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Heart attack pain is highly variable



DEAR DR. DONOHUE: My mother-in-law had chest pain in the center of her chest. The emergency room personnel told her it was indigestion. By the time it was diagnosed as a heart attack, 24 hours later, it was too late to save her. Please add this to your description of heart-attack pain. – N.N.

ANSWER: People experience a huge variety of different pain sensations on having a heart attack. The pain is described as burning, crushing, pressing or squeezing. It can be felt under the middle of the breastbone or in the left side of the chest. It may spread to the right side of the chest, the left or right shoulder and arms, the upper back, the neck, the jaw or the upper abdomen. One usually consistent feature of the pain is that it lasts for half an hour or more.

There is so much variability to heart-attack pain that other clues have to be taken into account in order not to miss an attack. One-quarter of heart-attack patients have no pain. Fatigue can be the sole symptom – a fatigue that is not sleepiness but such a total loss of energy that it’s hard to hold the head up. Nausea and vomiting can accompany a heart attack or can be the only signs of it. Sudden shortness of breath is another common sign.

Tests confirm a heart attack. The EKG usually shows clear evidence that a heart attack is occurring or has occurred. Blood tests are also helpful. Creatine kinase is an enzyme found in heart muscle, and a rise in its blood level is a tip-off of a heart attack. The same goes for the blood test for troponin, a protein found in heart muscle.

Your mother-in-law’s story is not something that happens often, but it is something that does happen. A patient might have none of the signs or symptoms of a heart attack. All tests might be normal. The patient is dismissed, only to die at home – a tragic chain of events about which everyone is desolate.

Heart attacks and related problems are North American’s No. 1 killer. The booklet on this subject explains what’s happening and what to look for. Readers can obtain a copy by writing: Dr. Donohue – No. 102W, Box 536475, Orlando, FL32853- 6475. Enclose a check or money order (no cash) for $4.75 U.S./ $6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR READERS: Some time ago, a reader asked if I knew of any organization that accepts used orthopedic devices like crutches, canes, braces and splints. I didn’t, but I asked readers if they had suggestions. They did. I’ve gathered some of them for publication now and hope to mention the rest at a later date. I want to thank those who were kind enough to write. The following organizations distribute such devices to people in need:

The Lending Cupboard Society of Alberta, 5406 C 43rd Street, Red Deer, Alberta, Canada, T4P 1C9; Elks Lodges and Senior Centers (many locations); local posts of the Veterans of Foreign Wars; in the St. Louis area, check www.equipyourneighbor.org; many local hospices.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475.

©2008 North America Synd.

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