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Hi, I was asleep and woke up with a sharp

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Posted on Mon, 4 Mar 2019
Question: Hi, I was asleep and woke up with a sharp pain in my back just below my shoulder blade on the right side and top and felt nauseated. Thought I was having a heart attack. Got up to go take an 81 mg aspirin and just like that when I leaned over to grab the aspirin bottle the pain disappeared. Do you think I had a heart attack? I am a 48 year old woman and I smoke almost a pack a day. Don’t drink or do drugs. Don’t even like prescription drugs
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Unlikely to be a heart attack

Detailed Answer:
Hello and welcome,

There are two things that make me think this was unlikely to be a heart attack. The first is that it was a sharp pain. When the heart is not getting enough oxygen during a heart attack, the pain is typically a pressure, crushing type of pain - not sharp. The second thing is that the pain seems to have been positionally related and went away abruptly. A heart attack doesn't change much with positional changes, and does not stop that abruptly.

So - this pain was due to something else. My best guess, without being able to examine you, is that it was musculoskeletal in origin - a strained muscle or pinched nerve. The second possibility is acid reflux or gas pains, which can sometimes be sharp and wake people from sleep, making them feel like they are having a heart attack.

You are at risk for heart disease (and other medical problems) because of the tobacco. If you are still menstruating, the estrogen provides some protection until menopause, but not full protection. I know that for most people it is terribly hard to quit smoking - it becomes both a friend and a chemical addiction. But quitting is possible, even if you haven't had success before. And some people find it easier with some of the medications (I know you are not a fan of rxs, but I thought I'd put that out there). In particular, I've had success with people taking the prescription Zyban (the antidepressant bupropion) as it markedly cuts down on people's cravings for tobacco and also provides the pick-me-up that people turn to cigarettes for, at least during the smoking cessation phase.

I hope this information helps. Please let me know if I can provide further info/clarification.


Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3138 Questions

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Hi, I was asleep and woke up with a sharp

Brief Answer: Unlikely to be a heart attack Detailed Answer: Hello and welcome, There are two things that make me think this was unlikely to be a heart attack. The first is that it was a sharp pain. When the heart is not getting enough oxygen during a heart attack, the pain is typically a pressure, crushing type of pain - not sharp. The second thing is that the pain seems to have been positionally related and went away abruptly. A heart attack doesn't change much with positional changes, and does not stop that abruptly. So - this pain was due to something else. My best guess, without being able to examine you, is that it was musculoskeletal in origin - a strained muscle or pinched nerve. The second possibility is acid reflux or gas pains, which can sometimes be sharp and wake people from sleep, making them feel like they are having a heart attack. You are at risk for heart disease (and other medical problems) because of the tobacco. If you are still menstruating, the estrogen provides some protection until menopause, but not full protection. I know that for most people it is terribly hard to quit smoking - it becomes both a friend and a chemical addiction. But quitting is possible, even if you haven't had success before. And some people find it easier with some of the medications (I know you are not a fan of rxs, but I thought I'd put that out there). In particular, I've had success with people taking the prescription Zyban (the antidepressant bupropion) as it markedly cuts down on people's cravings for tobacco and also provides the pick-me-up that people turn to cigarettes for, at least during the smoking cessation phase. I hope this information helps. Please let me know if I can provide further info/clarification.