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The classical symptomsof a heart attack are of sudden, severe crushingchest pain over the central part of the chest. The pain is persistent and does notimprove on resting. The degree of pain is not a very good pointer to how severe the heart attack is. Some people, especially elderly people may have relatively mildchest pain but have sustained a severe heart attack, while others may have had severe chest pain but have only minor damageto the heart. Together with chest pain there is often breathlessness, sweating because of pain and collapse into unconsciousness. If the heart attack is severe enough the heart goes into heart failure immediately or even stops beating altogether and that will lead to death within minutes unless help arrives. Anyone with the above symptoms should be dealt with as for a heart attack until proven otherwise.Once in hospital other investigations can confirm the situation.
These would include an ECG recording of the heart which would show characteristic changes, and measuringthe release of certain enzymes into the blood stream, such as troponins, which can give an early and accurate confirmation of what may otherwisenot be a completely clear picture.Unfortunately many heart attacks are followed by immediate death and even with the best treatment about a third of victims die within twenty-four hours. However, advances in treatment have reduced the risks beyond that very considerably, e.g. by 50% or more in recent years.

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