Understanding Heart Attack Symptoms
Dr. Kaustubh Dabhadkar, a preventive cardiologist from Charlotte, North Carolina, emphasizes the importance of recognizing unusual symptoms that may indicate serious heart issues. While chest pressure radiating to the arm or jaw is commonly known, atypical symptoms are more challenging to diagnose.
A study in the Journal of the American College of Cardiology reports over 99% of individuals developing coronary artery disease, heart failure, or stroke had at least one risk factor, such as high blood pressure, high cholesterol, elevated blood sugar, or a history of smoking.
An Anecdote and a Cautionary Tale
Dr. Dabhadkar shares a story from his cardiology fellowship, highlighting the potential for atypical symptoms. He recounts assessing a patient with ear lobe pain during a busy night at the hospital. Initially dismissing the symptom, an EKG revealed a heart attack, illustrating the heart has no private line for pain.
The major artery in the patient’s heart was shutting down, causing referred pain to the ear lobe.
Addressing this, Dr. Dabhadkar reminds physicians of the complex neural pathways of the heart, explaining that symptoms can appear in areas such as the chest, shoulders, arm, neck, jaw, and upper belly due to referred pain.
Spotting Atypical Symptoms
Atypical symptoms of heart attacks can include cold sweats, unexplained breathlessness, jaw, teeth, or throat pain, and fatigue without chest pain. Dr. Dabhadkar notes these symptoms may not lead patients to seek medical help unless they are recognized.
A third of heart attack patients show no chest pain, especially those over the age of 85. Symptoms that change with effort and improve with rest should raise concern. Cold sweats, nausea, or the sense that something is wrong warrant immediate care.
Approach to Diagnosis
Dr. Dabhadkar urges caution, not adding ear lobes to typical heart attack checklists despite the anecdote. He advocates erring on the side of caution, prioritizing patient safety even if it means facing false alarms, emphasizing early detection can prevent serious outcomes.