Heart Attacks Without Chest Pain

You could have a heart attack without the classic symptoms, reports CBS News Health Correspondent Dr. Emily Senay.

When we think of heart attacks, we also naturally think of chest pain. But a study in the Journal of the American Medical Association says that in many cases, heart attacks occur without chest pain and that this can affect the way patients are treated and how well they do after a heart attack.

The study looked at hundreds of thousands of heart attack victims and found that almost a third did not suffer chest pain as a symptom and, as a result, were almost twice as likely to die. Those patients also had a longer delay getting to the hospital and were less likely to be diagnosed quickly and receive lifesaving treatments.

The researchers say that the public and doctors probably need to be educated about symptoms -- in addition to chest pain -- that can mean a person is having a heart attack.

The symptoms –- other than chest pain -- that we all need to be on the lookout for when it comes to heart attack include:

• pain in the back, jaw, neck, shoulder, arm or stomach
  
• shortness of breath
  
• sweating
  
• irregular heartbeats
  
• fainting spells
  
• general weakness
  
• sudden indigestion

"If you feel sort of a sense of impending problems, accompanied by these symptoms, check it out. A lot of people delay and think, this is something benign and will go away…Be more suspicious than you were in the past," said Dr. Senay.

The people most at risk from having a heart attack without chest pain are women, diabetics, older people and people who have already suffered a heart attack or a stroke before.

"We don't know why with women. We have some idea about diabetics. Neurological problems can cause them to have a heart attack without pain," Dr. Senay explained.

There are tests, such as stress tests, to predict if someone is at risk of having a heart attack – but they don't work for everybody.

Most people don't find out that they have heart disease until they have a heart attack.

"If you have any risk factor, like high blood pressure or cholesterol problems, have a conversation with a doctor about this and consider getting a diagnostic test for a work up to help predict whether or not you could be at risk," suggested Dr. Senay.
Doctors are trying to find better ways to diagnose heart disease.

"Now they're looking at stress testing using echo-cardiograms and this is a new sort of way to narrow in on women to be better at diagnosing it," said Dr. Senay. In the future, there's going to be a lot more in this area to help make it easier to diagnose."