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HEART ATTACK SYMPTOMS

The accurate and rapid diagnosis of acute myocardial infarction (AMI) is of particular importance to the follow-up emergency actions and the fate of the patient. Approximately in 25% of all cases, especially diabetics and hypertensives, lacks the typical retrosternal pain (at the inner side of the breastbone) or discomfort. The clinical picture is most oftenly determined by a strong, long-lasting (over 30 minutes) pain, feeling of heaviness or tightness ("as being in a vice") behind the breastbone with irradiation (starburst spread of pain) to the left shoulder or to the left arm (most commonly at the inner side), to the lower jaw, to the back which cannot be influenced by sublingual administration of nitroglycerin. Most commonly the pain is accompanied by "mortal fear", restlessness, cold sweat, nausea, vomiting and diarrhea.

In lower infarction the location of the pain is more oftenly in the epigastrium as being similar it is confused with acute abdomen. In approximately 50% of the cases there are no early symptoms and it occurs as a "thunderbolt." In some cases the pain is at only one of the places of irradiation. In others especially in older people the start is manifested as collapse, left ventricular heart failure or cerebral (brain) events.

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