A little bit of breathlessness that wasn’t there before when climbing the stairs, a strange tiredness that doesn’t go away, every once in a while chest pain. Ignoring these seemingly harmless signals could cost you dearly and sooner or later lead to having to rush to the hospital with a heart attack in progress: underlined a recent document of the American Heart Association for which the US experts have reviewed all the most frequent symptoms of the most common cardiovascular diseasesso as to be able to provide citizens with a sort of “guide” to listen to their hearts and not underestimate the danger signals they could send us.
The heart attack: the symptoms of men and women
It is not trivial because they are often different between men and women and moreover they change over months or years, given that heart and vessel diseases develop over time; knowing which ones are the most common, however, in some cases can really make the difference between life and death. Let’s think, for example, of a heart attack: as he explains Furio Colivicchipresident of the National Association of Hospital Cardiologists (Anmco): «The classic chest pain that looks like a vice and oppresses behind the sternum, often leading to a fist on the chest, is a typical manifestation in middle-aged men: the pain is violentcomes and goes or persists over time, associates with cold sweat and to feeling of imminent failureso it doesn’t go unnoticed. “The case of women and the elderly is different: in females there is often unusual pain in the neck, shoulders or epigastricwhich moves», adds the cardiologist.
In the elderly heart attack often without pain
«In the elderly, classification can be even more difficult because the pain can be completely absent and the heart attack can present itself with an inexplicable breathlessness or a sort of obstacle to expanding the chest» specifies Furio Colivicchi. «Even in diabetics, where abnormalities in the cardiac innervation develop, infarction can arrive without pain. Symptoms less typical of heart attack, common to men, women and the elderly, are dizziness, fainting and feeling very light-headed due to impaired blood flow to the brain. They are equally common to the three categories of patients heart rate changes: normally the heart is not noticed, but if it beats too fast, slow or irregular it is good not to neglect it ».
Irregular beats
It is precisely the unusual symptoms of a heart attack that deceive and put you in greater danger, which is why it is good to know them: this is confirmed Emilio Assanelli, director of the Emergency Department of the Monzino Cardiological Center in Milan, underlining that «Chest pain in itself causes alert, it is difficult for patients not to arrive in the Emergency Department; if, on the other hand, you are short of breath, feel sluggish or have some palpitation but no pain, you may think it is nothing. A mistake especially if you have already had a heart attack with atypical manifestations, because when it happens it is more likely that a second event will present itself with unusual symptoms. The most important message to keep in mind? If you feel something you’ve never felt before, even if it seems like a minor symptom, it’s good to talk to your family doctor: the “novelty” of a symptom must generate a little alarm”. This especially applies to the donnewhich more often than men underreport symptoms of heart attack and angina not only because they frequently have atypical them, but also because they still tend to think that heart attacks don’t concern them: from fifty years onwards and after menopause, on the other hand, the risk rises rapidly and cardiovascular problems in our country are still today the leading cause of death in women.
breathlessness
The most elusive symptom of all, also because it is common to an acute event that requires immediate attention from doctors such as a heart attack but is associated with many chronic diseases not only of the heart, isbreathlessness. «It is often declassified as a normal disorder for an elderly person, or if there is a little overweight; instead the shortness of breath is an indicator to be investigated, because it is the common denominator of all cardiovascular diseases, from heart attacks to valve diseases, from heart failure to cardiomyopathies “, he specifies Pasquale Perrone Filardi, president of the Italian Society of Cardiology. «Evaluating the duration of the breathlessness, under what circumstances it appears, how it resolves and if it accompanies other ailments is important to understand its origin: if it is suspected that it may be due to a cardiovascular problem, for example, the doctor can prescribe the examination of the natriuretic peptide in the blood, discriminating between cardiac causes and of a different nature such as pulmonary or neuromuscular diseases, anemia, a psychogenic origin”.
Nuusea
One of the most frequent cardiac causes of breathlessness is decompensationi.e. theinability of the heart to pump enough blood around the body; the disease, before causing shortness of breath after small efforts, often manifests itself with more subtle discomforts such as loss of appetite and nausea, fatigue, insomnia, mood disorders and cognitive difficulties such as mental “fog” or a decline in memory. In women, just as with a heart attack, atypical symptoms such as palpitations, changes in digestion, pain not only in the chest, profuse sweating.
Changes
There are therefore many signs to pay attention to, but, as Colivicchi reiterates, it is the changes that should make us suspicious: «If you lack air after climbing a flight of stairs that recently did not cause you any worries, it is good to get evaluated». All the more so if you fall into a cardiovascular risk category because, as Assanelli adds, “it is important to know what your starting condition is, if for example there is a familiarity with cardiovascular events it is better to keep a higher guard on the symptoms, even less usual or nuanced, and when in doubt, it is better to insist on further investigation».
Underestimation
“Unfortunately, there is still not enough awareness of the signs of cardiovascular disease, especially the less typical ones; however, all are inevitably subjective, the degree of perception of a disorder is different between different people. «Today, then, psychological and social discomfort contributes to underestimation: many misrepresent the meaning of nuanced ailments, attributing them to stress or other things rather than to possible heart problems. Telling the doctor what is unusual, even if it does not seem directly related to the heart, is always necessary», concludes the director of the Emergency Department of the Monzino Center.
Heart attack or panic attack?
Light, nausea, palpitations, chest pain can be present in both situations, therefore the experts of the American Heart Association have tried to clarify the necessary premise that «When in doubt, it is always necessary to go to the Emergency Department to make sure that it is a heart attack, also because this can also affect people who have no known risk factors and therefore feel ‘safe’», explains one of the authors, Glenn Levine of the Veteran Affairs Medical Center in Houston, Texas. “The heart attack can be sudden and intense but often begins with less pain and discomfort that gradually worsens over minutes; lThe ever-present feature of a panic attack is intense and pervasive fear». However, you can also have a heart attack, which is why it is good to go to the emergency room. «Here some investigations allow for a rapid diagnosis», specifies the cardiologist Emilio Assanelli of the Monzino in Milan. «Chest pain, for example, can also depend on problems with the esophagus, an aortic dissection or a pneumothorax; evaluating its characteristics, how it started, how it is distributed, the association with other conditions of the patient can quickly direct to the correct diagnosis».