This article is from the American Heart Association

The first hour of a heart attack is known as the "golden hour." If you get help during that first hour, your chances of recovery are greatly improved. Yet many people hesitate to get help when they first experience symptoms. They're afraid of the embarrassment of going to the emergency room and finding that nothing is wrong. So, it is important that you know the symptoms that may indicate that a heart attack is in progress.

Many of the symptoms of heart attack can be brought on by digestive disturbances or other less serious conditions. But only sophisticated medical tests can determine for sure if you're having a heart attack. Heart attacks may vary from person to person, and from heart attack to heart attack. Women, for example, may experience "atypical' symptoms such! as pain between the shoulder blades rather than crushing chest pain. This may result in them delaying seeking treatment. That is a great mistake.

Heart attack is one instance where getting treatment promptly can mean the difference between life and death. If you are in doubt, err on the side of being more cautious and go to the emergency room and get yourself checked. We will try to describe some of the most common characteristics of heart attack here. Before that we will introduce the other pain called angina that is often precursor to a heart attack.

Angina Pectoris or Angina

Angina pectoris is a precursor to a heart attack. Usually, what happens is this: During physical exertion, during stress or an emotionally charged situation, in cold weather or after a big meal, the heart beats faster. Heart requires more oxygenated blood flow to the heart muscle to maintain the beating. But if the channels by which the blood and oxygen flow to the heart are narrow, not enough nutrients get to the heart muscle tissue. It suffers oxygen deficiency, and the heart tells you about this with a pain called angina pectoris.

The pain is quite distinct. It is described as: "a heavy, strangulating, suffocating experience-far more intense than anything like indigestion, chest wall injuries, pleurisy or spasms of the esophagus that you are familiar with. The pain may seem to start under the breastbone, on the left side of the chest, and sometimes radiates out to other places: throat, neck, jaw, left shoulder and arm and, occasionally, on to the right side.

Angina is an intense, scary episode. But with rest and calm (or by placing nitroglycerin or another kind of nitrate under the tongue), angina attacks usually go away in about 15 minutes or so. If they last longer than that, go to the hospital and have a thorough check up. Long-lasting angina attacks may be the prelude to heart attacks.

The statistics show that half of those! e with angina pectoris suffer sudden deaths, a third have heart attacks, and most victims are older men. And an estimated 350,000 new cases of angina occur each year.

Although you may not appreciate it when you are suffering from pain, angina itself is not bad. In fact it may be a blessing! Some doctors call angina "God's gift to humans" because many heart problems are silent, without symptoms, and go unnoticed until they become the cause of sudden death. Angina is an early warning sign that something is wrong. Its presence may help identify those at risk of heart attack so that you can seek proper medical treatment promptly.

Heart Attack

Dizziness can be an early symptom of heart attack

Cardiac chest pain is often vague, or dull, and may be described as a pressure or band-like sensation, squeezing, heaviness, or other discomfort.

Heart attacks frequently occur from 4:00 A.M. to 10:00 A.M. due to higher adrenaline amounts released from the adrenal glands during the morning hours. Increased adrenaline in the bloodstream can contribute to the rupture of the plaque that causes the formation of the clot and the eventual heart attack.

Studies have found that, at least in northern regions, heart attacks may occur more often in the winter months.

Heart attacks do not usually happen during exercise, although exercise is commonly associated with exert ional angina.

Approximately one quarter of all heart attacks are silent, without chest pain. In diabetics, the incidence of "silent" heart attacks may be much higher.

Typical Symptoms

The typical symptoms of a heart attack are similar to those of angina, but more severe and longer lasting. The victim feels a pain that is usually squeezing or burning or feels a terrible pressure in the middle of chest. This pain may also travel up to the neck, jaw, or shoulder or down the arm and into the back.

Sweating, dizziness, weakness, and shortness of breath often accompany the pain of a heart attack. If you have chest pain that lasts longer than 15 minutes and is not relieved by rest (or by a dose of nitroglycerin), get immediate medical attention.

Immediately after you call for medical help, chew and swallow an aspirin and drink a glass of water. (Don't take aspirin if you are allergic to aspirin.) Aspirin is known to thin the blood, which helps the heart get more blood if you are, indeed, having a heart attack.
In some cases, a heart attack may cause a sensation that feels like indigestion: you get a sick, aching feeling high in the middle of your abdomen. It can cause a feeling of great weakness, or a sense that you are about to faint. (Many of the people who had heart attacks thought that they had intestinal problem instead of associating it with a heart attack.)

Silent Heart Attack

Heart attacks can occur without any warning symptoms. These are called silent heart attacks. Some heart attacks may be associated with "atypical' symptoms, symptoms such as heartburn, nausea, or sudden light-headedness and sweating. These are more common in women, diabetics, and people older than 65.

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By Judith E. Pearson, Ph.D.

"The subconscious brain is more active, independent and purposeful than once thought." That is the conclusion of Benedict Carey who wrote an article, "Who's Minding the Mind?" in the July 31, 2007 issue of The New York Times. Carey cites several recent research studies showing that our decisions and judgments are often influenced by cues in the environment. Everyday sights, smells, and sounds can selectively activate motives that people already have.

For example, participants in a study were asked to help a lab assistant, who was carrying textbooks, a clip board, papers and a cup of coffee. They were asked to hold the cup, which contained either hot coffee or iced coffee. Later, the students who had held the hot cup rated the assistant as a warm person, while the students who held the cold cup rated the assistant as cold.

Other findings: people tidy up more thoroughly when there is a slight tinge of cleaning fluid in the air. They become more competitive if there is a briefcase in sight. They are more cooperative if they glimpse words like "dependable" and "support."

The use of environmental cues to shape behaviors and attitudes is called "priming." Advertisers use it in two ways. One is product placement-placing the product in a movie scene for example, to create brand recognition. The other is through commercials and ads that associate the product with common values such as family togetherness, success, safety, or sexuality.

Carey adds that overtly manipulating people often backfires, and that researchers don't know when unconscious drives become conscious or the circumstances under which people can override hidden urges. It's as though the subconscious mind is "an invisible partner who has strong reactions about the world that don't always agree with our own, but whose instincts...are at least as likely to be helpful, and attentive to others, as they are to be disruptive."

Can we as practitioners profit from this information? Perhaps. First we could articulate the values and motives we most want our clients to hold in therapy and counseling. I, for one, want to impart the message to my clients that I value them, and that they are competent. I want them to feel compellingly motivated toward their outcomes. I want my office to be a soothing, nurturing atmosphere. What do you want for your clients?

Second, who are your clients? Are they mostly parents with children, senior citizens, yuppies, women, men, or business executives? Consider the general characteristics of your clientele, and what values are meaningful to them. Articulate these values as well.

Third, let's take a look at the environments we provide for our clients, from the building exterior, to the waiting room, to the practitioner's office. Consider the colors, the placement of furniture, the accessories, the smells and the sounds. What messages do these things convey? If you aren't objective enough to answer these questions, invite a friend who has never seen your office to visit and give his or her initial impressions. You might even hire a consultant who specializes in environments---someone with expertise in Feng Shui, for instance. With a few changes, your office arrangement might be better "priming" your clients to benefit from your services.

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Dr. Judith E. Pearson has a private practice in Springfield, Virginia where she specializes in individual counseling using NLP and Hypnotherapy. She is the Executive Director of the National Board of Certified Clinical Hypnotherapists and a Licensed Professional Counselor. She has recently published The Weight, Hypnotherapy and You Weight Reduction Program: An NLP and Hypnotherapy Practitioner's Manual. The book can be purchased at her web site at www.engagethepower.com.

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