Heart Attack Symptoms
Heart attack symptoms can vary. They may come on suddenly and severely or may progress slowly, beginning with mild pain. Symptoms can also vary between men and women. Women are less likely than men to have classic chest pain, but they are more likely to experience shortness of breath, nausea or vomiting, or jaw and back pain.
Common signs and symptom of heart attack include:
- Chest pain. Chest pain or discomfort (angina) is the main sign of a heart attack. It can feel like pressure, squeezing, fullness, or pain in the center of the chest. Patients with coronary artery disease who have stable angina often experience chest pain that lasts for a few minutes and then goes away. With heart attack, the pain usually lasts for more than a few minutes and the feeling may go away but then come back.
- Discomfort in the upper body. People having a heart attack may feel discomfort in the arms, neck, back, jaw, or stomach.
- Shortness of breath can occur with or without chest pain.
- Nausea and vomiting
- Breaking out in cold sweat
- Lightheadedness or fainting
Symptoms That Are Less Likely to Indicate Heart Attack
The following symptoms are less likely to be due to heart attack:
- Sharp pain brought on by breathing in or when coughing
- Pain that is mainly or only in the middle or lower abdomen
- Pain that can be pinpointed with the tip of one finger
- Pain that can be reproduced by moving or pressing on the chest wall or arms
- Pain that is constant and lasts for hours (although no one should wait hours if they suspect they are having a heart attack)
- Pain that is very brief and lasts for a few seconds
- Pain that spreads to the legs
However, the presence of these symptoms does not always rule out a serious heart event.
Some people with severe coronary artery disease do not have angina pain. This condition is known as silent ischemia. This is a dangerous condition because patients have no warning signs of heart disease. Some studies suggest that people with silent ischemia experience higher complication and mortality rates than those with angina pain.
What to Do When Symptoms Occur
People who have symptoms of a heart attack should take the following actions:
- For angina patients, take one nitroglycerin dose either as an under-the-tongue tablet or in spray form at the onset of symptoms. Take another dose every 5 minutes up to three doses or when the pain is relieved, whichever comes first.
- Call 911 or the local emergency number. This should be the first action taken if angina patients continue to experience chest pain after taking the full three doses of nitroglycerin. However, only 20% of heart attacks occur in patients with previously diagnosed angina. Therefore, anyone who develops heart attack symptoms should contact emergency services.
- The patient should chew and swallow an uncoated adult-strength (325 mg) aspirin and be sure to tell emergency health providers so an additional dose is not given.
- Patients with chest pain should go immediately to the nearest emergency room, preferably traveling by ambulance. They should not drive themselves.
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Review Date: 05/05/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.