Afib after heart attack

Atrial Fibrillation vs. Heart Attack

Some biology can further explain the distinction. “Heart attack and atrial fibrillation are completely different. In a heart attack, blood flow to the heart is blocked and heart muscle dies. This leads to ventricular fibrillation, which means the main ventricles of your heart are not pumping. In atrial fibrillation the upper chambers of the heart are pumping chaotically, but the ventricles are still doing their job,” says A. Marc Gillinov, MD, a cardiovascular surgeon at the Cleveland Clinic.

Afib vs. Heart Attack: What Happens?

A heart attack is usually caused by a buildup of cholesterol and other substances inside one or more of the arteries that supply blood to your heart’s muscles. This is called coronary heart disease, and the buildup itself is called plaque. If some plaque breaks free, a blood clot can form and shut down the artery.

A heart attack feels like pain, pressure, or squeezing in the center of your chest. You may also have cold sweats and nausea and feel short of breath. You may feel the pain in your jaw, neck, or arms.

Risk factors for a heart attack include:

  • Older age
  • Family history of heart attack
  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Obesity

Atrial fibrillation is caused by abnormal electrical signals that start in the upper chambers of the heart. As the abnormal signals move through your heart, you may not feel anything, or you may feel your heart flutter and beat rapidly as you feel short of breath, tired, and lightheaded. “Atrial fibrillation may cause chest discomfort if the heart is beating very rapidly, but this type of chest pain is not as severe as a heart attack and rarely leads to a heart attack,” says Dr. Gillinov.

Risk factors for atrial fibrillation include:

  • Older age
  • Previous heart disease
  • High blood pressure

Heart Attack and Afib Complications

The biggest risk from atrial fibrillation is a stroke. “A stroke from atrial fibrillation occurs when a blood clot forms in the upper part of the heart because blood is not moving well. If the clot travels out of the heart to the brain, it can cause a stroke. The risk of stroke with atrial fibrillation is about 3 to 15 percent every year. But it is important to know that atrial fibrillation is not a life-threatening disease if it is well-managed,” says Dr. Jain.

The biggest risk from a heart attack is sudden cardiac arrest. Most people who have heart attacks survive and recover, but if heart attack leads to sudden cardiac arrest, your heart is not pumping well enough to keep you alive. Death can occur within minutes.

In some people, afib can develop after a heart attack. A study published in the journal Circulation followed 3,220 patients who were hospitalized for a first heart attack from 1983 to 2007. Only 304 patients had atrial fibrillation before their heart attack. The researchers found that after the heart attack 729 of the patients developed atrial fibrillation. Over the next 6.6 years the patients with atrial fibrillation after their heart attack had an increased risk of death compared to those without afib, and the highest risk was for those who developed afib more than 30 days afterward. The researchers concluded that atrial fibrillation after a heart attack does carry an increased risk of death.

Bottom Line on Afib and Heart Attack

Atrial fibrillation is the most common type of abnormal heart rhythm, or arrhythmia, in the United States. Although stroke is a serious atrial fibrillation risk, atrial fibrillation is not considered to be a life-threatening cardiac event. Most people can live a normal and active life with the right treatment.

Coronary heart disease is the most common type of heart disease in the United States. It causes about 935,000 heart attacks every year and more than 385,000 deaths. Most people will survive a heart attack, but it is important to know the warning signs and to get help right away.

Working closely with your doctor to reduce your risk factors and find the best treatment is the best way to reduce your risk from both of these cardiac events.

Tests for heart and circulatory conditions

What is atrial fibrillation?

Atrial fibrillation happens when electrical impulses fire off from different places in the top chambers of the heart (the atria) in a disorganised way.

These irregular impulses cause the atria to quiver or twitch, which is known as fibrillation. This causes as an irregular, and sometimes fast, heartbeat or pulse.

What are the symptoms of atrial fibrillation?

Symptoms of AF can include:

  • palpitations

  • tiredness

  • shortness of breath

  • dizziness or feeling faint.

Often, people don’t experience any of the symptoms listed above. This is especially common in older people.

What causes atrial fibrillation?

It’s not known exactly what causes AF, but it’s more common in people with other heart conditions or risk factors like:

  • high blood pressure

  • heart valve disease

  • congenital heart disease

  • pericarditis

  • cardiomyopathy

  • coronary heart disease

  • diabetes.

It can also be associated with other health conditions including:

  • asthma

  • lung cancer

  • pulmonary embolism.

Many people won’t have any pre-existing conditions or risk factors but will still develop AF.

When no cause can be identified, it’s known as lone atrial fibrillation.

Some people with atrial fibrillation also have atrial flutter. If this is the case, you may experience periods of atrial flutter followed by periods of atrial fibrillation.

How is atrial fibrillation diagnosed?

AF can be detected by feeling your pulse at your wrist. If you have AF, your pulse will feel irregular and the beats might have different strengths.

Some people have AF which comes and goes. This means their pulse may feel normal at times. At other times it will be irregular.

  • Watch our video on how to take your pulse. If you’re worried about your pulse, or it feels irregular, make an appointment to see your GP.

If your GP suspects you have AF, they should refer you for further tests including:

  • an ECG (electrocardiogram)

  • an echocardiogram

  • chest x-ray

  • blood tests.

How is atrial fibrillation treated?

If you have atrial fibrillation your doctor will aim control the rate and rhythm of your heart. This may include:

  • medication such as beta blockers and anti-arrhythmic drugs

  • ablation

  • cardioversion

  • having a pacemaker fitted.

Complications of atrial fibrillation

AF increases the risk of a blood clot forming inside the heart. If a clot travels to the brain, it can lead to a stroke. However, with the right treatment, your risk of stroke can be reduced.

Anticoagulant (blood thinning) drugs and a newer class of drugs called NOACs are the most effective treatments to reduce the risk of stroke in people with AF.

As well as taking medication, living a healthy lifestyle can also reduce your risk of having a stroke. There are many things you can do to be healthier:

  • eat healthily

  • be physically active

  • keep to a healthy weight and lose weight if necessary

  • don’t smoke

  • cut down on alcohol

  • control high blood pressure

  • control cholesterol levels

  • control blood sugar levels (if you have diabetes).

Read Kim’s story to see how he took simple steps to reduce his risk of a stroke following an AF diagnosis.

Living with atrial fibrillation

AF is a manageable condition and with the right treatment you can carry on as you were before you were diagnosed.

Being diagnosed with AF can be a shock and emotionally challenging for you and your loved ones. Speak to your GP about any struggles you might be having, as they might be able to refer you to counselling if you feel that might help.

You might have to think about practical matters, like driving, going on holiday or travel insurance after being diagnosed with AF. Again, your GP can help with any queries you might have.

  • Read how Andrew, who was diagnosed with AF aged 60, didn’t let his diagnosis stop him doing what he enjoyed.

Heart attack : When the artery that supplies blood to the atria is blocked, it can damage atrial tissue and lead to AFib. But the reverse isn’t true. AFib doesn’t cause heart attacks.

Heart surgery: AFib is the most common complication. It will happen to 2 or 3 out of every 10 people recovering from a heart operation.

High blood pressure : It’s the most common condition linked to AFib. It can make the atria, or upper chambers of your heart, get bigger, which makes it work harder

Lung disease : This includes chronic obstructive pulmonary disease (COPD), emphysema, or a blood clot in your lung (pulmonary embolism). COPD in particular often comes along with high blood pressure, heart disease, ventricle problems, and other problems that play a role in AFib, such as:

  • Low blood oxygen and high carbon dioxide levels
  • Cigarette smoking
  • Cardiac autonomic dysfunction — your autonomic nervous system controls your heartbeat. In lung disease, it can get out of whack.
  • Inhaled medications that boost your heart rate

An overactive thyroid gland (hyperthyroidism): It speeds up everything in your body, including your heart.

Obesity , diabetes , and metabolic syndrome : Not only are these conditions often linked with hypertension, they may also make it harder for your heart to empty. And they cause other physical changes that raise your risk of atrial fibrillation.

Sleep apnea : Each time you’re jarred awake by lack of oxygen, it puts a mechanical stress on and causes chemical changes inside your heart. Plus, over time, sleep apnea can lead to conditions like high blood pressure and obesity, which make AFib more likely.

Infections caused by a virus: The resulting inflammation could cause changes to your heart.

Medication: Research suggests that people who take high doses of steroids — perhaps for asthma or other conditions — may be more likely to get AFib. If your chances are higher anyway, this treatment can trigger an episode. So can over-the-counter cold medications with caffeine or other ingredients that rev up your heart rate.

Alcohol: For some people, binge drinking is a trigger. But for others, even a modest amount can trigger AFib.

Atrial Fibrillation Won’t Cause Heart Attack but Can Lead to Other Serious Complications

Atrial Fibrillation Won’t Cause Heart Attack but Can Lead to Other Serious Complications

January 14, 2011

Dear Mayo Clinic:

I suffer from atrial fibrillation. Are my chances of getting a heart attack higher?

Answer:

Your risk of a heart attack is not increased due to atrial fibrillation, a rapid and irregular heartbeat that can cause symptoms requiring medical attention. The condition does not cause a heart attack. However, atrial fibrillation can lead to other serious complications, so it needs to be treated promptly and monitored closely.

During atrial fibrillation, the heart’s two upper chambers (atria) beat chaotically and irregularly, out of coordination with the two lower chambers (ventricles). Because of the uncoordinated heartbeat it produces, atrial fibrillation causes your heart to pump less effectively than normal. The result is that the heart sends less blood out to your body with each beat. This can cause a variety of symptoms, including decreased blood pressure, light-headedness, weakness and shortness of breath.

Occasionally, the rapid heart rate associated with atrial fibrillation can result in chest pain or discomfort (angina) because of reduced blood flow to the heart muscle. People who have pre-existing heart disease are particularly susceptible to this symptom of atrial fibrillation. Angina can be hard to distinguish from other types of chest pain, so if you experience chest pain, it is important to seek medical attention right away.

Although it can cause chest pain and other symptoms that are similar to a heart attack, atrial fibrillation doesn’t lead to a heart attack. Instead, a heart attack (myocardial infarction) occurs when the coronary artery, which supplies blood to the heart, becomes blocked, depriving the heart of vital blood and oxygen.

The blockage is most commonly due to narrowing of a coronary artery that is caused by a buildup of cholesterol (plaques), a condition known as atherosclerosis. Those plaques can break open and, when they do, a blood clot forms at the site of the plaque rupture. If the clot is large enough, it can completely block the flow of blood through the artery, causing a heart attack.

Atrial fibrillation doesn’t create the conditions that lead to a heart attack. But a heart attack may cause atrial fibrillation. If a coronary artery involved in the heart attack normally supplies blood to the atria, the lack of blood flow may damage the atrial tissue and atrial fibrillation can result.

Even though your risk of a heart attack is not increased due to atrial fibrillation, your risk of other serious complications, such as stroke and heart failure, does go up because of this condition. The irregular heart rhythm of atrial fibrillation can cause blood to pool in your atria and form clots. Although those clots won’t lead to a heart attack, one of them could dislodge from the atria and travel through your bloodstream to your brain. There it might block blood flow, causing a stroke.

The risk of stroke in atrial fibrillation is higher as you get older. It’s also higher in people who have high blood pressure, diabetes, or a history of heart failure or previous stroke. If you have atrial fibrillation, medications such as blood thinners can significantly lower your stroke risk.

Heart failure can also be a concern, particularly if atrial fibrillation is not well controlled. The reason for concern is that atrial fibrillation with an uncontrolled rapid heart rate can weaken the heart muscle, eventually making your heart chronically unable to circulate enough blood to meet your body’s needs.

Talk to your doctor about the risks associated with atrial fibrillation and what you can do to reduce those risks.

— Stephen Hammill, M.D., Cardiovascular Diseases, Mayo Clinic, Rochester, Minn.

Why is Atrial Fibrillation a Problem?

StopAfib.org

You may have heard or read that atrial fibrillation is benign. That’s not true.

By not getting enough oxygen to the body, afib can lead to heart and valve diseases, sleep apnea, and chronic fatigue. In addition, atrial fibrillation can lead to two potentially life-threatening conditions, congestive heart failure and stroke. It needs to be treated seriously.

Congestive Heart Failure

Congestive heart failure results when your heart is overworked. The erratic electrical impulses that cause atrial fibrillation make the heart work too hard, and it becomes enlarged, ineffective, weak, and unable to pump oxygenated blood throughout the body and to the organs. Atrial fibrillation wears your heart out.

Detection of congestive heart failure is difficult. While weakness, fatigue, and shortness of breath may be symptoms of a heart attack, they may also be signs that you have congestive heart failure. By the time you recognize the symptoms, your heart is damaged. If you have any of these symptoms, talk with your doctor.

Congestive heart failure is particularly severe in afib patients with other significant heart problems, such as valve disease. The good news is that congestive heart failure can be repaired through a heart transplant.

Stroke

A stroke, the number three killer, is like a heart attack, but in the brain, which is why they are sometimes called “brain attacks.”

A stroke happens as a result of atrial fibrillation because afib causes blood to pool in the atria and form clots, which then break loose, block the arteries, and deprive the brain of oxygen. A stroke can cause blindness, difficulty walking and talking, paralysis, permanent disability, or death, and is very serious in that the damage can’t be repaired.

If you have atrial fibrillation, your odds of avoiding stroke aren’t that good — atrial fibrillation increases your risk five-fold, and about one-third of atrial fibrillation patients will actually have a stroke. And your risk increases even further if you have other stroke risks, such as heart disease, high blood pressure, obesity, smoking, high cholesterol, or excessive fat intake. If you get enough physical activity, your stroke risk decreases, but atrial fibrillation often leaves you weak and without the stamina for physical activity.

For more information, see Stroke Risks from Afib, Stroke Warning Signs, or Stroke Risk Factors.

Take Control of Your Atrial Fibrillation

Knowing these facts is scary, but it also means that you know how seriously to take the management of your atrial fibrillation. Your doctor needs to know your medical history and your lifestyle to determine how to best manage your atrial fibrillation. By educating yourself and understanding your atrial fibrillation, you can better partner with your doctor in managing it.

| Bookmark | Email Last Modified 12/23/2008

Do You Know What A Heart Attack Looks Like?

Be aware of “Early Heart Attack Care.” Did you know heart attacks have beginnings? These beginnings occur in over 50 percent of patients. If recognized in time these “beginnings” can be treated before the heart is damaged.

Heart disease is the number one cause of death in the United States. In fact, every minute an American will die of a coronary event.

What is a Heart Attack?

Blood flow through one of the coronary arteries becomes blocked. Fatty deposits narrow coronary arteries, restricting blood flow to the heart.

Understand the Three Types of Heart Attacks:

  1. The first type stops you in your tracks.
  2. Another type is a heart attack where damage takes place over a period of hours.
  3. Or, a heart attack may begin with mild symptoms and this is where Early Heart Attack Care (EHAC) can provide the most benefit.

Not All Heart Attacks Look Like This

Learn the early signs and symptoms of a heart attack

  • Chest discomfort. It may last for more than a few minutes or it may go away and come back. It may feel like pressure, squeezing, fullness, or pain.
  • Discomfort in other areas of the upper body. This may include pain or discomfort in one or both arms, the back, neck, jaw, or upper stomach.
  • Shortness of breath may occur with or before chest discomfort.
  • Other symptoms may include breaking out in a cold sweat, nausea, dizziness or light-headedness, “feeling of impending doom,” weakness and fatigue

Respond: If you feel these symptoms yourself or witness them in others, call 911.

Time = Muscle

If blood flow is not restored to your heart muscle within 20 to 40 minutes, irreversible death of the muscle begins to occur. The more heart muscle that is saved, the better your chance of survival. Angioplasty opens the artery and restores blood flow. A “STEMI” Alert will be called when the chest pain team is needed for intervention within 90 minutes.

Make a Difference in Someone’s Life

Make sure your family and friends know the signs of an early heart attack, and call 911. Time lost is brain and heart lost.

What If a Heart Attack Turns into Sudden Cardiac Arrest?

Know how to respond with the 3 Cs: Check for responsiveness, Call 911, Compress the chest to circulate blood flow. Visit Sarver Heart Center’s “Learn CPR” page to watch a video and learn more: http://heart.arizona.edu/cpr-video

Half the deaths from a heart attack occur in the first 3 or 4 hours after symptoms begin. It is crucial that symptoms of a heart attack be treated as a medical emergency. A person with these symptoms should be taken to the emergency department of a hospital in an ambulance with trained personnel.

The sooner that treatment of a heart attack begins, the better. Chewing an aspirin tablet after an ambulance has been called can help reduce the size of the blood clot. A beta-blocker may be given to slow the heart rate so the heart is not working as hard and to reduce the damage to the heart muscle. Often a person who is having a heart attack is given oxygen, which also helps heart tissue damage to be less.

People who may be having a heart attack are usually admitted to a hospital that has a cardiac care unit. Heart rhythm, blood pressure and the amount of oxygen in the blood are closely monitored so that heart damage can be assessed. Nurses in these units are specially trained to care for people with heart problems and to handle cardiac emergencies.

Drugs may be used to dissolve blood clots in the artery so that heart tissue can be saved. To be effective, these drugs must be given intravenously within six hours of the start of the symptoms of a heart attack. After six hours, most damage is permanent. (People who have bleeding conditions or severe high blood pressure and those who have had recent surgery or a stroke cannot be given these drugs.)

Instead of drug therapy, angioplasty may be performed immediately to clear the arteries. This approach is preferred as primary therapy in heart attacks. If the blockages are extensive, then coronary artery bypass surgery may be necessary.

Chances of surviving a heart attack can improve when an individual recognizes the symptoms early and seeks immediate medical attention. One out of every 10 people who have heart attacks, however, die within a year – usually within the first three or four months. Typically, these people continue to have chest pain, abnormal heart rhythms or heart failure. Older people and smaller people tend to not do as well after a heart attack as younger people and larger people. This may be one reason why women tend to fare less well than men after a heart attack – they tend to be both older and smaller, as well as have other disorders. They also tend to wait longer after a heart attack before going to the hospital.

After a heart attack (myocardial infarction), a doctor may require additional tests or treatment, including:

  • Wearing a Holter monitor for continuous monitoring of the heart’s electrical activity
  • An exercise stress test
  • Drug therapy, including taking a daily aspirin, beta-blockers or ACE inhibitors
  • Coronary angiography
  • Angioplasty
  • Bypass surgery
  • Lowering cholesterol levels

What is angina?

Angina is the medical term for chest pain or discomfort caused by a temporary disruption in the flow of blood and oxygen to the heart. People describe angina discomfort as a squeezing, suffocating or burning feeling – usually in the centre of the chest, behind the breastbone.

Key facts about angina:

  • It’s your heart telling you that it needs more oxygen.
  • You need to take a break from what you’re doing and/or take your medication.
  • It’s almost always a sign that you have blocked arteries and heart disease.
  • It’s usually a short-lived event – lasting for a few minutes.
  • It’s a warning that without treatment, you are at risk for heart attack, irregular heartbeat (arrhythmia) and cardiac arrest (cardiopulmonary arrest).

All chest pain should be checked out by a healthcare provider.

Is it Angina or a heart attack?

If you are experiencing chest pain for the first time, seek medical attention immediately. If you have already been diagnosed with angina and you are experiencing unusual symptoms, or if your medication isn’t working, see a healthcare provider immediately. You could be experiencing the emergency signs of a heart attack.

When does angina happen?

  • Often during physical activity or stress.
  • When you are in a very cold place.
  • After a large meal.

Heart attacks can happen at any time.

What does angina feel like?

Angina and heart attack can feel the same. Both may cause:

  • Pain or discomfort that can spread to the chest, jaw, shoulders, arms (mostly the left arm) and back.
  • Chest tightness, burning, heaviness, feeling of squeezing or not being able to breathe.

Angina will sometimes cause dizziness, paleness, weakness.

Heart attack symptoms often include nausea or throwing up, weakness, tiredness or sweating.
How long does angina last?

  • Three to five minutes – up to 30 minutes
  • Relieved by rest or medication

Heart attacks generally last more than 30 minutes.
What brings on angina?

  • Angina happens when exercise, emotional upset or other events make demands on the heart muscle.
  • The heart needs extra oxygen to respond to the demands.
  • If the heart muscle can’t get enough oxygen because of a blockage in blood flow, the strain causes the pain of angina.
  • The pain is relieved by stopping the event that caused the strain, or by taking nitroglycerin. Nitroglycerin widens the coronary arteries to allow more oxygen-rich blood to flow to the heart.

A heart attack is caused by a lack of oxygen to the heart causing damage to the heart muscle.
What do you do if angina lasts longer than a few minutes?

  • Call 9-1-1 or your local emergency response number immediately.
Types of angina

The two most common types of angina are stable and unstable. Stable angina (angina pectoris) can be managed with medication and lifestyle changes. Unstable angina may not respond to rest or nitroglycerin. It needs urgent attention.

Stable angina

  • Usually lasts 5 minutes; rarely more than 15 minutes.
  • Triggered by physical activity, emotional stress, heavy meals, extreme cold or hot weather.
  • Relieved within 5 minutes by rest, nitroglycerin or both.
  • Pain in the chest that may spread to the jaw, neck, arms, back or other areas.
  • May feel like the burning sensation of heartburn or indigestion.

What you can do if you experience an episode of stable angina:

  • Track what triggers it.
  • Record how long it lasts.
  • Note what helped ease the pain.

Unstable angina

  • Often happens while you are resting.
  • It occurs suddenly. You feel chest pain you did not have before.
  • Discomfort lasts longer than stable angina (more than 20 minutes).
  • Not relieved by rest or nitroglycerin.
  • Episodes may get worse over time.

What you can do if you experience an episode of unstable angina:

  • Unstable angina should be treated as a medical emergency.
  • Your doctor will do tests to find out if you are experiencing unstable angina.
  • You may need medical treatment to prevent a heart attack.

Variant angina (also called Prinzmetal angina)

  • Caused by a spasm in the coronary arteries. Spasms can be the result of exposure to cold weather, stress, smoking, cocaine use or medications that may tighten or narrow the arteries.
  • Most people with variant angina have a severe blockage in at least one major coronary artery and the spasm usually happens close to the blockage.
  • Usually happens while resting, and during the night or early morning.
  • Can be treated by medication

Microvascular angina (sometimes called cardiac syndrome X or CSX)

  • May be a symptom of a heart disease called coronary microvascular disease (MVD). MVD affects the smallest blood vessels of the heart.
  • Microvascular angina is caused when the tiny blood vessels that feed your heart don’t function properly.
  • Pain is more severe and can last longer than stable angina, sometimes 30 minutes or more.
  • Pain is unpredictable. It can happen during exercise or while resting.
  • Nitroglycerin may not relieve the pain.
  • Treatment includes medication and lifestyle changes.
  • It’s more common in women than men. About 70% of patients are women who are approaching – or have already gone through – menopause.

The Persistent Cardiac Pain Resource Centre has detailed information about cardiac syndrome X and its treatment.
Cardiac syndrome X is not the same as Syndrome X (also known as metabolic syndrome). Syndrome X is a group of risk factors that can lead to diabetes or heart disease.

Angina occurs when there’s not enough blood flow to the heart as a result of heart disease. Without enough blood, the heart doesn’t get enough oxygen. This triggers the chest pain.
Angina pain can be triggered by:

  • Physical activity
  • Exercise
  • Emotional stress
  • Extreme temperatures (either hot or cold)
  • Heavy meals
  • Drinking alcohol
  • Smoking

Angina can stem from these medical conditions:

Coronary artery disease (CAD)

Blocked arteries from coronary artery disease are the most common cause of angina.

  • When your arteries are too narrow, your heart doesn’t get enough blood.
  • When there’s less blood, there’s less oxygen.
  • Without enough blood and oxygen, your heart works too hard which triggers angina.

Coronary artery spasm

Coronary artery spasm is a contraction in the blood vessels that supply the heart.

  • If the blood vessel is constricted, blood flow to the heart can decrease or even stop
  • This lack of blood flow can cause angina or heart attack.

Uncontrolled high blood pressure
Narrowing of the valves in the heart (aortic stenosis)
Enlarged heart (hypertrophic cardiomyopathy)

Angina symptoms can vary from person to person, between men and women (see below), and by the type of angina you have. The main symptoms of angina are:
Shortness of breath or difficulty breathing

Pain

  • Tightness, pressure or discomfort in the centre of the chest
  • Ache or discomfort in areas other than the chest: jaw, shoulder, arms or back
  • A burning sensation that feels like indigestion or heartburn
  • Burning or cramping pain
  • More common in women – vague pain, pain in the neck or throat

Fatigue

When to call your doctor Women may describe their angina symptoms differently than men. They are more likely to experience:

  • Vague pain in the centre of the chest
  • Pain in the neck or tightness in the throat
  • The feeling of a panic attack, anxiety
  • Dizziness, fainting
  • Sweating at night
  • Fatigue

Be aware If you have chest pain that is new, worsening or constant, seek medical care immediately. You are at greater risk of:

  • Heart attack
  • Irregular heartbeat (arrhythmia)
  • Cardiac arrest

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