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.
Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
40% of heart attacks in this country are silent, meaning there are no warnings.
When plaque builds up in the heart and then breaks free, it blocks blood from getting to the heart and causes a heart attack.
Munaf Shamji, MD is here to discuss heart attacks. He gives life saving information on symptoms and what you should do if you think you may be having a heart attack.
Selected Podcast
How To Recognize Symptoms of a Heart Attack
Featured Speaker:
Munaf Shamji, MD
Munaf Shamji, MD is a cardiologist at VPH. Transcription:
How To Recognize Symptoms of a Heart Attack
Melanie Cole (Host): Some heart attacks are sudden and intense, and they go on really quickly. And some start slowly, with mild pain or discomfort. Have you ever felt any of these things and often people affected aren’t sure what’s wrong and they may wait too long before getting help. My guest today is Dr. Munaf Shamji. He’s a cardiologist at Valley Presbyterian Hospital. Welcome to the show, Dr. Shamji. I’d like to start with what you feel is the single most important thing that you would like listeners to hear about what to do, what they might feel, if they might possibly be suffering a heart attack.
Dr. Munaf Shamji (Guest): First of all, thank you so much. First of all, I think that the evolution of treatment of heart attacks has evolved so quickly and we are so far along over the last several years that I think the single most important thing that I can think about if they’re having a heart attack is to seek attention immediately. The reason I say that is because for every one minute that a person gets in treated earlier for heart attack, the incident of survival is much greater. Even if you have any suspicion whatsoever that one is having a heart attack, get into the hospital immediately. When we talk about what one should look for, although there are some classic symptoms such as sudden onset of chest pain, many times the chest pain is associated with other symptoms such as nausea, vomiting, sweating. Sometimes, it may radiate to the arms or even the jaw. However, there are times when the symptoms may not be so typical and they may be more subtle. Particularly, in women, sometimes women can have very atypical symptoms in terms of the chest pain may not feel like an elephant sitting on the chest. It may be very subtle. It may be only shortness of breath. It may occur just sitting around watching TV. Think that if there’s anything out of the ordinary in the area of the chest, one needs to seek attention.
Melanie: Okay, out of the ordinary. Women especially, we suffer from shortness of breath sometimes just during our menstrual periods. We suffer from muscle aches and pains after working out. How do you know the difference between a little shortness of breath or little aches and pains, chest pain, arm pain, jaw pain, any of these things to what might be just normal aches and pains?
Dr. Shamji: Indeed a fantastic question because it is incredibly difficult not only for the layperson but also for the medical community. However, I think that for patients who may have shortness of breath with normal activity, et cetera, they may have had it for a long time, many times when it’s a heart attack, many patients are able to tell us that they feel a difference, that they feel that the symptom was very different from the way they felt before. For example, one can argue that if you walk long enough, most of us will have some shortness of breath. However, one of the things that may delineate a heart attack versus a symptom that may not be related to it is simply, for example, someone who can walk 10 minutes and then get short of breath. However, suddenly they walk only a minute, half a minute, or even during normal activity, going from the bathroom to the bedroom, they get severely short of breath. Many patients will tell us that they actually feel that there’s been a change in the amount of activity they can do before they get the shortness of breath. Many times, many patients don’t have shortness of breath at rest, and yet, even while they’re sitting watching TV, suddenly they may start having difficulty breathing. There is definitely a change in the way they feel. Subjectively, it’s extremely difficult to delineate as to point A, B, C as the shortness of breath is different from the way they normally are except many patients do know the difference. If they start noticing that the shortness of breath is occurring earlier next time or that they’re getting shortness of breath at rest when they never had before. Many times, the shortness of breath is severe in nature. It’s not simply walking 10 minutes, feeling a little winded, but it’s a lot more exaggerated.
Melanie: If they feel this and you’re recommending we call 911 and I know a lot of people are afraid to call 911, they think they’re being overdramatic or maybe it’s not really a heart attack, it’s an anxiety attack so they don’t always want to call, what do you think about that? Is it a myth about taking an aspirin, or if someone you love is having a heart attack, giving them an aspirin? What is that?
Dr. Shamji: Taking an aspirin is not a myth. There has been some debate about aspirin in the setting of heart disease and in terms of preventive measures for heart disease. But in a situation of a heart attack, if someone is not on aspirin, indeed, chewing an aspirin, 162 milligrams or more, certainly is of benefit. There is scientific data to prove that taking an aspirin if you’re having a heart attack before you get to the hospital will actually improve survival. It is an absolute necessity to take an aspirin if one feels that someone’s having a heart attack. However, there has been some controversy in terms of aspirin and prevention. Although someone is having a heart attack, taking aspirin is a necessity, folks who have never been diagnosed with heart disease, someone who is 45, may have a family history, some risk factors but who has no heart disease, no proven heart disease, there is fair amount of data that tells us that taking in a baby aspirin a day in that situation may not be of benefit. The second question that you mentioned is about being melodramatic and getting into the emergency room versus maybe it’s a panic attack. Well, many times you can’t tell. However, if you can’t tell, the better part of valor is to take the precaution and get into emergency room. However, the question then becomes: should I drive or should I take the paramedics? Well, if you’re having a heart attack, the reason people have sudden death or die is because the electricity of the heart goes haywire during the heart attack and the heart can stop. If you call the paramedics, they have the equipment to revive you. If you’re driving, you unfortunately may lose your life. For that reason, it is imperative that you get in the hospital via paramedics rather than taking a two-, five-, or ten-minute chance in your own car.
Melanie: Just tell us a little bit in the last few minutes, Dr. Shamji, about Valley Presbyterian Hospital as a STEMI-receiving center and what that means for patients when they come there.
Dr. Shamji: Well, I’ve been at the hospital for the last 14 years, and the heart center has evolved substantially over the time. Several years ago, if a patient came in for a heart attack, within several hours, they may end up getting an angiogram, which is a procedure where you put a tube up into the heart via the artery of the arm or the leg, they can look at the artery and hopefully open up a blockage. Over the last several years, the concept of a STEMI center, which primarily needs is that if the hospital, such as Valley Pres, is designated as a STEMI center, it means that this particular center is equipped to handle heart attacks 24 hours a day. And if someone comes in with a specific heart attack that needs certain criteria, within 90 minutes, we are required to try and open up the artery so as to prolong survival. Given that Valley Pres is a STEMI center, it provides high technology with fantastic results for those who have heart attacks because they are able to provide that service and that 24-hour care, where if anyone comes in at any time, day or night, within 90 minutes, we expect that patient to be taken care of and that blocked artery to be opened up so that the vessel can get new normal blood flow to the heart.
Melanie: Please give your best advice for people worried about heart disease, worried about having a heart attack, your best advice for prevention and symptom management, symptom diagnosis, to know what to look for.
Dr. Shamji: Always I think something out of the ordinary. As you were so clear earlier, it is not so easy to tell both for patients as well as the medical personnel. However, if you notice that there is something out of the ordinary, not something normal that you feel on a normal basis, whether it be chest pain, whether it be shortness of breath, sweating, unexplained nausea, limited exercise capacity, if you notice things are just not normal, then certainly, seek attention. When you do seek attention, it is imperative that you get in quickly and take care of your needs. Furthermore, if you think about long-term prevention, yes, medicine, yes, going to the doctor. There are a lot of things that one can do to prevent heart disease. However, two important things that one should remember is always diet and regular exercise. It is simple yet most vital to your health.
Melanie: Absolutely great and possibly life-saving information. You’re listening to VPH Med with Valley Presbyterian Hospital. For more information, you can go to valleypres.org. That’s valleypres.org. This is Melanie Cole. Thanks so much for listening.
How To Recognize Symptoms of a Heart Attack
Melanie Cole (Host): Some heart attacks are sudden and intense, and they go on really quickly. And some start slowly, with mild pain or discomfort. Have you ever felt any of these things and often people affected aren’t sure what’s wrong and they may wait too long before getting help. My guest today is Dr. Munaf Shamji. He’s a cardiologist at Valley Presbyterian Hospital. Welcome to the show, Dr. Shamji. I’d like to start with what you feel is the single most important thing that you would like listeners to hear about what to do, what they might feel, if they might possibly be suffering a heart attack.
Dr. Munaf Shamji (Guest): First of all, thank you so much. First of all, I think that the evolution of treatment of heart attacks has evolved so quickly and we are so far along over the last several years that I think the single most important thing that I can think about if they’re having a heart attack is to seek attention immediately. The reason I say that is because for every one minute that a person gets in treated earlier for heart attack, the incident of survival is much greater. Even if you have any suspicion whatsoever that one is having a heart attack, get into the hospital immediately. When we talk about what one should look for, although there are some classic symptoms such as sudden onset of chest pain, many times the chest pain is associated with other symptoms such as nausea, vomiting, sweating. Sometimes, it may radiate to the arms or even the jaw. However, there are times when the symptoms may not be so typical and they may be more subtle. Particularly, in women, sometimes women can have very atypical symptoms in terms of the chest pain may not feel like an elephant sitting on the chest. It may be very subtle. It may be only shortness of breath. It may occur just sitting around watching TV. Think that if there’s anything out of the ordinary in the area of the chest, one needs to seek attention.
Melanie: Okay, out of the ordinary. Women especially, we suffer from shortness of breath sometimes just during our menstrual periods. We suffer from muscle aches and pains after working out. How do you know the difference between a little shortness of breath or little aches and pains, chest pain, arm pain, jaw pain, any of these things to what might be just normal aches and pains?
Dr. Shamji: Indeed a fantastic question because it is incredibly difficult not only for the layperson but also for the medical community. However, I think that for patients who may have shortness of breath with normal activity, et cetera, they may have had it for a long time, many times when it’s a heart attack, many patients are able to tell us that they feel a difference, that they feel that the symptom was very different from the way they felt before. For example, one can argue that if you walk long enough, most of us will have some shortness of breath. However, one of the things that may delineate a heart attack versus a symptom that may not be related to it is simply, for example, someone who can walk 10 minutes and then get short of breath. However, suddenly they walk only a minute, half a minute, or even during normal activity, going from the bathroom to the bedroom, they get severely short of breath. Many patients will tell us that they actually feel that there’s been a change in the amount of activity they can do before they get the shortness of breath. Many times, many patients don’t have shortness of breath at rest, and yet, even while they’re sitting watching TV, suddenly they may start having difficulty breathing. There is definitely a change in the way they feel. Subjectively, it’s extremely difficult to delineate as to point A, B, C as the shortness of breath is different from the way they normally are except many patients do know the difference. If they start noticing that the shortness of breath is occurring earlier next time or that they’re getting shortness of breath at rest when they never had before. Many times, the shortness of breath is severe in nature. It’s not simply walking 10 minutes, feeling a little winded, but it’s a lot more exaggerated.
Melanie: If they feel this and you’re recommending we call 911 and I know a lot of people are afraid to call 911, they think they’re being overdramatic or maybe it’s not really a heart attack, it’s an anxiety attack so they don’t always want to call, what do you think about that? Is it a myth about taking an aspirin, or if someone you love is having a heart attack, giving them an aspirin? What is that?
Dr. Shamji: Taking an aspirin is not a myth. There has been some debate about aspirin in the setting of heart disease and in terms of preventive measures for heart disease. But in a situation of a heart attack, if someone is not on aspirin, indeed, chewing an aspirin, 162 milligrams or more, certainly is of benefit. There is scientific data to prove that taking an aspirin if you’re having a heart attack before you get to the hospital will actually improve survival. It is an absolute necessity to take an aspirin if one feels that someone’s having a heart attack. However, there has been some controversy in terms of aspirin and prevention. Although someone is having a heart attack, taking aspirin is a necessity, folks who have never been diagnosed with heart disease, someone who is 45, may have a family history, some risk factors but who has no heart disease, no proven heart disease, there is fair amount of data that tells us that taking in a baby aspirin a day in that situation may not be of benefit. The second question that you mentioned is about being melodramatic and getting into the emergency room versus maybe it’s a panic attack. Well, many times you can’t tell. However, if you can’t tell, the better part of valor is to take the precaution and get into emergency room. However, the question then becomes: should I drive or should I take the paramedics? Well, if you’re having a heart attack, the reason people have sudden death or die is because the electricity of the heart goes haywire during the heart attack and the heart can stop. If you call the paramedics, they have the equipment to revive you. If you’re driving, you unfortunately may lose your life. For that reason, it is imperative that you get in the hospital via paramedics rather than taking a two-, five-, or ten-minute chance in your own car.
Melanie: Just tell us a little bit in the last few minutes, Dr. Shamji, about Valley Presbyterian Hospital as a STEMI-receiving center and what that means for patients when they come there.
Dr. Shamji: Well, I’ve been at the hospital for the last 14 years, and the heart center has evolved substantially over the time. Several years ago, if a patient came in for a heart attack, within several hours, they may end up getting an angiogram, which is a procedure where you put a tube up into the heart via the artery of the arm or the leg, they can look at the artery and hopefully open up a blockage. Over the last several years, the concept of a STEMI center, which primarily needs is that if the hospital, such as Valley Pres, is designated as a STEMI center, it means that this particular center is equipped to handle heart attacks 24 hours a day. And if someone comes in with a specific heart attack that needs certain criteria, within 90 minutes, we are required to try and open up the artery so as to prolong survival. Given that Valley Pres is a STEMI center, it provides high technology with fantastic results for those who have heart attacks because they are able to provide that service and that 24-hour care, where if anyone comes in at any time, day or night, within 90 minutes, we expect that patient to be taken care of and that blocked artery to be opened up so that the vessel can get new normal blood flow to the heart.
Melanie: Please give your best advice for people worried about heart disease, worried about having a heart attack, your best advice for prevention and symptom management, symptom diagnosis, to know what to look for.
Dr. Shamji: Always I think something out of the ordinary. As you were so clear earlier, it is not so easy to tell both for patients as well as the medical personnel. However, if you notice that there is something out of the ordinary, not something normal that you feel on a normal basis, whether it be chest pain, whether it be shortness of breath, sweating, unexplained nausea, limited exercise capacity, if you notice things are just not normal, then certainly, seek attention. When you do seek attention, it is imperative that you get in quickly and take care of your needs. Furthermore, if you think about long-term prevention, yes, medicine, yes, going to the doctor. There are a lot of things that one can do to prevent heart disease. However, two important things that one should remember is always diet and regular exercise. It is simple yet most vital to your health.
Melanie: Absolutely great and possibly life-saving information. You’re listening to VPH Med with Valley Presbyterian Hospital. For more information, you can go to valleypres.org. That’s valleypres.org. This is Melanie Cole. Thanks so much for listening.