Recognizing the common, uncommon and silent symptoms of a heart attack


Every year, more than 600,000 Americans have their first heart attack. Many of those people have warning signs days or even weeks before the onset of the attack, but those symptoms can vary in intensity and be different for each person.

A heart attack can happen to anyone, not just people at high risk for heart disease. Recognizing the signs before a heart attack begins or as soon as it happens will help you get treatment quickly. Getting the right medication or procedure within the first hour of a heart attack could save your life.

What is a heart attack?

A heart attack , also known as acute myocardial infarction, occurs when the heart muscle isn’t getting enough blood and oxygen. The blood flow to one or more areas of the heart is blocked. The heart is starved for oxygen and begins to fail.

The most common cause of heart attacks is coronary artery disease (CAD). CAD occurs when deposits, cholesterol and other substances cause a buildup of plaque in the arteries (atherosclerosis). When a plaque breaks, a blood clot forms and blood can’t flow through that artery. A heart attack is often the first sign that someone has CAD.

Signs of a heart attack

Sometimes the symptoms of a heart attack are obvious, but most heart attacks are not sudden and intense. They can come on slowly, with mild symptoms, as blood flow to the heart is reduced. About two out of three people who have heart attacks have some symptoms before the attack.

The most common and recognizable symptom of a heart attack is chest pain (also called angina). The pain may feel like pressure, squeezing, burning or tightness in the center of your chest. It may last more than a few minutes, or it may continue to come and go.

There are other, less obvious, symptoms of heart attack that may or may not accompany chest pain. They include:

  • Dizziness or fainting
  • Nausea or vomiting
  • Pain, numbness, pinching or other uncomfortable sensation in your arm, jaw, back or stomach
  • Shortness of breath or difficulty breathing deeply
  • Unexplained sweating or cool, clammy skin
  • Unusual fatigue

Heart attack symptoms in women

According to the American Heart Association, women are more likely to die from heart disease than anything else. Yet, women often assume their symptoms aren’t life-threatening and attribute them to aging, anxiety or acid reflux.

Chest discomfort or pain is the most common indication of heart attack for women. But women are more likely than men to experience some of the other symptoms of heart attack, specifically shortness of breath, nausea/vomiting and back or jaw pain. Sometimes these symptoms happen without chest pain.

Silent heart attacks

About one out of five heart attacks is silent. These heart attacks have few, if any, symptoms. And the symptoms that appear are the less obvious signs of a heart attack. People who have silent heart attacks often recall mild symptoms of indigestion, feelings of a strained chest muscle or flu-like symptoms.

Like any heart attack, silent heart attacks involve a blockage of blood flow and often cause damage to the heart muscle. Having a silent heart attack puts you at greater risk for another heart attack. If you experience any mild symptoms of a heart attack that are out of the ordinary or give you pause, it’s better to be cautious and talk to your doctor. Your doctor will use imaging tests such as an electrocardiogram or echocardiogram to identify damage to your heart.

What to do if you have heart attack symptoms

If you are having symptoms of a heart attack, call 9-1-1 immediately. Do not drive yourself to the hospital, as it may waste precious time and could pose a risk. The sooner you get treatment, the more you can reduce the damage to your heart. The paramedics can test you immediately (using an electrocardiogram) to see what’s happening.

Take the Next Step

To learn more about heart attacks and how to reduce your risk of heart disease, reach out to your primary care provider.