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What does a heart attack feel like?
I am asked this question All The Time. Whether in the examining room by a concerned patient, as a dinner party conversation starter by the stranger sitting next to me who just found out I’m a Cardiologist, or by one of my daughters calling before a college final confusing anxiety with chest pain. (It’s even come up as a write in question on the blog already.)
No matter the “asker,” this question is not so easily answered or explained. Typically, women have more, a different quality, or no symptoms at all as compared to men. However, for either gender, symptoms of chest pressure and or arm heaviness (typically the left) may occur. Nausea, sweating, and palpitations are other symptoms frequently associated with heart attacks. But not everyone will display these symptoms and different people will suffer with varying degrees.
Sometimes, pain from your esophagus (you probably know this as “heartburn”) may feel like a heart attack (or rather, what you assume a heart attack feels like based on where the pain is). At night after a large meal, sometimes severe chest pain is the result of food and acid burning your esophagus. Sharp pains or pains that are made worse by moving your torso are usually musculoskeletal not a heart attack! However, that being true, take prolonged, repeated, or unexplained chest pain seriously. See a medical practitioner and check out why this is occurring.
The tricky thing about identifying a heart attack? Many things can be associated with a heart attack and this makes many people have false alarms or wait too long. This is why it is important to know your risk (age, cholesterol number, and family history all play their parts) and please talk with your doctor about your risks before you think you are in the midst of a heart attack.
If you want to read more, here are a few more posts I’ve written about attacks:
Heart Attack vs. Cardiac Arrest – What’s the Difference?
Heart Disease vs. Heart Attack
5 Ways to Ensure a Heart Attack
A Grand Canyon Moment
Sadly, after having been home a whole week, the warm fuzzy vacation aura is gone. Fortunately, some images continue to make me feel healthy and happy – on the train ride, looking out from the back platform and seeing elk, the deep and wide Colorado River revealing itself like a long aqua dot at the bottom of the canyon – to name a few. As I now sit at home and worry about work and life, all of a sudden I am soothed by memories of the incredible sights from every angle of the canyon.
I really believe that rest activities (like afternoon naps!) or the joy activities in my life, like fly- fishing, bowling and traveling will make me live better, healthier and longer. I also believe they make me a better doctor. Visions and memories of the Grand Canyon made my mind calmer, as I raced down the Ventura freeway in the wee, dark hours of the morning this weekend, to aid a patient, my turn “on call”.
On the train from Williams, AZ to the south rim of the Grand Canyon
Hermits Rest (west end of the south rim) looking down at a speck of the Colorado River
Moran’s Point (east end of the south rim) looking down over red cliffs to the Colorado River.
Am I dreaming or am I still looking at one of the worlds natural wonders?
That last 15 pounds
Well, I’m three months into my diet. I’ll stop calling it “the fad diet” because I admit my interpretation of it is very loose. I still drink the shakes as meal replacements once or twice a day (I do like the way they taste), but beyond that, I’ve used my nutrition wisdom to guide me – to varying success. I frequently let life get in the way (a trip to the Grand Canyon here, a decadent birthday party there), but all in all I’ve tried to be as consistent as I can be.
I’ve lost eight pounds since I started this diet. Yes, at one point I was a pound lighter than I am now. And no, I’m not exactly burning away pounds as swiftly as I’d originally hoped. But the good news is – I’m practicing what I preach. I’m actually not a fan of quick fix diets and I always discourage my patients from them. If you can take weight off that quickly, you can put it on just as quickly, and more. If I continue along this slow boat path to weight loss, an average of 1-2 pounds off per month, I’ll reach my goal weight within the year (which is to lose a total of 20 pounds).
Right now, the important thing is to not let this minor (and a pound is very minor) setback discourage me. How easy it would be to let myself go now, but I plan to “keep calm and carry on” and continue to tweak my lifestyle enough to lose those remaining 12 pounds.
What’s that children’s story again? About the turtle and the hare? Slowly but sturdy wins the race.
You can view my past posts on my weight loss journey here, here, here, here, and here!
What is a good resting heart rate?
Question: How important is it to try to lower your resting heart (pulse) rate? For example, say there are two adults, both aged 50, neither overweight nor with high blood pressure, both in reasonably good shape and health. One has a resting pulse rate of 55 and the other 70. Should the one with 70 worry and try to reduce that rate down closer to the one with 55, or does it not matter?
Answer: It fascinates me how myths in medicine get started. Resting heart rate is usually between 60 -100 beats per minute. People are considered abnormal if their heart rates are consistently higher than a hundred. What this means is you and your physician then try to establish if something is causing the heart rate to be to high or low.
However, short of a cause such as a thyroid problem, fever, anemia or some more exotic issues I recommend that you and your friend who as you say are both in good health, not on blood pressure medicines and in good shape, not worry about your divergent heart rates. Don’t worry about the different heart rates you have. They are actually pretty close. Neither one of you is “better” or worse.
With added exercise, the likelihood is both of your resting heart rates will be lower than before exercise. But for safety sake before you start a rigorous new exercise program it is a good ideas to get a physical from your doctor.
Health at Your Age: 75 – and BEYOND!
Congratulations, your age has defined you as senior. In most societies you’re considered the wisest, most learned members of society. Your body and mind may still be in very good shape. Yet, joint problems and muscle aches and sprains are most likely part of your life. Some chronic illnesses have likely been diagnosed and you know your physicians all to well. Medications are also now usually a part of the picture.
So…..here goes! Remember you are here where many generations have not gone before. It may be that you are one of the very lucky ones and your health has always been good. Or you followed all the health advice given you in the years preceding this blog. Either way congratulations. Keep up the intermittent exercise and dietary recommendations. Continue the flu shots
and perhaps the shingles vaccine. Get eight hours of sleep. Keep your mind occupied.
Now if you have that nagging hip or ankle issue or shoulder etc. and you’ve tried physical therapy, medicines and the doctor says its not too late for a corrective surgery. I would HIGHLY encourage surgery. You have potentially many wonderful years ahead once you have made it this far……
If you have other medical problems remember that physical therapy, medicines, diet, exercise and a positive attitude may all help. Good luck…and smile.
So all, with this post I conclude my “Health at Your Age” Thursday series!
For more on Health at 65, click here. For more on Health at 55, click here. For more on Health at 45, click here. For more on Health at 35, click here. For more on Health at 25, click here.
Should I get the Shingles Vaccine?
The following question was written in by a reader. If you have any questions for me, feel free to write in here.
Question: Dr. Dan – I want to know more about the Shingles Vaccine. Yes, I had chicken pox as a kid; yes, my grandmother suffered with shingles. Do I, at 62, need the shingles vaccine?
Answer: Whether or not you had chicken pox as a child, the CDC recommends a shingles shot for those over 60. A third of patients will develop shingles over their lifetime. This disease is VERY painful and in some cases can cause permanent damage. So, I would recommend that since you are 62 and are concerned, that you get the vaccine.
The main reason to prevent getting shingles is to prevent the pain of shingles. This pain is described from devastating to sharp and recurrent. Over a million people a year get shingles. If you are immune compromised (i.e. have a disorder that makes you more likely to get infections, such as many autoimmune disorders) you should not take this vaccine without asking your doctor first.
Good luck… Dr. Dan
Vacation is a Welcome Thing
Good health is welcome on vacation. Clean air, less electronics and more peaceful thinking, certainly do not hurt!
So let’s start with this…American workers take less vacation time than any other modern country in the world. Why? I have no idea. Is it that we don’t like to relax and enjoy some decreased stress? I don’t think so.
As I look over the 277 mile long and 18 mile wide amazing canyon in front of me, not only is it easy on the eyes, but is warm and soothing for the soul and spirit. Millions and millions of years of time sculpted this majestic vista. Just as millions of millions of years of evolution have sculpted me. Wow, somehow I share time with my surroundings and can look out, let my mind flow and luxuriate in random, peaceful thought.
My friends – find some time for yourselves. It’s a unique and special gift to give yourself. My experience with patients over the past 33 years, has taught me that no one ever says they wish they had taken less vacation. They all wish they had taken more.
Did I just see a Condor fly by? How wide was that wing span?….let me think awhile….
Signin’ off…..Dr Dan Canyon
Hiatus
So sorry! I am traveling (will update about that in a bit) and haven’t been able to get my next “Health at Your Age” post up (no, you cannot ignore your health after 65!) Coming soon…
-Dr. Dan
When is chest pain heart related?
The following question was written in by a reader. If you have any questions for me, feel free to write in here.
Question: I am 58, have no family history of heart disease nor any risk factors (never smoked, BP and cholesterol are normal). I started playing tennis about 10 years ago and competitively about 4 years ago. I am pretty focused on the court and play to win. Last week I was playing a match after work and experienced chest pain as well as a little dizziness. I continued the match, sat down to rest between sets, and felt better. I’ve had this kind of “false alarm” in the past, have even been to the cath lab once for observation and have always been diagnosed with stress or GI-related ailments. When is chest pain heart-related and not to be ignored?
Answer: Well, it sounds like you have sought medical attention before on this topic. I assume you were told that the heart was ok and that your risk statistically of heart disease is low. However, your rigorous tennis habit can sometime bring out lots of aches pains and even heat symptoms. For physicians it is very difficult to dismiss symptoms that occur with exercise (tennis) without seeing you. I would suggest asking your private physician what to do – he (or she) knows your full history and can take a better look. Many things are possible here, and while, most likely your health will check out fine again, it’s a good idea to report this dizziness again and have your physician monitor you and perhaps help you develop a game plan in case this happens again. Remember you have been tested and your risk may be low, but seeing your doctor or touching base can be very helpful. Good luck.
More questions on this topic? Ask me or check out some related posts below:
What’s the difference between a heart attack and heart disease?
How you can make sure to cause a heart attack.
Health at Your Age: 65
You are now 65 years old. Seriously, quite the milestone. You have lived longer than many generations before, and if you reach this age you’ll likely live at least another ten to fifteen years or more (and that’s being conservative).
Health-wise, you may have one of the many chronic diseases such as high blood pressure or diabetes. Your cholesterol may be elevated, and for sure you know or have known people that have succumbed to health problems or are fighting them. Hopefully you are seeing your doctor and following his or her advice to minimize effects.
Also, by now you have your own patterns of health care and living. Exercise and diet or lack there of is now part of your daily routine. I would hope that personal health management is important to you. This means going to the doctor occasionally (following through with care is a commitment you should make to yourself). In your personal life, you may be retired or thinking of retirement. Social security and medicare are now available and those program safety nets bring with them a semblance of security.
If you have read my blogs for your 25, 35, 45 and 55 year-old counterparts, you may be asking yourself, what do I do now? My answer: all of it, if you can. Most of my patients around 65 feel like they’re 10 to 15 years younger than they are. If that describes you, congratulations! Proceed as though you are 55, or even 45! Even if you are experiencing aches and pains, or even bigger medical issues like new discs in the back, new knees or hips, etc., the 65 year old of 2012 can still bounce back from many ailments and live happily and healthily.
Travel, exercise, and sex are all still possible. (If sex is not what it used to be, consider possible hormonal issues, ask your doctor.) Perhaps not in that order, but much of it is a matter of habits. If your habits have been smoking (you can still quit) or you’ve gained weight then you may not feel as well as the healthier person of your age, but my biggest point: IT’S NOT TOO LATE!!!!
You CAN start now. I do recommend that you get a physical and/or speak with your doctor before you throw yourself into any new regime, but don’t view that advice as a barrier. Go to a gym or a dietitian and start a program to help your physical health. Local YMCA’s and many other organizations have great programs aimed at wellness for people in this age group. Age is just a number.
(and oh yes….you might also ask your doctor about the shingles vaccine.)
See you at 75!
Genes vs. Behavior – Who to Blame?
The following question was written in by a reader. If you have any questions for me, feel free to write in here.
Question: My father has heart disease and type two diabetes. He also smoked. I have heart disease and type two diabetes. I smoked until my mid 50′s. I quit after my heart attack. Diet and exercise did little to lower my numbers over the course of a year. Meds put my cholesterol in check within a month. How much of my health is my fault and how much is my father’s?
Answer: This is a great question. Less than one in five hundred people with high cholesterol have a genetic predisposition to early heart disease. Most people have high cholesterol because of diet. For you, most likely it is the diet combined with low cholesterol medicines such as statins that have lowered your heart disease risk. Quitting smoking is a huge benefit to your health – most of the current medical literature suggests that after two to three years of smoking cessation, your heart and cancer risks decrease. Your type two diabetes is mildly genetic but mostly as you put it, is “your fault”. Placing blame, however, isn’t going to help you much. Instead, focus on the positive – no matter who’s “fault” your ailments are, diet and exercise (and ultimately weight loss) can decrease your chances of getting and staying diabetic. Thanks for the question!
Health at Your Age: 55
As a 56 year old man myself, I fit firmly into this category. Though I feel healthy and strong, I truly am watching my body change slowly. So what are we to do?
This age range has a lot in common with my blog post for the 45 year old age group. Go ahead and check it out - anything you aren’t currently doing, I would absolutely try to remedy (diet, exercise, doctor visits, etc.)
But as you are ten years older, there are a few additional guidelines I suggest you follow:
- Both men and women over the age of 50 should schedule a screening Colonoscopy to assess colon cancer risk – yes this is a huge pain (figuratively and literally) – but incredibly worth it! Assuming everything is normal on your first screening, you won’t have to be rechecked for five years.
- Men: at age 50, you should get your PSA (Prostate-Specific Antegin) checked as a screening test for prostate cancer. After your initial check, recommendations for further testing annually or less frequently for PSA need to be discussed with your physician.
- Women need annual mammograms and gynecological exams with their physicians.
Yes, these do all have to do with cancer screening. Heart disease and cancer are the two biggest causes of death in your age group. If you’ve been careful, you have a pretty good assessment of your heart disease risk at this point – annual visits to your doctor and the routine blood tests that come with it should give you a heads up. As for cancer – it’s amazing the breakthroughs in the medical field over the past 10 to 15 years – cancer no longer has to be the death sentence it once was. The best defense is a good offense and having the proper tests gives you your strongest chances of winning the game.
In your day to day life, you may have noticed some changes between 45 and 55:
- Ouch! Aches and sprains are more common (and they often occur out of nowhere). We’re not bouncing back from small injuries as well as we used to (I myself broke my ankle a few years ago and have struggled to heal since). Be sure to take care of yourself. While I absolutely encourage fitness, don’t start a strenuous fitness program without first speaking to your doctor about it.
- Weight gain. Fat bulges may be appearing in strange parts of the body. Shocked at the appearance of love handles? Suddenly your pants are too tight? I know the feeling. (I’ve suddenly, for the first time in my life needed to go on a diet!) Our bodies are changing….and it’s time to really start thinking about the food you ingest. My advice: Eat smaller meals and less calories. We here in the USA have a huge obesity problem which frequently leads to diabetes, high blood pressure and high cholesterol. Focusing on your intake can drastically improve your health.
Your 50s are a milestone time in your life – it’s the last time you can significantly improve your health if you have otherwise ignored it. Habits you pick up now really can mean the difference between a long and pleasant old age and failing health.
Now is the time to own your health. As my friend Nike says: Just do it!
This is the fourth in my series of “Health at Your Age.” For more on Health at 45, click here. For more on Health at 35, click here. For more on Health at 25, click here.
