Heart Attack: The Unkown


Today, we will discuss about heart attack, also known as myocardial infarction in the medical field. We are sure everyone is well aware of this illness because it is indeed common among the middle aged population in this country. It is also one of the most common causes of sudden death and hospitalisation in this nation. Well, today we are not going to bore you all on the management or the complicated facts regarding heart attacks but rather educate further on the different presentations of heart attack in general. In the medical field, we are always aware of something we call as atypical presentation of illness which basically means the absence of common signs and symptoms of a particular illness. However, before going further into that, let’s find out more about the typical symptoms (also referred medically as “presentations”) of a heart attack.

Typical Heart Attack Symptoms

Heart attack typically presents as a typical chest pain which is often described as a discomfort rather than an actual pain. This is more commonly expressed by terms including pressure, tightness, squeezing, burning, strangling, heavy weight on chest, constriction and so on. The more generalized pain described as sharp, knife like stabbing, pins and needles rarely happens in cases of any heart diseases. Some may question on the site or location of such discomfort, the most common site is of course around the chest area more towards the middle rather than the left side. Besides, having discomfort around the upper stomach area, back, jaw and arms are also common sites for heart attacks as well. This form of attack usually takes place during a strenuous environment both physically and psychologically especially in situations such as exercise and emotional stress. In general, whatever that stresses the body can precipitate a heart attack or worsens it. Chest pain that is usually caused by coughing, breathing, light contact and position change is often related to other systems in the body rather than the heart. However, nowadays, diseases have evolved further and so also their symptoms.

Heart Attack

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Atypical Heart Attack Symptoms

Enough of all the mundane stuffs up there, let’s move on to something interesting. Well, at least interesting for some we hope.

How can a heart attack present abnormally as in, away from the norm?

Heart attack can nowadays present as symptoms coming from other systems like gastrointestinal (stomach, intestines, etc...) and respiratory (airways, lungs, etc.…) systems such as abdominal discomfort, vomiting, shortness of breath and nausea (feel like vomiting) and this is what we call as atypical presentations of heart attacks. Based on a recent health report in Korea, the common atypical symptoms of heart attack are shortness of breath, nausea, excessive sweating (diaphoresis) and sudden loss of consciousness (syncope).

Some may think the relevance of this information since it only happens to a minority group of people. Well, fellow readers, it is this minority group of people that has longer delay before being taken to hospitals, they are less likely to be treated as a heart attack on admission and less likely to be treated with optimal medical therapy. Thus, this results in higher death rates in hospitals and higher in-hospital health complications. Apart from that, more and more people are presenting atypically as compared to the classical presentation of a heart attack.

Risk Factors of Atypical Presentation

Now, the magical question that one would be anticipating would be this…

Who is more likely to present atypically?

As for current situation, everyone is at risk as the disease is evolving further. But, the more specific question would be, who will be at higher risk compared to the general population?

Based on researches and current reports worldwide, age, gender and existing illness such as diabetes and stroke are factors involved for someone to be at high risk of atypical heart symptoms.


Let’s look at the gender first. Women are more likely to have atypical heart attack symptoms compared to men. They are less likely to have a typical chest discomfort and if at all present, it is induced by rest, sleep and mental stress as compared to physical exertion in men. It is indeed a nightmare for a doctor to suspect or diagnose a woman with heart attack because of their unknown presentations. Scientific studies have shown that post-menopausal women is at high risk of getting heart diseases. This is because during their fertile period, estrogen, a female hormone is believed to have a positive effect on vascular health. When this hormone level declines, the protective factor wears off and women are more susceptible towards heart diseases in addition to their existing high fat diet and sedentary lifestyle.

So, watch out ladies.. Never be too complacent about your health. Get yourself checked when something is out of the ordinary because you may present atypical symptoms that you may have no knowledge about.

Heart Attack

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Age is also another factor that needs consideration. From recent study in Korea, it has been said that elderly people aged 70 and above, presents atypical heart attack symptoms more commonly than the younger age group. This is probably because of their aging response mechanism towards diseases. The older you are, the slower you respond towards diseases or the more atypical you may present.

Existing medical illness (e.g. Diabetes, stroke)

 Last but not least, having co-morbidities such as diabetes puts you at high risk of presenting atypical heart attack symptoms compared to the general population. This is because diabetes works by destroying nerve endings and blood vessels throughout the body. That is why people with poorly controlled diabetes have heart conditions, poor vision, poor sensation and so on. Nerve endings are responsible for pain recognition, so when diabetes takes a toll in a person’s life then the pain that should be recognized from the heart during an attack diminishes. This in turn results in atypical heart attack symptoms such as the ones mentioned above.

For those diabetic folks out there, please be on the alert at all times for any atypical symptoms of heart attack and do keep sugar levels under control to prevent other health complications.

Phewww…. I guess that was a tough topic to write on. Anyways, we really hope that it has been explained sufficiently regarding the atypical symptoms of a heart attack. It is always important to know these things because early detection of any illness puts us a better chance of a positive health outcome as compared to various health complications from a late detection. It is alright to be paranoid about health because health is the only wealth that matters.

Do visit your personal family doctor to discuss more about this topic if you have any of the symptoms mentioned above. Act now before it’s too late.

If you have experienced such a scenario in your life, do share your viewpoints and opinions in our Discussion Forum.

Emanuell Jesu Dass

by Emanuell Jesu Dass

A medical practitioner who's always seeking new opportunities to embrace life. Open to just about anything life throws at him, Emanuell is GetDoc's latest addition to the family and he's just waiting to give back! View all articles by Emanuell Jesu Dass.


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