8 signs of a heart attack that often go overlooked in the weeks before

Dr Nighat reveals heart attacks symptoms in women

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Hollywood is great for a lot of things but accurate health information is not one of them. Agonising chest pain is a popular onscreen depiction of a heart attack but this is by no means the only warning sign. In fact, many subtle signs can surface ahead of time.

According to health body The Hospitals of Providence, this is particularly true for women: heart attack symptoms in women sometimes go “unnoticed”.

These subtle signs include:

  • Back pain
  • Dizziness
  • Fainting
  • Pressure, fullness, squeezing pain in the centre of the chest, spreading to the neck, shoulder or jaw
  • Unusual fatigue
  • Unusual shortness of breath
  • Upper abdominal pressure or discomfort
  • Vomiting.

According to The Hospitals of Providence, the more classic signs include chest pain or discomfort, discomfort in other areas of the upper body, shortness of breath and breaking out in a cold sweat.

All of the above signs may occur “hours or weeks” before the actual heart attack, the health body warns.

A study conducted by researchers at the University of Arkansas for Medical Sciences sought to rank the prevalence of different early heart attack symptoms in women.

The study found that women who’d had heart attacks remembered having unusual fatigue or other new symptoms as much as a month beforehand – suggesting a new way to stop heart attacks before they happen.

“New or different fatigue, sleep problems, shortness of breath, indigestion, and anxiety could be early warning signs of heart disease,” Jean C. McSweeney, Ph.D., R.N., of the UAMS College of Nursing, said. “The appearance of these new symptoms, in conjunction with women’s standard cardiovascular risk factors, should help providers recognise women who should be thoroughly checked for heart disease.”

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Professor McSweeney was the lead researcher in the study published in Circulation, the journal of the American Heart Association.

In a three-year study of women in Arkansas, North Carolina, and Ohio, the UAMS researchers found that 95 percent of women who had heart attacks remembered having new symptoms more than a month beforehand.

At the time of publication, the American Heart Association called the study, funded by the National Institute of Nursing Research, “one of the first comprehensive examinations of issues that might allow prevention of imminent heart attack in women”.

The most common early symptoms that women remembered were unusual fatigue (70 percent), sleep disturbance (48 percent), shortness of breath (42 percent), indigestion (39 percent), and anxiety (35 percent). The symptoms stopped after their heart attacks.

Only 30 percent of women in the survey remembered chest discomfort, which they usually described as aching, tightness, or pressure, but not pain.

“Women need to understand that the appearance of new symptoms could warn of imminent heart attack or developing heart disease, especially if they have other cardiovascular risk factors such as smoking, high blood pressure, high cholesterol, diabetes, being overweight, or a family history of heart disease,” Professor McSweeney said.

In earlier studies, Professor McSweeney and her colleagues found that women who remembered a variety of symptoms in the month before their heart attacks either ignored the signs or were misdiagnosed when they sought medical help.

Women also tend to have different symptoms during heart attacks.

Rather than the chest pain that men typically experience, women are more likely to have shortness of breath (58 percent), weakness (55 percent), unusual fatigue (43 percent), cold sweat (39 percent), and dizziness (39 percent).

How to respond

The NHS says: “Call 999 immediately if you think someone might be having a heart attack. The faster you act, the better their chances.”

The health body continues: “If you have had a heart attack, it’s important that you rest while you wait for an ambulance, to avoid unnecessary strain on your heart.

“If aspirin is available and you are not allergic to it, slowly chew and then swallow an adult-size tablet (300mg) while you wait for the ambulance.”

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