Signs to watch for and when to call for help

By Dr. Shereif Rezkalla

Cardiologist, Marshfield Clinic

The heart, like any other organ, has arteries to supply it with blood so it can function properly. The arteries going to the heart to supply it with blood are called coronary arteries.

Because of many risk factors such as smoking, high cholesterol, and family history, these arteries may narrow or get progressively tighter due to plaque buildup. As it continues to build up, the plaque can break free and clog arteries. When this happens, the part of the heart no longer getting blood from the clogged artery will begin to die.

Within four hours of the onset of the clogged artery, most of the affected heart muscle will begin to die, and subsequently scar tissue will form.

In six hours the heart muscle death will be complete. Because of that, the earlier you come to the hospital after the onset of a heart attack, the better your outcome likely will be.

If you come within the first hour, you probably will have no damage at all, and if we can open the artery quickly in the hospital–within 90 minutes–the damage will be very minimal, and the heart function will continue to be almost normal.

One of the best questions people should ask themselves is, “Are these symptoms I am having today symptoms of a heart attack, and I need to go to the hospital right away, or are these atypical symptoms?”

A heart attack usually does not feel like basic pain. It is not similar to what will happen when you sprain an ankle and usually is not a sharp stabbing pain. A heart attack usually includes some kind of chest discomfort. The discomfort is usually felt as tightness or burning in the chest. It could be pressure or aches much like a toothache.

Pain can occur in the chest or other areas, such as the area just below your ribs, in your neck, or left arm. Very rarely other areas may feel this pain.

The discomfort may make you feel sick or uneasy and may be associated with gastrointestinal symptoms such as nausea or vomiting. Heart attacks usually are associated with shortness of breath, particularly if a large artery supplying a larger area of the heart is the culprit of that episode.

Once you have any discomfort, the best thing to do is to sit down and call 911. Sometimes the symptoms are not very clear and do not appear exactly as those I have shared. In such a case, you should talk immediately with your doctor or to a nurse over the phone to describe the atypical symptoms for a definite recommendation.

If you have any questions, you can call any individual at the Marshfield Clinic Cardiology Department or any person in the cardiology department closest to you.