It is important to go to an Emergency Service, or call 112 if this is impossible, in the case of chest pain without an apparent cause that can radiate to the arms, back, neck, or jaw. Especially if it is also accompanied by general malaise, nausea, excessive sweating, shortness of breath, or anxiety.
“Every year there are more than 100,000 cases of acute myocardial infarction in Spain. Despite its high incidence, a large part of the population does not know how to identify the warning signs. This is even more worrying in the case of women, in whom the symptoms are perhaps more non-specific, as well as in the case of people with diabetes,” warns Dr. Ignacio Ferreira González, cardiologist at the Dexeus University Hospital in Barcelona.
Thus, a “myocardial infarction”, better known as a “heart attack”, is caused by a more or less sudden obstruction of a coronary artery (arteries that distribute blood through the myocardium or heart muscle). “The obstruction of the artery produces a lack of irrigation in an area of the myocardium that, if not reestablished in a short period of time, inevitably leads to the death of that area of the heart.”
Doctor Ignacio Ferreira González, cardiologist at the Dexeus University Hospital in Barcelona.
With this, this cardiologist maintains that the person who suffers an acute myocardial infarction usually perceives that something important is happening; These are the main signs of this coronary problem:
- Pain or tightness in the center of the chest that may spread to the arms, back, neck, or jaw.
Gender differences
Women may present with more non-specific symptoms of myocardial infarction, which complicates the diagnosis
But, as the specialist from the Dexeus University Hospital warns, it has been observed that women can manifest more non-specific symptoms of myocardial infarction, although within the usual range. “This can complicate the diagnosis or cause the patient to delay her visit to the hospital,” warns the doctor, pointing out that, in the case of women, the signs of a heart attack can be:
- Non-specific chest pain, not necessarily oppressive, not very intense or of variable intensity.
- Epigastric pain, in the upper abdominal area.
Exhaustion or asthenia before the heart attack.
“This heart problem in women also occurs about 10 years later when compared to men. This, added to the delay in diagnosis, causes greater mortality from this disease in the female population,” adds Dr. Ferreira.
Absence of chest pain
In elderly people with diabetes, the heart attack can manifest itself differently, only with general discomfort
This cardiologist also warns that, in people with diabetes, especially of advanced age, the heart attack can manifest itself differently, and appear only with general malaise, sweating, extreme exhaustion, or shortness of breath.
“Up to half of them may not show pain since patients with diabetes sometimes have neuropathy that can prevent them from feeling the characteristic chest pain. Likewise, these situations can also occur in older adults, which complicates the early detection of acute myocardial infarction,” he emphasizes.
But the matter does not stop there because, according to Dr. Ferreira, we must not forget that myocardial infarction does not escape in young people, although it is obviously less frequent among them: “The incidence of myocardial infarction increases with age. Therefore, it is not common in young people, although it is not impossible either. In fact, there are cases of certain diseases, some genetic, that accelerate the process of arteriosclerosis, which is the disease that leads to the obstruction of the coronary arteries. “This is especially relevant in genetic diseases that promote the early development of diabetes, or that lead to unusually high cholesterol levels, such as familial dyslipidemia or type I diabetes.”
On the other hand, Dr. Ferreira points out that another possible trigger of a myocardial infarction in young people may be the consumption of certain drugs, while indicating that smoking from an early age, along with taking oral contraceptives in the case of women , can also contribute to suffering a heart attack at these ages.
“We must also warn that, although myocardial infarction in young people usually manifests with the same symptoms, its diagnosis can be delayed due to the fact that it is an unexpected problem at that age,” adds the specialist at the Dexeus University Hospital.
Still, this cardiologist explains that a myocardial infarction can occur suddenly, and in fact, he points out that in precisely half of the cases the infarction represents the first manifestation of coronary heart disease. “Therefore, it does not necessarily arise after physical exertion. However, in patients with severe coronary artery disease, who already have partial blockages in their coronary arteries, intense exercise can act as a trigger for angina or heart attack.”
With all this, Dr. Ferreira recalls that in the hospital, the electrocardiogram test is what allows most cases of this disease to be detected.
Early diagnosis is key
The electrocardiogram is the medical test that detects most cases of myocardial infarction.
“The treatment of a heart attack consists of performing a cardiac catheterization, an intervention that allows us to find out which is the occluded coronary artery, which is the one that caused the heart attack, and proceed to mechanically open it. The latter is achieved by inflating a balloon and, in most cases, implanting a ‘stent’ (the famous ‘spring’) or intracoronary prosthesis. This treatment for heart attack has managed to reduce mortality very significantly in recent decades,” concludes this expert.
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