Would you recognize a heart attack? Symptoms of a heart attack are not the same for everyone. Most people think the only symptom of having a heart attack is extreme chest pain and the feeling of impending doom. Actually that is not typically the case. The most common symptom is shortness of breath but people present with different symptoms all the time. The majority of symptoms are listed below according to specific populations. These are the most frequent symptoms for each category but are certainly not the only ones each may present with a heart attack.

• Men – Chest Pain, Jaw Pain, Abdominal Pain, Dizziness, Weakness, Shortness of Breath, Heart Pounding or Change in Rhythm, Sweating
• Women – Generalized pain, Back Pain especially at the Shoulder Blades, Sleep Disturbances, GI Complaints such as nausea/vomiting/diarrhea, Heart Pounding, Sweating, Chest Pain as more sharp than crushing
• Elderly – Shortness of Breath, Chest Pressure, Fainting, Mental Status Change or Confusion, Weakness, Fatigue
• Diabetics – Atypical or no Chest Pain, Shortness of Breath, Sweating, Weakness

If you experience a sudden onset of any of these symptoms that do not resolve with rest and think you might be having a heart attack, what would you do? Drive yourself to the doctor or hospital? Call a family member or friend to drive you? No. You need to CALL 911 IMMEDIATELY!!

What is so special about calling the EMS? You feel you can make it to the hospital without them, right? WRONG! All of our local EMS are trained to care for heart attack victims. Before you ever get to the hospital, you can expect:

• EKG to show if you are actively having a heart attack
• Oxygen
• Medications
• Advanced Life Support if needed
• Calling ahead to let us prepare for your arrival

This will ensure you are given priority. If you are actively having a heart attack, we will have the cardiologist contacted and the Cardiac Catheterization Lab waiting. We certainly want to provide the best care possible and minimize any chance of disability or death.

Your responsibility in your cardiac health is to be knowledgeable regarding the symptoms of a heart attack and seek treatment immediately by calling 911.

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Keri Morris, R.N., BSN is a Chest Pain & Stroke Coordinator at Methodist Le Bonheur Germantown Hospital. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.

Smoking by itself increases the risk of coronary heart disease.

When it acts with the other factors, it greatly increases your risk from those factors, too. Smoking decreases your tolerance for physical activity and increases the tendency for blood to clot. It decreases HDL (good) cholesterol. Your risks increase greatly if you smoke and have a family history of heart disease. Smoking also creates a higher risk for peripheral artery disease and aortic aneurysm. It increases the risk of recurrent coronary heart disease after bypass surgery, too.

Many people find support groups and hotlines helpful when quitting smoking. Knowing that someone out there understands and shares your struggle can help you stay committed to being smoke-free. These organizations may offer personalized help or listings of classes and support groups in your community:

• American Cancer Society
  Toll-free hotline: 800.ACS.2345 (800.227.2345)
• American Lung Association
  Toll-free hotline: 800.LUNGUSA (800.586.4872)
• MedLine Plus – Local Smoking Cessation Resources (from the National Library of Medicine and the National Institutes of Health)
• National Cancer Institute
  Toll-free hotline: 877.44U.QUIT (877.448.7848)
• National Institutes of Health – Clinical Trials on Smoking Cessation
• National Network of Tobacco Cessation Quitlines
  Toll free hotline: 800.QUITNOW (800.784.8669)
  TTY: 800.332.8615
• Nicotine Anonymous
  415.750.0328

For more information on heart disease or heart treatment in Memphis, contact the Cardiovascular Institute at 888.777.5959.

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Jennifer Hutzel is a Registered Nurse at the Methodist North Chest Pain Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.

Weight gain and and an inactive lifestyle can influence heart diseases. These also increase the risk of high blood pressure, diabetes and increased blood cholesterol levels, which increases the risk of heart disease. Knowing how to maintain or lose weight and also to maintain cardiac (heart) fitness is important.

Tips on Calories:

1. The formula for losing or gaining weight is generally simple. If you burn more calories than you take in, you'll lose weight because the calories are used up and your body begins burning fat instead. If you take in more calories than you burn, the extra calories are converted to fat and are stored in the body.
2. Use up at least as many calories as you take in.   
3. Find out how many calories you should be eating and drinking to maintain your weight. 
4. Don’t eat more calories than you know you can burn up every day. 
5. Increase the amount and intensity of your physical activity to match the number of calories you take in. 
6. Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. 
7. For weight maintenance, aim for at least 30 minutes of moderate physical activity every day. If you can’t do at least 30 minutes at one time, you can add up 10-minute sessions throughout the day.

Tips on Physical Activity:

1. Being active brings many benefits for your heart and your health.
2. Regular exercise improves blood pressure and blood sugar levels
3. It also reduces risk for diabetes, osteoporosis, obesity, depression, and colon and breast cancer. 
4. Try to live an active lifestyle: incorporate as much physical movement into your usual daily activities as you can. For example, decide to take the stairs instead of riding the elevator; try not to drive to a nearby shop, and instead try walking to the shop. 
5. How much activity do you need?  At least 30 minutes of moderate physical activity on most, if not all, days of the week. For losing weight, 30 to 60 minutes moderate physical activity is required on most days.

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Dr. Santhosh K.G. Koshy, DM, FACC, FSCAI is the Director of Interventional Cardiology and Director of UT services at Methodist Healthcare and the University of Tennessee Health Sciences Center in Memphis, Tenn. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.

Fast action is the best weapon against heart attack! Artery opening treatments can stop a heart attack in its tracks. They can prevent or limit heart damage–but they need to be able to be performed as soon as possible after the symptoms begin.

• Chewing and swallowing a 325 mg aspirin can reduce damage to the heart if you or someone you know is experiencing symptoms of a heart attack.
• Call 911 and get the person to the hospital as soon as possible.

Know the Early Symptoms of Heart Attacks

Early warning signs are present in nearly 50% of all heart attacks. Symptoms are usually present 24 hours before the attack but can occur 2-3 weeks beforehand. Symptoms are typically intermittent lasting from a few minutes to a few hours, followed by a pain-free period before the acute attack.

Non-specific signs include:

• Weakness/fatigue
• Clammy/sweating
• Nausea
• Indigestion
• Dizziness/nervousness
• Shortness of breath
• Neck/back/jaw pain
• Feeling of doom

Specific signs of a heart attack:

• Chest discomfort
• Chest pressure
• Chest ache
• Chest burning
• Chest fullness

Some heart attacks are sudden and intense—like the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help.

Immediately call 9-1-1 or your emergency response number so an ambulance (ideally with advanced life support) can be sent for you. As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives—maybe your own. Don’t wait more than five minutes to call 9-1-1 or your emergency response number.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive—up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.

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Jennifer Hutzel is a Registered Nurse at the Methodist North Chest Pain Center. All opinions expressed here are those of their authors and not of their employer. Information provided here is for medical education only. It is not intended as and does not substitute for medical advice. Call 888.777.5959 for more information.