Your heart isn't called a ticker for nothing. When it runs like clockwork, it’s a terrific little machine. But when it doesn't, it can be a time bomb. For the 46th Vice President of the U.S., the bomb went off – about five times, starting with his first heart attack at age 37 and ending in a seven-hour heart transplant procedure at age 71 in March 2012.
“Dick Cheney is a perfect example of how much the field of cardiology has advanced over the past 15 years,” says Marrick Kukin, M.D., the director of the Heart Failure Program at St. Luke's-Roosevelt Hospital in New York City and professor of clinical medicine at Columbia University's College of Physicians & Surgeons.
“Here you have a guy who has had angioplasties, by-pass surgery, statins, beta-blockers, an implanted defibrillator (it detects and treats arrhythmias to shock the heart into a regular rhythm), a left-ventricular assist device (it pumped blood throughout his body for two years) and a heart transplant. All this stuff is new,” Dr. Kukin says. “Everything we do in cardiology today was not taught when I graduated medical school in 1982.”
All of these breakthroughs are good news for you because as the field of cardiology has evolved, so has doctors' understanding of crucial symptoms patients should never dismiss, especially if you have a family history of heart disease.
“The heart has so many different levels of areas where you can get into trouble. You can have ventricle problems (arrhythmias), plumbing problems (coronary artery disease), mechanical problems (weak heart muscle) and structural problems (ruptured aorta),” Dr. Kukin says. “If something feels different, don't try to self-diagnose. Seek medical attention,” he advises.
The big question: What kind of doctor should you see? Should you call your family doctor, or 911? Do you need a routine exam, or the E.R.? Read on and we’ll tell you what moves to make for each symptom.
1. Crushing Chest Pain Associated With Nausea, Vomiting and Sweating
This is the classic symptom of a heart attack. Some symptoms are very obvious, but variations of these could be subtle. Also, keep in mind, they don't all always spell heart attack.
YOUR MOVE: Call 911. Even if your symptoms don’t feel life-threatening, that’s not for you to diagnose. They could get worse fast.
2. Chest Pressure That Feels Like an Elephant is Sitting on You
People define their experiences differently. For one person it's pain, while for the other it's pressure. Regardless what you call that funny feeling in your chest, don't risk it!
YOUR MOVE: If the pressure lasts more than 20 minutes, call 911. For shorter periods of discomfort, call your regular doc for instructions – depending on your symptoms, she may send you to the E.R., or help set you up for a battery of tests.
3. Back Pain That Resembles a Tearing Sensation Usually in the Upper Back
It could be a pulled muscle. Or it could be something far more serious: a rupture of the aorta. Jonathan Larson, the playwright who wrote the hit Broadway musical Rent, died of a ruptured aortic aneurism.
YOUR MOVE: If the pain starts during or after exercise or following a trauma or injury, see your regular doctor, especially if it shifts to another part of your body (other than your chest). If the backache comes on unprompted and persists for more than 20 minutes, plus is accompanied by nausea, call 911.
4. Tingling in the Arms
Another textbook definition of a heart attack symptom. The numbing sensation starts in your chest and radiates down your left arm. It can also appear in your neck, right arm, teeth and stomach.
YOUR MOVE: For tingling alone, see your regular doctor. But if it lasts for more than half an hour and triggers other symptoms (seemingly-unrelated to arm motion), such as dizziness and nausea, call 911.
5. Undue Fatigue While Doing Your Regular Chores
This one is very common in women. If you're doing your usual housework or running errands and, all of a sudden, are finding yourself feeling especially tired, it could be a sign of a cardiac condition.
YOUR MOVE: Make an appointment with your regular doctor immediately. It could be aging, or stress, or even lack of sleep. But it may be something worse. Your doctor can help find the root cause and direct your treatment.
6. Shortness of Breath During Any Activity, Such as Walking
Another pretty significant sign that something could be wrong. Especially when paired with chest pain or pressure that goes away when you stop doing the activity. Also, having trouble breathing while lying in bed is a possible sign of heart failure.
YOUR MOVE: Sitting upright in bed might make you feel better. If it doesn't and you're still having trouble catching your breath or are breathing rapidly for more than 30 minutes, call an ambulance.
Here’s one that always throws people off. It's an easy excuse to snub the situation. It's even more confusing when you belch and feel relief. But the truth is, indigestion may be a serious sign of coronary disease.
YOUR MOVE: Take two Tums, Mylanta or Nexium and then watch the clock. If the discomfort doesn't disappear within half an hour, call your doctor and ask whether or not you should take a trip to the E.R.
Swelling, or edema in medical terms, is caused when the heart is not pumping adequately. If you're feeling weak and exerted while walking or have swollen ankles, plus are experiencing difficulty lying down at night, then you've got a whole slew of suspect symptoms.
YOUR MOVE: Make an appointment with your doctor immediately.
9. Irregular Heart Beat (Abnormal Palpitations) and Arrhythmias (a Racing Heart Beat)
These are surefire signs that you need to go in for an evaluation. Everyone has a little heart hiccup now and then or rapid palpitations from stress or too much caffeine, but the key difference in danger is if this comes with symptoms like dizziness, light-headedness, and fainting.
YOUR MOVE: Take your pulse. Place a finger on your wrist and count the beats for 15 seconds, then multiply by four. If it's greater than 140, call 911.
Pop Quiz: Should You Call An Ambulance Or Drive To The E.R.?
If you have heart attack symptoms (or some other life-threatening emergency), a well-meaning friend can easily say, “I’ll drive you to the E.R., it’ll be faster than waiting for an ambulance.” Even worse, if you’re alone, you may think that you can drive yourself to the E.R. and save time that way. There can also be a level of denial involved with calling 911. If you drive yourself or have someone drive you, maybe your emergency isn’t that bad. An ambulance … well, that’s serious business.
Don’t fall for any of those traps. If you experience any of the symptoms that merit an E.R. trip, call 911 and let an ambulance take you. Here’s why:
*Time savings is a myth. Yes, you’ll have to wait for an ambulance to arrive. But once it does, EMTs are trained to deliver professional care in the field.
*Once en route to a hospital, EMTs will alert the E.R. of your symptoms and condition. The ambulance pulls into the ambulance bay and you’re rolled right into the hands of the people most needed for your case.
*If you or a friend drives you to the E.R., you have to explain your case to the reception staff. Even if they’re quick on the response, you’re still wasting valuable minutes as they triage your case and determine what you need.