Atypical Symptoms of Heart Attack

Most people usually think that heart attack (myocardial infarction) always produces chest pain and it cannot be missed, but this is not true. Sometimes, heart attack presents with atypical symptoms that are confusing and may be related to other organs and diseases. At times, there is even no symptom at all. No doubt, chest pain is the most common and typical symptom of heart attack, but other somewhat atypical symptoms may also be due to a heart attack. These symptoms include:

• Breathlessness even at rest.
• Dizziness or lightheadedness.
• Palpitations.
• Profuse cold sweating.
• Weakness and undue fatigue.
• Syncope or loss of consciousness.
• Nausea and vomiting.
• Blackout.
• Fits (when there is cardiac arrest).
• Sudden death.

These atypical symptoms are more common in females, older people (both males and females), and those with diabetes mellitus. These atypical symptoms may be because of non-cardiac conditions, but a cardiac cause should be strongly suspected in:

1. Those with risk factors for atherosclerosis such as old age, high blood pressure patients, diabetics, high cholesterol patients, and smokers.
2. Alcoholic and other illicit drug users.
3. Those with psychiatric illness.
4. Obese and overweight people.

In such patients, any of the symptoms mentioned above may be due to heart attack, so it should not be ignored, and emergency department of the hospital should be reached ideally through emergency medical services without wasting time.

Sometimes there is no symptom, and myocardial infarction is diagnosed later when ECG, echocardiography or other cardiac imaging test is done for screening and insurance purposes. At the other extreme, heart attack causes sudden death within minutes of typical or atypical symptoms, which is diagnosed later on autopsy findings.