Medical Health Information

There is no need to stop being sexually active due to heart problems. But people who have had a heart attack, often need advice before they leave the hospital, to continue their sexual life.

Sex is often part of the normal life you should return to after a heart attack .

Resuming sexual activity is perfectly safe for most people. But many who have been hit by a heart attack, is afraid that the effort associated with sex can be a strain on the heart.

What happens in the heart by heart attack?

Soothing conversation
If you have had a heart attack, and you wonder if it is safe to resume sex, you should talk to your doctor. Remember that your doctor is well used to answer these types of questions.

A new study shows what areas people get before they leave the hospital, the mean for their sex lives, and how likely it is that patients resuming sex after they returned home.

Three out of four heart attacks can be prevented

The researchers interviewed 1760 people who had recently undergone a heart attack. They were then followed up one year after. The study was conducted by researchers at the University of Chicago, USA. The results are not yet published in a scientific journal, but, according to BMJ group presented by "the American Heart Association's Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke."

According to researchers, it is safe for most people to have sex within a few weeks after a heart attack, but clarifying conversation with the doctor may reduce concerns. Your doctor can provide information about whether sex can create problems, and advice on what the patient should do if he or she is experiencing symptoms such as chest pain during or after sex.

Exercise and Heart Disease

More men than women
The results of the study show that there are more men than women get advice about sex before they leave the hospital. Yet they belong to discussing this topic with a doctor, a clear minority. There are also more men than women who have had some sort of sexual activity in the year after heart attack - 68 percent of men, compared with 41 percent of the women resumed their sex life.

The researchers found that if patients did not receive personal advice, it was between 30 to 40 percent more likely they largely stopped having sex after heart attack. The researchers stressed that more research is needed on the subject. They also point out that the reason for the differences between the groups could be that people who are most concerned to resume their sex life, frequently ask your doctor for advice.

Want to know more?

• Myocardial infarction, rehabilitation
• Risk factors for heart attack
• What are the symptoms of heart attack?
• Sex life in old age
• Myocardial infarction, animation
• How the heart works, animation

PCI is a method where one block up the narrow portions of coronary arteries using a catheter that is passed through the skin, through an artery to the aorta, and then into the narrow crane hearth.

The procedure is also called coronary angioplasty, PTCA shortened

Coronary Arteries

The heart is a powerful muscle that pumps blood around the body. To clear pump job requires heart constantly supplied with oxygen (O 2, oxygen) and other nutrients. This industry is supplied through the blood vessels located outside of the heart arteries (coronary arteries). There are three major arteries, each of which divides into many smaller branches. Together they ensure good supply of oxygen and nutrients.

Angina pectoris and myocardial infarction
As we age, the arteries become narrower due to deposition of fatty material inside the vessel wall, it is called atherosclerosis . When an artery is narrowed, this can lead to oxygen deficiency in the part of the heart muscle that is nourished by the narrow blood vessel. First, this will be felt when the heart rate rises during physical activity. A heart that pumps urgently need more oxygen, and in such a situation may arise hypoxia. Oxygen deficiency in the myocardium labeled as chest pain or pressure / chest tightness. When the activity stops and the pulse rate will be lower, decreases oxygen demand - and if the heart muscle when getting sufficient oxygen, the pain goes away. Such an exercise-induced hypoxia and chest pain called angina pectoris .

If a coronary artery, or a small branch of the artery suddenly becomes completely clogged, part of the heart muscle lose oxygen supply. In a short time, this part of the heart muscle die and gradually replaced by scar tissue. This is called a heart attack , or sore at heart. At the heart experiences the most sudden, strong and oppressive pain behind the breastbone, ev. also to the jaw or the arms.

What is percutaneous coronary intervention?
The procedure involves an internal opening ("repair") of the vessel wall of a coronary artery. If you come quickly after a clot has closed a vein, one can manage to avoid the heart muscle dies or damage can be limited in scope. To achieve this it is urgent hospitalization and treatment of myocardial infarction.

The procedure
The first part of the procedure consists of a catheter (a thin tube) that passes through the skin and into an artery in the inside of the arm. If you are not going to the arm, a larger vein in the groin (in exceptional cases). The catheter entered the bloodstream up to the aorta just outside the heart, where the coronary arteries have their origin. Along the x-ray fluoroscopy is used to verify that the catheter is in the right place.

Through this catheter is injected into contrast, and on a screen, your doctor may follow and image contrast flowing into the coronary arteries. You get a picture of any narrow sections or areas full stop of blood flow. If conditions are favorable swelled and stenting goes one further procedure.

Until the block is applied where a catheter near the tip of the catheter is mounted on a balloon that inflates from the outside. Surface this balloon is a compressed metal mesh (stent) that folds out when the balloon is inflated. After the stricture is located maneuvered the probe into the relevant crane artery, and passed on to the balloon stands in the cramped party. The balloon is then pumped up with so much force that the blood vessel is directed or "burst" out. When the air is then discharged metallstenten again and keep the vein open, and the catheter can be withdrawn.

If everything goes smooth and uncomplicated, the whole procedure from start to finish to be over in half an hour. After the procedure will be added compression on the injection site on your arm to prevent bleeding, and the patient is monitored in terms of complications of the procedure, and considering requiring treatment arrhythmia.

Stent
Stent to be inserted to keep the flared portion open, is made of body-friendly metals. There is now such that most stents also have a sheath that contains and releases a small dose of a drug (chemotherapy) to the vein wall. This drug makes scar treatment does not grow too quickly and thereby prevents arrskrumpning and disease recurrence.

When done PCI?
PCI is now routine therapy for acute myocardial infarction in all that can reach a hospital who master this technique, within 90-120 minutes after symptoms started. If treatment is started much later than this, the damage has come too far for any muscle can be saved. The treatment is available at all regional and university hospitals, and some other major hospitals. The treatment is centralized because it is necessary to frequent and regular exercise at all levels in order to do this safely.

Patients who have a long pathway, and can not reach the hospital in time, the clot-dissolving medicine directly into the bloodstream of the local doctor or hospital, if necessary. ambulance. This is also a very good treatment of acute myocardial infarction?

PCI is also done on patients with angina pectoris where drug therapy alone does not lead to control of symptoms. If the study with contrast injection shows narrow portions of the coronary arteries, which are suitable for stenting, treatment can be performed in a manner consistent with acute myocardial infarction. It is possible to enter multiple stents during the same procedure.

The alternative to PCI in angina open heart surgery where they sew into new blood vessels that lead blood past the narrow sections. This is done primarily if the anatomical conditions are such that one can not come to the catheter. This procedure requires general anesthesia and the use of heart-lung machine, and is overall a much larger and more burdensome interventions than PCI.

Is PCI durable?
After PCI was introduced as standard treatment for heart attack survival is significantly improved! In 2000, the mortality rate within 30 days after an acute myocardial infarction approx. 9% - in 2009 this was reduced to 2.5%. The Nordic countries have the lowest mortality rate in the world in this area.

Some patients (approximately 10%) will relapse within one year after the procedure. In such cases it is necessary to make a new stenting. Alternatively operation arise.

To prevent new problems after PCI treated everyone with blood-thinning medicine (Albyl-E) and cholesterol-lowering medicine. When using drug-stent used two blood-thinning drugs for the first year. Most also get the addition of beta blockers and anti-hypertensive therapy when needed. Exercise, healthy eating and smoking cessation is also important to prevent recurrence of angina or infarction.

Many scientific studies have shown that exercise and exercise reduces the incidence of cardiovascular disease ( angina pectoris and myocardial infarction ). Regular physical activity is beneficial for fat levels in the blood, blood pressure, insulin sensitivity, obesity and blood's ability to clot. Few studies have looked at the importance of exercise intensity in relation to these diseases.

In men

In a U.S. study of 44,452 men asked to participants about their training activities, and followed them for 10 years. It was found that the intensity of training clearly influenced the risk of heart disease. The more intensely you trained, the lower the risk of heart disease. Eg. led jogging at a speed higher than 10 km per hour for more than 1 hour per week, to a 42% lower risk than no jogging. No more than 30 minutes of weight training per week, more than 23% less than the weight training it led to a 18% reduction in the levels of brisk walking. To reduce the risk of low-intensity activities were not as clear.

In women

In a large U.S. study of 73,743 women aged 50-79 years compared the effects of walking with the impact of more intensive training, in relation to the risk of getting heart disease. The women were followed for at least 3 years. The findings showed that the more physically active woman was, the less the risk of getting heart disease. The intensity of the workout had less to say. Exercise for at least 2.5 hours per week, either walks or jogs, reduced the risk of approx. 30%. Quick walk gave lower risk. Prolonged daily sitting gave higher risk.

Recommendations
Regular exercise protects against heart disease. Efforts which means that you are tired and out of breath, seems to have stronger preventive effect than less intense activities. But the most important thing seems to be that they are exercising and avoiding to be busy all day.

Directorate of Health has given its recommendations for physical activity:

Adults should engage in physical activity of moderate intensity at least 30 minutes daily, for example in the form of a tour of brisk walking where one gets hot and gets increased heart rate. This is enough to provide a health benefit to those who previously had facilitate daily activities

The activity can be divided into smaller sections, eg. 3 x 10 minutes
The greatest health benefits come when you go from being intaktiv to be active, then the increased physical activity provide further gains

Myocardial infarction, angina pectoris and stentbehandling of heart coronary arteries means that there is coronary artery disease. Preventive treatment in these patients results in fewer deaths, fewer heart attacks and fewer other complications.

What is coronary artery disease?
Coronary artery disease is a collective term for diseases caused by narrowing or blockages in the coronary arteries, coronary arteries. Angina pectoris and myocardial infarction constitute the vast majority of cases of coronary artery disease.

By angina pectoris is the narrowing of one or more coronary arteries. At rest, the blood supply to the heart satisfactorily during physical exertion in which the heart needs increased blood supply, blood supply for the poor, which makes the patient in the form of chest pain, angina.

At an acute heart attack blocking a coronary artery completely, and the area of the heart muscle that receive blood supply its from this artery, it "dies" - there is an infarction of the myocardium.

How frequent is coronary artery disease?
Coronary artery disease is one of the leading causes of death. Estimates suggest that between 12 000 and 15 000 persons receiving acute myocardial infarction every year. In 2008 died, according to Public Health 3004 men and 2632 women with coronary artery disease, it was barely 14 percent of all deaths that year (a total of 41 716 deaths).

Several survive coronary disease today
Advances in treatment have improved survival after the acute myocardial infarction or angina pectoris, but people with established coronary artery disease have a high risk of future cardiovascular events 1 . Research shows that people with coronary artery disease can reduce their risk of subsequent cardiovascular events by implementing preventive measures (so-called secondary prevention) reduces mortality and improves quality of life.

What are the preventive measures?
Treatment is directed towards three main areas: improvement in lifestyle, lessened the influence of underlying risk factors and drug therapy. Lifestyle measures are smoking cessation, increased physical activity, healthy diet, any weight reduction. Underlying risk conditions that must be handled satisfactorily high blood pressure and diabetes. The drug treatment consists in thrombosis prophylaxis (antithrombotic therapy), the use of beta blockers and statins to lower cholesterol.

Lifestyle measures
Physical activity and exercise
Regular physical activity is an important part of secondary prevention of coronary disease. It increases the physical capacity, treating underlying risk factors and improve the quality of life. Fewer of those who exercise regularly, die, compared with those who do not exercise. Physical exercise decreases the amount of fats in the blood, it lowers blood pressure.

You should exercise or use body moderately intense 30-60 minutes, for example in the form of brisk walking or cycling, most, preferably all days of the week. You can start training soon after a heart attack or after you have been blocked up a narrow coronary artery. And for most such training can take place outside the hospital.

Weight and nutrition consultations
Obesity (BMI over 30) increases mortality from coronary disease and adversely affect cardiac function and other risk factors. Long-term weight control is best achieved by being physically active on a regular basis as well as having a diet with moderate calorie intake. Improvement in risk factors for coronary disease seen even by moderate weight reduction.

Smoking Cessation
Smoking cessation has been shown to reduce the incidence of death among patients with established coronary artery disease. A person with myocardial infarction or coronary surgery can reduce risikioen of death by at least one third, and smoking cessation is at least as useful as modifying other risk factors.

Risk Conditions for coronary artery disease
High blood pressure
If your blood pressure is forhøyt, it will bring down your blood pressure decrease mortality. U.S. recommendations indicate treatment indication by BT of 140/90 or 130/80 in patients with diabetes or chronic kidney disease. It is recommended to start treatment with beta-blocker or ACE inhibitor with additional medication as needed.

Diabetes
Mortality from coronary heart disease is higher among patients with diabetes than in those without diabetes. Recent studies suggest that intensive glucose control (HbA1c less than 7) is unfavorable and increases mortality,. Secondary prevention of coronary artery disease in patients with diabetes also includes the treatment of high blood pressure, high cholesterol and blood clot inhibiting.

Depression?
Depression is common in patients after a heart attack than the general population, and it is indicated that 15-20% of hospitalized patients with acute myocardial infarction meet the criteria for depression. Studies have shown that depression is associated with higher risk of new heart attacks for 1-2 years after a heart attack. It is uncertain whether treatment with antidepressants have no effect on the forecast.

Preventive medications by coronary artery disease
Platelet Inhibitors
The use of platelet inhibitors, Albyl-E in doses of 75-100 mg is recommended for all in secondary prevention of coronary artery disease. In a large meta-analysis reduced platelet inhibitors risk of new cardiovascular disease by 25%. Treatment with Albyl-E should start immediately after the diagnosis of coronary artery disease is set and resume life. Another type of platelet inhibitor, clopidogrel (Plavix) is an effective alternative for patients who can not take Albyl-E. A combination of ASA + kopidogrel recommended for up to 12 months after an acute coronary event with insertion of stents in coronary artery. or percutaneous coronary intervention with stent placement.

Beta-blocker
Anyone with myocardial infarction is recommended treatment with beta blockers lifetime in the absence of contraindications. A number of studies have shown that beta-blockers reduce the risk of having another heart attack, sudden death and death in connection with a new heart attack.

Statin therapy
Statin is a common name for the medicines we use today to reduce the amount of cholesterol in the blood. Statins, such as simvastatin, is recommended for virtually everyone with coronary artery disease regardless of cholesterol value, and in any case the total cholesterol higher than 5.0 mmol / L or LDL cholesterol higher than 3.0 mmol / L. Reduction of cholesterol levels reduces the risk of new coronary disease. Those at highest risk have the greatest gain.

If you have just had a heart attack or undergone heart surgery, is not well thought of exercise that most deadlines. But for many with heart disease is a medically guided cardiac rehabilitation program that can help you to get your heart into shape and improve your overall quality of life.

Cardiac rehabilitation is a comprehensive program designed to help you to regain better health, whether you have had a heart attack, undergone heart surgery or have other heart diseases. It is a safe and effective way to overcome some of the physical complications that are associated with certain types of heart disease. It can limit your risk of developing more heart problems, help you return to an active social life and career, and improve your mental wellbeing. Rehabilitation can help you regain strength and could actually help you live longer.

Who benefits from cardiac rehabilitation?
Previously, cardiac rehabilitation is often seen as something that was only appropriate for younger people who needed to be fit to resume his work after having a heart attack or undergone heart surgery. Training was perceived as too risky or to be of little benefit to others. Today however, with better applications and closer medical supervision, this is the course for many people with various forms of heart disease.

You can benefit from such a program if you have had a heart attack or have angina , heart failure , cardiomyopathy , or have undergone certain surgical procedures such as bypass surgery , balloon angioplasty , stent implantation and valve surgery.

Age is not a barrier. People who are older than 65 years appear to benefit as much from a cardiac rehabilitation program as younger. Yes, indeed it is the case that older people with heart disease often have greater benefit from such a program, because left to themselves they will have less energy to be physically active.

Since hospital stays for people who have had a heart attack, are becoming shorter, the usefulness of the training program the better. In this program you can make lifestyle training and psychological support that you could easily miss during a brief hospital stay. The full meaning of a serious cardiac event attracts not to sink into the hospital because of the short length of stay. The questions pop up often only after their discharge, and then there is no doctor or nurse who can answer. Retraining in a rehabilitation facility makes it possible to get all your questions answered and improves long-term prognosis by restructuring your lifestyle. Research shows that home-based cardiac rehabilitation is probably as effective as institutional.

What is the rehabilitation program?

The program has four main pillars:

• Medical Assessment
• Supervised training
• Lifestyle Training
• Psychosocial support

Cardiac rehabilitation has both short and long term goals. In the short term, the program will help you to resume a normal life with normal activities and master the psychological and social aspects of cardiovascular disease. The program also aims to reduce your risk of new heart problems and control the symptoms, such as pain or fatigue, caused by the condition or operation.

In the long term you will learn to recognize and control the risk factors that led to your heart disease. You can also tie contacts or make new friends who have gone through the same thing as you. Heart-healthy behaviors become part of your life, and your overall health will improve.

Depending on everyone cardiac rehabilitation program. It is ideal for a person who had a small heart attack; bypass surgery may be associated with the hospital recently underwent a distinct possibility lasting. 

Different phases of a rehabilitation program
A rehabilitation program typically consists of several phases.

In the hospital. Ideally, start your recovery like after you've had your heart attack or heart surgery, while still in the hospital. A number of specialists emerging as cardiologist, teaching nurse, dietitian, physiotherapist, occupational therapist. Step by step increases the demand. You start with small power-intensive activities such as sitting up in bed, moving joints, perform morgentoilette, get dressed. Eventually you up and leave the room, the hallway and stairs. Without such pressures will quickly lose muscle strength as it takes a long time to recoup.

Early rehabilitation. The next phase of recovery begins when you leave the hospital. It lasts for 2 to 12 weeks, depending on the application. You can continue your training at a medical center, if there is one near where you live. Or you can on your own following a plan which you have received. During this period of early rehabilitation will gradually increase your overall activity level. Rehabilitation team can suggest exercises that you can safely carry on with the home, such as walking or running on the light rhythmic exercises. You learn about healthy diet, smoking cessation, psychological adjustment, taking up sexual activity and find social support.

Later training. After 6 to 12 weeks you will have developed your own workout routines at home or at a local gym. It may still be useful to have medical attention. Training in nutrition, lifestyle and weight loss continues. The rehabilitation phase typically lasts for 3 to 6 months.

Maintenance Training. Once you have learned appropriate training methods and has started to make healthy changes in your diet and lifestyle, you are ready for more independence. You probably will not need regular heart checks or medical supervision in connection with the exercise. The goal now is to establish your new lifestyle as a lifelong living. Regular visits to the rehabilitation center for example. semi-annually or annually can help to reinforce the new pattern of life.

Some details
Medical Assessment
A thorough assessment will help the rehabilitation team to assess your physical abilities, medical limitations, other conditions you have and your psycho-social needs. These findings will help them to create a training program tailored to your situation. A program that is safe and effective. Up to a third of people who have had a heart attack, have such. clear signs of depression. A medical evaluation can help to ensure that the condition is detected and treated as part of the rehabilitation program.

Physical Activity
Earlier doctors recommended bed rest, often for weeks, in patients with severe heart problems. As a result of increased knowledge of what happens when a heart attack, the recommendation is almost the opposite. Physical activity is good for your heart, even if it has been damaged. Exercise provides a number of advantages:

• It increases blood flow to the heart and strengthens the heart's contractions so it pumps more blood and strives less
•  It helps to achieve and maintain a healthier weight, and gives better control of risk factors such as diabetes, high blood pressure and high cholesterol
• It also helps relieve stress, improve your physical fitness and reduces pain
• Exercise activities may consist of a mixture of heating, stretching, walking, biking or indoor activities that use of the treadmill, exercise bike or swimming.

When you start a cardiac rehabilitation program, the physical strain initially be small. Medical monitoring can be useful but is not essential. As strength increases, training more intense and you will exert yourself harder and longer. It is important not Skopte training, it will limit the improvement in your condition. The beneficial effects of exercise does not by whether you stop exercising.

The goal for you to be sure you exercise / training with moderate intensity for 30-40 minutes at least 3 days a week. Even better is if you can manage 60 minutes almost every day. New information suggests that weight training to strengthen the muscles may be beneficial for older people. Various types of equipment make equally good use. But you do not need to go to a gym, you can eg. improvise solutions at home.

Exceptionally, the risks associated with physical exercise exceed the benefits. The training must be limited. Your healthcare professional will advise you if this applies to you.

Lifestyle Intervention
Just like everyone else so will the way you live can affect your health. But when you have heart disease, the risk of major problems. By having a healthy diet and eliminate negative habits, you can improve your health and reduce your risk of another heart attack and other cardiovascular complications such as. stroke.

Many rehabilitation program gives you the opportunity to get advice from a dietitian to set up a healthy diet. You will learn about the fat and cholesterol affect your health. If you are overweight, you will receive training in dietary and exercise habits that can help you to lose weight. Those who run rehabilitation program can also advise you on how you possibly can stop smoking.

Psychosocial support
A heart attack can be a great and serious illness in greater or lesser degree affect your life. To adapt to the new situation can often take time. You can develop depression and anxiety, lose touch with your social network, and you can be away from work for shorter or longer - yes, some forever. You may notice that stress and anxiety persists even after your physical condition has stabilized. The disease can also affect your family.

To participate in an organized rehabilitation program also provides community with others who are in the same situation as yourself. You can share your feelings and experiences, which can make it easier for you to adapt to the new situation.

Many cardiac rehabilitation program provides advice and information about depression, stress, anger and other psychosocial reactions that you experience in the rehabilitation phase. Some need the assistance of occupational health, social security and employment agency to adapt the workplace conditions to the new situation.

A better prognosis
If you have had a heart attack or heart surgery, it may be helpful for you to participate in an organized rehabilitation program. If you have not received such an offer, you should contact your GP or the hospital to get help to get into such a program. Research has shown that such training improves quality of life and even can increase your lifespan.

With advancing age, increased amounts of cholesterol and calcium being deposited in the walls of the coronary arteries (coronary arteries). Such deposits termed plaques. The process termed atherosclerosis (hardening of the arteries). Smoking and cholesterol diet combined with lack of exercise can accelerate this process.

Plaques grow; they begin to inhibit blood flow. Growth of plaque in the inner core is surrounded by a hard shell and soft with cholesterol. Such plaques are likely to crack and expose the interior of cholesterol. Loose pieces of plaque can build. Artery may be partially or completely cut off the loose pieces. Blocked artery is more; most of the damage is on your mind.

Atherosclerosis of the coronary arteries

This is the most common cause of heart attack, and the degree of atherosclerosis increases with the incidence of a number of risk factors. The more risk factors you have, the greater the likelihood that you have atherosclerosis. The most common risk factors are:

• Inheritance - accumulation of cases of heart disease in the family
• Men are more prone than women and have a heart attack on average 10 years earlier than women. For both sexes, the risk of myocardial infarction with increasing age
• High cholesterol - especially the high levels of the "bad cholesterol" (LDL, low-density lipoprotein) and low levels of 'good cholesterol (HDL, high-density lipoprotein)
• Cigarette smoking or other tobacco use as cigars, snuff and chewing tobacco. Cigarette use is the most important of the controllable risk factors
• High blood pressure
• Diabetes
• Obesity or overweight
• Physical inactivity, lack of regular exercise
• High fat content in the diet
• Much stress
• Type-A personality - hard-working, perfectionist

Coronary artery disease without atherosclerosis
Coronary arteries can occasionally be blocked for reasons other than atherosclerosis. It may be inflammatory disease of the arteries (vasculitis), damage to blood vessels and diseases that cause thickening of the coronary arteries. Other causes are problems with circulation and oxygen supply due to external influences such as cocaine use. Heart attacks can also come as a complication after bypass surgery or catheterization. Certain heart problems that are present from birth, can also lead to heart attacks.

Overall, however, this small group. Most cases of heart attacks caused by atherosclerosis.

Heart attacks occur when an artery or coronary artery becomes blocked by a blood clotting.

Heart attack and heart attack
Possibility of looming heart failure or heart attack has already occurred is a sign, as your treatment, the doctor can prevent or limit the extent of the damage to the heart muscle. A heart attack is a permanent damage to the heart muscle. The dead muscle tissue then replaced by so-called connective tissue. Such cells have the ability to actively tighten. This part of the heart is thus weakened. If the extent of muscle damage is large, the heart could be significantly impaired.

Symptoms and signs of heart attack and heart attack
Heart attack may have been related symptoms and signs. Not everyone who has a heart attack, suffered the same or about the alike level. Many heart attacks are not as exciting as you watch TV or in the movies. For example, heart attack symptoms in women, elderly people and those with diabetes, often less severe than the usual details.

Common symptoms of a threatening or occurring heart attack is chest pain, discomfort, in many cases it feels like a band tightening around your chest. But almost around one third of all women and a quarter of all men who have a heart attack, have no pain. Many people experience only minor pain and nausea, dizziness, malaise, cold sweating. The following symptoms are typical of a heart attack in progress:

• Chest pain or tightness in the chest that lasts for several minutes. Described as squeezing, pressure end or screwing. Often located just behind the breastbone
• Often radiation to one or both arms - especially the left - and the neck or jaw. The pain may also be localized only in the neck, jaw, back or upper abdomen
• The pain is usually strong and not relieved by rest or nitroglycerin
• Nausea and vomiting are common
• Unexplained shortness of breath, dizziness
• Unexplained sweating, perceived as "cold sweat"
• Breast Fire or discomfort from stomach
• Back pain
• Anxiety, agitation, drowsiness, lethargy

Other signs of heart attack
A heart attack usually occurs suddenly. It can occur at any time - at work or play, while you rest or while you exert yourself. Many people who experience a heart attack have had warning symptoms for hours, days or weeks in advance. The earliest sign of a heart attack is recurrent chest pain triggered by physical exertion and relieved at rest ( angina ).