Signs of a Cardiac Event

Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:
Neck, jaw, shoulder, upper back or abdominal discomfort.
Shortness of breath.
Right arm pain.
Nausea or vomiting.
Lightheadedness or dizziness.
Unusual fatigue.

READ more about A Cardiac Event

Immediate attention is critical to surviving a cardiac event. But how do you know whether to head for the hospital or your bathroom medicine cabinet? A guide to making the distinction between heartburn and heart attack.

It’s the middle of the night. You sit up in bed your chest throbbing. Uncertainty exacerbates your discomfort—now you’re dealing with anxiety as well as what hurts. Are you having a heart attack or simply suffering the consequences of a late-night burrito?

Doctors say—talk to the hand—it’s likely the best indicator of whether or not you’re experiencing cardiac arrest or some form of gastrointestinal pain.

Heart attack victims often make a clenched fist when asked to describe the nature of their discomfort. Conversely, people suffering from heartburn are inclined to point to the source of their pain with single fingers.

While it can be every bit as intense as that produced by a heart attack, the pain associated with indigestion is usually more localized.

“Cardiac discomfort can vary from one person to another,” says Dr. Garry Mackenzie, medical director of Cardiology Services at McKay-Dee Hospital Center in Ogden, Utah, “but for the majority of people their pain is in the center of the chest, behind the sternum. They feel heaviness, pressure and aching. It’s diffuse, and people frequently make a clenched fist when describing it. Those with esophageal discomfort will spread their fingers out over their chest. This is a pretty consistent rule-of-thumb.”

Matters of the heart are never simple, particularly in respect to vascular health. At some point everyone experiences the dread and confusion that accompanies severe chest pain. While no one wants to be labeled a hypochondriac, ignoring signs of heart disease can prove fatal.

Heart-related chest pain generally produces a feeling of pressure, accompanied by shortness of breath. The pain may radiate outward, spreading to the arms, shoulders, neck and even the jaw. Gastrointestinal pain is unlikely to reach beyond the abdominal or chest area.

It’s an important difference, but doctors caution that self-diagnosis is fraught with peril.

Gall bladder disease, acid reflux and pulmonary embolism also mimic heart attack symptoms, adding to the confusion.

“It’s difficult enough at times for doctors to make a distinction between symptoms,” comments Dr. Nieca Goldberg, ( chief of Women’s Cardiac Care at New York’s Lenox Hill Hospital, and author of The Women’s Healthy Heart Program, (available at

“I think it’s very hard for people to differentiate between heart attack symptoms and gastro intestinal symptoms. It can be even more difficult for women. Heart disease symptoms among women sometimes differ from those of men. They may not experience any chest discomfort, but will get shortness of breath or unexplained fatigue. Women can have jaw or neck pain without any chest pressure.”

According to Dr. Goldberg, the best way to proceed when chest pain arises is to examine your history, and determine what precipitated the symptoms. If it was exertion then heart disease is likely present. Gastro intestinal symptoms usually arise after a meal.

It’s important to note, however, that acid reflux can co-exist in someone with heart disease.

“The safest course of action when you experience symptoms,” says Dr. Goldberg, “is to contact your doctor and get evaluated. People sit in my office arguing why it’s their stomach and not their heart. Nobody wants it to be their heart.”


Thanks in large measure to the efforts of Dr. Goldberg, it is now widely accepted that heart disease affects women differently than men, resulting in better care and treatment. Here are the symptoms of heart disease common to women:

Back pain
Shortness of breath

Men experience all the symptoms classically associated with heart attacks. Among them:
Squeezing sensation in the chest
Pain in the arms, neck, shoulders and jaw
Shortness of breath
A cold sweat

Whether it’s due to ignorance or denial, people usually miss warning signs of an impending heart attack. Exertion is almost always a factor, but if the discomfort is not acute, people are unlikely to respond. A typical scenario that plays out repeatedly is that of an overweight man in his sixties who experiences chest pain while cutting grass, shoveling snow or moving furniture. He attributes it to overeating, and feels reassured when the symptoms cease after completing his task.

It’s a sad fact, but the discomfort that precedes a heart attack is usually not acute enough to cause alarm.

That’s why it’s so important to know whether or not there’s a history of heart disease in your family. Determining your risk factors is the first step towards heart attack prevention.


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