How to Recognize a Heart Attack

Medically reviewed by Carmen W. Landrau, MD

Last Updated: January 11, 2024 Approved

A heart attack happens when your heart cannot get enough oxygen because the blood flow is abruptly disrupted. The heart muscle cannot pump properly, and tissue rapidly begins to die. About 735,000 Americans have a heart attack every year.^{[1]
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Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

Go to source} However, only about 27% of people know all the urgent symptoms of a heart attack.^{[2]
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Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

Go to source} Don't let yourself be a statistic. Crushing chest pain and upper body soreness (with or without exertion) are the typical heart attack symptoms, but there are other warning signs you should also heed. Recognizing the signs of a heart attack and getting to the hospital immediately can mean the difference between survival, irreversible tissue damage, and death. If you have any doubt about whether the pain you're experiencing is a heart attack, seek medical help immediately.

Part 1

Part 1 of 5:

Recognizing When to Get Emergency Medical Attention

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1
Pay attention to chest pain. A pain in the chest, whether it's sharp or dull, is the most common sign of a heart attack. People who are having heart attacks often say they feel squeezing, fullness, pressure, tightness, or a sharp sensation in the center or left area of the chest. This feeling may last a few minutes or more, or disappear and return later.^{[3]
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Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

Go to source}
- Chest pain that stems from a heart attack is not always the crushing, heavy feeling that some people describe - often called the "Hollywood" heart attack. It can actually be quite mild, so don't ignore any type of chest pain.
- "Retrosternal" chest pain is commonly felt. This refers to a pain behind the breastbone, or sternum. It is easy to confuse this pain with abdominal discomfort, like gas. If you have any doubt about this pain, call a doctor.
- Keep in mind that chest pain is not always present when a heart attack is occurring; in fact, over half of heart attack patients don't experience chest pain. Don't rule out the possibility of a heart attack just because you aren't hurting in that area.
Sometimes the pain from a heart attack radiates from the chest area outward, causing discomfort in the neck, jaw, abdomen, upper back, and the left arm.^{[4]
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Domino, F. (n.d.). In The 5-minute clinical consult standard 2015 (23rd ed.)} The pain in these areas is usually a dull ache. If you haven't recently worked out or done anything that could cause upper body soreness, this type of pain could be a sign you're having a heart attack.

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Watch for dizziness, lightheadedness, and fainting.^{[5]
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American Heart Association
Leading nonprofit that funds medical research and public education

Go to source} These are also extremely common signs of a heart attack, though they are not present in every person who is having one.
- Like other heart attack symptoms, dizziness, lightheadedness and fainting are also signs of other illnesses, so they are easily overlooked. Don't ignore these symptoms, especially if you are also feeling chest pain.
- Women tend to have these symptoms more frequently than men, though not all women experience them.
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Monitor your breathing. Shortness of breath is a subtle heart attack symptom that should not be taken lightly. It is distinct from shortness of breath related to other illnesses because it seems to come out of nowhere. People who have experienced shortness of breath related to a heart attack describe feeling as though they have been exercising heavily even though all they've been doing is sitting and relaxing.
- Shortness of breath may be your only heart attack symptom. Do not take it lightly! Particularly if you have not done anything that typically causes shortness of breath, seek emergency medical help if you experience this symptom.
The nausea may also lead to breaking out in a cold sweat, and even vomiting. If you experience these symptoms, especially in conjunction with other symptoms, you may be having a heart attack.^{[6]
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Many heart attack patients get extremely anxious and feel what is referred to as a "sense of impending doom." This feeling is not to be taken lightly; immediately seek medical attention if you experience this extreme emotion.
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Call emergency services immediately if you suspect that you or someone you know is having a heart attack. The sooner medical treatment is received, the greater the chance of surviving the attack. Don't risk talking yourself out of it or waiting too long.
- One study showed that more than average person with symptoms of a heart attack wait to seek help for more than 3 hours.^{[7]
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  MedlinePlus
  Collection of medical information sourced from the US National Library of Medicine
  
  Go to source} Almost half of deaths caused by heart attack occur outside a hospital.^{[8]
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  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  
  Go to source} Don't neglect any symptom, no matter how mild a nuisance it might seem. Get emergency help fast.

Part 2

Part 2 of 5:

Recognizing Other Early Warning Signs

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1
Seek medical attention for angina. Angina is chest pain that can feel like a slight pressure, a burning, or a fullness. It is often mistaken for heartburn. Angina can be a sign of coronary heart disease, which is the most common cause of heart attacks. If you feel any type of pain in your chest, it's best to get it checked out right away.^{[9]
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National Heart, Lung, and Blood Institute
Research and education center within the National Institutes of Health

Go to source}
- Most angina pain occurs in the chest. However, it may also occur in the arms, shoulders, neck, jaw, throat, or back. It may be hard to tell exactly where you're feeling the pain.^{[10]
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  FamilyDoctor.org
  Family-focused medical advice site run by the American Academy of Family Doctors
  
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- Angina pain usually gets better once you've rested for a few minutes. If your chest pain lasts for more than a few minutes or doesn't improve with rest or angina medication, seek emergency medical assistance.^{[11]
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  National Heart, Lung, and Blood Institute
  Research and education center within the National Institutes of Health
  
  Go to source}
- Some people experience angina after exercising, and it's not always a sign of disease or a heart attack. A change in normal patterns is the most important thing to watch for.
- If you have what you believe to be painful indigestion, you may actually be experiencing angina. Make an appointment with your doctor to determine the cause of the pain.
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Determine whether you have an arrhythmia. Arrhythmias are abnormal heart rhythms, and they're present in at least 90% of people who have heart attacks. If you have a fluttering feeling in your chest or feel like your heart “skipped a beat,” you may have an arrhythmia.^{[12]
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Research source} See a specialist who can conduct testing to determine the cause of your symptoms.
- Arrhythmia may also display more serious symptoms, such as dizziness, lightheadedness, fainting, rapid or pounding heartbeat, shortness of breath, and chest pain. If you experience any of these symptoms with arrhythmia, seek emergency medical assistance.^{[13]
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  American Heart Association
  Leading nonprofit that funds medical research and public education
  
  Go to source}
- Although arrhythmia is very common, especially in older adults, it can be a sign of severe medical issues. Do not simply ignore an arrhythmia. Consult with your physician to be sure you do not have a more serious condition.^{[14]
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  American Heart Association
  Leading nonprofit that funds medical research and public education
  
  Go to source}
In older people, these symptoms may actually be a sign of heart problems. Seek medical attention if you experience unexplainable cognitive difficulties.
Women are more likely than men to experience unusual, sudden, or unexplained fatigue as a symptom of heart attack.^{[15]
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American Heart Association
Leading nonprofit that funds medical research and public education

Go to source} This fatigue may start a few days in advance of an actual heart attack.^{[16]
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Mayo Clinic
Educational website from one of the world's leading hospitals

Go to source} If you experience abrupt, unusual fatigue without having changed your daily activities, talk with your doctor immediately.

Part 3

Part 3 of 5:

Taking Action While Waiting for Emergency Assistance

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1
Contact emergency services immediately. Your emergency medical services may tell you how to help the person experiencing symptoms. Do exactly what the operator instructs. Call for help before doing anything else.^{[17]
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National Heart, Lung, and Blood Institute
Research and education center within the National Institutes of Health

Go to source}
- Calling 911 (or your emergency services number) will speed up your admittance into the hospital vs. driving to the emergency room yourself. Call an ambulance. Do not drive to the hospital yourself unless you have no other option available. ^{[18]
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- Treatment for heart attacks is most effective if started within 1 hour of the first appearance of symptoms.
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Stop all activity. Sit down and rest. Try to keep calm by breathing evenly as best as you can.^{[19]
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- Loosen any tight clothing, such as shirt collars and belts.
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Take any medication you have been prescribed for a heart condition. If you take prescription medication such as nitroglycerin, take your recommended dose while you wait for emergency services to arrive.^{[20]
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- Do not take prescription medication that has not been specifically prescribed for your use by a physician. Taking someone else's medication could harm you.^{[21]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source}
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Take aspirin. Chewing and swallowing an aspirin can help break up the blood clot or blockage contributing to the heart attack.^{[22]
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- Do not take aspirin if you're allergic or have been told by your doctor not to take aspirin.^{[23]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source}
Even if your symptoms improve within five minutes, see your doctor. A heart attack can leave clots in your bloodstream that can cause more health problems, such as a future heart attack or stroke. You need to be evaluated by a medical professional.

Part 4

Part 4 of 5:

Understanding Other Causes of Symptoms

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1
Recognize dyspepsia symptoms. Dyspepsia is also known as “indigestion” or “upset stomach.” It is usually a chronic or recurrent pain that occurs in your upper abdominal area.^{[24]
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Research source} Dyspepsia can cause mild chest pain or pressure. One or more of the following symptoms will likely coincide with this pain:^{[25]
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- Heartburn
- Feeling bloated or full
- Burping
- Acid reflux
- Stomach pain or “upset stomach”
- Loss of appetite
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Recognize GERD (gastroesophageal reflux disease) symptoms. GERD happens when your esophagus muscles do not close properly, allowing your stomach contents to leak back into your esophagus. This can cause heartburn and a feeling as though food is “stuck” in your chest. You may experience nausea, especially after eating.^{[26]
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- The symptoms of GERD usually occur after eating. They get worse if you lie down or bend over, or they may worsen at night.
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Recognize asthma symptoms. Asthma can cause feelings of chest pain, pressure, or tightness. These symptoms usually co-occur with coughing and wheezing.^{[27]
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- Mild asthma attacks usually lessen after a few minutes. If you still have difficulty breathing after a few minutes, seek medical assistance.
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Recognize a panic attack. People experiencing a feeling of intense anxiety may suffer a panic attack. The symptoms of a panic attack may initially seem similar to those of a heart attack. You may experience a racing heartbeat, sweating, feeling weak or faint, chest pain, or trouble breathing.^{[28]
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Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source}
- The symptoms of a panic attack occur very rapidly and usually disappear rapidly as well. If your symptoms do not improve within 10 minutes, seek medical assistance.^{[29]
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  Agabegi, S. (2013). Diseases of the Cardiovascular System. In Step-up to medicine (3rd ed., p. 8). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.}

Part 5

Part 5 of 5:

Knowing Your Risk

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1
Consider your age. Your risk of heart attack increases as you age. Men who are 45 or older, and women who are 55 or older, are more likely to have a heart attack than younger people.^{[30]
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Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source}
- People who are older may have different symptoms of heart attack than younger adults. Symptoms to watch for in older individuals include fainting, trouble breathing, nausea, and weakness.
- Dementia symptoms, such as incomplete memory, erratic or unusual behavior, and impaired reasoning, may be signs of a “silent” heart attack in elderly people.^{[31]
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  Domino, F. (n.d.). In The 5-minute clinical consult standard 2015 (23rd ed.)}
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Consider your weight. Being overweight or obese puts you at a higher risk of experiencing a heart attack.^{[32]
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Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source}
- A sedentary lifestyle also increases your risk.^{[33]
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  Mayo Clinic
  Educational website from one of the world's leading hospitals
  
  Go to source}
- A diet high in saturated fats increases your risk of coronary artery disease, which may lead to having a heart attack.
Smoking and exposure to secondhand smoke increase your risk of having a heart attack.^{[34]
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National Heart, Lung, and Blood Institute
Research and education center within the National Institutes of Health

Go to source}
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Think about other chronic health issues. Your risk of heart attack is greater if you have any of the following medical conditions:^{[35]
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Cleveland Clinic
Educational website from one of the world's leading hospitals

Go to source}
- High blood pressure
- High blood cholesterol
- Family or personal history of heart attack or stroke
- Diabetes
  - People with diabetes may experience less dramatic heart attack symptoms. Seek medical attention immediately for any suspected symptoms.^{[36]
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    Domino, F. (n.d.). In The 5-minute clinical consult standard 2015 (23rd ed.)}

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Do not allow embarrassment or worry that you aren't “really” having a heart attack to keep you from seeking medical help. Delaying seeking medical assistance could kill you.

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Do not take any heart attack symptoms lightly. If you do not feel better after a few (5-10) minutes of sitting and resting, seek immediate medical assistance.

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Warnings

You are at higher risk for a second heart attack if you have had one before.

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Do not use a defibrillator (AED) unless you are specifically trained.

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In silent ischemia, a heart attack may occur with no prior symptoms or warning signs.

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