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Recognising heart attack, stroke and angina


WebMD Medical Reference
Medically Reviewed by Dr Rob Hicks

Doctors call it the “Hollywood heart attack”: a middle-aged man breaks into a cold sweat, grimaces, and clutches his chest - just like in films. Unfortunately, in real life, heart attack symptoms don't always announce themselves so dramatically. Signs can be more subtle, such as unexplained fatigue or abdominal discomfort, and many people wait for hours before seeking help.

Doctors say this is a serious mistake. The ability to quickly spot signs of heart attack, angina, and stroke can be life-saving. The sooner you call 999, the faster you can get to Accident and Emergency for treatment. Early treatment not only minimises heart and brain tissue damage, it can save your life.

UK heart attack statistics

Around 92,000 people a year have a heart attack in England alone. Most heart attacks affect the over-45 age group. Men are around two to three times more likely to have a heart attack than women.

Researchers from the University of Oxford’s department of public health reported the death rate from heart attacks in England halved between 2002 and 2010. It wasn't clear whether the improvement was down to better treatment or better prevention.

Women's heart attack symptoms different

Research published in 2012 in the Journal of the American Medical Association found that many women - especially those 45 and under - can have a heart attack without any chest pain or discomfort.

The study involved more than a million people and found that among heart attack patients, 42% of women and 30% of men arrived at hospital without chest pain or discomfort.

Symptoms of heart attack: Why do people wait?

Often, people expect the Hollywood heart attack, so they may ignore unfamiliar heart attack symptoms. For example, they may blame abdominal discomfort on indigestion. Women may also experience very different symptoms to men, and fail to recognise them as signs of a heart attack.

With some symptoms, we have a natural tendency to not act on them in the hope that they'll just go away.

Patients also delay because they fear making a fuss or feeling embarrassed if symptoms turn out to be a false alarm, experts say.

Heart attack symptoms: What to watch out for

During a heart attack, blood flow to heart muscle is reduced or cut off, often because a blood clot blocks an artery. When heart muscle is starved of oxygen-rich blood, it can die.

Ideally, treatment to restore blood flow, such as angioplasty (a procedure to widen a narrowed artery) or clot-dissolving drugs, should begin within one hour after symptoms begin. The faster you can get to Accident and Emergency, the better your chance of survival. And yet, one study found that half of people with heart attack symptoms delayed seeking help for more than four hours. According to the British Heart Foundation, many people fail to recognise the symptoms and one in three heart attack victims die before they get to hospital.

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