Many of us have experienced that moment. Perhaps we’re driving in traffic or working out at the gym when we feel a twinge in our chest, or an aggressive pulse. Or maybe we just don’t feel right. We might pause at these moments and wonder if our hearts are okay. Truth is, both men and women may notice subtle heart symptoms months before an actual heart attack occurs. And that reality can leave us wondering when it’s time to hightail it the doctor – and when it’s time to relax.
We spoke with Sutter Health Cardiologist Zi-Jian Xu, M.D., FACC, Ph.D., to provide some perspective.
Is it true that women can experience symptoms months before a heart attack actually occurs?
That is true -- for both men and women. The symptoms can occur months or even longer sometimes, and you can have a very wide spectrum of symptoms. Some people may present for the first time with a heart attack after having no symptoms, while others may have symptoms a long time.
What do these early symptoms typically look like?
The majority of patients, including women, experience somewhat typical symptoms, such as radiating chest pain, heaviness or discomfort, heart palpitations, cold sweats and shortness of breath. However, women are more likely than men to experience atypical symptoms as well, which may include fatigue, a general sense of unease, vague discomfort, back or abdominal pain and declining stamina. Both types of symptoms can be experienced months before an actual heart attack occurs.
Is there anything that distinguishes these symptoms? How can women know when the subtle, atypical symptoms could be heart disease?
When we see patients and address these symptoms, it’s very important to look at the risk profile of each individual person. We look at family and personal history, blood pressure, cholesterol, age and disease history. From those risk profiles, we can identify patients as high, intermediate or low risk. Within the context of risk, we can evaluate symptoms. Are the symptoms typical or not? How does someone experience the symptoms? At rest, during exertion? Are they associated with emotional stress or cold weather? Are they happening in conjunction with other symptoms such as shortness of breath, rapid heart beating, cold sweats?
Each person should really be aware of his or her own risk profile. Everybody should have a general idea of, ‘What is my chance of dying of a heart attack?’ We look at all these things to determine whether symptoms require further evaluation.
These predromal symptoms don’t really sound like the “Hollywood heart attack” experience.
There are two main ways that people present with heart attacks:
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