Allergic reaction or heart attack: can you tell the difference?

For this, my 250th Heart Sisters post here, let’s look at shortness of breath. Dizziness. Nausea. Would you be able to tell if these are symptoms of an allergic reaction or a heart attack? Or could they be both? Overlapping symptoms can cause dangerous delays in correct diagnosis. And studies show that women are often misdiagnosed when having a heart attack, and that women tend to downplay their own symptoms, which can become even more complex when symptoms of two or more conditions overlap.

According to WomenHeart: The National Coalition of Women With Heart Disease, if you are a woman who is already diagnosed with heart disease, you are likely to be taking several cardiac medications.  Some of these can produce allergic reactions with distressing symptoms. Or you may be coping with seasonal or food allergies along with your heart condition.   

Before taking any allergy medications — whether over-the-counter or prescribed by your doctor – WomenHeart reminds you to check with your physician or pharmacist to make sure that none of your medications will negatively interact with each other.

Sometimes doctors mistakenly diagnose patients with angioedema as having allergies, leading to improper treatment, according to a report from the American College of Allergy, Asthma, and Immunology.*

Angioedema is a painful skin condition characterized by a swelling that is similar to hives, but the swelling is under the skin instead of on the surface.  It usually affects the eyes and lips, and may also be found on the hands, feet, and throat. Fainting, wheezing or shortness of breath may also happen in angioedema.

But recurrent swelling that lasts three days or more, affects the bowel, is preceded by early warning (prodromal) symptoms, and is not accompanied by hives are all signs that these attacks may not result from an allergic reaction but from angioedema. The ACAAI report also noted that epinephrine and other treatments for allergic reaction have no effect on angioedema attacks.  Seek immediate emergency care if you have these  symptoms of angioedema.

The form of angioedema most likely to be encountered by physicians is in those patients who are taking blood pressure medications called angiotensin converting enzyme (ACE) inhibitors, drugs that are likely the most common – albeit still rare – cause of angioedema.

Make sure that you carry a “Medications Card” in your wallet or purse that includes a potentially life-saving list of all the medications that you are currently taking as well as any allergies that you have. Post this same list on your fridge door at home. In case of an emergency, medical personnel will often check for this type of information so that you can be treated appropriately if you are unable to speak for yourself.

Both heart patients and those with serious allergies should always wear a medical I.D. bracelet or dogtag necklace as well.

If you take drugs called beta blockers, commonly prescribed for high blood pressure, angina, arrhythmia and congestive heart failure, talk with your physician about switching to another medication before starting any allergy treatments. And make sure that your doctor is aware of any allergies you have to food or dyes before taking any beta blockers, because your allergies could become more severe as a result of an interaction with the beta blockers.

A small percentage of people also have sensitivity to aspirin, commonly taken as a preventive bloodthinning agent against heart attacks for those at risk. Aspirin can potentially cause serious asthma attacks in people who have asthma or sinus problems.

Allergies and heart attacks do share several symptoms, but the important differences are that heart attacks tend to be accompanied by chest tightness or other symptoms that can extend to the abdominal area, a cold sweat or upper body pain that could include the jaw, shoulders and upper back. Allergies, on the other hand, can have a variety of different symptoms, depending on what type of allergy it is.

If you think you are having a severe allergic reaction, immediately call 911 — do not wait. If you are having mild but ongoing symptoms which you think could be an allergy to a medication, food or other substance, talk to your doctor. You may need to switch to different medications or see an allergist who can better pinpoint the problem. Sometimes it can be a long process to determine the source of an allergy, but your persistence will pay off in the end!

• congestion
• runny nose
• itchy, watery eyes
• swelling of the lips, tongue, face or throat
• itchy or red skin
• hives
• coughing or wheezing
• shortness of breath
• nausea, vomiting, and/or diarrhea
• dizziness

• loss of consciousness
• severe breathing problems
• rapid, weak pulse
• rapid drop of blood pressure

Source: WomenHeart: The National Coalition For Women With Heart Disease

* American College of Allergy, Asthma, and Immunology. Source reference: Lang D et al “International consensus (ICON) on hereditary and acquired angioedema” Ann Allergy Asthma Immunol 2012.

See also:

• Are You A Priority In Your Own Life?
• How Does It Really Feel To Have a Heart Attack? Women Survivors Tell Their Stories

Q:  Do you have both allergies and heart disease?