The connection between pain and heart attacks is often misunderstood. While pain itself does not typically cause a heart attack in a healthy individual, severe pain can trigger physiological responses that may affect the heart, especially for those with underlying heart conditions. It is also important to recognize that pain can be a significant symptom indicating a heart attack is already in progress.
Understanding the Body’s Response to Severe Pain
Severe pain, regardless of its origin, can activate the body’s “fight or flight” response, a survival mechanism designed to prepare the body for perceived threats. This response involves the rapid release of stress hormones, such as adrenaline and cortisol. Adrenaline increases heart rate and blood pressure, while cortisol can narrow arteries and flood the bloodstream with glucose. These hormonal changes elevate the heart’s workload and demand for oxygen.
For individuals with pre-existing cardiovascular conditions, such as narrowed arteries or a weakened heart muscle, this stress-induced surge poses a risk. The increased heart rate and blood pressure can strain an already compromised system, potentially leading to reduced blood flow to the heart and even triggering a cardiac event. It is the underlying vulnerability combined with this acute stress response that raises concern, rather than the pain directly initiating the heart attack. Prolonged or chronic stress from pain can also lead to sustained elevations in these hormones, contributing to long-term cardiovascular strain and inflammation.
Pain as a Heart Attack Symptom
Pain is a prominent and widely recognized symptom of a heart attack, but it is a sign that the heart is already experiencing distress due to a severely reduced or blocked blood flow. The most common heart attack symptom is chest pain, often described as a feeling of pressure, tightness, squeezing, or aching. This discomfort typically lasts for more than a few minutes or may go away and return.
The pain associated with a heart attack frequently extends beyond the chest, radiating to other areas of the upper body. This can include discomfort or pain in one or both arms, particularly the left arm, as well as the back, neck, jaw, teeth, or even the upper abdomen. Other accompanying symptoms often include:
Shortness of breath
A cold sweat
Nausea or vomiting
Lightheadedness
Sudden dizziness
These symptoms indicate an ongoing cardiac event, with the pain serving as a warning sign of the heart’s compromised state.
How Other Types of Pain Can Affect Heart Health
Beyond being a symptom of a heart attack, severe pain from other sources, including acute injuries or chronic conditions, can also influence cardiovascular health. Acute, non-cardiac pain can elicit a stress response similar to that described earlier, leading to temporary increases in heart rate and blood pressure. While these short-term responses in a healthy individual typically do not cause lasting damage, they can add to cardiovascular strain.
Chronic pain conditions, such as migraines or fibromyalgia, have a more sustained impact on the cardiovascular system. Research indicates a connection between chronic pain and an increased risk of cardiovascular disease, high blood pressure, and elevated heart rate. For instance, individuals with chronic pain may experience persistent activation of the sympathetic nervous system, leading to ongoing increases in heart rate and blood pressure. Studies show that migraine, especially with aura, is associated with an increased risk of cardiovascular events like myocardial infarction and atrial fibrillation. Similarly, fibromyalgia has been linked to a higher risk of heart disease, partly due to the condition’s impact on the body’s stress response and potential for reduced physical activity due to discomfort.
When to Seek Immediate Medical Attention
Any new, severe, or concerning pain, especially if it occurs in the chest or is accompanied by other symptoms, warrants immediate medical evaluation. If you suspect a heart attack, it is imperative to call emergency services, such as 911, without delay. Fast action can significantly improve outcomes, as prompt medical treatment can reduce the extent of damage to the heart muscle.
While waiting for emergency medical personnel, remain calm and rest. Emergency operators may instruct you to chew and swallow an adult-size aspirin (325 mg), provided you are not allergic or have other conditions that make aspirin unsafe. Never attempt to drive yourself to the hospital. Seek professional medical help for any persistent or unusual pain, particularly if it is accompanied by symptoms like shortness of breath, dizziness, or sweating.