12 Heart Attack Symptoms and Early Warning Signs

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Signs and symptoms of a heart attack can include chest pain, nausea and arm pain.

What is a heart attack?

Heart attack, or myocardial infarction, is the number one killer of both men and women in the U.S. Each year, about 735,000 Americans suffer a heart attack, and heart disease is the leading cause of death for both men and women in the US. Most of the deaths from heart attacks are caused by ventricular fibrillation of the heart that occurs before the victim of the heart attack can reach an emergency room. Those who reach the emergency room have an excellent prognosis; survival from a heart attack with modern treatment should exceed 90%. The 1% to 10% of heart attack victims who die later include those victims who suffer major damage to the heart muscle initially or who suffer additional damage at a later time.

Fortunately, procedures such as coronary angiogram andPTCA (coronary balloon angioplasty), and clot dissolving drugs are available that can quickly open blocked arteries in order to restore circulation to the heart and limit heart muscle damage. In order to optimally benefit heart attack victims and limit the extent of heart damage, these treatments to open blocked arteries should be given early during a heart attack. Blood pressure is not a reliable measurement of whether one is having a heart attack. Blood pressure during a heart attack can be low, normal, or elevated.

Heart Attack illustration - Myocardial Infarction
Heart Attack illustration - Myocardial Infarction

Heart Attack Symptoms and Signs in Women

The classic symptoms of heart attack include a feeling of extreme pressure on the chest and chest pain, including a squeezing or full sensation. This can be accompanied by pain in one or both arms, jaw, back, stomach, or neck. Other symptoms of heart attack include shortness of breath, nausea, vomiting, lightheadedness, and a feeling of breaking out in a cold sweat. Although chest pain and pressure are the characteristic symptoms, women are somewhat more likely than men to experience heart attack that does not occur in this typical fashion. Instead, some women with heart attacks may experience more of the other symptoms, like

  • lightheadedness,
  • nausea,
  • extreme fatigue,
  • fainting,
  • dizziness, or
  • pressure in the upper back.
Chest pain can be a sign of a serious medical condition.

Cardiac arrest vs. heart attack

Sometimes there is confusion between the terms "cardiac arrest" and "heart attack." A heart attack, or myocardial infarction, is damage to the heart muscle that occurs due to reduced blood flow to the heart muscle, depriving the heart muscle of the oxygen it needs to function properly. Cardiac arrest means that the heart stops beating and death is imminent. A heart attack, if severe, can lead to cardiac arrest, and this is what occurs when a heart attack is fatal. However, other conditions, such as serious arrhythmias or shock, can also cause cardiac arrest.

What are symptoms of a heart attack?

Knowing the early warning signs of heart attack is critical for prompt recognition and treatment. Many heart attacks start slowly, unlike the dramatic portrayal often seen in the movies. A person experiencing a heart attack may not even be sure of what is happening. Heart attack symptoms vary among individuals, and even a person who has had a previous heart attack may have different symptoms in a subsequent heart attack. Although chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a diversity of symptoms. The following list describes the symptoms of heart attack in more detail.

Chest pain and shortness of breath are common symptoms of a heart attack.

What are symptoms of a heart attack? (Continued)

1. Chest discomfort, manifest as pain, fullness, and/or squeezing sensation of the chest

Chest pain is the hallmark symptom of a heart attack, although it can take many different forms. In other cases, chest pain may not occur at all. The characteristic chest pain of a heart attack has been described as a sense of pressure, squeezing, fullness, or pain that starts in the center of the chest. The pain or discomfort typically lasts more than a few minutes, or it may go away and then return. It can spread down the arms, to the back, or to the head and neck. Both women and men report chest pain as a primary symptom of heart attack, but women more often than men are likely to have some of the other symptoms, such as nausea, jaw pain, or shortness of breath, that are described below.

2. Jaw pain, toothache, headache

The pain of a heart attack can spread down both arms, to the jaw or head, or to the back. Some people report tooth pain or headache as a symptom of a heart attack. It is possible to have these types of pain without chest pain during a heart attack.

3. Shortness of breath

Feeling short of breath or like you are gasping for air is a common symptom of a heart attack. Shortness or breath, or difficulty breathing, is medically known as dyspnea. Shortness of breath may occur before or during the chest pain of a heart attack, and in some cases, it may be associated with other heart attack symptoms without any chest pain.

View the Heart Disease Slideshow
Nausea and sweating can also be symptoms of a heart attack.

What are symptoms of a heart attack? (Continued)

4. Nausea

Nausea or feeling sick on your stomach is a less common but possible symptom of heart attack. Sometimes belching or burping can accompany the nausea, and some patients have described a feeling like indigestion associated with a heart attack. Women are more likely than men to report these less typical symptoms of heart attack, and some patients have described feeling as though they are developing the flu.

5. Vomiting

The nausea that accompanies a heat attack can become so severe that vomiting occurs.

6. General epigastric (upper middle abdomen) discomfort

Sometimes the pain of heart attack is described as stomach pain, or pain in the middle of the upper abdomen. The pain usually feels more like discomfort of heaviness srather than sharp, stabbing pain, and the pain tends to persist more than a few minutes. This can occur with or without pain in the true chest area.

7. Sweating

Sweating, or perspiration, can accompany a heart attack. Some people have described feeling like they are breaking out in a cold sweat.

Arm pain along with other heart attack symptoms could be a sign you are having a heart attack.

What are symptoms of a heart attack? (Continued)

8. Heartburn and/or indigestion

As mentioned above, some people experiencing a heart attack can have belching and burping and describe a feeling of indigestion. Likewise, the pain and pressure of a heart attack may occur in the epigastric or upper middle abdominal area, similar to the pain of heartburn.

9. Arm pain (more commonly the left arm, but may be either arm)

The chest pain of a heart attack can spread, or radiate, down one or both arms and to the shoulders. This often happens, and the pain may even extend to the wrist and fingers. This is most common on the left side of the body but it can also occur on the right side.

10. Upper back pain

The upper back is another common location for spread of the pain from a heart attack. Most commonly, back pain that stems from a heart attack is described as occurring between the shoulder blades.

11. General malaise (vague feeling of illness)

A feeling of being generally unwell or like you are coming down with an illness can accompany a heart attack. This can be described as fatigue or even lightheadedness, with or without fainting. Some people will experience severe anxiety or panic during the heart attack. This has been described as feeling a sense of doom, as one experiences with a panic attack.

Heart attack symptoms may be subtle or non-existent.

What are symptoms of a heart attack? (Continued)

12. No symptoms

Approximately one quarter of all heart attacks are silent, without chest pain or new symptoms and silent heart attacks are especially common among patients with diabetes mellitus).

Even though the symptoms of a heart attack at times can be vague and mild, it is important to remember that heart attacks producing no symptoms or only mild symptoms can be just as serious and life-threatening as heart attacks that cause severe chest pain. Too often patients attribute heart attack symptoms to "anxiety," "indigestion," "fatigue," or "stress," and consequently delay seeking prompt medical attention. One cannot overemphasize the importance of seeking prompt medical attention in the presence of symptoms that suggest a heart attack. Early diagnosis and treatment saves lives, and delays in reaching medical assistance can be fatal. A delay in treatment can lead to permanently reduced function of the heart due to more extensive damage to the heart muscle. Death also may occur as a result of the sudden onset of arrhythmias such as ventricular fibrillation.

Call for emergency services if you are experiencing signs of a heart attack.

What should you do if you experience these symptoms?

Doctors agree that if you're in doubt, get checked out anyway. Even if you're not sure if something is really wrong, you should call 9-1-1 if you experience heart attack symptoms. Prompt administration of drugs can help restore circulation to the heart and increase your chances of survival.

Subscribe to MedicineNet's Heart Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Reviewed on 2/18/2016
References
REFERENCE:

National Heart, Blood, and Lung Institute (NHLBI). "Heart Attack."

IMAGES:

1.iStock

2.iStock

3.iStock

4.iStock

5.Getty Images

6.iStock

7.iStock

Health Solutions From Our Sponsors