Signs and Symptoms of a Heart Attack

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The symptoms of an acute heart attack, also called a myocardial infarction (MI), can range from telltale chest pain to less obvious indications such as sweating, nausea, fatigue, and/or a sense of impending doom. Heart attacks also can occur without causing any symptoms at all, and these are only diagnosed after the fact—what's often referred to as a silent heart attack.

What's more, women tend to experience heart attacks differently than men do. Because symptoms can vary dramatically from person to person, it's important to listen to your body and not ignore any symptoms that are unusual or scary for you. This is especially important for anyone who has or is at risk for coronary artery disease (CAD).

Classic Symptoms

There's no such thing as a typical heart attack but there are a handful of symptoms that most people experience.

  • Chest pain (angina): The majority of both men and women describe chest pain during a heart attack, although the terminology that they use varies and might include a sense of fullness, tightness, or burning. Others liken the pain to the sensation of a knot or weight in the chest. Often, it's focused on the center or left side of the chest. Men are more likely than women to describe chest and left arm pain during a heart attack. Whatever the nature or location of heart attack pain, it may begin gradually and come and go, come on suddenly, or simply feel like a dull, steady ache. Any change in the pattern of pain is important to note, particularly when it takes less and less activity to bring it on.
  • Shortness of breath: During a heart attack, a feeling of pressure in the chest can make it hard to breathe.
  • Pain, stiffness, or numbness in the upper body: This could be centered in one or both arms, the back, shoulders, neck, jaw, or upper abdomen.
  • A cold sweat: Profuse perspiration is a common response to stress and a facet of the fight-or-flight response that tells the brain the body is being threatened in some way.
  • Nausea and/or vomiting
  • Light-headedness, dizziness, or fainting (syncope): As a heart attack progresses and a portion of the heart becomes damaged, blood pressure drops. This can slow blood flow to the brain, which in turn can result in dizziness or loss of consciousness.

Other Symptoms

Besides the classic ones, there are other symptoms associated with MI that are less common or may seem unrelated to a heart problem:

  • Fatigue: A decrease in blood flow to the heart can deplete the body of energy and cause extreme tiredness that can set in days or weeks before a heart attack occurs and be an important warning sign.
  • Heartbeat changes: This could be a pounding heart, or an irregular or rapid heart rate.
  • Stomach discomfort: Some people report feeling as if they have heartburn or indigestion.
  • A blue tint to the lips, hands, or feet: This is an indication that blood is not reaching those areas.

Differences in Women

Women tend to experience, and respond to, heart attacks differently than men do. They're more likely to ignore or downplay what they're feeling (and therefore delay seeking medical treatment) because their symptoms so often are different from or more subtle than the classic ones, according to the Cleveland Clinic. Women are more likely to blame stress or anxiety for their symptoms. However, in one study, more women than men reported seeking medical care for their symptoms prior to hospitalization (29.5%) compared to men (22.1%). Yet 53% of women stated that the provider did not think their symptoms were related to a heart problem, compared to only 37% of men who stated that the medical provider seemed to rule out a cardiac issue.

In one study, women reported initially believing that their heart attack symptoms were due to sleep problems, arthritis, influenza, osteoporosis, and tooth infection, among other unrelated maladies.

Women are more likely to experience shortness of breath, nausea or vomiting, and pain in the jaw, neck, arms, or between the shoulder blades during a heart attack. Among the heart attack symptoms women report are:

  • "Non-classic" chest discomfort: Although some women do have crushing chest pain during a heart attack, many experience different or less severe chest symptoms, such as the sensation of pressure or tightness. According to the Mayo Clinic, this may be because women tend to have blockages in the smaller arteries that supply blood to the heart as well as the main arteries—what's known as small vessel heart disease or coronary microvascular disease.
  • Pain in both arms: Men usually feel pain only in the left arm.
  • Sleep problems: Women are more likely to experience symptoms of a heart attack while resting or sleeping, including chest pain severe enough to cause them to awaken in the night.
  • Excessive fatigue brought on by seemingly mundane activities: Simply walking from one room to another can be exhausting.
  • Anxiety or a feeling of impending doom

In addition, women tend to have worse outcomes with heart attacks than men, according to a 2016 statement by the American Heart Association. For example, those who survive a heart attack and wind up in the hospital are more likely to have shock, bleeding, or heart failure, likely due to delays in seeking treatment.

Complications

The short-term and long-term consequences of a heart attack are determined by how much of the heart muscle is damaged. For that reason, once an artery that supplies blood to the heart becomes blocked, it's critical to unblock it as quickly as possible to restore blood flow. A matter of minutes can make the difference between a full recovery, permanent disability, or death.

  • Increased risk of another heart attack: Once destroyed, the portion of the heart that's damaged will form scar tissue. This tissue cannot contract as healthy tissue does, which can prevent the heart from pumping normally and increase the possibility of another heart attack.
  • Challenges with everyday activities: Damaged tissue also makes it difficult for someone to exert themselves as they otherwise might have been able to, which can interfere with even simple tasks like climbing the stairs.
  • Death: According to a 2018 report by the American Heart Association, around 14% of people who have a heart attack will die as a result.

When to Go to the Hospital

It cannot be stressed enough that any type of chest pain or discomfort with or without other possible symptoms of a heart attack should be treated as a medical emergency. The same goes for milder symptoms that don't seem to have another cause or that seem odd or bring on a feeling of panic or anxiety.

Always listen to your intuition about any symptoms you may be feeling and head straight to the emergency department of the closest hospital, or call 911.

Anyone who has one or more risk factors for CAD needs to pay close attention to any sudden, unusual or unexplained symptoms involving the upper half of the body.

A Word From Verywell

Most hospitals are geared up to deliver treatment rapidly once a heart attack diagnosis is clear. Most of the delay in beginning treatment is, in fact, in the hands of the person experiencing the event. Take quick action if you recognize possible symptoms of a heart attack and describe them as such to medical staff. Doctors, nurses, and EMTs will not judge you if it turns out there is another explanation for how you're feeling. And if you happen to be right, you will receive the treatment you need to stop the event and preserve as much heart tissue as possible.

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Article Sources

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  2. Jackson MN, Mcculloch BJ. 'Heart attack' symptoms and decision-making: the case of older rural women. Rural Remote Health. 2014;14:2560.

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