One of the patients who was being treated at our centre forST-elevation myocardial infarction (a heart attack from a completely blocked vessel) did not realise that she was having a heart attack and kept self-medicating herself with home remedies for indigestion until she was rushed to the emergency care at the one of the best heart hospital in the Delhi NCR. Timely ECG was done and her angiography demonstrated a 100% blocked vessel, she was immediately treated by a team of world-renowned cardiology experts who implanted two stents in the vessel. This is a common theme encountered by most cardiologist across various cases.
Most heart patients admitted to emergency care with cardiac problems reportedly misjudge the heart attack symptoms as indigestion problem. People usually associate a heart attack with pain in the chest radiating to the jaw and down the left arm. Visuals of the classic Levine sign – where the patient places his clenched fist over the chest to describe the pain of heart attacks in the movies and the inapt information regarding heart attacks can be considered as the reason for this belief.
Woman, elderly or diabetic suffering heart attack may or may not show such symptoms but some variation of pain and discomfort as in the above-mentioned case. We should be aware of the symptoms and should be able to discern between indigestion and a heart attack otherwise it may become a life-threatening situation. It is important to know the typical and not to so typical pains that should prompt a visit to the best cardiology hospital.
Most symptoms of severe indigestion and heart attack may seem similar but if you are aware of the symptoms you can easily distinguish between the two. While symptoms of indigestion and other non-cardiac chest pain occur in behind the chest bone same as heart attack, the later causes intense pain with a feeling of discomfort, squeezing, tightness, pressure, constriction, crushing, strangling, burning, heartburn, fullness in the chest, band-like sensation, a knot in the centre of the chest, lump in the throat, ache, heavyweight on chest (elephant sitting on the chest) and toothache (when there is radiation to the lower jaw). It is generally may or may not be as sharp, fleeting, knife-like, stabbing, or like pins and needles.
Some features of the pain that suggests it is more likely from the heart –
· Sudden pain radiating to right or left or both arms and/or shoulders
· Left chest pain radiating to the jaw or back
· Pain that worsens on exertion
· Pain associated with sweating
· Pain associated with nausea or vomiting
· Pressure pain
· Worse than previous cardiac pain or similar to the last episode
· Indigestion with sweating
Some features to suggest that the pain is less likely from the heart –
· Pain that worsens with breathing
· A sharp pain that lasts for a few seconds
· Pain that worsens on touching
· Quality and intensity of the pain that changes with position
It must be mentioned that above all symptoms may also occur due to other medical conditions, so it is advisable to consult a cardiologist at the first instance when you perceive any of the above symptoms.
Dr. Sameer Gupta, FACC, FSCAI
Consultant, Interventional Cardiology & Peripheral Intervention
Director, Cardiac Cath Lab, Metro Group of Hospitals,
(Limb Disease Specialist)