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This Might Save Your Life
by author Susan Biali, MD

�I�m going to call an ambulance,� I told my patient, a woman in her early 50s. She knew that something was wrong, but I knew she wasn�t convinced that her symptoms were serious. Most women, and many men, aren�t aware of the more subtle signs of a heart attack.
My patient had come to the clinic where I was working that evening.

�But I can�t go to the hospital. I have too much to do tonight. I�ll be fine! I�m going home,� my patient insisted. I sighed, and steeled myself for battle.

As a general practitioner with two years of specialty training in emergency medicine, I was well-schooled in the ways that an atypical, potentially lethal heart attack might try to trick me, and my patients, into missing the diagnosis.

�I�ve been feeling so tired for the last few days,� she�d told me. �I can�t walk very far at all without getting short of breath. And I�m so sweaty! I feel terrible. Is it the flu?�

Diagnosing the Problem
The shortness of breath made me suspicious that the problem might be her heart. People going through a heart attack can feel breathless, particularly when exerting themselves or exercising. Sweating, or damp, clammy skin, is another sign, as is unusual and sudden fatigue.

She didn�t have any chest pain, but when I asked her if her chest felt tight or like something was sitting on it, she said yes. That was enough�I picked up the phone to dial 911. Not all heart attacks announce themselves with crushing chest pain.

According to the Public Health Agency of Canada, women over 55 are more likely to die from heart disease than any other disease. Unfortunately, we�re far more likely to worry about preventing or diagnosing other less common diseases such as cancer. We often think of heart disease as a condition of old age. Not so, as heart disease affects many women who are well under 65.

Understanding what�s happening during a heart attack can help you make sense of its symptoms. At the root of cardiovascular disease is a condition called atherosclerosis, which is a buildup of fatty plaques in our arteries, particularly the delicate arteries which deliver blood to the heart (our coronary arteries). As these plaques build up, our arteries get narrower, and less blood flows through to feed the hard-working heart muscles.

Is there a way of knowing if you have atherosclerosis? Unfortunately, unless you�re in the advanced stages, you probably won�t feel a thing. Plaques begin to build up in our arteries as early as adolescence. With today�s epidemic of childhood obesity, those fatty plaques are getting more of a head start than ever before.

If the plaque gets thick enough, its surface can rupture, triggering a blood clot that can completely block the artery, stopping blood flow to the heart. This damages the heart muscle and typically causes symptoms of chest pain and pressure. If this goes on for long enough (which may be just hours) the heart muscle starts to die irreversibly.

Recognizing the signs
If you identify the symptoms of a heart attack early enough and are rushed to a hospital for treatment, today�s emergency rooms are equipped with medications that can dissolve the lethal clot and restore the blood flow to your heart, preventing permanent damage. That�s why it�s so important for you to be able to identify the signs and symptoms of a heart attack in theearly stages.

So, what would a heart attack feel like? The classic symptoms are central chest pain, pressure, or tightness, accompanied by shortness of breath and sweating. Though your heart is located in the left side of your chest, the wiring of your nerves causes the pain to be referred to the centre of your chest, up into your jaw or shoulder, down your left arm, or into your back.

Susan Biali, MD, is a wellness expert, life coach, and speaker. She has an additional degree in dietetics and appears frequently in print, radio, and television media across North America.

Source: alive #316, February 2009