Are you a cannon ball or a ticking bomb? How you can tell you when you are about to have a heart attack in Kingston, New York

Are you a cannon ball or a ticking time bomb?  Knowing the difference will help you tell when you are about to have a heart attack.

What is the difference between a cannon ball and a ticking time bomb?

Let's say you have a chest pain after maximal, or near maximal, physical activity.  For example, your chest hurts after you sprint up a hill and you are concerned that you have been having chest pain every time you push yourself physically.  When you are not running or sprinting, you do not have chest pain.  This is known as stable angina--you have a predictable pattern of chest pain.

Stable angina is chest pain that is triggered by maximal, or near maximal physical activity.  You can predict when you will have chest pain.  By all means, you should report the chest pain to your physician and get checked out by your doctor, but you are not the proverbial ticking time bomb ready to explode.

With stable angina, your heart condition is akin to an old cannon ball that you find in you attic in a box that reads, "Civil War cannon ball. Danger, explosive."  When you first discover the cannon ball, you are tempted to run out out of your house immediately. But then you think, "that cannon ball has been sitting in that box for the last 150 years and nothing has happened."  You realize the cannon ball is not going to explode on you and you decide that running out of your house is not quite necessary.  You will get the cannon ball checked out, but it is not an emergency.

Stable angina, or chest pain at maximal physical activity, is something that you should report to your doctor and have checked out, but it is not an emergency.  Stable angina is the proverbial cannon ball sitting in your attic.

Why unstable angina is a ticking time bomb

Let's say you are sitting around in your house when out of the blue you have an episode of chest pain.  Chest pain or chest heaviness while at rest or moderate physical activity is known as unstable angina and it is deadly serious. Unstable angina will cause a heart attack or kill you if you do not get medical treatment.

If you have chest pain while resting or you are doing moderate physical activities, your heart is not getting enough oxygenated blood (called myocardial ischemia) and the absence of adequate blood flow to your heart causes the chest pain.  Your heart is a ticking time bomb just waiting to explode (not literally but you get the picture).

Here's the "ticking bomb" metaphor: You are in an airport when you spot a suspicious package sitting by itself in a corner.  You walk up to the package and hear a ticking sound coming from the package.  In this post 9-11 era, you immediately think "that's a bomb", but you're not sure and you don't want to create chaos in the airport. 

So, what do you do?  You reconsider your first impression of the package and you think, "it might just be a clock in the package".  You consider walking away and letting someone else deal with the package and hope for the best.  You might think there's only a 1 out of 20 chance that there's a bomb in the package.  But what if you're wrong?  If there is only a 5% chance that a bomb is in the package, do you really want to walk away and forget about it?  I hope not.

You do the smart thing by informing the airport security about the suspicious package and asking them to have a bomb squad make sure it does not contain a bomb.  You don't want to take any chances with this suspicious package; in the 5% chance that a bomb is in the package, you don't want to risk the lives of everyone in the airport (including yourself!).

The same reasoning applies to chest pain that occurs at rest or at moderate physical activity.  It might very well be nothing--maybe it was just some spicy food you had at that bad Mexican restaurant.  But what if your chest pain at rest or moderate physical activity is the proverbial ticking time bomb?  Unstable angina is a sign that you are at high risk of having a heart attack and dying.

What you should do when you have chest pain at rest or at moderate physical activity

When you have chest pain or chest heaviness while at rest or moderate physical activity (such as doing household chores), you need to call 911 and get to the hospital immediately.  You can't take any chances with unstable angina.

The hospital can give you medications (blood thinners and aspirin) that reduce the demands of your heart for oxygenated blood and open up the arteries that provide blood to your heart. The medications alone will greatly reduce your risk of a heart attack.  A cardiologist at the hospital can perform an emergency surgery, if necessary, to remove blockages from the arteries that supply blood to your heart.  The "time bomb" can be defused quickly at the hospital by the "bomb squad" or physicians and nurses.

The lesson for the day: if you have chest pain at rest or at moderate physical activity, you are a ticking time bomb.  Go to the Emergency Room now!

Here's what you can do if you have questions

Do you want more information about unstable angina or the warning signs that you are about to have a heart attack?  If so, I welcome your phone call on my toll-free cell at 866-889-6882.  You can always request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com.