Most deaths associated with a heart attack occur in the first one hour of its onset. The prime hurdles associated with a timely intervention in saving lives during a heart-attack are the timely diagnosis of it and then its timely treatment.
Probably when William Heberden in 1772, described angina-pectoris or cardiac chest-pain as “a sense of strangling…with a painful sensation in the chest…often more to the left than to the right side of the center of the chest….very frequently extending from the chest to the middle of the left arm”, it was so vivid a description that all the other variations of pain in a heart-attack eluded the layman’s understanding, sadly leading to the costly misconception of it, delayed diagnosis, delayed treatment and otherwise preventable fatalities!
In my practice of cardiology, I have seen many lives, and many so young, lost, merely from the ignorant delay in reaching a hospital, for the want of a crucial timely diagnosis of a heart-attack, purely from the patient’s own failure and or delay in understanding the symptoms of a heart-attack. In despair, I have always felt a conscientious urge of educating the masses on how very different the pain in a heart-attack can be from Heberden’s classic description of it and that no time should be lost in getting expert medical attention.
Though the classic pain in a heart-attack is described as a constricting heaviness on the left side of the chest, where the heart is located,up to 35 to 45% patients can experience a heart-attack without any form of chest-pain. A heart-attack can present deceptively as just breathing difficulty, or less alarmingly as mere tiredness or giddiness especially in the older and diabetic patients or more commonly as belching or ejection of air or gas from the stomach through the mouth or as a burning sensation in the upper middle area of the abdomen or the center of the chest. It can at times present only as pain in the jaw or throat and sometimes as back pain. Though often a heart-attack can be accompanied with sweating, nausea or vomiting, it is not always the rule. Thus it is important that it be driven to the comprehension of every individual that a heart-attack can present differently and even without any chest-pain, especially being of utmost concern if the person has risk-factors as diabetes, smoking, a sedentary life-style, obesity, a strong family history of heart attackor is a post-menopausal woman.
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