin and wait 5 minutes. If your symptoms don't improve or if they get worse, call or other emergency services. Describe your symptoms, and say that you could be having a heart attack. Stay on the phone. The emergency operator will tell you what to do. The operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Aspirin helps keep blood from clotting, so it may help you survive a heart attack.
If you do not have nitroglycerin: Call or other emergency services now. How is a heart attack treated? You may be given: Aspirin and other medicines to prevent blood clots. Medicines that break up blood clots thrombolytics. Medicines to decrease the heart's workload and ease pain. It can detect signs of poor blood flow, heart muscle damage, abnormal heartbeats, and other heart problems.
Blood tests, including tests to see whether cardiac enzymes are high. Having these enzymes in the blood is usually a sign that the heart has been damaged. Cardiac catheterization , if the other tests show that you may be having a heart attack. This test shows which arteries are blocked and how your heart is working.
Can you prevent a heart attack? To improve your heart health: Don't smoke, and avoid second-hand smoke. Quitting smoking can quickly reduce the risk of another heart attack or death. Eat a heart-healthy diet that includes plenty of fish, fruits, vegetables, beans, high-fibre grains and breads, and olive oil.
Get regular exercise. Your doctor can suggest a safe level of exercise for you. Control your cholesterol and blood pressure. The study analyzed UCR that met the proposed inclusion criteria in March. Ten records were excluded due to ICD non-observance. Regarding the epidemiological characteristics of patients who sought care for chest pain in a UCU, the majority were women Regarding age, there was an expressive demand from young adults between 18 and 30 years with this complaint, accounting for 83 The age group between 31 and 50 years and above 51 accounted for Concerning the description of the complaint among the three categories in which chest pain was grouped, according to the description of the classifier in the UCR record, complaint 1, chest pain, had a frequency of , while complaint 2, chest pain and RUL or LUL had a frequency of 32, and complaint 3, chest pain and other symptoms appeared times.
In addition, cardiac enzyme collection was requested for 74 Still on the findings, among the AMI, two were diagnosed by the alteration in the electrocardiographic tracing, namely ST-segment elevation and one case by elevated troponin level.
As for the symptoms, none of them had chest pain radiating to the LUL. Two had only chest pain, and one had chest pain associated with other symptoms. Regarding gender, the three cases were male. On the other hand, there was age dispersion in the selected categories. Therefore it was not possible to relate this data to the findings of other authors. Table 2 shows the data on the diagnosis of AMI.
In the present study, there were no women affected by AMI, although this was the largest group with this pain complaint. These authors also noted that the age above 60 years is the age group with the highest incidence, a fact that in this study is statistically close to the described studies, although the largest number was not in this age group.
Although 74 individuals A study by Barbosa et al. The higher incidence of AMI in males, corresponding to the three cases confirmed in this study, corroborate the studies described. This data is very similar to those obtained in this study, an average of These authors identified that most of the patients with AMI also had risk factors for coronary artery disease, such as hypertension, smoking, obesity, and dyslipidemia, which were not analyzed in this study.
Regarding clinical manifestation, none of the patients diagnosed with AMI reported typical pain. In the study, there were two cases of patients who reported only chest pain and one case In this study, of the three confirmed cases, two had altered electrocardiograms, that is, Arq Bras Cardiol.
The study showed that the cardiac causes are not the first cause of chest pain, and among the cardiac causes AMI is one of the diseases, but there are others, as also identified in a study by Barbosa et al. Pain which is located in the center of chest is more likely to be ischemic than a peripherally located chest pain.
We found that precordial chest pain is the most common site for chest pain. De Silva also noticed that precordial and retrosternal sites are most common sites for chest pain in CAD. Pain was present on the left side of chest in 56 Bosner et al 22 noticed that chest pain was localized on the right side of the chest in However, in our settings none of the patient presented with right sided chest pain.
Most common site where AMI pain radiates is left shoulder and arm. In our study 55 Solt et al 25 claimed a high prevalence of chest pain radiation to the jaw especially in females. However, we have noticed that only 4 1. Duration of chest pain more than 20 minutes can be taken as cutoff for AMI. Similar results have been proven in multiple other international studies. Although chest pain is the most important symptom of AMI but it may be invariably absent in some patients.
In our setting 6. Chest pain remains most important symptom of AMI but in few patients it may not be there. Further studies on large scale are required about the characteristics of chest pain favoring AMI. There is considerable overlap in chest pain of cardiac as well as non cardiac causes. However, vigilant evaluation of parameters of chest pain in history taking may help to overcome this dilemma.
The authors are thankful to Mr. National Center for Biotechnology Information , U. Pak J Med Sci. Muhammad Ajmal Malik 1 Dr. Find articles by Muhammad Ajmal Malik. Shahzad Alam Khan 2 Dr. Find articles by Shahzad Alam Khan. Sohail Safdar 3 Mr. Find articles by Sohail Safdar. Ijaz-Ul-Haque Taseer 4 Dr. Find articles by Ijaz-Ul-Haque Taseer. Author information Article notes Copyright and License information Disclaimer. Correspondence: Dr. E-mail: dritaseer hotmail. Copyright notice.
This article has been cited by other articles in PMC. Abstract Objective: To study various characteristics of chest pain in acute myocardial infarction patients. Key Words: Chest pain, acute myocardial infarction, Precordial chest pain. Age Group Frequency Percentage Total 5 1. Open in a separate window. References 1. American Heart Association.
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