6 Signs You’re Having a Heart Attack

Don’t expect it to look like the movies.

Doctors and nurses rushing to patient on ambulance stretcher.

A heart attack might not cause chest pain.

Recognizing when you or someone else is having a heart attack is critical to getting help, and often to survival. But a person having a heart attack won’t necessarily grab his or her chest and announce it. “The single most important thing to know is that often, a heart attack is not accompanied by severe chest pain,” says Dr. Christopher Granger, cardiology professor at Duke University and director of the Cardiac Care Unit at Duke University Medical Center. Some heart attacks come on fast and strong with chest pain, but many happen with discomfort, sweating or fatigue. Here are signs to watch for:

Next:1. Elephant on the chest

Senior Man Suffering Heart Attack Whilst Jogging

1. Elephant on the chest

Rather than pain, heart attacks often present as pressure on the chest, squeezing, fullness or shortness of breath. “Often, it’s a chest pressure or an uncomfortable feeling,” Granger says. That’s because during a heart attack, also called a myocardial infarction, the blood flow to part of the heart is blocked, often by a blood clot. If symptoms last less than about 10 seconds, it’s unlikely it’s a heart attack. If they last more than five minutes, call 911.

Next:

A heart attack might not cause chest pain.

Recognizing when you or someone else is having a heart attack is critical to getting help, and often to survival. But a person having a heart attack won’t necessarily grab his or her chest and announce it. “The single most important thing to know is that often, a heart attack is not accompanied by severe chest pain,” says Dr. Christopher Granger, cardiology professor at Duke University and director of the Cardiac Care Unit at Duke University Medical Center. Some heart attacks come on fast and strong with chest pain, but many happen with discomfort, sweating or fatigue. Here are signs to watch for:

1. Elephant on the chest

Rather than pain, heart attacks often present as pressure on the chest, squeezing, fullness or shortness of breath. “Often, it’s a chest pressure or an uncomfortable feeling,” Granger says. That’s because during a heart attack, also called a myocardial infarction, the blood flow to part of the heart is blocked, often by a blood clot. If symptoms last less than about 10 seconds, it’s unlikely it’s a heart attack. If they last more than five minutes, call 911.

2. Pain in other areas of the upper body

Other warning signs can include pain or discomfort in one or both arms or the back, neck, jaw or stomach. Some people describe a radiating feeling in the left arm. Others experience pain in the upper abdomen. Heart attack symptoms can also feel like severe indigestion. In that case, doctors recommend you think about whether you have eaten something that may have caused the discomfort. If you can make the pain start and stop with movement, it’s probably not a heart attack. The key is that the pain does not subside, even while someone is at rest.

3. Cold sweat, nausea or lightheadedness

If you feel like you’ve suddenly broken out into a cold sweat and you can’t figure out why, it could be a warning sign of a heart attack. Other signs are extreme nausea, lightheadedness and flu symptoms. “It could be that someone tells you that you don’t look good. People look unwell when they’re having a heart attack,” says Dr. Rory Weiner, a cardiologist at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School. “If your spouse tells you you look pale, you need to pay attention.” It’s often a spouse or a friend who calls 911.

4. Different symptoms for men and women

Women tend to experience heart attacks differently than men. It’s less likely for women than men to have crushing chest pain. Women can experience extreme fatigue, pain in the extremities, vomiting or even toothaches. One thing to know is that blood pressure is not a good measure of whether someone is having a heart attack because it can be low, normal or high during a heart attack.

5. Familiar pain or discomfort

Heart attacks can be tricky to diagnose because they present differently for each person. An important rule is to think about symptoms you’ve had in the past. Many people who have heart attacks have experienced angina, which is chest pain or discomfort that comes and goes. During a heart attack, symptoms are often similar to prior heart-related symptoms, but they don’t ease up after several minutes. For someone who has had a heart attack before, a second heart attack will likely feel familiar. “Different people will have different pain, but each person will often present the same symptoms as they’ve had in the past,” Weiner says.

6. No symptoms at all

Almost half of all heart attacks are silent, meaning they produce such subtle symptoms that people don’t realize they’re having one, according to a recent study in the journal Circulation, a journal of the American Heart Association. “Usually people have some symptoms but they don’t know what it is,” Granger says. “Maybe they felt crummy with indigestion.” People only find out later, when they’re having an electrocardiogram, or EKG, to test the electrical activity in the heart. Silent heart attacks are dangerous because the people who have them do not get the medical attention they need, both in the moment and concerning future preventive care.

And remember: Act fast. Minutes count.

Experts stress that a quick response is critical. Don’t wait and think the symptoms will pass. Doctors say “time is muscle,” meaning the quicker a person can get help, the more of the heart muscle can be saved. After a heart attack, heart surgeons will open up arteries, or reroute arteries to bypass clogged ones. When done quickly, this restores oxygen and blood to the heart before the heart muscle is damaged. “If a person waits hours to call 911, much of the damage is usually already done, and there’s little we can do,” Granger says.

Women: Be educated and vigilant.

Women are more likely to experience non-chest pain symptoms of heart attack than men, according to research published in February 2018 in Circulation. This is important because among patients who sought medical care before hospitalization, women were “less likely to be told their symptoms were heart-related,” researchers wrote. Researchers interviewed more than 2,000 women and nearly 1,000 men between 18 and 55 who were hospitalized for a heart attack. In the study, almost 90 percent of women and men experienced chest pain, tightness or discomfort as heart attack symptoms. Overall, women had a greater number of non-chest symptoms, such as indigestion, nausea and pain or discomfort in the stomach, jaw, arms, neck or between the shoulder blades. A separate study, published in August 2018 in the International Journal of Cardiology, reached similar conclusions. Because women “significantly misinterpreted their symptoms more often,” it’s important that the public and high-risk individuals be aware of symptoms other than chest pain, researchers wrote.

Be aware of these signs of a heart attack.

To review, here are six signs you’re having a heart attack:

  • Elephant on the chest
  • Pain in other areas of the upper body
  • Cold sweat, nausea or lightheadedness
  • Different symptoms for men and women
  • Familiar pain or discomfort
  • No symptoms at all