Typically Heart attack is described as a crushing chest pain on the left side of the chest with pain radiating into the left jaw or left arm.

If you see a movie, person having the heart attack is shown to be clutching his chest, and having a lot of pain. Everything is very dramatic. You can look at the person and know right away that this character is having a heart attack. But in real life- the picture is not so perfect. Some heart attacks may be sudden and intense just like you seen in the movies, but most may be slow and with only mild discomfort or pain. Sometimes the heart attack may be silent- we call it "Silent MI" (Myocardial Infarction), and one may not know that they are having a heart attack or myocardial infarction (MI).

Myo-cardium= muscle of the heart

Infarction= death of heart muscle due to cut in nutrition supply and oxygen secondary to complete blockage of the blood vessel- as in Heart Attack.

Ischemia: cell injury (not complete death)- because the cell is getting a little bit of oxygen/ blood supply because of narrowing of the blood vessel- and the blood supply has not been completely cut off. ---as in Angina.

Often heart attack symptoms are not so bold and clear- heart attack can be sneaky.The patient may not be even sure that he is having a heart attack and may wait too long before seeking help. Time from onset to getting heart treatment is very critical,so get help immediately. "Time is muscle"- in other words faster you get to the hospital, faster the blood supply can be restored to the heart. Once the heart cells get asphyxiated due to lack of blood supply-they cannot be revived, and that part of the heart will die and make the heart weak as a pump.

Warning Signs of Heart Attack:

1) Chest discomfort: Remember "chest discomfort" - not chest pain.Person may not have sharp pain or knife like pain, instead they may describe it as a pressure like feeling in the center of the chest, or a feeling of fullness in the chest.

Some describe it as heaviness in the chest as if someone put a heavy weight on their chest- or "like an elephant" is sitting on their chest.

It could feel like a "tight band" around the chest- squeezing hard.

Feeling of "impending doom"

It may feel like indigestion- this may be because heart is so close to the stomach.

Few people may get typical book like symptoms that clearly indicate that they are having a heart attack.

Other signs:

Patient may complain of back pain between the shoulder blades (behind the heart).

Jaw pain (like dental ache) and neck pain

Discomfort in one or both arms. Mostly the discomfort in the arms is on the inner side of the arms towards the little finger- not on the thumb side.

Shortness of breath: Suddenly the patient feels like they cannot catch their breath. This "sudden" feeling could be related to heart attack leading to heart failure.

Diaphoresis ( breaking out in cold sweat), nausea, or light-headedness.

All the above signs may accompany chest discomfort or just appear without chest discomfort.

Women may just feel extremely fatigued and lightheaded, and cold and clammy.

These signs are more compelling of impending or ongoing heart attack in patients with a personal history or family history of previous heart attack, coronary artery disease, diabetes, high cholesterol level, and high blood pressure.

What Can You Do?

1) Call 911 immediately- get help - If the patient is having one or more of the above signs of heart attack- please do not wait - get help right away. The Emergency medical services (EMS)staff or paramedics are very well trained in dealing with heart attack victims.

- Take an Aspirin ( Avoid aspirin if you are actively bleeding or if you are allergic to aspirin)

2) Do not drive yourself to the hospital, because heart attack can be life threatening- and you do not want to get into accidents. In addition, EMS can get to you to the hospital much faster than you can yourself. If you cannot get the EMS, then have someone else drive you to the nearest emergency room.

3) Go to the hospital----- please do not go to a doctor's clinic.Clinics are usually not well equipped to help heart attack victims. Heart attack patients usually need to get treatments that will either dissolve the clot quickly so that blood can flow freely- or percutaneous angioplasty (PTCA) to open the blood vessel with a balloon or a stent; and clinics do not have such help.

You may visit www.americanheart.orgto learn more about heart disease.