Symptoms of a heart attack can appear a month or more in advance. Chest pain, sleep problems, and unusual fatigue are among the most commonly reported warning signs.

Every year, about 805,000 people in the United States have a heart attack. And for about 605,000 of those people, it’s their first heart attack.

Research suggests that many people develop symptoms in the days or months leading up to their heart attack. These early symptoms are known as prodromal symptoms.

Recognizing the potential warning signs of a heart attack can allow you to seek medical attention quickly and improve your chances of a full recovery.

Read on to learn more about the symptoms that might appear in the month or weeks before a heart attack.

Language matters

You’ll notice that the language used to share stats and other data points in this article is pretty binary, fluctuating between the use of “male” and “female” or “men” and “women.” Although we typically avoid language like this, specificity is key when reporting on research participants and findings.

Unfortunately, the studies and surveys referenced in this article did not include data on, or include, participants who were transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.

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Symptoms of a heart attack can potentially develop months in advance. Unexplained chest pain is the most frequently reported symptom.

In a 2023 study involving 242 people who were treated for a heart attack at one heart center in Pakistan, 41.3% of the participants had prodromal symptoms. The authors noted that these findings are similar to those of other studies, which reported rates of 45–59%.

In this study, the most common prodromal symptoms were:

The researchers also found that people who had a heart attack due to a partial blockage more often reported symptoms in the week before the heart attack. In comparison, those who had a heart attack due to a totally blocked artery more commonly reported symptoms a month or more in advance.

About 70% of heart attacks occur in males, but females are more likely to die within 1 year of experiencing a heart attack.

In a 2023 review of studies, researchers found evidence that females seem to be more likely to have prodromal symptoms than males.

Females also seem to more often develop symptoms that are less typically associated with a heart attack. The researchers report that more than 50% of females experienced sleep problems within 4 weeks of their heart attack, while only 32% of males did.

In a 2022 study, researchers found that chest pain was the most common prodromal symptom in males and females, occurring in 93.9% of males and 94.4% of females.

While chest pain is the most common prodromal symptom in people of both males and females, females often experience additional symptoms, including:

  • sleep problems
  • anxiety
  • fatigue
  • shortness of breath
  • nausea or vomiting
  • back or jaw pain

When to see a doctor

It’s critical to seek medical attention right away if you develop complications such as chest pain or shortness of breath, which can be warning signs of a heart attack. While these symptoms might also be caused by other conditions, seeing a doctor can help you catch an impending heart attack before it causes life-changing symptoms.

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Cardiac arrest and prodromal symptoms

In a 2023 Danish study, researchers found that nearly 1 in 5 people called the emergency medical helpline of the Capital Region in the month before they experienced cardiac arrest.

Cardiac arrest is a sudden loss of heart activity due to an irregular heart rhythm. People often incorrectly refer to this as a heart attack.

A heart attack happens when blood flow to your heart is blocked or cut off. When your heart isn’t getting the oxygen-rich blood it needs, you might have a higher risk of heart failure and other serious complications.

About half of people in the Danish study called in the week before they experienced cardiac arrest. Trouble breathing was the symptom most reported to the helpline.

According to the American Heart Association (AHA), some heart attacks occur suddenly and intensely, while others start slowly with mild symptoms.

The AHA recommends calling 911 if you experience:

  • discomfort (pressure, squeezing, fullness, or pain) in the center of your chest that lasts more than a few minutes or goes away and returns
  • discomfort in other areas, such as:
    • one or both arms
    • your back or stomach
    • your neck
    • your jaw
  • shortness of breath, with or without chest pain
  • other symptoms, such as:

What to do if you or someone you know appears to be having a heart attack

If you think you’re having a heart attack, it’s important to immediately call 911. If you’re with somebody else who may be having a heart attack, here’s how you can help them:

  1. Call 911 immediately and ask for an ambulance.
  2. If they are not allergic to aspirin and it’s available, have them chew and swallow one 325-milligram tablet of regular-strength aspirin or two 81-milligram tablets of baby aspirin.
  3. Stay with them until the ambulance arrives.
  4. Tell the paramedics that the person has taken aspirin (if you gave it to them).
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Many people develop symptoms days to months before experiencing a heart attack. Chest pain is one of the most common symptoms. Sleep problems, chest heaviness, and heart palpitations are also commonly reported.

It’s critical to seek immediate medical attention if you think you or somebody you’re with is having a heart attack. Seeking medical attention right away gives you the best chance of treating your heart attack without serious complications.