Heart attacks are a life-threatening emergency. If you think you or someone you are with is having a heart attack call 911 immediately.
A heart attack is due to a blood clot or a partially or completely blocked blood vessel in the heart from a blood clot or narrowed or completely occluded blood vessel. This causes slow or lack of blood flow to areas of the heart where the vessel is blocked. Lack of oxygen to the portion of the heart affected causes heart muscle in that area to die.
Hiatal hernia is a common gastrointestinal (GI or digestive) tract condition in which the upper portion of the stomach protrudes into the chest cavity through an opening of the diaphragm called the esophageal hiatus. This opening usually is only large enough to accommodate the esophagus. With weakening and enlargement, however, the opening (or herniation) can allow upward passage (herniation) or even entrapment of the upper stomach above the diaphragm. Some people have a hiatal hernia to some degree by age 60; moreover, up to 60% of people have it to some degree. There are two types of hiatal hernia.
Classic symptoms of a heart attack may include
The chest pain feels like a tightness, fullness, pressure, or ache, which may radiate from the chest to the neck, jaw, shoulder, or back, associated with shortness of breath, nausea, and sweating.
Unfortunately, many people do not have these classic signs. Other signs and symptoms of heart attack may include
This is NOT a complete list of heart attack symptoms and signs since many people can experience a heart attack with minimal symptoms. In women and the elderly, heart attack symptoms can be atypical and sometimes so vague they are easily missed. The only symptom may be extreme weakness or fatigue. The chest pain may also radiate from the chest to the neck, jaw, shoulder, or back and be associated with shortness of breath, nausea, and sweating.
For most people, a hiatal hernia by itself causes no symptoms. When symptoms do occur, they include:
Pain: At times, a hiatal hernia causes chest pain or upper abdominal pain when the stomach becomes trapped above the diaphragm through the narrow esophageal hiatus. Rarely, in a fixed hiatal hernia the blood supply is cut off to the trapped portion of the stomach, which causes extreme pain and serious illness. This is called a strangulated hiatal hernia, and it is a medical emergency.
Hiatal hernia also causes symptoms of discomfort when it is associated with a condition called gastroesophageal reflux disease (GERD). GERD is characterized by regurgitation of stomach acids and digestive enzymes into the esophagus through a weakened sphincter that is supposed to act as a one-way valve between the esophagus and stomach. Hiatal hernia is thought to contribute to the weakening of this sphincter muscle.
Although it is true that a hiatal hernia or GERD can cause chest pain like angina (or heart pain) including chest pressure that can radiate to the arm or neck, do not assume that such pain is caused by the less serious condition of the two. When in doubt, it is safer to be seen by a doctor immediately in order to rule out more serious problems first.
Over time, plaque can build up along the course of an artery and narrow the channel through which blood flows. Plaque is made up of cholesterol buildup and eventually may calcify or harden, with calcium deposits. If the artery becomes too narrow, it cannot supply enough blood to the heart muscle when it becomes stressed. Just like arm muscles that begin to ache or hurt when heavy things are lifted, or legs that ache when you run too fast; the heart muscle will ache if it doesn't get adequate blood supply. This ache or pain is called angina. It is important to know that angina can manifest in many ways and does not always need to be experienced as chest pain.
If the plaque ruptures, a small blood clot can form within the blood vessel, acting like a dam and acutely blocking the blood flow beyond the clot. When that part of the heart loses its blood supply completely, the muscle dies. This is called a heart attack, or an MI - a myocardial infarction (myo=muscle +cardial=heart; infarction=death due to lack of oxygen).
Suspected causes or contributing factors
Chest pain is almost always considered an emergency. Aside from heart attacks, pulmonary embolus (blood clot in the lung) and aortic dissection or tear can be fatal causes of chest pain. Classic pain from a heart attack is described as chest pressure or tightness with radiation of the pain to the jaw and down the arm, accompanied by shortness of breath or sweating. But it is important to remember that heart problems may not always present as pain or with the classic symptoms. Indigestion, nausea, profound weakness, profuse sweating, or shortness of breath may be the main symptom of a heart attack.
If you have any symptoms that you believe are related to your heart, call 911. First responders, emergency medical technicians, and paramedics can begin testing and treatment even before you arrive at the hospital. Remember to take an aspirin immediately if you are concerned that you are having a heart attack.
Many people die before they seek medical care because they ignore their symptoms out of fear that something bad is happening, or by diagnosing themselves in error with indigestion, fatigue, or other illnesses. It is much better to seek medical care if you are unsure whether your symptoms are related to heart disease and find that all is well than to die at home.
When to call the doctor
When to go to the hospital
Acid reflux is a digestive (GI, gastrointestinal) tract problem in which acid backs up from the stomach into the esophagus, and even up into the throat. The acid refluxing irritates the tissues lining the throat. Symptoms of acid reflux include heartburn, regurgitating bitter acid into the throat, bitter taste in mouth, chest pain, dry cough, hoarseness, feeling of tightness in the throat, and wheezing.
