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Sea Sick: Symptoms of heart attack not what you expect

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Sea Sick: by Keith Murray

In February we think of Valentine’s Day, and the symbol for Valentine’s Day is the heart. So I thought it fitting that we discuss the heart – or more specifically, how to recognize if you are having a heart attack.

The most common symptom of a heart attack for both men and women is chest pain or discomfort, although women are more likely than men to have atypical symptoms, such as shortness of breath, nausea or vomiting. Other symptoms that both men and women may experience are pain or discomfort in one or both arms; feeling weak or tired; breaking out in a cold sweat; lightheadedness; back or jaw pain; and an uncomfortable pressure, squeezing, fullness or pain in the chest. Many say it feels like an elephant is sitting on their chest. If you notice any of these symptoms in yourself or anyone around you, call for immediate medical attention.

Several years ago, my friend Capt. Rob noticed he was feeling tired earlier in the day.  He was also sweating more than usual, but that did not really raise concerns since he worked outside in the hot Florida sun. About the same time, he noticed indigestion or heartburn, so he started taking Zantac. He wasn’t sure what was going on, but he knew he did not feel well. After several days of this, he decided to go the doctor’s office, where he was informed that he was having a heart attack. Capt. Rob required open-heart surgery; happily, he survived and is back to 100 percent.

In a CPR class I was teaching in Pennsylvania once, a student shared a story similar to Capt. Rob’s. He said that when he was only 40 years old, he began feeling severe heartburn and indigestion, so he started drinking Maalox antacid. For two weeks this feeling continued, and he continued to drink the Maalox. Then one morning a new symptom began. He said it felt like someone stabbed him with him a two-by-four between the shoulder blades, then lit it on fire.  At this point he dialed 911 and was flown by helicopter to a cardiac hospital for surgery. He survived, but many are not so fortunate – especially those who wait too long.

Sometimes our body sends signals to the brain that don’t always seem logical. Two of my female students who experienced heart attacks felt the pain in their elbows. It can happen. And while chest pain may be an indication of a heart attack, it also may be only heartburn. The problem is that it can be difficult to tell the difference. Gastrointestinal problems – such as ulcers, muscle spasms in the esophagus, GERD, a gallbladder attack or pancreatitis – also can cause chest pain and other symptoms that are similar to those of a heart attack or angina.

Angina is chest pain or discomfort that occurs when an area of your heart muscle doesn’t get enough oxygen-rich blood.  Often, angina feels like pressure or squeezing in your chest, or like an elephant sitting on your chest. The pain also can occur in your shoulders, arms, neck, jaw or back. Angina pain may feel like indigestion.

Part of the problem in detecting where the pain is coming from is that the nerves in the chest are not as well-tuned as those in, say, our hands. The brain knows which hand or finger hurts, but when the chest hurts, it often has difficulty determining whether the pain comes from the heart, lungs, pancreas, esophagus or stomach. The brain just knows the chest hurts.

The key is to recognize the symptoms early and seek immediate medical attention. The longer you wait for medical treatment, the greater the chance of death. If you notice these symptoms before a cruise, seek medical treatment before you leave. If you notice these symptoms while at sea, contact a doctor immediately via satellite phone or radio. On land in the U.S., be quick to dial 911.

Trained as an emergency medical technician, Keith Murray now owns The CPR School, which provides onboard CPR, AED and first-aid training as well as AED sales and service (www.TheCPRSchool.com). Comments are welcome below.

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