Cause of pain:
The pain that accompanies a heart attack is caused by a complete blockage of one of the coronary arteries. The muscle supplied by that artery immediately becomes severely ischemic (oxygen starved), and the ischemia of the heart muscle usually produces significant pain.Characteristics of pain:
The pain accompanying a heart attack is usually similar to classic angina, but tends to be more severe and longer lasting. The pain classically is described as a pressure-like, squeezing, crushing, or tight pain. The pain often radiates to the jaw, shoulders or arms, and can be accompanied by nausea, sweating, shortness of breath, dizziness, weakness, or fatigue. Unlike angina it tends to persist, and to worsen for at least the first 15 or 20 minutes. The pain is often accompanied by a feeling of intense fear - classically described as a "sense of impending doom."Evaluation:
The evaluation includes a careful medical history and physical examination, which often point to the diagnosis, and an ECG, which often clinches the diagnosis. Cardiac enzymes (heart proteins that leak into the bloodstream when cells die) are measured in blood tests to confirm the diagnosis. Evaluation of suspected heart attacks must occur rapidly and expeditiously, because early aggressive therapy can greatly improve the ultimate outcome.
