Doc Talk | Heart attack symptoms


It's not "one size fits all" when it comes to heart attacks. Not everyone has chest pain or an abnormal heartbeat when having a heart attack. Some may just feel dizzy or have stomach pain.

It's because sometimes a heart attack isn't just a heart attack, but a random tear in the coronary artery wall.

When it comes to matters of the heart, things are always a little different for men and women.

"Women usually have additional symptoms that are sometimes underdiagnosed or brushed away because we think of them as something else," said Geisinger Holy Spirit cardiologist Dr. Aditya Sharma.

Typically a heart attack is caused by a stop in blood flow due to a blockage or blood clot in the coronary artery, but there can also be a spontaneous coronary artery dissection or SCAD.

"The heart arteries have three layers, and they have muscle in them so the layers of the muscle split in the artery," said Dr. Sharma.

Dr. Sharma says that splitting or tear forms a hematoma or swelling filled with blood that affects regular blood flow in the artery. He says all this happens suddenly in a matter of seconds. It's not caused by the typical plaque buildup that we associate with heart attacks.

It's also more common in women.

"Eighty percent of cases are in women. We think there’s a hormonal balance. We don’t completely understand this disease process," said Dr. Sharma.

The theory behind its association with hormonal balance is because it often happens in women during childbirth or their menstrual cycle. Doctors say if you think this may be happening to you, call 911. They'll likely treat you for the attack first and diagnose the SCAD later.

"This is clinically indistinguishable from its traditional types of heart attacks that people have."

Dr. Sharma says because it's so hard to see, it's often not until the doctor takes you into the cath lab that they're able to figure out what happened. He says there's really no way to prevent a SCAD other than the typical lifestyle choices like diet, exercise and not smoking.

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