Symptoms

Symptoms That Are Less Likely to Indicate a Heart Attack. The following are symptoms that are more likely to be due to causes other than a heart event:

• Sharp pain brought on by lung movements or coughing
• Pain that is mainly or only in the middle or lower abdomen
• Pain that can be pinpointed with the top of one finger
• Pain that can be reproduced by moving or pressing on the chest wall or arms
• Pain that is constant and lasts for hours (although no one should wait hours if they suspect they are having a heart attack)
• Pain that is very brief and lasts for a few seconds
• Pain that spreads to the legs

The presence of these symptoms, however, does not always rule out a serious heart event.

Ruling Out Other Causes of Symptoms

Chest pain is a very common symptom in the emergency room, but heart problems account for only 10% to a third of all episodes. High on the list of other causes of chest pain are the following:

• The most common causes of chest pain are muscular and bone problems. Problems affecting the ribs and chest muscles include injured muscles, fractures, arthritis, spasms, and infections.
• Anxiety attacks
• Gastrointestinal disorders (gallstone attacks, peptic ulcer disease, hiatal hernia, heartburn)
• Asthma
• Spasm in the coronary artery
• Abnormalities of the heart muscle itself
• Rupture of the aorta, collapsed lung, acute inflammation of the heart, or a blood clot in the lung
• Hyperthyroidism
• Anemia
• Vasculitis (a group of disorders that cause inflammation of the blood vessels)
• Exposure to high altitudes (rare)

What To Do When You Have Symptoms of a Heart Attack

Immediately call 911 or the local emergency number.

If patients have been previously diagnosed with angina, they should take one nitroglycerin dose either as an under-the-tongue tablet or in spray form at the onset of symptoms. They should take another dose every 5 minutes up to three doses or when the pain is relieved, whichever comes first.

It should be noted, however, that only 20% of heart attacks occur in patients with long-standing angina.

Anyone who has heart disease or risk factors for it and experiences heart attack symptoms should immediately contact emergency services.

The patient should chew an aspirin (250 to 500 mg) and be sure that emergency health providers are informed of this so an additional dose is not given.

Patients who experience chest pain should go immediately to the nearest emergency room, preferably traveling by ambulance. They should not drive themselves.