Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
It is important to recognize the signs of a heart attack and to act immediately by calling 911. A person's chance of surviving a heart attack increases if emergency treatment is administered as soon as possible.
James Nossett, MD, is here to discuss the symptoms of a heart attack and why it is so important to get help as soon as possible.
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How to Spot a Heart Attack (And When To Call 911!)
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Learn more about Dr. Nossett
James Nossett, MD
Dr. Nossett is the Medical Director of EMS at Hendricks Regional Health and StatFlight 4.Learn more about Dr. Nossett
Transcription:
How to Spot a Heart Attack (And When To Call 911!)
Melanie Cole (Host): It’s important to recognize the signs of a heart attack into act immediately by calling 911. A person’s chance of surviving a heart attack increases if emergency treatment is administered as soon as possible. My guest today is Dr. Jim Nossett. He’s an emergency medical services physician at Hendricks Regional Health. Welcome to the show, Dr. Nossett. So, tell the listeners the first most important information that you want people to know about surviving a heart attack.
Dr. Jim Nossett (Guest): Well, sure. Time is of the essence. When people start to have symptoms of a heart attack and we can talk about those shortly but they really need to call 911, get the ambulance on the way to be picked-up and taken care of at their location, first and foremost, and then be taken on into the hospital. So, time is really, really important. We say in emergency medicine that “time is muscle” when referring to the heart. And so, if somebody is truly having a heart attack, they need to be cared for as soon as possible and that starts with 911 and EMS being on the scene with the patient. And then, they can transport the patient into the hospital and get the continue treatment like a cath lab and a standard surgery and whatever else comes after that. But, it is so vital that people say, “You know what? This is not normal. Something’s wrong. I’m sick or my father or wife or sister is sick and I need to call 911 and get this thing rolling now.”
Melanie: So, before we even get to symptoms, let’s talk about risk factors. Who’s at risk for a sudden heart attack?
Dr. Nossett: Sure. Well, there’s a group of risk factors that are very well known. Smoking is a huge one because the damage done to arteries from smoking, it causes people to develop coronary artery disease way earlier than they otherwise would. So, smoking is a big one. Diabetes, both Type 1 and Type 2, that is onset as a child or onset as an adult. Both of those are certainly of risk factors. High cholesterol, high lipids, is also a risk factor. And then, family history is another big one. It is very common that people who look otherwise healthy but have substantial history in their family, their mom and dad, brothers, sisters who had coronary disease and heart attacks. That means that almost likely, almost definitely, that person is going to have the same problem. And then, aging, of course. The older we get, the more everything starts to break down, including the arteries in our heart. So, that also leads to the increase risk of a heart attack.
Melanie: Is there any predetermining screening, to let somebody know they might be at risk. Is there any way to know ahead of time?
Dr. Nossett: Sure. Besides those risk factors that we know of, there are a few things that can be done. Certainly, when somebody has run some test on their cholesterol check and it’s very, very high. They already know then, wow, I’m at a high risk for a heart attack. But, somebody who doesn’t necessarily know those numbers can talk to their physician. And, if they have some potential risk factors, they might be put on a treadmill and have a stress test done where they walk on a treadmill or have some other testing done that checks to see if there’s any sign that the heart is suffering when exercise is good to the heart. When somebody has a coronary disease, often they don’t feel it if they’re at rest a lot of the time. But, when they exercise or they put their body to work, and put that heart to work and it starts demanding more blood flow and more oxygen because it’s working harder. That’s when symptoms can show up or maybe not symptoms but some very, very subtle signs on an EKG or an echocardiogram. So, there’s a stress test that can be done to test somebody for coronary disease. And, there’s also something that’s becoming more popular and, quite frankly, is very easy. It’s a CT scan that is done, somebody is run through the CAT scanner. It takes just a matter of very few minutes and it specifically looks at the heart and the coronary arteries to see if there are signs of heavy calcifications, which is often a sign that there is a closure or near closure of an artery starting to occur and the coronary arteries in the heart. That’s a pretty decent, if you put it that way, screening tool for somebody to see if maybe they have, some at least developing, coronary disease. It’s not the perfect one but certainly it is a great screen that could give you a little bit more confidence. And, when we see it shows something, it often means something. And that means, when we see some calcifications on arteries on that scan, we can say, you know what? I think we need to go with some further testing here. That might mean the stress testing, etc.
Melanie: So, Dr. Nossett, people get some of the symptoms, you’re going to describe just from stress or anxiety. I think one of the big questions is: how do you know when a symptom is something really more serious? So, describe the symptoms for us if you would.
Dr. Nossett: Sure. Well, the symptoms, the classic one is chest pain, of course, and I say “classic” but the classic symptoms would be chest pain in the center and left side of the chest that is usually described as a crushing or squeezing sensation. Many people say that it feels like somebody is sitting on my chest or an elephant is sitting on my chest. That’s sort classic description of it. The pain will radiate into other parts of the body, typically into the left arm or shoulder. And then, possibly up into the neck or jaw and sometimes into the back. And it kind of varies as to where in the heart the problem lies as to how that radiation happens. Some people don’t get radiated pain at all but usually they do. And then, shortness of breath often goes with it, at least a mild shortness of breath. And then, often people will break out into a sweat. And that’s just the body’s reaction to a painful, potentially serious problem that’s going on. So, chest pain with some radiation maybe into the arm and shortness of breath, and sweatiness. Sometimes with a little bit of nausea with it, too. Those are kind of the classic symptoms. And now, I will say this and that is that not everybody follows the rules, meaning their bodies don’t always do what we put into the textbook. As a matter of fact, probably I get half the time, we don’t get even close to all of those symptoms.
Melanie: I was just going to ask you about women because aren’t there signs just a little different?
Dr. Nossett: They often are. Now, when a woman comes in with those classic symptoms, then she’s having a heart attack until proven otherwise. But, very commonly, ladies will have, I would say, lesser symptoms. Things that don’t just jump out that it was classic as that. Sometimes it’s just a significant tiredness. They just well way more tired than usual on a particular day. Maybe a little shortness of breath. They might have an ache or two in their chest but sometimes not as prominent as guys get. Who knows why? That’s just how women are built sometimes. So, it’s a little more subtle for women. So, if a lady starts to feel, you know what? I’m just suddenly way more tired and maybe is going through the day and kind of not felt right, but then suddenly that overwhelming, “I’m exhausted. I feel a short of breath, something’s wrong”, breaking a little sweat. That, indeed, is a possible sign that she’s having a heart attack.
Melanie: Now, women, we’re more likely not to report these symptoms, true? Because we often say that they’re anxiety, stress or pre-menopause, or whatever the reason, so women tend to discount some of these symptoms as just something.
Dr. Nossett: Well, that’s really very true and, quite frankly, I’ll say this as a guy, women might think they’re tougher in many ways or at least. A lot of us guys are just wimps and I say that we complain quicker. I don’t know why but women do sometimes just think, “Well, I’ll make it through this. I just don’t feel good. I’ve been busy. I’ve got all these things going on, and I’m carrying all this stressful load on my life. They do put it off as that.” It’s a psychological thing probably more than anything. And, they just sort of tough it out, maybe a little more stoic sometimes which is, sadly, a dangerous thing because the longer they put that off, those symptoms off, the more damage is being done to their heart.
Melanie: So, just wrap it up for us, Dr. Nossett and it’s so beautifully put. You’re an amazing doctor, I can tell. So, tell everybody what you really want them to know, what you tell them every single day about preventing a heart attack and what to know about the signs of one.
Dr. Nossett: Sure. Well, in preventing a heart attack. First of all, the prevention would be this: take good care of yourself. One of the symptoms, excuse me. One of the risk factors I didn’t say at the beginning in this talk and I just realized it was high blood pressure. So, high blood pressure certainly is another risk factor. So, if you have high blood pressure, first of all, go to your doctor. If you don’t have a doctor, if you haven’t been seen or have a good check-up lately, go to your doctor and get a good check-up. It’s awesome how often people go to the doctor, things are found early before they cause damage before they lead to a heart attack and they can be taken care of. So, go to your doctor, first of all, and have somebody that you have as the primary care giver who will assess you for this things. But, anyway, take care of your blood pressure. Take your medicine, if you have high blood pressure. If you’re diabetic, you need to follow the rules and take good care of yourself as far as taking your medications and eating appropriately. Exercise is absolutely vital. Our hearts are so craving exercise. They are meant to beat and beat hard, and beat well and be strong and have good blood flow. Exercise brings that about. It keeps the blood moving quite honestly. Quit smoking. If you are a smoker, you know it’s bad for you. We all know it’s bad for us. Pursue ways to stop smoking and talk to your doctor about that. Those are some ways to prevent these stuff. So, what about if you start feeling poorly. What I would say is this, if you develop these symptoms or symptoms that just don’t feel right. And you say, “Wow, something is definitely wrong in my body right now and, particularly, regarding your chest. If you feel short of breath in your chest. If you feel pain in your chest. If it is starting to ache down on arm or your neck and jaw starting to ache and you think, “What is going on here? I don’t feel right and I’m aching up here in my chest, my neck or my arm.” That very well could be a sign that you’re having a heart attack. And, what I tell people is this. Don’t get into your car, or along with your spouse or family member and say “Let’s go to the hospital.” Honestly, you should call 911. And here’s why: you do eventually need care and hospital. There’s no doubt about that. And, if you’re having a heart attack, you’re going to probably end up in a heart cath lab and having that testing done as well as procedure done to open your artery up. But, in the immediate timing, you need to have what EMS can provide you. They can arrive on the scene very quickly. They can provide medications as needed, like nitroglycerine and aspirin and oxygen and they can transport you safely to a hospital. If you need to get there fast, they can get you there way more safely fast than you can or your family member can drive. And, the other piece of that is this. It’s not uncommon that somebody having a heart attack literally goes into cardiac arrest or at least passes out and it goes into shock. You cannot take care of yourself in a car if that happens to you nor can you take care of your family member who’s having a heart attack if that happens to them while you’re driving to the hospital. It is way better to get the care you need there within just a short period of time by the professionals who are the paramedics and the EMTs. They know how to do this. They do it every day. They literally bring a portion of the hospital to you and they bring the care you need immediately to you right away. And then can take you to the hospital for the rest of the trip.
Melanie: Wow. What amazing information, Dr. Nossett, and tell us why listeners should come to Hendricks Regional Health for their care.
Dr. Nossett: Hendricks Regional Health is a full service hospital. We provide awesome care. We have some great professionals. We have specialist in emergency medicine who would see a patient potentially having a heart attack immediately in emergency department. We do this on a daily basis. Our physicians are ready, our nurses are ready. We have a system in place to take care of patients who are having chest pain, to evaluate to see if it’s a heart attack or not. We have awesome cardiologists who could take care of their heart attack or just their symptoms that are signs that there is a heart problem. A cath lab ready to open up an artery. We got some wonderful physicians and wonderful caregivers who are ready to go at work at any moment. Come to Hendricks Regional Health and we’re ready.
Melanie: Thank you so much for being with us, Dr. Nossett. It’s great information. You’re listening to Health Talks with Hendricks Regional Health. For more information, you can go to Hendricks.org. That’s Hendricks.org. This is Melanie Cole. Thanks so much for listening.
How to Spot a Heart Attack (And When To Call 911!)
Melanie Cole (Host): It’s important to recognize the signs of a heart attack into act immediately by calling 911. A person’s chance of surviving a heart attack increases if emergency treatment is administered as soon as possible. My guest today is Dr. Jim Nossett. He’s an emergency medical services physician at Hendricks Regional Health. Welcome to the show, Dr. Nossett. So, tell the listeners the first most important information that you want people to know about surviving a heart attack.
Dr. Jim Nossett (Guest): Well, sure. Time is of the essence. When people start to have symptoms of a heart attack and we can talk about those shortly but they really need to call 911, get the ambulance on the way to be picked-up and taken care of at their location, first and foremost, and then be taken on into the hospital. So, time is really, really important. We say in emergency medicine that “time is muscle” when referring to the heart. And so, if somebody is truly having a heart attack, they need to be cared for as soon as possible and that starts with 911 and EMS being on the scene with the patient. And then, they can transport the patient into the hospital and get the continue treatment like a cath lab and a standard surgery and whatever else comes after that. But, it is so vital that people say, “You know what? This is not normal. Something’s wrong. I’m sick or my father or wife or sister is sick and I need to call 911 and get this thing rolling now.”
Melanie: So, before we even get to symptoms, let’s talk about risk factors. Who’s at risk for a sudden heart attack?
Dr. Nossett: Sure. Well, there’s a group of risk factors that are very well known. Smoking is a huge one because the damage done to arteries from smoking, it causes people to develop coronary artery disease way earlier than they otherwise would. So, smoking is a big one. Diabetes, both Type 1 and Type 2, that is onset as a child or onset as an adult. Both of those are certainly of risk factors. High cholesterol, high lipids, is also a risk factor. And then, family history is another big one. It is very common that people who look otherwise healthy but have substantial history in their family, their mom and dad, brothers, sisters who had coronary disease and heart attacks. That means that almost likely, almost definitely, that person is going to have the same problem. And then, aging, of course. The older we get, the more everything starts to break down, including the arteries in our heart. So, that also leads to the increase risk of a heart attack.
Melanie: Is there any predetermining screening, to let somebody know they might be at risk. Is there any way to know ahead of time?
Dr. Nossett: Sure. Besides those risk factors that we know of, there are a few things that can be done. Certainly, when somebody has run some test on their cholesterol check and it’s very, very high. They already know then, wow, I’m at a high risk for a heart attack. But, somebody who doesn’t necessarily know those numbers can talk to their physician. And, if they have some potential risk factors, they might be put on a treadmill and have a stress test done where they walk on a treadmill or have some other testing done that checks to see if there’s any sign that the heart is suffering when exercise is good to the heart. When somebody has a coronary disease, often they don’t feel it if they’re at rest a lot of the time. But, when they exercise or they put their body to work, and put that heart to work and it starts demanding more blood flow and more oxygen because it’s working harder. That’s when symptoms can show up or maybe not symptoms but some very, very subtle signs on an EKG or an echocardiogram. So, there’s a stress test that can be done to test somebody for coronary disease. And, there’s also something that’s becoming more popular and, quite frankly, is very easy. It’s a CT scan that is done, somebody is run through the CAT scanner. It takes just a matter of very few minutes and it specifically looks at the heart and the coronary arteries to see if there are signs of heavy calcifications, which is often a sign that there is a closure or near closure of an artery starting to occur and the coronary arteries in the heart. That’s a pretty decent, if you put it that way, screening tool for somebody to see if maybe they have, some at least developing, coronary disease. It’s not the perfect one but certainly it is a great screen that could give you a little bit more confidence. And, when we see it shows something, it often means something. And that means, when we see some calcifications on arteries on that scan, we can say, you know what? I think we need to go with some further testing here. That might mean the stress testing, etc.
Melanie: So, Dr. Nossett, people get some of the symptoms, you’re going to describe just from stress or anxiety. I think one of the big questions is: how do you know when a symptom is something really more serious? So, describe the symptoms for us if you would.
Dr. Nossett: Sure. Well, the symptoms, the classic one is chest pain, of course, and I say “classic” but the classic symptoms would be chest pain in the center and left side of the chest that is usually described as a crushing or squeezing sensation. Many people say that it feels like somebody is sitting on my chest or an elephant is sitting on my chest. That’s sort classic description of it. The pain will radiate into other parts of the body, typically into the left arm or shoulder. And then, possibly up into the neck or jaw and sometimes into the back. And it kind of varies as to where in the heart the problem lies as to how that radiation happens. Some people don’t get radiated pain at all but usually they do. And then, shortness of breath often goes with it, at least a mild shortness of breath. And then, often people will break out into a sweat. And that’s just the body’s reaction to a painful, potentially serious problem that’s going on. So, chest pain with some radiation maybe into the arm and shortness of breath, and sweatiness. Sometimes with a little bit of nausea with it, too. Those are kind of the classic symptoms. And now, I will say this and that is that not everybody follows the rules, meaning their bodies don’t always do what we put into the textbook. As a matter of fact, probably I get half the time, we don’t get even close to all of those symptoms.
Melanie: I was just going to ask you about women because aren’t there signs just a little different?
Dr. Nossett: They often are. Now, when a woman comes in with those classic symptoms, then she’s having a heart attack until proven otherwise. But, very commonly, ladies will have, I would say, lesser symptoms. Things that don’t just jump out that it was classic as that. Sometimes it’s just a significant tiredness. They just well way more tired than usual on a particular day. Maybe a little shortness of breath. They might have an ache or two in their chest but sometimes not as prominent as guys get. Who knows why? That’s just how women are built sometimes. So, it’s a little more subtle for women. So, if a lady starts to feel, you know what? I’m just suddenly way more tired and maybe is going through the day and kind of not felt right, but then suddenly that overwhelming, “I’m exhausted. I feel a short of breath, something’s wrong”, breaking a little sweat. That, indeed, is a possible sign that she’s having a heart attack.
Melanie: Now, women, we’re more likely not to report these symptoms, true? Because we often say that they’re anxiety, stress or pre-menopause, or whatever the reason, so women tend to discount some of these symptoms as just something.
Dr. Nossett: Well, that’s really very true and, quite frankly, I’ll say this as a guy, women might think they’re tougher in many ways or at least. A lot of us guys are just wimps and I say that we complain quicker. I don’t know why but women do sometimes just think, “Well, I’ll make it through this. I just don’t feel good. I’ve been busy. I’ve got all these things going on, and I’m carrying all this stressful load on my life. They do put it off as that.” It’s a psychological thing probably more than anything. And, they just sort of tough it out, maybe a little more stoic sometimes which is, sadly, a dangerous thing because the longer they put that off, those symptoms off, the more damage is being done to their heart.
Melanie: So, just wrap it up for us, Dr. Nossett and it’s so beautifully put. You’re an amazing doctor, I can tell. So, tell everybody what you really want them to know, what you tell them every single day about preventing a heart attack and what to know about the signs of one.
Dr. Nossett: Sure. Well, in preventing a heart attack. First of all, the prevention would be this: take good care of yourself. One of the symptoms, excuse me. One of the risk factors I didn’t say at the beginning in this talk and I just realized it was high blood pressure. So, high blood pressure certainly is another risk factor. So, if you have high blood pressure, first of all, go to your doctor. If you don’t have a doctor, if you haven’t been seen or have a good check-up lately, go to your doctor and get a good check-up. It’s awesome how often people go to the doctor, things are found early before they cause damage before they lead to a heart attack and they can be taken care of. So, go to your doctor, first of all, and have somebody that you have as the primary care giver who will assess you for this things. But, anyway, take care of your blood pressure. Take your medicine, if you have high blood pressure. If you’re diabetic, you need to follow the rules and take good care of yourself as far as taking your medications and eating appropriately. Exercise is absolutely vital. Our hearts are so craving exercise. They are meant to beat and beat hard, and beat well and be strong and have good blood flow. Exercise brings that about. It keeps the blood moving quite honestly. Quit smoking. If you are a smoker, you know it’s bad for you. We all know it’s bad for us. Pursue ways to stop smoking and talk to your doctor about that. Those are some ways to prevent these stuff. So, what about if you start feeling poorly. What I would say is this, if you develop these symptoms or symptoms that just don’t feel right. And you say, “Wow, something is definitely wrong in my body right now and, particularly, regarding your chest. If you feel short of breath in your chest. If you feel pain in your chest. If it is starting to ache down on arm or your neck and jaw starting to ache and you think, “What is going on here? I don’t feel right and I’m aching up here in my chest, my neck or my arm.” That very well could be a sign that you’re having a heart attack. And, what I tell people is this. Don’t get into your car, or along with your spouse or family member and say “Let’s go to the hospital.” Honestly, you should call 911. And here’s why: you do eventually need care and hospital. There’s no doubt about that. And, if you’re having a heart attack, you’re going to probably end up in a heart cath lab and having that testing done as well as procedure done to open your artery up. But, in the immediate timing, you need to have what EMS can provide you. They can arrive on the scene very quickly. They can provide medications as needed, like nitroglycerine and aspirin and oxygen and they can transport you safely to a hospital. If you need to get there fast, they can get you there way more safely fast than you can or your family member can drive. And, the other piece of that is this. It’s not uncommon that somebody having a heart attack literally goes into cardiac arrest or at least passes out and it goes into shock. You cannot take care of yourself in a car if that happens to you nor can you take care of your family member who’s having a heart attack if that happens to them while you’re driving to the hospital. It is way better to get the care you need there within just a short period of time by the professionals who are the paramedics and the EMTs. They know how to do this. They do it every day. They literally bring a portion of the hospital to you and they bring the care you need immediately to you right away. And then can take you to the hospital for the rest of the trip.
Melanie: Wow. What amazing information, Dr. Nossett, and tell us why listeners should come to Hendricks Regional Health for their care.
Dr. Nossett: Hendricks Regional Health is a full service hospital. We provide awesome care. We have some great professionals. We have specialist in emergency medicine who would see a patient potentially having a heart attack immediately in emergency department. We do this on a daily basis. Our physicians are ready, our nurses are ready. We have a system in place to take care of patients who are having chest pain, to evaluate to see if it’s a heart attack or not. We have awesome cardiologists who could take care of their heart attack or just their symptoms that are signs that there is a heart problem. A cath lab ready to open up an artery. We got some wonderful physicians and wonderful caregivers who are ready to go at work at any moment. Come to Hendricks Regional Health and we’re ready.
Melanie: Thank you so much for being with us, Dr. Nossett. It’s great information. You’re listening to Health Talks with Hendricks Regional Health. For more information, you can go to Hendricks.org. That’s Hendricks.org. This is Melanie Cole. Thanks so much for listening.