Heart Attack usually takes place suddenly. One minute the victim is carrying on his usual activities and the next minute
he gets incapacitated with intense pain which originates in the chest, or sometimes in the upper part of the tummy, from where it often travels to the left shoulder and left arm. The patient feels that his chest is being squeezed, constricted or crushed. The attack may begin under almost any circumstance: while the person is working in his office, attending a luncheon party, driving a car, resting in a chair or even while sleeping. It may be triggered by vigorous exercise if one is not used to it. Often the pain is so intense tat there is difficulty in breathing. The person feels weak and dizzy and may pass out. Frequently, he is nauseated and may vomit. He often perspires heavily and his skin may turn moist and cold. A feeling of impending death may overpower him.
The site and nature of pain is very similar to angina, ad reasonably so, as both situations are caused by the reduction of blood supply to the heart. But there are some obvious differences. As opposed to the pain of angina, an infarct pain increases in intensity until a maximum has been reached. There is neither a let off in the pain with rest, nor a definite excitatory cause. Once having reached its crescendo, an infarct pain persists for half an hour or more.
The
symptoms may also be confused with those of indigestion, particularly when the pain begins in the pit of the stomach and is accompanied by nausea. Many instances are recorded where a person has attempted to dismiss his symptoms with a bottle of soda water, a helping of
churan or a digestive preparation, only to know later that he had suffered a heart attack.
In some patients the classical symptoms do not appear. Some 15 to 20% of myocardial infarcts are completely
painless. Their frequency may even be higher than this estimate, because without pain patients are not likely to report to a doctor. Such painless infarcts are more common in patients with diabetes, and their occurrence increases with age. In the elderly, a heart attack may present itself just as a sudden attack or breathlessness. Less commonly, it may appear as loss of consciousness, confused state, sensation of profound weakness, sudden waywardness of heart rhythm, or an unexplained drop in arterial blood pressure.