Catch it early

February 16, 2023

If there is one message that saves lives and saves the quality of life, it is to pay attention to the symptoms of heart blockages and take action immediately. In honor of American Heart Month this February, here are some facts about angina and heart attack.

Angina means a coronary artery is blocked badly enough so the heart muscle is not getting enough blood and oxygen.

Symptoms of angina can include:

Chest, neck, jaw, or teeth, either shoulder or arm or upper back pain or discomfort which feels like: pressure, squeezing, tightness, aching, fullness, burning (indigestion-like). Some patients do not have any chest discomfort with angina.
Difficulty breathing.
Tiredness. You may feel like sleeping more than usual. You may get fatigued when doing physical work that you previously did without difficulty.
Blood pressure may increase from your baseline.
Symptoms can occur during physical activity or under mental or emotional stress.
Symptoms may occur while at rest, could awaken you from sleep, or could occur without a clear reason.
What do you do about this? If you have any of the above symptoms: STOP activity. Rest. Deep breathe. Call 911.

A heart attack is when a coronary artery is blocked 100%, or significant enough that the heart muscle is not getting oxygen or blood supply. The longer the heart muscle goes without treatment to improve the blood flow, the more damage occurs to the heart muscle.

Symptoms of heart attack can include:

Chest, either arm, neck, jaw, teeth, or upper back pain or discomfort. May feel like pain, tight, heavy, pressure, burning, aching, squeezing or indigestion-like or something just doesn’t feel right.
1. Typically, the pain or discomfort of a heart attack is more severe, but not always. The symptoms can last more than a few minutes, or they go away and come back.
Difficulty breathing. This may occur along with the chest, arm, neck, or back pain, or as the only symptom.

May feel weak, light-headed, faint, or sweaty.
May have unexplained tiredness and nausea or vomiting.

Dr. Patti Hook, MLHS Physician, states “Not every heart attack feels like excruciating pain. Women and people with diabetes may have symptoms that are less severe than what they believe a heart attack would cause. If something feels like it is wrong, act on it! Call 911.”

Here are a few testimonials from patients in the Cardiac Rehab program.

“You can’t monitor what you don’t measure, so track something.” - Brian Benson

Know Your Numbers. Track your blood sugars, blood pressure, symptoms, weight, and exercise. This puts you in control of your health as best as you can rather than letting illnesses take over.

“Shortness of breath came on gradually & I accepted it as just getting older. I couldn’t walk up an incline which had previously been no problem for me.” Richard Erickson

Shortness of breath is never normal – at any age. Breathing difficulty may accompany chest discomfort or it may be your only symptom. It can occur with activity or at rest.

Take control before you have a heart attack. See a medical provider to manage your risk factors. Mille Lacs Health System offers programs to help such as: care for high blood pressure, tobacco cessation, cardiac stress testing, diabetes management, nutrition counseling, weight management, mental health management, and rehab services to manage muscle or bone pain which prevents you from being active. Cardiac Rehab is a program for ongoing education and activity after an event with your heart.

Here are more real patient experiences. The patients hope their stories will encourage others to not ignore symptoms and to see their medical provider early if they are having these symptoms.


Patient Statements:	Medical Recommendations:
Prediabetes and Diabetes: “I was told to take care of my prediabetes, but I never really did it. I felt indestructible because I was young. Once it happens, you don’t think that way anymore. I treat my body like a castle now by taking good care of it.”	Prediabetes and Diabetes: Prediabetes is the time when our bodies produce plaque in arteries. Many patients are not aware that those with diabetes are twice as likely to have a heart attack or stroke than people without diabetes. See your provider and MLHS CDE- Certified Diabetes Educator to manage this condition, it will be well worth the effort!
	Diabetes: Angina or heart attack symptoms may not feel as severe for those with diabetes: might be short of breath or more tired or your blood glucose or blood pressures might be higher

“My Dad was young. He would often heavily sigh as if he was upset with us. After his heart attack, we learned this had been an angina symptom.”	Again, do not ignore ongoing symptoms and rationalize them as being caused by something else.
Less Activity Tolerance: A young person said: “I could just tell something wasn’t right. I couldn’t keep up with my regular walking partner anymore due to difficulty breathing. I did not have any chest discomfort or tightness. If I had been a person who didn’t do much activity, I might not have recognized I was getting short of breath.”	Regular walking is the absolute best exercise you can do to prevent heart disease. Compare how you tolerate activity now to how you did last week, month or last season. If it is harder, without any other reason or injury, see your medical provider.
Women and Angina Symptoms: Women may have less intense symptoms or might have the following: dull, heavy, indigestion-like or sharp chest discomfort or pain. Might be more likely to have upper back or upper abdomen pain. Might be more prone to have pain in their neck, jaw, throat or teeth while exerting themselves and the pain lessens or goes away when they rest. Might have fatigue, nausea, or vomiting.	Women and heart attacks: Symptoms may be any of those listed above. Or a heart attack may cause chest discomfort, or pain, upper back, neck or teeth pain, Indigestion, nausea or vomiting. Extreme fatigue. Dizziness. Shortness of breath. Fluttering or palpitations.
A young woman states, “When I had my heart attack, I had clutching arm pain. It was also in my upper back then neck then teeth. Its pains you’ve never had before.”	If the pain goes away, don’t wait to see if it will return. Don’t sleep on it and hope it is gone in the morning. Severe pain that is new to you is never normal.
Early treatment saves heart muscle: “Advocate for yourself: Clearly state that something is wrong and describe it as best as possible. Don’t get frustrated and just stay home because you are afraid someone will say there’s nothing wrong. Go in to have testing and an evaluation.”	Angina symptoms may be similar to several other illnesses. It is the job of the patient to seek medical help. It is the job of the medical providers to search for the cause. Be sure you get help early, don’t stay home too long and don’t try to diagnose yourself! You don’t have all the tests or equipment to test yourself at home
Symptoms at Rest: “First I had pain in both arms. Then had chest pressure. If it got bad enough, the pain would go down my arm even to my thumb. One time I awoke from sleep with chest and arm pain.”	Call 911 if you ever experience chest, arm, back pain that awakens you from sleep.
“I woke up one morning with severe chest pain. It went away after a few hours, but came back when I woke up. I figured our days are numbered and there was little I could do about it anyway and I would be ok if I passed so I could see my spouse again.”	We have heard this story too many times! People sometimes do die from their heart disease. However, many do not. Please save heart muscle by getting treatment early. According to Dr. Patti Hook, “When you wait too long, a portion of your heart muscle can literally die. You might have difficulty doing the activities you like because you feel short of breath and tired. Save your heart muscle. Call 911 early with symptoms!”

Article by Michelle Harmon, RN, Cardiac Services