We've
all read the signs of a heart attack listed on posters in the hospital
waiting room. But what if there were other, earlier signs that could
alert you ahead of time that your heart was in trouble?
It
turns out there are. Researchers have done a lot of work in recent
years looking at the signs and symptoms patients experienced in the
months or even years leading up to a heart attack. "The heart, together
with the arteries that feed it, is one big muscle, and when it starts to
fail the symptoms can show up in many parts of the body," says
cardiologist Jonathan Goldstein of St. Michael's Medical Center in
Newark, New Jersey. Here are five surprising clues that your heart needs
checking out. Any of these signs -- and particularly two or more
together -- is reason to call your doctor for a workup, says Goldstein.
1. Neck Pain
Feel
like you pulled a muscle in the side of your neck? Think again,
especially if it doesn't go away. Post-heart attack, some patients
remember noticing that their neck hurt and felt tight, a symptom they
attributed at the time to muscle strain. People commonly miss this
symptom because they expect the more dramatic acute pain and numbness in
the chest, shoulder, and arm. Women in particular are less likely to
experience heart pain that way, and more likely to feel twinges of pain
and a sensation of tightness running along the shoulder and down the
neck, says Margie Latrella, an advanced practice nurse in the Women's
Cardiology Center in New Jersey and coauthor of Take Charge: A Woman's Guide to a Healthier Heart (Dog Ear, 2009). The pain might also extend down the left side of the body, into the left shoulder and arm.
Nerves
from damaged heart tissue send pain signals up and down the spinal cord
to junctures with nerves that extend out into the neck and shoulder.
The
pain feels like it's radiating out in a line, rather than located in
one very specific spot. And it doesn't go away with ice, heat, or muscle
massage.
2. Sexual problems
Having
trouble achieving or keeping erections is common in men with coronary
artery disease, but they may not make the connection. One survey of
European men being treated for cardiovascular disease found that two out
of three had suffered from erectile dysfunction for months or years
before they were diagnosed with heart trouble. Recent studies on the
connection between ED and cardiovascular disease have been so convincing
that doctors now consider it the standard of care to do a full
cardiovascular workup when a man comes in complaining of ED, according
to cardiologist Goldstein says. "In recent years there's been pretty
clear evidence that there's a substantially increased risk of heart
attack and death in patients with erectile dysfunction," Goldstein says.
Just
as arteries around the heart can narrow and harden, so can those that
supply the penis. And because those arteries are smaller, they tend to
show damage much sooner -- as much as three to four years before the
disease would otherwise be detected.
In
this case, the cause isn't going to be immediately distinguishable. If
you or your partner has problems getting or maintaining an erection,
that's reason enough to visit your doctor to investigate cardiovascular
disease as an underlying cause. "Today, any patient who comes in with ED
is considered a cardiovascular patient until proven otherwise," says
Goldstein.
More
than 40 percent of women in one study published in Circulation: Journal
of the American Heart Association, reported having experienced
shortness of breath in the days before a heart attack. You might feel
like you can't breathe, or you might feel dizzy or faint, as you would
at high altitude. If you can't catch your breath while walking upstairs,
vacuuming, weeding the garden, or doing other activities that
previously caused you no trouble, this is a reason to be on the alert.
Not
enough blood is getting through the arteries to carry sufficient oxygen
to the heart. The heart muscle pain of angina may also make it hurt to
draw a deep breath. Coronary artery disease (CAD), in which plaque
builds up and blocks the arteries that feed the heart, prevents the
heart from getting enough oxygen. The sudden sensation of not being able
to take a deep breath is often the first sign of angina, a type of
heart muscle pain.
If
shortness of breath is caused by lung disease, it usually comes on
gradually as lung tissue is damaged by smoking or environmental factors.
If
heart or cardiovascular disease is the cause, the shortness of breath
may come on much more suddenly with exertion and will go away when you
rest.
Although
most of us expect pain from any condition related to the heart to occur
in the chest, it may actually occur in the abdomen instead. Some
people, particularly women, experience the pain as heartburn or a
sensation of over-fullness and choking. A bout of severe indigestion and
nausea can be an early sign of heart attack, or myocardial infarction,
particularly in women. In one study, women were more than twice as
likely as men to experience vomiting, nausea, and indigestion for
several months leading up to a heart attack.
Blockages
of fatty deposits in an artery can reduce or cut off the blood supply
to the heart, causing what feels like tightness, squeezing, or pain --
most typically in the chest but sometimes in the abdomen instead.
Depending on which part of your heart is affected, it sends pain signals
lower into the body. Nausea and light-headedness can also be signs that
a heart attack is in progress, so call your doctor right away if the
feeling persists.
Like
all types of angina, the abdominal pain associated with a heart problem
is likely to worsen with exertion and get better with rest. Also,
you're likely to experience repeated episodes, rather than one prolonged
episode as you would with normal indigestion or food poisoning.
Ongoing
jaw pain is one of those mysterious and nagging symptoms that can have
several causes but can sometimes be a clue to coronary artery disease
(CAD) and impending heart attack. The pain may travel along the jaw all
the way to the ear, and it can be hard to determine which it's coming
from, says cardiovascular nurse Margie Latrella. This is a symptom
doctors have only recently begun to focus on, because many patients
surveyed post-heart attack report that this is one of the only symptoms
they noticed in the days and weeks leading up to the attack.
Damaged
heart tissue sends pain signals up and down the spinal cord to
junctures with nerves that radiate from the cervical vertebrae out along
the jaw and up to the ear.
Unlike
the jaw pain caused by temporomandibular joint disorder (TMJ), tooth
pain, or ear infection, the pain doesn't feel like it's in one isolated
spot but rather like it's radiating outward in a line. The pain may
extend down to the shoulder and arm -- particularly on the left side,
and treatments such as massage, ice, and heat don't affect it.
