How Can You Tell Whether You Are Experiencing Heart Attack Or Fatigue?

To make sure that you get the right treatment, it is essential that you and your doctors have a sense of whether you are experiencing a heart attack or overwhelming fatigue from some other cause. Since arterial imaging is all too often inaccurate, resulting in false negative results in up to 1 in 8 cases, and since heart enzyme levels are not enough, it is very important that you and your doctors understand the nature of your fatigue. The problem with assessing fatigue is that nearly everyone has a different view of what fatigue is.

Interruption of Basic Day-to-Day Activities

One way of thinking about fatigue, and measuring fatigue as a symptom of heart disease, is to consider it functionally. How badly does fatigue interfere with your day to day activities?

If you have fatigue that makes you feel too tired to take care of household chores, or to get dressed when you get out of bed, and you are too tired to go to work, you are far more likely to be suffering heart disease than if you just don't feel like parasailing, hang gliding, or taking a mountain hike. There is a standardized scale for measuring this kind of fatigue known as the Fatigue Symptom Inventory (FSI).

Changes in Mood

Another way of assessing the likelihood that fatigue is related to heart disease is by measuring changes in mood. Researchers at the University of Minnesota created an instrument known as the Profile of Mood States (POMS) to capture the specific changes in mood that are most frequently associated with heart disease. People who have had just had or who are about to have a heart attack, it turns out, generally experience high degrees of frustration. They "should" be able to perform daily life or work or recreational activities, but they just can't. In people who are already taking statin medications for cholesterol or inflammation, it is also common to experience vague aches and pains, memory loss, and general feelings of helplessness.

Cardiologists have tried to link changes in mood to changes in ejection fraction (the amount of blood the heart can pump with each beat), but what they found is that ejection fraction does not really make a difference in mood. Everyone who has heart disease tends to feel lousy.

Quality of Life

It is also common for people who are just about to have a heart attack to make a complaint on the lines of "My life is totally going to hell." As people have less and less energy and more and more pain, they lose control of the events of their lives. Although most people who have heart attacks do not hit rock bottom in their personal affairs, a surprisingly high percentage do.

The Short Form 36-Question Survey (SF-36) is designed to give doctors an indication of the effects of fatigue on quality of life. Replete of questions such as "Do you feel full of vitality?" and "Is today a great day?" this test often elicits responses in which the potential heart attack patient tells the psychologist what to do with the test. General grouchiness and a dismal outlook on life, it turns out, are highly predictive of heart disease. And the sooner treatment is initiated, the sooner heart function may be restored and the sooner life may resume its quality.