Surviving a heart attack often depends on getting prompt medical attention when your body signals that a heart attack is occurring. Yet many people who have a heart attack may go for hours before seeking care because they don't recognize the signs of a heart attack — or are afraid of appearing foolish. Don't worry about confusing a heart attack with indigestion or another minor medical problem. Get help.
Long before coronary artery disease leads to a heart attack, it may cause chest pain, or angina pectoris. Angina is a symptom of a condition called myocardial ischemia (lack of blood supply), which occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs for a given level of work.
Most people experience angina as a feeling of pressure or fullness in the chest. However, many people experience a different feeling, such as burning or aching. Rarely angina produces a feeling of sharp pain.
Angina can occur when blood circulation to the heart is sufficient for normal needs but inadequate when the heart's needs increase, such as during physical exertion or emotional excitement. Running to catch a bus, for example, could trigger an attack of angina if you have a severely narrowed artery, whereas walking to a bus stop might not. Some people, such as those with a coronary artery spasm, may have angina when they're resting. Angina can be a warning sign that you are at risk for a heart attack.
If you have angina, your doctor may prescribe nitroglycerin, a fast-acting medication that can be prescribed in the form of a pill, a skin patch, an ointment or an aerosol that is sprayed under the tongue. The drug works to relax your arteries, allowing blood to flow more freely. Your doctor may also prescribe longer acting nitrates, or other drugs such as beta-blockers, that can prevent the onset of angina pain.
There are two basic types of angina: stable angina, which causes chest pain at predictable times like when exercising; and unstable angina, which is pain of increasing severity at different, unpredictable times. The presence of unstable angina implies that the underlying situation is fragile and worsening. Unstable angina often appears before a heart attack develops.
Other symptoms that should set off alarm bells are fainting (or episodes of near fainting) or shortness of breath with unusually low levels of activity. Heart attacks and heart disease can first make their presence known with other symptoms (such as confusion, sweatiness or indigestion), particularly in older patients and people with diabetes.