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Heart Attack Symptoms

You have already read in the last chapter how cholesterol deposits, which occur in the lumen of the coronary arteries, block these arteries and produce ischaemic heart disease. This disease manifests itself in the form of angina pectoris and heart attacks (myocardial infarction). In this chapter we shall discuss the symptomatology of these conditions, so that you can recognize them and take timely action by consulting your physician or arranging for an urgent admission in a hospital, as the case may be.

Angina Pectoris

What is Angina pectoris?
Angina is a heart pain that lasts for short duration ( a few minutes). It can be considered cry of the heart muscle due to a temporary imbalance between the demand and supply of oxygen to this muscle.

What is the cause?
As discussed in the previous chapter, it is caused by the partial obstruction of a coronary artery by fatty (cholesterol) deposits, so that the blood supply to a segment of the heart is reduced, the supply may be sufficient during rest, but when the demands of the heart are increased due to exertion, the supply becomes insufficient.

How can one recognize angina?
Angina is recognized by its symptoms, their character, pain radiation, and so on. The pain is constricting, squeezing, or choking, or as if a heavy weight has been placed on the chest. Some patients experience several burning pain in the pit of the stomach or behind the lower end of the sternum ( breast bone) and insist that the pain is due to severe dyspepsia. The pain is usually located in the central portion of the front of the chest in the region of the lower portion of the breast bone. Although the heart lies more to the left, the pain is rarely left-sided. The pain may radiate to the left shoulder and arm, right shoulder and arm or both, to the neck or lower jaw or directly to the back into the are between the two shoulder blades. Sometimes, no pain may be felt in the chest but only in one of the sites of radiation, i.e., shoulder, arm, neck, jaw or even pit of the stomach. The patient may feel very anxious.

What are the precipitating factors?
There is usually no pain when the person is at rest. An exercise like brisk walking, running, going uphill, climbing the stairs or doing physical work precipitates the pain if such exertion is undertaken soon after meals. Emotional outbursts, anger, fright, hurry or sexual activity may induce such pain.

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