The diagnostic challenges
Each year, over 57,000 Australians have a heart attack. They typically occur because a blood vessel to the heart is blocked – cholesterol plaque builds up on the vessel walls or a large blood clot creates a plug. When that happens, timing is critical.
“The earlier the symptoms are recognised, the better your outcome,” says director of interventional cardiology Dr Shamir Mehta, over 90 per cent of people who have heart attacks had warning signs in the days, weeks or months beforehand.
But symptoms can be subtle and confounding, which is why the Brock research team has developed the Prodromal Symptoms Screening Scale, a free, web-based questionnaire to help people identify them.
Furthermore, according to recent research led by the Yale School of Public Health, which examined gender differences in almost 3000 people who were hospitalised with heart attacks, women tend to have more varied symptoms than men – not only chest pain but also things like nausea or jaw discomfort. It could be one reason why women are misdiagnosed much more often; in a joint UK-Swedish study in 2016, the rate was 50 per cent higher.
“Women and men also communicate differently,” points out Dr Sharon Mulvagh. “Men often answer in a sentence or two.” Women, on the other hand, may give more detailed descriptions of what they’re feeling, which health-care providers can misinterpret as anxiety.
Women themselves are also almost twice as likely as men to believe their symptoms are due to stress, according to the Yale study. And they may delay attending to them, putting their own needs on the back burner.
“If you feel like something is off and you’re not your normal self, you should seek medical help,” says Cindy Yip of the Heart and Stroke Foundation. “Listen to your body, because chances are the signs are there, and you can act on them quickly.”
Here are 11 heart attack symptoms you shouldn’t ignore.
This symptom, called angina, is caused when your heart is deprived of blood because a coronary artery is clogged. It might come and go with exertion and rest. It’s not usually described as sharp pain – more of a tightness, pressure or heaviness.
One long-standing myth about female heart attacks is that they don’t typically come with chest pain. Researchers now know that some degree of chest discomfort is experienced by 90 per cent of men and women having heart attacks. The Harvard School of Public Health showed that although men are more likely to call it ‘chest pain’ and women are more apt to use words like ‘discomfort’ or ‘pressing’, the sensations they’re feeling are similar.
People with diabetes, on the other hand, who may have nerve damage, are less likely to feel chest pain with a heart attack. “Sometimes all they have is a sense of feeling unwell and having to lie down – but it’s their heart,” says Mehta.
Discomfort in the arm, especially in the left arm, is another common symptom. This is referred pain from the chest area, “Pain fibres are very primitive; the signals can be transmitted to other areas of the body” says Mulvagh. It’s usually described as a dull ache in the arm, not a shooting pain, as you might have with a pinched nerve, for example. The arm might feel heavy, and the fingers may tingle.