To Your Good Health: Heart attack symptoms may vary

DEAR DR. ROACH: My very healthy husband collapsed and died on the way to the hospital. They worked on him for a long time but could not revive him. They didn’t do an autopsy, and they declared his death as “atherosclerotic vascular disease.” He was 79 years old and had no health problems. He came into the house and said that something was in his throat and he couldn’t swallow. He tried to cough it up, but nothing came up. He then collapsed. He had no pain. I am still puzzled by that symptom of a heart attack. Have you ever heard of that? I am really curious and still in shock. I hope you can explain. – T.S.

ANSWER: I am very sorry to hear about your husband. I think he likely did have a heart attack, which is the leading cause of death in the industrialized world.

Although many people have symptoms of heart disease that they ignore, some people have no symptoms until sudden death. Atherosclerosis, hardening of the arteries due to cholesterol plaque and calcium in the blood vessels of the heart, almost always is present in people with a heart attack.

The initial symptom of a heart attack varies widely. Throat discomfort is not rare. Cough is a common symptom, as the heart becomes damaged and the pressure in the lungs increases. The classic symptom of chest pain certainly does happen, but there are many variations. Both men and women can have atypical presentations.