A common symptom of coronary heart disease is chest pain or tightness, known as angina. It may be the earliest sign of heart disease and usually brings someone to a health care provider for the first time.
Episodes of angina occur when the heart's need for oxygen increases beyond the oxygen available from the blood. Physical exertion is the most common trigger for angina. Other triggers can be emotional stress, extreme cold or heat, heavy meals, alcohol and cigarette smoking.
A person may feel heaviness, tightness, pain, burning, pressure or squeezing, usually behind the breastbone but sometimes also in the arms, neck or jaws. It can also cause shortness of breath. The pain usually gets better or goes away with rest.
An episode of angina is not a heart attack. A heart attack occurs when the blood flow to a part of the heart is suddenly and permanently cut off. This causes permanent damage to the heart muscle. Typically, the chest pain is more severe, lasts longer and does not go away with rest or with medicine. It may be accompanied by indigestion, nausea, weakness and sweating. However, some people, especially women, have heart attacks without ever having any of these symptoms.
A half-million women have heart attacks each year.
Heart attacks often feel different to a woman than to a man. Women are more likely than men to have "silent" or unrecognized heart attacks (myocardial infarction). Not all heart attacks begin with sudden, crushing chest pain, the way they are often shown in the movies and on TV.
Heart attack symptoms may be severe from the start, or they may be mild at first, and then gradually worsen. Women are more likely than men to have nausea, pain high up in the abdomen or burning in their chest during a heart attack.
Heart attacks and their aftermath tend to be more deadly in women. About one-quarter more women than men die within a year of having a heart attack. This may happen because women are generally older than men when they suffer heart attacks. Also, women don't respond as well as men to the treatments usually prescribed during or after a heart attack.
Preventing or controlling heart disease may mean making changes in the way you live. A healthy heart requires a personal action plan. But where do you begin? A complete medical checkup is a sensible first step, especially if you have multiple risk factors. Your health care provider can tell if you have cardiovascular disease or its risk factors, and if so, help you with a practical treatment plan. Even if you don't have any risk factors now, you can discuss ways to lessen your chances of developing them. Prevention is your key to survival. See the Risks and Prevention sections of this Action Area to learn how to change your risk factors for heart disease.
The most common warning signals for heart attack are:
Pain or discomfort in the center of the chest that lasts more than a few minutes, or goes away and comes back
Chest discomfort with sweating
Pain that spreads from the chest to the arm, neck or jaw
Shortness of breath, tiredness or upset stomach; these are particularly common in women
If you are at risk for heart disease and notice any of these symptoms, contact your health care provider immediately. Time is a crucial factor in a heart attack because drugs that break down blockage in the arteries (thrombolytic therapy) should be given within the first 1 to 2 hours.
Good communication with your health care provider is important. Choose someone you trust who will listen to your questions, answer them fully and take your concerns seriously. But while advice from your provider is important, the final responsibility for heart health lies with you. Only you can make the kinds of lifestyle changes-changes in eating, drinking, smoking and physical activity that will help protect against, or control, cardiovascular diseases.
If you have concerns about your health, it's important to take an active role in your health care. That means giving as much information as you can about your condition to your health care provider, as well as making sure you understand your treatment. Here are some tips for good, clear communication between you and your health care provider.
Be prepared Before your office visit, make a list of your symptoms, past treatments and any concerns or questions you may have. Also, bring a list of all medicines you are taking now.
Be open During the office visit, briefly describe each of your symptoms, including when each started, how often it happens and if it has been getting worse. Also tell your health care provider about any causes of stress in your life.
Ask questions If you don't understand something your health care provider says, ask for an explanation. Be sure you fully understand how to take medication, when to take it, how much to take, what side effects may occur and what to do if you forget a dose. It may help to write down the instructions.
Bring a support person If you are worried about understanding what your health care provider says, or if you have trouble hearing, bring a friend or relative with you. You may want to ask that person to write down instructions for you.
Speak up If something is bothering you, say so. Your health care provider needs to know if a treatment is working or not, or if you are having trouble following his or her instructions. In some cases, simply getting more information from your health care provider may solve a problem. In other cases, your health care provider may be able to recommend a different treatment or approach that works better for you.
Ask about tests If your health care provider recommends a diagnostic test, ask why you need it and what you will find out from it. Also ask what the test involves and how to get ready for it, and whether you will need help getting home afterward. Be sure to find out if the test has any risks or side effects. Your health care provider only recommends a test. The decision to take it is yours.
Inquire about procedures If your health care provider recommends a special procedure, ask about its benefits and risks. Find out what kind of provider will do the procedure and whether you will need a referral. Also ask if you will need to be hospitalized and for how long, what kind of pain or discomfort you may feel and what the recovery period will involve. You may want to get a second opinion. Just as with tests, the decision to have any medical procedure is up to you.