### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
What are the signs of a heart attack...I am 61 yrs old, have been having severe chest pains, heavyness at chest, pounding so bad that I feel it in my throat, no numbing of the arms, my concern is I am getting these symptoms when sitting or laying down. Today I ate and started with the pain about 45 min later so I am hoping it is heartburn. Other times it just happens suddenly. I am waiting for insurance approval to see a cardiologist.

### output:

Hi, Patients with a heart attack usually present with severe chest pain which is prolonged, usually with about 30 minutes in duration, can radiate to the neck or arms and may occur at rest or with minimal exertion. Before a heart attack, patients with coronary heart disease would usually have milder exertional chest pains (but can also be precipitated by eating) which is relieved by rest or by intake of sublingual Nitrates. There are certain medications which are known to reduce the risk of heart attacks which includes antiplatelet, statins, beta-blockers and ACE-inhibitor medications, and are usually the regimen for chronic stable heart disease. But patients who are having a heart attack should be taken to a hospital to check for other parameters including a physical examination, blood test for a troponin I (a marker of heart muscle damage) as well as blood sugar and other blood tests as indicated, and a 2D echocardiogram to check for heart muscle and other structural problems. From these, the appropriated medications can be given to help lessen the risk of a major cardiac event, to improve your quality of life, which includes less frequent chest pains, or even a chest pain-free life. I would suggest either an outpatient or emergency room check-up for appropriate physical examination and management, as well as to rule out other causes of chest pain, which as you have mentioned, gastrointestinal, as well as pulmonary disease as a cause of the symptom. Hope I have answered your query. Let me know if I can assist you further. 