EULALEE THOMPSON
HEART ATTACK pains are oppressive and constricting; the chest tightens up and the sufferer should immediately visit the emergency room.
"The pain is most significant when it radiates either downwards to the upper part of the belly, and sometimes that is mistakenly associated with gastric problems," said Dr. Knox Hagley, consultant physician and chairman of the Heart Foundation of Jamaica. "The pain in the middle of the chest can also radiate upwards to the neck and jaw and even to the back and shoulder blade."
The chest pains associated with a heart attack (myocardial infarction), Dr. Hagley explained, is related to inadequate blood flow to the heart muscles. It is usually felt in the middle of the chest, though the man-in-the-street is more acquainted with a pain in the left chest radiating to the left upper arm and maybe the waist.
Dr. Hagley said, however, that in some cases, the pain may, in fact, radiate to the right arm and may not even start in the chest, but in the neck, jaw and epigastrium.
"So we should stress that it is a pain that radiates, it's not just there. It is a constricting chest pain often in the middle of the chest and radiating," he said.
There are other interesting characteristics of the heart-attack-type pain which Dr. Hagley said the general public should be aware of:
Sometimes the pain is not severe, comes with other symptoms such as palpitations, or if occurring in the background of previous heart disease, the pain comes with other symptoms, such as shortness of breath.
Occasionally, if severe, the heart attack victim will go into shock and may not be able to communicate well with the physician on duty at the emergency room. (This is, however, an atypical manifestation).
In diabetic patients their nerves may become infected (neuropathy) and they may not be aware of the pain and so, the recommendation is for persons with diabetes to pay special attention to heart health.
A heart attack comes on at any time, even at rest, so it is not necessarily related to activity. Usually severe pain is accompanied by severe sweating and vomiting, and that is a source of confusion in that it may be mistakenly connected to gastric problems.
MALE VS FEMALE
Is there any sex difference in heart attack symptoms ? Dr. Hagley explains it like this:
"Not every pain is a heart attack, there is angina which one may get when running up the stairs or during sexual intercourse, that is, angina of effort ... inadequate amount of flow to heart muscle and it responds by pain, so if activity stops the pain disappears. Some women get angina and it is not related to heart attack ... there is a change in the blood vessel but not enough to cause narrowing; it's not a significant change but causes a little spasm."
The high-risk groups for heart attack are those suffering chronic diseases such as diabetes, hypertension (high blood pressure), high cholesterol levels and also tobacco smokers. In absence of these risk factors, Dr. Hagley said that the at-risk age group for heart attacks may fall in the 60s and 70s but it would not be unusual to see the condition in younger people, especially among smokers and those with high cholesterol levels or hypertension over an extended period.
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