Most people picture a heart attack as sudden, crushing chest pain. Sometimes it is. But heart attacks often begin more quietly, and some symptoms are easy to dismiss as indigestion, tiredness or a pulled muscle. Recognising the less obvious signs, and acting on them quickly, matters. In a possible heart attack, time is heart muscle.
The classic warning signs
The American Heart Association lists these major warning signs of a heart attack: [1]
- Chest discomfort, often in the centre of the chest, lasting more than a few minutes or going away and coming back. It can feel like pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body, including one or both arms, the back, neck, jaw or stomach.
- Shortness of breath, with or without chest discomfort.
- Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
The signs that are easy to miss
Discomfort rather than pain. Many people describe pressure, tightness or heaviness rather than pain, and wait because "it doesn't really hurt."
Symptoms away from the chest. Jaw, neck, back or arm discomfort, or an upset stomach, can be the main symptom.
Breathlessness or unusual fatigue. Shortness of breath with ordinary activity, or exhaustion that feels out of proportion, can be a warning sign.
Symptoms that come and go. Discomfort that eases and returns is still a reason to seek care.
Women's symptoms are often different
Chest pain or discomfort is the most common heart attack symptom in women as well as men. But the AHA notes that women are somewhat more likely than men to experience other symptoms, particularly shortness of breath, nausea or vomiting, and back or jaw pain. [2] These symptoms are sometimes attributed to stress, flu or indigestion, which can delay care.
What to do
Call 911 immediately if you or someone near you may be having a heart attack. Do not drive yourself to the hospital, and do not wait to see whether the symptoms pass. Emergency medical teams can begin assessment and treatment on the way.
Know your own risk
Warning signs are the last line of defence. The first is understanding your own risk: blood pressure, cholesterol, blood sugar, family history, smoking and activity. Those are conversations to have with your physician well before any symptom appears, and to revisit regularly.
This article is general information and not a substitute for medical advice. If you think you may be having a heart attack or another emergency, call 911.
About the author. Dr. Irfan Siddiqui is a cardiologist providing concierge care to executives and VIPs through Regenerative Health & Wellness, at home and around the world. More about Dr. Siddiqui · Explore membership.