Would you know if you or someone you love were having a heart attack? Heart attacks, or acute myocardial infarctions, are the leading cause of death for people over the age of 40 [source: GAA]. In the United States alone, there are 1.2 million heart attacks per year, and about half of those are fatal [source: CDC].
A heart attack happens when arteries get completely blocked and the heart is deprived of oxygen because blood can't get through the blockage. When the heart is deprived of oxygen, its cells start to die. The chest pain that most people associate with heart attacks is the heart's way of calling out for help when it starts dying.
Many people think heart attacks are more of a problem for men than for women, but in fact nearly half of those who die from heart attacks in the United States are women [source: Women's Heart]. Most heart attacks aren't as dramatically painful as the movies suggest. The symptoms of a heart attack are varied, and can be mild and take weeks to manifest. Chest pain is the most common sign, but 16 percent of heart attack sufferers don't experience that at all [source: WebMD]. Women are much less likely to have chest pain before a heart attack and more likely to experience symptoms (like fatigue) that could be mistaken for some other ailment [source: Women's Heart].
With so are many different warning signs, it's not easy to know whether a symptom like nausea or a racing heart is signaling a heart attack. In most cases, though, and especially if you have several risk factors for heart attack, it's better to call for professional help as soon as possible. The sooner you get treatment, the better the chance of survival. You should never wait more than five minutes if you think you might be having a heart attack.
But how do you know? In this article, we'll look at the ten most common symptoms of a heart attack and give some pointers on determining whether or not they could be signs of a heart attack. The most definite sign is first on our list: Where there is chest pain, medical care should follow without delay.
Chest Pain and/or Pressure
If you are doubled over while clutching your chest in agony, you needn't contemplate the chances that the pain indicates a heart attack. Just call 911. Sections of your heart are probably dying, and if you don't get help immediately, you may have permanent heart damage -- if you survive at all. And strange as it may sound, intense, debilitating pain is probably the best symptom you can have if you have to have a heart attack.
The chest pain or pressure associated with a heart attack is called angina, and it's the most common symptom. Unfortunately for long-term survival, angina is usually much milder than people think, and this delays them from seeking attention. People may think it's nothing and just wait for it to pass. The result of this delay may be permanent heart damage that could have been avoided if the person had sought immediate medical attention.
Even if the pain is just mild or moderate, there are certain characteristics that may help you determine whether what you're feeling is a heart attack or just a bit of nervousness because you're starting a new job or going out on a first date. Call 911 immediately if:
- You experience severe, debilitating chest pain.
- You feel any level of pain or pressure in the center of your chest for more than a minute or two, and sitting down or resting doesn't make it go away instantly. It may also go away and then come back. This feeling in the chest may also be experienced as tightness, aching, a burning sensation, fullness or squeezing.
Even if sitting down or resting does make the pain or pressure subside, you should still seek medical attention as soon as possible, as this could indicate a pre-heart-attack state of oxygen deprivation or a mild heart attack.
You definitely shouldn't mess around with chest pain -- no matter what. Other symptoms, though, can be more ambiguous. The next symptom on the list might be due to any number of less serious conditions, but it's important to realize that it could be telling you to call 911.
Fatigue is a common heart attack symptom. It's also one of the trickiest considering that most people feel fatigued at least occasionally. The key to recognizing fatigue as a sign of a heart attack is when it occurs without explanation and in combination with other symptoms like chest or jaw pain.
Fatigue is not considered one of the classic heart attack symptoms. However, it turns out that symptoms like sleep disturbances, fatigue, shortness of breath, indigestion, and anxiety are far more commonly reported among women who have had heart attacks than is chest pain [source: Cleveland Clinic].
Fatigue associated with heart attack can come on suddenly or gradually over a period of days and can range from mild to severe. Fatigue can also be caused by depression, fibromyalgia, or a variety of other problems. The key to identifying fatigue as a heart attack symptom is to note by what else is going on at the time. If you experience fatigue along with a fever, it's unlikely to be an emergency. Fatigue accompanied by chest pain, sweatiness, or shortness of breath should have you dialing 911 without delay.
Unfortunately, fatigue is just one of several heart attack symptoms that are easily ignored. Another is indigestion, the next symptom on our list.
Did you know that feelings of indigestion are commonly associated with heart attack? If not, you're not alone. Indigestion is a lesser-known heart attack symptom. And like fatigue, it can be a confusing one. This is because indigestion is caused by a variety of different conditions, including ulcers, gastrointestinal reflux disease (GERD), cancer, or certain pancreatic conditions [source: NIDDK]. The good news is that there are ways of knowing whether feelings of indigestion are caused by a heart attack.
When indigestion is associated with a heart attack, it is usually also accompanied by other symptoms, including chest pain, shortness of breath, and pain or tightness in the arms, neck, upper back, or jaw. You may also feel nausea or sweatiness, neither of which are signs of indigestion. There are also other telltale signs of indigestion that are not linked with heart attack, such as a burning sensation in the back of the throat [source: NIDDK]. If you're having heartburn and not experiencing other typical heart attack symptoms, take an antacid. If that cures the problem, it's unlikely that your ticker is in trouble.
Indigestion may not be one of the classic signs of heart attack, but it's not uncommon, particularly among females [source: AHA].
Indigestion is a particularly dangerous heart attack symptom because it's so easily attributed to something else. Evidence suggests that people having a heart attack are more likely to delay calling for help if their symptoms were easily confused with indigestion [source: WebMD]. The next symptom in our list, jaw pain, is also potentially confusing, though difficult to ignore.
Most people don't associate jaw pain with cardiovascular trouble, but it's actually one of the telltale signs of heart attack, especially in the lower jaw [source: Mayo Clinic]. However, jaw pain is rarely the only symptom of a heart attack. More often, it is accompanied by sweatiness, fatigue, shortness of breath, and pain or discomfort in the neck, shoulders, and chest.
If you are experiencing jaw pain and you're not sure if it could be related to your heart, try this simple test: Move the jaw around a bit. If movement makes the problem worse, it's probably not a heart attack. Increased discomfort when moving the jaw is more likely to be associated with temporomandibular joint (TMJ) pain or a dental problem [source: Health Central].
If you do experience jaw pain that does not change much with movement, and it is accompanied by symptoms such as chest pain, shortness of breath, or sweating, don't take any chances. Call 911 ASAP. If your symptoms worsen, you could soon be incapable of calling for help. This is also true if you experience dizziness, which is the next symptom on our list.
If you're having a heart attack, every second counts. Unfortunately, people are often reluctant to call for help because they don't realize that they're having a heart attack. This is due in part to the misleading effect of the "Hollywood heart attack." In the movies, heart attacks are typically portrayed as someone becoming woozy and dropping to the floor clutching their chest, often quite dramatically. Real life is somewhat different.
While it's possible to have a "Hollywood heart attack," most people's experiences are not so Oscar-worthy. Often a heart attack begins with a feeling of dizziness. During a heart attack, blood flow to the brain is restricted [source: MedLinePlus]. This causes dizziness or lightheadedness, which may be accompanied by feelings of euphoria and/or disorientation. Along with indigestion and sweating, dizziness is one of the more commonly overlooked symptoms of a heart attack, particularly among women [source: ABC News].
Dizziness may or may not cause you to pass out [source: Women's Health]. If it doesn't, luck is on your side. Take advantage of your good fortune and call 911 immediately. And remember that time is of the essence – half of all cardiac deaths occur within one hour of symptom onset [source: CDC].
Don't worry that you're overreacting. It's always better to be safe than sorry. However, the next heart attack symptom we review also has several causes but it's far more likely to have people calling for help.
One of the most common heart attack symptoms is sweatiness, often accompanied by clammy palms. The good news about sweating during a cardiac event is that it's one of the symptoms most likely to cause a heart attack sufferer to reach out for help [source: WebMD]. In fact, among the heart attack sufferers, sweating typically ranks higher than chest pain in terms of getting people to the hospital.
Researchers are not sure why sweating makes people reach out for help more than other symptoms of a heart attack. It may mean that sweating is more troubling to patients, or perhaps that sweating is a sign of a more serious heart attack. Whatever the reason, when accompanied by other symptoms of a heart attack, sweatiness is a clear sign that something is wrong. If you begin sweating excessively for no apparent reason, call 911 right away. This is especially important if you have sweatiness combined with other heart attack symptoms, such as upper body discomfort, which is the next symptom on our list.
Upper Body Discomfort
Movies and TV often show someone clutching his or her left arm during a heart attack. Pain in one, either or both arms is indeed a sign that you could be having a heart attack. You could also experience pain in one or both shoulders or back. And as with the chest pain, it may feel very mild -- like a tightness, pressure or general discomfort.
Of course, this type of pain could also indicate you're overdoing it in a tennis match. One way to tell that the pain in your shoulder or back is indicating a heart attack is if it's happening in conjunction with chest pain. If your left shoulder starts to ache and your chest hurts, too, by all means call 911 immediately.
It's important, by the way, that you call 911 first, not a family member or friend. Call a friend only after emergency personnel are on their way.
If your back, arm or shoulder hurts and you also have the next symptom on the list, you should get medical attention without thinking twice, no matter your age or state of health or whether your chest hurts.
Shortness of Breath
Difficulty breathing is a good reason to call 911, whether it indicates a heart attack or not. But it's good to understand that shortness of breath isn't just associated with lung activity; it could also be a sign that your heart is calling for help.
Experiencing "shortness of breath" can mean several things in terms of how it feels -- it could mean you find yourself struggling to breathe. It could mean you suddenly feel the need to take deep, long breaths -- and maybe (but not always) you have trouble doing so. It could also mean your breathing speeds up and/or your breaths are shallow.
As with the other symptoms on this list, it's especially important that you call for help without wasting time if you experience breathing irregularities and also have another symptom of heart attack, like pain in your back or arms.
That other symptom might also be a racing heart, which is next up on the list of heart attack warning signs.
When your pulse speeds up, it's an obvious indicator that your heart is working overtime. Your pulse reflects your heart's pumping speed: Each beat of your heart pushes blood through your body, and you can feel the pressure of each push in places like your wrist or your neck.
When your pulse rate increases, it means your heart is pumping faster. It can also mean it's having trouble pumping and is working harder and faster to get enough blood to your body parts. This can mean you're having a heart attack.
The trouble is, an increased heart rate, even in combination with shortness of breath, could also indicate other things -- especially if you're exercising. A good way to tell if your heartbeat is speedy because you're running or because you're having a heart attack is to sit down and see if it slows down. If it doesn't, and you smoke or have high blood pressure or high cholesterol, and especially if you also have pain in your left shoulder or arms, get to a phone and worry about sorting it out later.
To complicate matters further, a racing heart and shortness of breath can also be a sign of an anxiety attack, and a feeling of anxiety is also an indicator of a heart attack.
Like most other symptoms on this list, it's seldom cut-and-dried when you feel causeless anxiety -- it's sometimes a sign your heart is in trouble. It can also mean you have an anxiety disorder (see How Fear Works) or there's something you're unconsciously very worried about. Or, the fear is entirely warranted because your heart muscle is in the process of dying, and you just don't realize it.
Awareness can help you make the call. Anxiety is a common symptom of lots of ailments, but ask yourself these questions:
- Does your anxiety seem entirely irrational?
- Is this the first time you're experiencing this type of anxiety?
- Does it feel like a sense of impending doom -- like something bad is about to happen, but you don't know what that is?
- Are you also feeling dizzy, nauseous, sweaty or clammy?
- Do you also have one or more of the other symptoms on this list?
If so, you should call 911. It could be a heart attack, and it's best not to wait it out to find out for sure. After all, even if it's an anxiety or panic attack and not a heart attack, you'll probably still need to get medical help, so you might as well get to the hospital.
While it's difficult to know if anxiety, a racing heart or an aching shoulder means your heart is dying, the worse news is that some heart attacks have no symptoms at all. There's something called a silent heart attack, and you'd never know you're having one until it's too late. One study in Massachusetts found that about 25 percent of heart attacks were only discovered later during routine exams, because they gave off no warning signs [source: Health Central]. The best way to prevent permanent damage, then, is to get regular heart screening if you know you're at risk (see How Heart Disease Works). That way, even if you do have a silent heart attack, you'll get help for it the next time you see your cardiologist, not when you keel over.
How are skipping breakfast and atherosclerosis related? Learn about the results of a new study in this HowStuffWorks article.
More Great Links
- ABC News. Heart Attack Symptoms That Women Often Miss. (Jan 20, 2012) http://abcnews.go.com/Health/WomensHealth/heart-attack-symptoms-women-miss/story?id=12823615#.TxpAiZj7VT6
- American Heart Association. Heart Attack Symptoms and Warning Signs. (Jan 10, 2012) http://www.americanheart.org/presenter.jhtml?identifier=4595
- American Heart Association. Stories of Women and Heart Disease. (Jan 20, 2012)
- Centers for Disease Control and Prevention. Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms. (Jan 20, 2012)
- Cleveland Clinic. Heart Attack – Symptoms. (Jan 20, 2012) http://my.clevelandclinic.org/heart/disorders/cad/mi_symptoms.aspx
- Go Ask Alice. Heart Attack Symptoms -- Different for Men and Women? (Jan 10, 2012) http://www.goaskalice.columbia.edu/2010.html
- Health Central. Heart Attack Symptoms and Warning Signs. (Jan 10, 2012) http://www.healthcentral.com/heart-disease/patient-guide-44510-6.html
- Health Central. Jaw Pain Could Be a Sign of Serious Heart condition. (Jan 20, 2012) http://www.healthcentral.com/heart-disease/c/77/34816/heart-condition
- Heart Healthy Women. Heart Disease Signs & Symptoms. (Jan 20, 2012)
- Mayo Clinic. Heart attack symptoms: Know what signals a medical emergency. (Jan 10, 2012) http://www.mayoclinic.com/health/heart-attack-symptoms/HB00054
- MedLinePlus. Dizziness. (Jan 20, 2012)
- National Digestive Diseases Information Clearinghouse. Indigestion. (Jan 20, 2012)
- WebMD. Sweating Prompts Heart Attack Care. (Jan 20, 2012) http://www.webmd.com/heart-disease/news/20051115/sweating-prompts-heart-attack-care