A heart attack can occur with or without chest pain. You may experience pain in other spots, like the shoulder, and symptoms including sweating and fatigue, among others.
The heart is a muscle that contracts to pump blood throughout the body. A heart attack (often called a myocardial infarction) occurs when the heart muscle doesn’t get enough blood. Blood carries oxygen and nutrients to the heart muscle. When there isn’t enough blood flowing to your heart muscle, the affected part can get damaged or die. This is dangerous and sometimes deadly.
Heart attacks happen suddenly, but they normally result from long-standing heart disease. Typically, a waxy plaque builds up on the walls inside your blood vessels that feed the heart muscle. Sometimes a chunk of the plaque, called a blood clot, breaks off and prevents blood from passing through the vessel to your heart muscle, resulting in a heart attack.
Less commonly, something like stress, physical exertion, or cold weather causes the blood vessel to contract or spasm, which decreases the amount of blood that can get to your heart muscle.
There are many risk factors that contribute to having a heart attack, including:
- high blood pressure
- high cholesterol
- poor diet
- excessive alcohol consumption (on a regular basis: more than one drink per day for women and more than two drinks per day for men)
- physical inactivity
A heart attack is a medical emergency. It’s really important to listen to what your body is telling you if you think you might be having one. It’s better to seek emergency medical treatment and be wrong than to not get help when you’re having a heart attack.
Most people with heart attacks experience some sort of chest pain or discomfort. But it’s important to understand that chest pains don’t occur in every heart attack.
Chest pain is a common sign of a heart attack. People have described this sensation as feeling like an elephant is standing on their chest.
Some people don’t describe chest pain as pain at all. Instead, they may say they felt chest tightness or squeezing. Sometimes this discomfort can seem bad for a few minutes and then go away. Sometimes the discomfort comes back hours or even a day later. These could all be signs your heart muscle isn’t getting enough oxygen.
If you experience chest pains or tightness, you or someone around you should call 911 immediately.
Pain and tightness can also radiate in other areas of the body. Most people associate a heart attack with pain working its way down the left arm. That can happen, but pain can also appear in other locations, including:
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The pain may not be concentrated in the chest at all. It could feel like pressure in the chest and pain in other parts of the body. Upper back pain is another symptom women more commonly cite than men.
Sweating more than usual — especially if you aren’t exercising or being active — could be an early warning sign of heart problems. Pumping blood through clogged arteries takes more effort from your heart, so your body sweats more to try to keep your body temperature down during the extra exertion. If you experience cold sweats or clammy skin, then you should consult your doctor.
Night sweats are also a common symptom for women experiencing heart troubles. Women may mistake this symptom for an effect of menopause. However, if you wake up and your sheets are soaked or you cannot sleep due to your sweating, this could be a sign of a heart attack, especially in women.
A heart attack can cause exhaustion due to the extra stress on your heart to try to pump while an area of blood flow is blocked. If you often feel tired or exhausted for no reason, it could be a sign that something is wrong.
Fatigue and shortness of breath are more common in women than men and may begin months before a heart attack. That’s why it’s important to see a doctor as early as possible when you experience early signs of fatigue.
Your breathing and your heart pumping blood effectively are very closely related. Your heart pumps blood so it can circulate to your tissues as well as get oxygen from your lungs. If your heart can’t pump blood well (as is the case with a heart attack), you can feel short of breath.
Shortness of breath can sometimes be an accompanying symptom to unusual fatigue in women. For example, some women report they would get unusually short of breath and tired for the activity they were performing. Going to the mailbox could leave them exhausted and unable to catch their breath. This can be a common sign of heart attack in women.
Lightheadedness and dizziness can occur with a heart attack and are often symptoms women describe. Some women report they feel like they might pass out if they try to stand up or overexert themselves. This sensation is certainly not a normal feeling and shouldn’t be ignored if you experience it.
Heart palpitations can range from feeling like your heart is skipping a beat to having changes in heart rhythm that can feel like your heart is pounding or throbbing. Your heart and body rely on a consistent, steady beat to best move blood throughout your body. If the beat gets out of rhythm, this could be a sign you’re having a heart attack.
Heart palpitations due to heart attack can create a sense of unease or anxiety, especially in women. Some people may describe heart palpitations as a sensation their heart is pounding in their neck, not just their chest.
Changes in your heart’s rhythm shouldn’t be ignored, because once the heart is consistently out of rhythm, it requires medical intervention to get back into rhythm. If your palpitations are accompanied by dizziness, chest pressure, chest pain, or fainting, they could be confirmation that a heart attack is occurring.
Often people begin experiencing mild indigestion and other gastrointestinal problems before a heart attack. Because heart attacks usually occur in older people who typically have more indigestion problems, these symptoms can get dismissed as heartburn or another food-related complication.
If you normally have an iron stomach, indigestion or heartburn could be a signal that something else is going on.
If you think you are having a heart attack, you or someone nearby should call emergency services immediately. It’s unsafe to drive yourself to the hospital during a heart attack, so call an ambulance. While you may feel awake and alert enough to drive, the chest pain could get so severe that you may have trouble breathing or difficulty thinking clearly.
After you call emergency services
When you call emergency services, the dispatcher may ask you about the medicines you take and your allergies. If you don’t currently take a blood thinner and you aren’t allergic to aspirin, the dispatcher may advise you to chew an aspirin while you’re waiting on medical attention. If you have nitroglycerin tablets, you may also wish to use these as directed by your doctor to reduce chest pain.
If you have a list of medications you currently take or any information about your medical history, you may wish to take this information with you. It can speed your medical care.
At the hospital
When you arrive at the hospital, you can expect the emergency medical personnel to take an electrocardiogram (EKG). This is a pain-free way to measure your heart’s electrical activity.
If you’re having a heart attack, an EKG is performed to look for unusual electrical patterns in your heart. The EKG can help your doctor determine if the heart muscle is damaged and what part of your heart was damaged. A doctor will also likely order a blood draw. If you’re having a heart attack, your body usually releases certain proteins and enzymes as a result of the stress to your heart.
If you’re having a heart attack, your doctor will discuss treatment options with you. Your risk of severe heart damage is lowered if you start treatment within several hours of developing symptoms.
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People who have already had a heart attack should make sure to take all medications prescribed to them by their doctor. If your doctor placed cardiac stents to keep your heart vessels open or you had to have bypass surgery for your heart, taking the medications your doctor prescribed to you are vital to preventing a future heart attack.
Sometimes if you require surgery for another condition, your doctor may recommend stopping some medications you take for your heart. An example might be an antiplatelet (anticlot) medication like clopidogrel (Plavix), prasugrel (Effient), or ticagrelor (Brilinta). Always check with the doctor you see for your heart before you stop taking any of your medications. It’s unsafe to abruptly stop many medications, and stopping abruptly could increase your risk of heart attack.