How can you tell if you are having a heart attack, stomach indigestion, or simply arthritis pain? According to the American Heart Association, there are definite early warning signs and symptoms of heart attacks. Women can experience all, some, a few, or none of these symptoms. Only examination by a doctor, who will administer an electrocardiogram (EKG) and/or a blood test, can confirm if you are having a heart attack.

The most important thing to do if you think you are having heart attack symptoms is to call an ambulance or get to a hospital emergency room as quickly as possible so a doctor can examine and treat you.

Also, crush or chew a full-strength aspirin (swallow with a glass of water) to prevent further blood clotting.

Symptoms
The symptoms to look for are:

• Uncomfortable pressure, fullness, squeezing or pain in the center of the chest lasting more than a few minutes, or goes away and comes back.
• Pain spreading to the shoulders, neck, upper back, jaw, or arms.
• Chest discomfort with lightheadedness, fainting, sweating, nausea, or shortness of breath.

Some women have fewer chest symptoms, but do experience a range of other symptoms:

• Atypical chest pain, stomach or abdominal pain.
• Nausea or dizziness.
• Unexplained anxiety and nervousness, weakness or overwhelming tiredness.
• Cold, sweaty skin, and paleness.
• Swelling of the ankles and/or lower legs.

Some women mistakenly think only crushing chest pain is a symptom of a heart attack and, therefore, delay seeking medical care. Others have found that healthcare providers have mistakenly failed to recognize their heart attack symptoms by attributing the cause of symptoms to other health problems, such as indigestion. This is why it is so important to insist that the doctor or nurse administer an EKG test or an enzyme blood test to see if you are having a heart attack. Don't be shy - it's your heart and your life!

What Is a Heart Attack?
A heart attack, or myocardial infarction (MI), is the most extreme form of heart muscle pain and signals that a portion of your heart is dying. Usually a blockage of fatty deposits, or plaque, in a heart artery reduces or cuts off the blood and oxygen to a certain portion of your heart. Or a small piece of plaque can break off and a blood clot will form around it in the artery, shutting off the blood and oxygen. Either way, without oxygen this portion of your heart muscle begins to die - this is the pain of a heart attack.

To prevent death or severe heart damage, doctors can administer blood thinning or clot-dissolving medicines or perform an angioplasty procedure that removes arterial blockages, among other treatments. Getting to the hospital quickly is the best insurance for staying alive and saving your heart. Also, if experiencing heart attack symptoms, crush or chew a full-strength aspirin (swallow with a glass of water) to prevent further blood clotting.

"Silent" Heart Attacks
Some women experience no pain or other symptoms during a heart attack. Only a subsequent EKG or blood enzyme test will discover this "silent" attack. Even so, damage to the heart has occurred. These "silent" attacks are dangerous because the heart's ability to survive another heart attack, however mild, is greatly reduced.

"Silent" heart attacks often accompany a condition called "silent ischemia", which is a long-term shortage of blood and oxygen to the heart due to the gradual accumulation of plaque in the arteries. You are more likely to have ischemia if you have at least three risk factors for heart disease (smoking, high cholesterol, high blood pressure, diabetes, lack of exercise, and obesity) and are a post-menopausal woman. If this sounds like you, ask your doctor to perform a cardiac stress test -- a workout on a treadmill that traces how well your heart is performing -- to determine if you have ischemia.

Angina
Many women suffer shortness of breath or indigestion that accompanies heart muscle pain, or angina, which a first warning sign of blocked heart arteries. The pain means that the heart is not getting enough oxygen because not enough blood and oxygen can get to your heart through your arteries. Angina typically goes away after exertion and eased by rest. It is often not particularly painful. Tell your doctor if you are experiencing angina, as there are many effective methods and medicines to treat it. Untreated angina can lead to a heart attack.

No More Excuses
Women delay getting medical care for heart attacks more so than men. This happens for several reasons:

• Most frequently, they don't know the heart attack warning signs and symptoms.
• The mistakenly think crushing chest pain is the only heart attack symptom.
• They falsely believe that only men and very old people have heart attacks.
• They are pre-occupied with family responsibilities, can't get childcare or transportation, or don't want to impose their needs on others.
• They are depressed, fatalistic about their health, or resigned to suffering.

Don't become heart attack statistic - learn all you can about heart attack warning signs and symptoms. If you are having symptoms, call an ambulance or get to an emergency room immediately, take an aspirin to prevent further blood clotting, and demand that the doctor takes your complaints seriously. Make sure the doctor gives you an EKG and/or blood enzyme test to see if you are having a heart attack.