Ask about the symptoms of a heart attack, and most people will think of chest pain. Over the last couple decades, however, scientists have learned that heart attack symptoms aren't so clear cut, and actually show up in several different ways, depending on a number of factors: whether you're a man or a woman, what type of heart disease you have, and how old you are.
It's important to dig a little deeper to understand the variety of symptoms that may indicate a heart attack, so you can be sure to get the right help for yourself or your loved ones.
Early Symptoms of a Heart Attack
The sooner you can get help for a heart attack, the better your chances for a complete recovery. Unfortunately, many people hesitate to get help even if they suspect that there may be something wrong. They worry they may be mistaken, and they don't want to go through emergency care only to find out the problem was a little heartburn or muscle soreness. They may also fear humiliation or embarrassment if it turns out they weren't really suffering a heart attack.
Doctors, however, overwhelmingly encourage people to get help if they suspect early heart attack symptoms. Even if you're wrong, going through a few tests is so much better than suffering long-term heart damage or other health issues because you waited too long. Heart attack symptoms vary from person to person, and even from one heart attack to another, so the important thing is to trust yourself. You know your body better than anyone—if something feels "off" or wrong, don't hesitate. Get to the emergency room right away.
Keep in mind as well that according to the Society of Chest Pain Centers, early heart attack symptoms occur in 50 percent of all heart attack patients, and if people are aware of the symptoms, they can actually prevent the heart attack itself. For those heart attacks that start more slowly, early symptoms may include the following:
- mild pain or discomfort in the chest that may come and go—also called "stuttering" chest pain
- pain in the shoulders, neck, and jaw
- nausea and vomiting, sweating
- lightheadedness, fainting
- a feeling of "impending doom"
- severe anxiety or confusion
Symptoms of a Heart Attack in Men
According to the American Heart Association, a man's risk of heart attack increases significantly after the age of 45. A family history of heart disease plus other risk factors like high blood pressure, high blood cholesterol, cigarette smoking, and overweight can increase that risk even more.
Fortunately for men, much research has been done on how the heart reacts during a man's heart attack, and what symptoms are common. These include:
- standard chest pain that feels like "an elephant" is sitting on your chest; the squeezing sensation may come and go, or may be constant and intense
- rapid or irregular heartbeat
- shortness of breath—you feel like you can't get enough air, even when you're resting
- dizziness, or feeling like you're going to pass out
- breaking out in a cold sweat
- stomach discomfort that feels like indigestion
Remember, however, that each heart attack is different, so your symptoms may not fit the cookie-cutter description.
Symptoms of a Heart Attack in Women
Only in recent decades have scientists realized that heart attack symptoms in women can be quite different than those in men. They didn't realize this earlier simply because they weren't conducting studies on women, believing whatever they found in men would be the same for women. When they started studying women more closely, however, they realized this was not the case.
In a multi-center study of 515 women published in the journal Circulation who had a heart attack, the most frequently reported symptoms did not include chest pain. Instead, women reported unusual fatigue, sleep disturbances, and anxiety, with nearly 80 percent reporting at least one symptom for more than a month before the heart attack. Other symptoms more common in women include:
- unusual fatigue for several days; or a sudden, severe fatigue
- anxiety and sleep disturbances
- lightheadedness and/or shortness of breath
- indigestion or gas-like pain
- upper back or shoulder pain; possibly throat pain
- jaw pain or pain that spreads up to the jaw
- pressure or pain in the center of the chest, that may spread to the arm
According to a 2009 American Heart Association survey, only half of women said they would call 911 if they thought they might be having a heart attack. Even if you're not sure, get to the emergency room right away. Base your decision on what is normal and not normal for you. If you haven't experienced symptoms like this before, don't hesitate to get help. If you don't agree with the doctor's conclusion, get a second opinion.
Symptoms of a Heart Attack in Women Over 50
Women go through a significant physical change around the age of 50—menopause. During this period, levels of the hormone estrogen drop. Estrogen is believed to be protective for the health of the heart, and researchers know for sure that after menopause women experience an increased risk of heart attack. Unfortunately, research shows that women who experience one are less likely to survive than men, and scientists don’t yet know why. Therefore, it becomes even more important for postmenopausal women to be conscious of their heart health.
The symptoms of a heart attack in women over the age of 50 are the same as those listed for women above, and may also include some of those listed for men—severe chest pain, sweating, and a rapid or irregular heartbeat. Being aware of these symptoms, as well as getting regular checkups with your doctor, can help safeguard your health.
Silent Heart Attack Symptoms
A silent heart attack is like any other heart attack, except that it occurs without the usual heart attack symptoms. In other words, the patient is often unaware that they have experienced a heart attack. A blood clot has likely reduced the supply of oxygen to a certain part of the heart, and some heart tissues may have died as a result, but for some reason, there were no serious symptoms—sometimes because nerves in the heart were also damaged. This type of heart attack is more common among people with diabetes and in those who have had previous heart attacks, and may be diagnosed during a doctor's routine exam.
According to a 2009 study out of Duke University Medical Center, it's estimated that as many as 200,000 Americans have heart attacks without even knowing it every year. Unfortunately, these events damage the heart and increase the risk of future attacks. Symptoms that are mild but that may indicate a silent heart attack include:
- mild discomfort in your chest, arms, or jaw that go away after resting
- shortness of breath and tiring easily
- sleep disturbances and increased fatigue
- abdominal pain and/or heartburn
- skin clamminess
After the silent heart attack has occurred, patients may also experience more fatigue than before, or find that exercise is more difficult. To stay on top of your heart health, get regular physical exams, and if you have cardiac risk factors, talk to your doctor about tests to check up on the condition of the heart itself.