It's known among emergency physicians as the "Christmas coronary" – a heart attack that is associated with rich holiday foods, too many glasses of wine and high-cholesterol eggnog, an overindulgence in salt, a temporary abandonment of daily medications, and too much stress. What's more, it frequently involves the patient who has waited too long to come into the emergency department – for fear of ruining a long-awaited family gathering or disrupting hectic holiday travel – and sadly with deadly consequences.

Medical research confirms this seasonal upswing, including recent findings from a study conducted at Vanderbilt University, and from a University of California at San Diego study, which found that Dec. 25 is the deadliest day for heart attack patients, followed by Dec. 26 and Jan. 1.

"In many ways, the holidays constitute 'the perfect storm' for heart attacks, and emergency departments typically experience an influx of cardiac patients, beginning just before Thanksgiving and ending around New Year's," said ACEP spokesperson Dr. Linda Lawrence, MD, FACEP. "These studies confirm why people should not ignore the symptoms of a heart attack, even if they seem mild – because when it comes to cardiac problems, even a delay of only a few minutes can spell the difference between life and death."

In addition to seeking immediate treatment, Dr. Lawrence said it's important for the public to recognize the signs of a heart attack, especially in women, because their symptoms can be different from men's – and to be alert to those symptoms, in case they occur in a family member or friend who may be reluctant to speak up.

Often an individual having a heart attack will experience some, but not all, of the following symptoms, which may come and go:

• Uncomfortable pressure, fullness, squeezing sensation or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back.
• Pain that spreads to the shoulders, neck, jaw, arms or back.
• Chest discomfort accompanied by lightheadedness, fainting, sweating, nausea or shortness of breath.

Some less common but still serious warning signs of heart attack include:

• Shortness of breath and difficulty breathing.
• Abnormal chest pain (angina), stomach, or abdominal pain. (Symptoms may feel like indigestion or heartburn.)
• Nausea or dizziness.
• Unexplained anxiety, weakness or fatigue.
• Palpitations, cold sweat or paleness.

As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience the less common symptoms, including shortness of breath, nausea/vomiting, and back or jaw pain without the presence of chest pain.

A heart attack is not always a sudden, deadly event, Dr. Lawrence added. Often, it is an evolving process during which a clot forms in an artery of the heart, depriving the heart of blood and oxygen. The longer the heart attack process continues, the more permanent damage the damage becomes to otherwise healthy heart muscle.

Hospitals have life-saving medications and techniques that can stop a heart attack, but these measures work best when implemented within the first one or two hours after the onset of heart attack symptoms, when damage is still limited.

"Because of this short window of opportunity, acting fast during a heart attack is key," said Dr. Lawrence. "It's essential not to let valuable time slip away."

If you suspect a heart attack:

• Call 9-1-1 or a local emergency services number immediately, tell them a heart attack may be involved and wait until the ambulance arrives. Do not attempt to drive to the hospital, especially if you are the one having the symptoms. Emergency medical services personnel are equipped to provide care along the way and can bypass traffic to transport the patient more quickly.
• If the person is alert, have him or her chew and swallow an aspirin (not acetaminophen ibuprofen or naproxen), unless his or her physician has advised otherwise; the ideal dose is two to four baby aspirin or one full or extra-strength tablet (325 mg or 500 mg). Also help the person take nitroglycerin tablets if prescribed.
• If the person is conscious, keep him or her calm and in a comfortable position. The victim should stop all physical activity, lie down, loosen clothing around the chest area, and remain that way until the ambulance arrives.
• If unconsciousness results, make sure the person is lying on his or her back. Clear the airway and loosen clothing at the neck, chest and waist. Check for breathing and pulse; if vital signs are absent, and if trained to do so, begin cardiopulmonary resuscitation (CPR).

ACEP also advises that persons who have major risk factors for heart disease talk to their physician about taking aspirin to reduce the chances of having a heart attack. In addition, especially for persons with a family history of heart disease, it's important to maintain a healthy lifestyle and get regular check-ups. More information can be found on the American Heart Association's website www.americanheart.org.