What are symptoms of a heart attack?

Knowing the early warning signs of heart attack is critical for prompt
recognition and treatment. Many heart attacks start slowly, unlike the
dramatic portrayal often seen in the movies. A person experiencing a heart
attack may not even be sure of what is happening. Heart attack symptoms
vary among individuals, and even a person who has had a previous heart
attack may have different symptoms in a subsequent heart attack.
Although chest pain or pressure is the most common symptom of a heart
attack, heart attack victims may experience a diversity of symptoms. The
following list describes the symptoms of heart attack in more detail.

12 Heart Attack Symptoms and Early Warning Signs

1. Chest discomfort, manifest as pain, fullness, and/or squeezing

sensation of the chest
Chest pain is the hallmark symptom of a heart attack, although it can take
many different forms. In other cases, chest pain may not occur at all. The
characteristic chest pain of a heart attack has been described as a sense of
pressure, squeezing, fullness, or pain that starts in the center of the chest.
The pain or discomfort typically lasts more than a few minutes, or it may go
away and then return. It can spread down the arms, to the back, or to the
head and neck. Both women and men report chest pain as a primary
symptom of heart attack, but women more often than men are likely to have
some of the other symptoms, such as nausea, jaw pain, or shortness, that
are described below.

2. Jaw pain, toothache, headache

The pain of a heart attack can spread down both arms, to the jaw or head, or
to the back. Some people report tooth pain or headache as a symptom of a
heart attack. It is possible to have these types of pain without chest pain
during a heart attack.

3. Shortness of breath
Feeling short of breath or like you are gasping for air is a common symptom
of a heart attack. Shortness of breath, or difficulty breathing, is medically
known as dyspnea. Shortness of breath may occur before or during the chest
pain of a heart attack, and in some cases, it may be associated with other
heart attack symptoms without any chest pain.

4. Nausea
Nausea or feeling sick on your stomach is a less common but possible
symptom of heart attack. Sometimes belching or burping can accompany the
nausea, and some patients have described a feeling like
indigestion associated with a heart attack. Women are more likely than men
to report these less typical symptoms of heart attack, and some patients
have described feeling as though they are developing the flu.
5. Vomiting
The nausea that accompanies a heart attack can become so severe
that vomiting occurs.

6. General epigastric (upper middle abdomen) discomfort

Sometimes the pain of heart attack is described as stomach pain, or pain in
the middle of the upper abdomen. The pain usually feels more like
discomfort of heaviness rather than sharp, stabbing pain, and the pain tends
to persist more than a few minutes. This can occur with or without pain in the
true chest area.

7. Sweating
Sweating, or perspiration, can accompany a heart attack. Some people have
described feeling like they are breaking out in a cold sweat.

8. Heartburn and/or indigestion

As mentioned above, some people experiencing a heart attack can have
belching and burping and describe a feeling of indigestion. Likewise, the pain
and pressure of a heart attack may occur in the epigastric or upper middle
abdominal area, similar to the pain of heartburn.

9. Arm pain (more commonly the left arm, but may be either arm)
The chest pain of a heart attack can spread, or radiate, down one or both
arms and to the shoulders. This often happens, and the pain may even
extend to the wrist and fingers. This is most common on the left side of the
body but it can also occur on the right side.

10. Upper back pain

The upper back is another common location for spread of the pain from a
heart attack. Most commonly, back pain that stems from a heart attack is
described as occurring between the shoulder blades.

11. General malaise (vague feeling of illness)

A feeling of being generally unwell or like you are coming down with an
illness can accompany a heart attack. This can be described as fatigue or
even lightheadedness, with or without fainting. Some people will experience
severe anxiety or panic during the heart attack. This has been described as
feeling a sense of doom, as one experiences with a panic attack.

12. No symptoms
Approximately one quarter of all heart attacks are silent, without chest pain
or new symptoms and silent heart attacks are especially common among
patients with diabetes mellitus).
Even though the symptoms of a heart attack at times can be vague and mild,
it is important to remember that heart attacks producing no symptoms or
only mild symptoms can be just as serious and life-threatening as heart
attacks that cause severe chest pain. Too often patients attribute heart
attack symptoms to "anxiety," "indigestion," "fatigue," or "stress," and
consequently delay seeking prompt medical attention. One cannot
overemphasize the importance of seeking prompt medical attention in the
presence of symptoms that suggest a heart attack. Early diagnosis and
treatment saves lives, and delays in reaching medical assistance can be
fatal. A delay in treatment can lead to permanently reduced function of the
heart due to more extensive damage to the heart muscle. Death also may
occur as a result of the sudden onset of arrhythmias such as ventricular
fibrillation.