Signs and symptoms of a heart attack (myocardial infarction) are the indications that permanent damage to the heart has occurred. Symptoms are subjective and are what victims experience or perceive with their senses. Signs are what others observe in the victims. Some of the signs and symptoms are primary and some are secondary. The primary ones are those that commonly occur with the damage. The secondary ones are those that occur because of secondary problems caused by the damage.
Symptoms of a heart attack
The classic symptoms of a heart attack are intense chest pain, nausea, vomiting, fatigue, excessive sweating, lightheadedness, anxiety, weakness and shortness of breath. Victims also frequently have a feeling of impending doom. These symptoms usually occur suddenly, but in some instances warning signs of tiredness, mild chest discomfort, or vague bodily discomfort occur a few days before the actual event.
The chest pain is in the mid-to-lower portion of the breastbone. Victims describe it as squeezing, pressing, crushing, or tight. A more specific description might be a feeling like an elephant is sitting on the chest. According to textbooks the pain radiates from the breastbone into the left shoulder, left arm, left jaw, left side of the neck, or teeth. Patients might report that the pain is similar to that experienced with angina except it is more severe and that placing nitroglycerin under the tongue does not relieve it.
Many individuals don’t experience the classic symptoms though. They might report only some of those symptoms, atypical symptoms, vague symptoms, or no symptoms at all. The chest pain might be atypical in its description or it may not be in the chest at all. Victims might describe the chest pain as sharp, stabbing, aching, or burning. It might be described as indigestion or feeling full of gas. Instead of chest pain the pain might be in an unusual area such as the upper abdomen, back of the throat, the teeth, the head, the upper back between the shoulder blades, or elsewhere.
There has been much speculation that women experience different chest pain than men during myocardial infarctions. Researchers studied this issue in 2475 patients enrolled in seven medical centers in Europe. The study group consisted of 796 women and 1679 men. It showed that there were some differences in the chest pain experienced during heart attacks by the women than the pain experienced by men, but that the differences were not significant enough to conclude that women are from Venus and men are from Mars when it comes to having a heart attack.
Many heart attacks occur without causing chest pain. A heart attack without symptoms, with minimal symptoms, or with unrecognizable symptoms is called a silent MI (short for myocardial infarction). Approximately 25% of the elderly experience silent MIs. Diabetics also frequently experience silent MIs.
Signs of a heart attack
Common primary physical signs of a heart attack are rapid breathing, a rapid heart rate, an irregular rhythm, pale skin, restlessness, and confusion. Secondary signs are observable if damage to the heart causes weakness of its ability to pump blood or normally conduct electrical activity.
With pump weakness fluid and pressure backs up into the vessels and tissues of the lung: a condition known as congestive heart failure. A medical professional can detect water in the lungs (pulmonary edema) by listening to the chest with a stethoscope and hearing crackling sounds called rales. Other physical signs of congestive heart failure which a physician can detect are an extra heart sound (S3 gallop), swelling of the veins in the neck and swelling of the lower limbs if present.
If water in the lungs is affecting oxygen uptake by blood the skin may be bluish or grayish in color. If the damage to the heart muscle has caused considerable pump weakness the blood pressure will be low.
A disturbance of the electrical activity can cause an abnormally fast or abnormally slow heartbeat. Additionally, it can cause an irregularity of the heartbeat, which if severe can also drop the blood pressure and in the worse-case scenario result in sudden death.
Heart attack signs and symptoms oftentimes provide evidence that permanent damage to the heart has occurred or is in the process of occurring, but appropriate laboratory tests must be performed to confirm the diagnosis.