You feel an anxiety that was not there a moment ago. Your skin is clammy and you can't seem to catch your breath. Worse, a sudden pain shocks you unexpectedly. You had better call 911 right now - you are probably having a heart attack.
In 2004 there were about 75,000 heart attacks in Canada, 19,000 of which killed the person. Some two-thirds of Canadians have at least one or more risk factors for coronary heart disease. Every year, thousands die of heart attacks because they did not get medical treatment quickly enough.
Knowing the signs and warning signals of a heart attack can mean the difference between life and death, whether yours, or that of someone close to you.
A heart attack occurs when the blood supply to the heart is slowed or stopped because of a blockage. It can also occur when a coronary artery temporarily contracts or goes into a severe spasm, effectively shutting off the flow of blood to the heart. The length of time the blood supply is cut off decides how much damage there is to the heart.
Cardiac arrest is when a person stops breathing and the heart stops beating. It is not a heart attack and can be brought on by a variety of causes in addition to heart disease including drowning, stroke, electrocution and many others.
The signs of heart attack vary from mild to extreme. They may appear singly or in combination with others; they may even be completely absent! The sooner a heart attack is recognized, the better the odds for the patient. Look for these signals:
Pain: A sudden discomfort or pain that does not go away with rest. It may be in the chest, neck, jaw, shoulder, arms or back and may feel like burning, squeezing, heaviness or pressure. It may be chest pain that is brought on with exertion and goes away with rest.
Shortness of breath is another sign, like difficulty breathing. Nausea with or without indigestion and vomiting is a sign, as is sweating, cool and clammy skin. And fear, anxiety and denial may also be signs of a heart attack.
Sometimes there are no signs at all. A "silent" MI (myocardial infarction) can occur in anyone, though it occurs more often among people with diabetes.
Having recognized that "it may be a heart attack" (better safe than sorry, by the way), the first step is to call 911. With help on the way, stop all activity and sit or lie down, in whatever position is most comfortable. If there is chest pain, chew and swallow one adult 325 mg ASA tablet (Aspirin) - pain medications like acetaminophen and ibuprofen do not work the same way and will not help in this emergency.
Now, with help on the way, just sit or lie back and rest comfortably as you wait for the arrival of emergency personnel.
Dr. Paul Martiquet is the Medical Health Officer for the Sea to Sky.