Unless you spent this year watching reruns of The Love Boat, you'll know more or less how many South African men die of heart attacks each year. Here's how to tell if you're having one, and what you should do about it.

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Look out for:

• A feeling of fullness or tightness in the chest, as though Os du Randt were sitting on it. Some blokes who've experienced it have also described it as "a squeezing pain" in the centre of the chest;
• A feeling of pain or discomfort, usually in the left side of the jaw or upper left arm or neck that spreads to the chest;
• Nausea, dizziness, sweating or shortness of breath.

If you have these symptoms, you have a right to be worried. You should do the following:

• Chew an aspirin. Disprin and a number of other analgaesics (that's painkillers to you and me) contain aspirin, which thins the blood. If there's a clot in your heart's blood vessels, it may help buy you some time. Check the packaging though, as painkillers containing paracetamol won't have the same effect.
• Call an ambulance. You're better off arriving at the hospital with sirens wailing and George Clooney and the people from ER going "get-outa-the-way" than walking in on your own. Also, you could pass out while driving yourself to hospital and add a car crash to your woes. Some medical funds have contracts with private ambulance firms that may arrive several weeks earlier than the ones from the government hospitals. Save their numbers in your cellphone's memory, or stick them on the fridge and in your wallet.
• Call your family doctor. If you have a cardiologist, speak to him or her as well. Even if you're not having a full-on heart attack that warrants an ambulance, you may have angina.

These are all emergency measures. There are several ways in which you can limit the chances of having a heart attack. Stop smoking, control your cholesterol, eat a balanced healthy diet, limit your intake of salt, get regular exercise, reduce your stress levels, and manage depression and anger.

If you're in your 30s or older, you should speak to your doctor about having a stress ECG, whereby an ECG is done while you exercise (such as on a treadmill) in your doctor's rooms.

If there seems to be problem, you might require an angiogram. A tiny tube is inserted into a vein in your leg and pushed up to your heart where, with the help of a dye, doctors can see whether the blood vessels are narrowed or blocked. You'll be glad to know that this happens under local anaesthetic.

- (William Smook, updated May 2008)

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