Dr. Philip Krause
Excellent question, Georgia. Women can present with heart attack symptoms that are what we call "atypical" Chest fullness or tightness, shortness of breath, indigestion or heartburn, nausea and even neck or jaw pain or aching. Also, we can see women with upper back pain, dizziness and sweating. Other findings may include change in exercise tolerance. They may not be constant and can come and go. you should seek medical care immediately if symptoms like this occur.

Dr. Philip Krause
Jim- Glad you asked. Certainly, acid reflux or GERD can cause burning after meals and at night. However, chest pain due to a heart problem such as angina when an artery is blocked can cause very similar symptoms as well as chest pressure, heaviness, nausea, difficulty breathing or sweating. Based on other risk factors such as high blood pressure, smoking, family history of coronary disease, diabetes and high cholesterol, you may be in line for a stress test or other imaging. It is imperative for people to know the warning signs and seek medical attention immediately to address the issue and prevent heart attack, heart damage and potential heart failure or worse. prevention is key.

Dr. Philip Krause
Willis: After suffering a heart attack or MI (myocardial infarction) the treatment depends on whether a coronary angiogram and PTCA and stent were placed to treat a blocked artery. If so, then daily aspirin 81 mg along with another antiplatelet agent such as clopidogrel or ticagrelor is used to prevent the stent from forming a blood clot. These patients also benefit from cholesterol-lowering medications such as statins. Strict control of blood pressure and diabetes is also imperative. Those who smoke should quit immediately to prevent another heart attack. Cardiac rehabilitation should be considered for a smooth recovery. Most importantly, these recommendations should be discussed with you prior to discharge from the hospital with your physicians and healthcare team members.

Dr. Philip Krause
If you are referring to the heart attack symptoms I just mentioned, the first step is to take 4 chewable aspirins (81 mg each). If the symptoms last more than 10 minutes and persist, the patient should call 911 to get to the nearest hospital and get treated quickly. This is especially important if symptoms of chest pressure come on suddenly and accompanied by shortness of breath or sweating. If a patient loses consciousness, this is an ominous sign and 911 should be called immediately. People with risk factors such as tobacco use, High blood pressure, high cholesterol, diabetes, and family history of heart attack should see their physician and go over these risk factors and choose an appropriate treatment strategy.

Dr. Philip Krause
The symptoms of headache nausea and vomiting are more consistent with migraine headache or stroke. This should be addressed immediately especially if it is the first episode. The symptoms of nausea and vomiting may occur with heart attack as well. Either way, getting to the nearest Emergency Department is key to preventing damage.

Dr. Philip Krause
The symptoms of a few seconds of twitching do not sound like a heart-related problem. You should discuss them with your physician to try and identify a cause. It does not sound dangerous based on your description but you need to discuss with your healthcare provider.

Dr. Philip Krause
Great Question, Nancy. Modify the modifiable risk factors: Stop smoking. Adhere to a low cholesterol low-fat diet like the Mediterranean diet. Weight loss with smaller portion sizes. Stop eating when no longer hungry. Do not eat until full. Take blood pressure medications as prescribed and do not skip pills. Get BP checks regularly. Keep cholesterol low with diet as well as cholesterol medications if needed. Keep blood sugar in check and adhere to a strict diabetic diet and medical care to keep sugar levels in check Regular exercise when deemed safe by your doctor. 30 minutes of daily dedicated walking or aerobic activity at least 5 days per week. Manage stress in healthy ways. Limit alcohol intake - moderation is the key

Dr. Philip Krause
No such thing as " heart muscle pull" but can be related to the chest muscle (pectoralis) during an upper-body activity like tennis or weight training. If symptoms of a grasping of the chest occurs and CONTINUES OR GETS WORSE, this can be due to a heart attack or an aortic tear/dissection and requires emergent attention in the ER. If symptoms are fleeting and last a second or 2, and do not recur, this is not typically associated with a heart or vascular problem. Still, it should be discussed with a physician.

Dr. Philip Krause
Good question, Kate. A cardiac calcium CT score is a screening test to look for calcium buildup in and around the arteries of the heart. A score of 0 is excellent and the likelihood of a heart attack within the next few years is very low, but not 0. The other risk factors need to be reviewed. We use this test to decide if cholesterol medicine is needed for a score > 100 or if a patient may benefit from a stress test for a higher score.

Dr. Philip Krause
Risk factors differ in women in that the family history of premature coronary disease is age less than or equal to 65 vs. men which is family history of a relative at age less than or equal to 55. Women who are premenopausal are protected with estrogen until mid to late 50' s but it is not a guarantee; just lower risk at this age then men. However, once menopause occurs, the women catch up quickly and their risk for heart attack rises quickly. The other risk factors include: Smoking Diabetes High blood pressure High cholesterol