We've
all read the signs of a heart attack listed on posters in the hospital waiting
room. But what if there were other, earlier signs that could alert you ahead of
time that your heart was in trouble?
It turns out there are. Researchers have done a
lot of work in recent years looking at the signs and symptoms patients
experienced in the months or even years leading up to a heart attack. "The
heart, together with the arteries that feed it, is one big muscle, and when it
starts to fail the symptoms can show up in many parts of the body," says
cardiologist Jonathan Goldstein of St. Michael's Medical Center in Newark, New
Jersey. Here are five surprising clues that your heart needs checking out. Any
of these signs -- and particularly two or more together -- is reason to call
your doctor for a workup, says Goldstein.
1. Neck Pain
Feel like you pulled a muscle in the side of your
neck? Think again, especially if it doesn't go away. Post-heart attack, some
patients remember noticing that their neck hurt and felt tight, a symptom they
attributed at the time to muscle strain. People commonly miss this symptom
because they expect the more dramatic acute pain and numbness in the chest,
shoulder, and arm. Women in particular are less likely to experience heart pain
that way, and more likely to feel twinges of pain and a sensation of tightness
running along the shoulder and down the neck, says Margie Latrella, an advanced
practice nurse in the Women's Cardiology Center in New Jersey and coauthor of Take Charge: A Woman's Guide to a Healthier
Heart (Dog Ear, 2009). The pain might also extend down the left side of the
body, into the left shoulder and arm.
Why
it happens:
Nerves from damaged heart tissue send pain signals
up and down the spinal cord to junctures with nerves that extend out into the
neck and shoulder.
What
distinguishes it:
The pain feels like it's radiating out in a line,
rather than located in one very specific spot. And it doesn't go away with ice,
heat, or muscle massage.
2. Sexual problems
Having trouble achieving or keeping erections is
common in men with coronary artery disease, but they may not make the
connection. One survey of European men being treated for cardiovascular disease
found that two out of three had suffered from erectile dysfunction for months
or years before they were diagnosed with heart trouble. Recent studies on the
connection between ED and cardiovascular disease have been so convincing that
doctors now consider it the standard of care to do a full cardiovascular workup
when a man comes in complaining of ED, according to cardiologist Goldstein
says. "In recent years there's been pretty clear evidence that there's a
substantially increased risk of heart attack and death in patients with
erectile dysfunction," Goldstein says.
Why
it happens:
Just as arteries around the heart can narrow and
harden, so can those that supply the penis. And because those arteries are
smaller, they tend to show damage much sooner -- as much as three to four years
before the disease would otherwise be detected.
What
distinguishes it:
In this case, the cause isn't going to be
immediately distinguishable. If you or your partner has problems getting or
maintaining an erection, that's reason enough to visit your doctor to
investigate cardiovascular disease as an underlying cause. "Today, any
patient who comes in with ED is considered a cardiovascular patient until
proven otherwise," says Goldstein.
3. Dizziness, faintness, or shortness
of breath.
More than 40 percent of women in one study published
in Circulation: Journal of the American Heart Association, reported having
experienced shortness of breath in the days before a heart attack. You might
feel like you can't breathe, or you might feel dizzy or faint, as you would at
high altitude. If you can't catch your breath while walking upstairs,
vacuuming, weeding the garden, or doing other activities that previously caused
you no trouble, this is a reason to be on the alert.
Why
it happens:
Not enough blood is getting through the arteries to
carry sufficient oxygen to the heart. The heart muscle pain of angina may also
make it hurt to draw a deep breath. Coronary artery disease (CAD), in which
plaque builds up and blocks the arteries that feed the heart, prevents the
heart from getting enough oxygen. The sudden sensation of not being able to
take a deep breath is often the first sign of angina, a type of heart muscle
pain.
What
distinguishes it:
If shortness of breath is caused by lung disease, it
usually comes on gradually as lung tissue is damaged by smoking or
environmental factors.
If heart or cardiovascular disease is the cause, the
shortness of breath may come on much more suddenly with exertion and will go
away when you rest.
4. Indigestion, nausea, or heartburn
Although most of us expect pain from any condition
related to the heart to occur in the chest, it may actually occur in the
abdomen instead. Some people, particularly women, experience the pain as
heartburn or a sensation of over-fullness and choking. A bout of severe
indigestion and nausea can be an early sign of heart attack, or myocardial
infarction, particularly in women. In one study, women were more than twice as
likely as men to experience vomiting, nausea, and indigestion for several
months leading up to a heart attack.
Why
it happens:
Blockages of fatty deposits in an artery can reduce
or cut off the blood supply to the heart, causing what feels like tightness,
squeezing, or pain -- most typically in the chest but sometimes in the abdomen
instead. Depending on which part of your heart is affected, it sends pain
signals lower into the body. Nausea and light-headedness can also be signs that
a heart attack is in progress, so call your doctor right away if the feeling
persists.
What
distinguishes it:
Like all types of angina, the abdominal pain
associated with a heart problem is likely to worsen with exertion and get
better with rest. Also, you're likely to experience repeated episodes, rather
than one prolonged episode as you would with normal indigestion or food
poisoning.
5. Jaw
and ear pain
Ongoing jaw pain is one of those mysterious and
nagging symptoms that can have several causes but can sometimes be a clue to
coronary artery disease (CAD) and impending heart attack. The pain may travel
along the jaw all the way to the ear, and it can be hard to determine which
it's coming from, says cardiovascular nurse Margie Latrella. This is a symptom doctors
have only recently begun to focus on, because many patients surveyed post-heart
attack report that this is one of the only symptoms they noticed in the days
and weeks leading up to the attack.
Why
it happens:
Damaged heart tissue sends pain signals up and down
the spinal cord to junctures with nerves that radiate from the cervical
vertebrae out along the jaw and up to the ear.
What
distinguishes it:
Unlike the jaw pain caused by temporomandibular
joint disorder (TMJ), tooth pain, or ear infection, the pain doesn't feel like
it's in one isolated spot but rather like it's radiating outward in a line. The
pain may extend down to the shoulder and arm -- particularly on the left side,
and treatments such as massage, ice, and heat don't affect it.
