Acute coronary syndrome (heart attack)

Symptoms

Chest pain is the most common symptom of acute coronary syndrome. However, up to 25% of women may not have chest pain and report so-called atypical symptoms, such as pain in the jaw, neck or back, nausea and vomiting, sweating, as well as shortness of breath, palpitations, dizziness or light-headedness and/or unusual tiredness.

Stay alert to your body’s signals!

Here are some symptoms to be aware of and how to respond

• Unusual tiredness during exertion (during everyday activities) → See your doctor straight away.
• Palpitations (rapid or irregular heartbeat) → Monitor the situation and, if these episodes recur, see your doctor; if they persist, worsen or are accompanied by anxiety, call the emergency services (112).
• Chest pain associated with breathing or coughing → If in doubt or if the pain is severe: call the emergency services (112).
• Severe chest pain radiating to the arm, jaw or shoulder → Call the emergency services immediately (112).
• Exhaustion, shortness of breath or digestive problems (difficulty digesting food, heartburn, nausea, vomiting) → See your doctor promptly and call the emergency services (112) if symptoms persist or worsen.
• The feeling of a ‘skipped’ heartbeat (extrasystole): generally harmless but should be monitored if it becomes frequent → Discuss this with your doctor if the symptom persists.

Diagnosis of acute coronary syndrome

If acute coronary syndrome is suspected, the diagnosis must be made quickly and is based on several complementary factors:

• symptoms (chest pain, but also atypical symptoms that are more common in women, such as fatigue, shortness of breath or nausea)
• an electrocardiogram (ECG), which can detect certain abnormalities in the heart’s rhythm or electrical activity
• a blood test, particularly for troponin, a substance released when the heart muscle is damaged.

Depending on the situation, imaging tests may be carried out, such as a cardiac ultrasound or a CT scan. A cardiac MRI may be recommended in more specific cases.

In women, diagnosis can be more difficult, as symptoms are sometimes less typical and certain ECG abnormalities may be less pronounced. Particular care is therefore needed to avoid a delay in diagnosis.

Look after yourself: if you have any doubts or notice any warning signs, speak to your doctor!