Heart Attack Signs and Symptoms

Helpful Highlights

• Typical signs and symptoms of a heart attack are those that are common and with which most adults are familiar.

• Atypical signs and symptoms of a heart attack are those that are unusual and may get dismissed as something else. They occur frequently in women, persons with diabetes, and the old-old.

• Never ignore signs and symptoms, and if you suspect a heart attack, always call 9-1-1 for emergency services transport to the hospital.

In an emergency

If your loved one experiences symptoms of a heart attack, call 9-1-1 for emergency services (EMS) transport to the hospital. Do not wait and do not drive them to the hospital yourself. An ambulance ride could be the difference between life and death.

Steps you can take before EMS arrival

Call 9-1-1 for EMS help and ambulance transport to the hospital.

• Only if 9-1-1/EMS is not available in your area, then drive your loved one to the hospital right away.

  • Please do not speed or ignore lights and signs. This will not help your situation, as it only puts you and others at risk, including your loved one. Choose the quickest route to the hospital and take it, obeying all traffic rules.

  • If you are speeding or running lights and stop signs and see law enforcement lights in your rearview - PULL OVER. Immediately explain to the officer that you believe your loved one to be having a heart attack and listen for instructions from the officer.

If your loved one is already prescribed nitroglycerin, you may give them nitroglycerin as prescribed while awaiting emergency services.

• Nitroglycerin is administered specifically and sparingly! Pay close attention to dosing and instructions.

• Never get nitroglycerin from someone else and administer it to your loved one.

What to do in the event of a heart attack

If your loved one is unconscious and you think they may be having a heart attack, first call 9-1-1 or your local emergency number and put them on speaker so you can talk and work. Then check if your loved one is breathing and has a pulse, as the emergency operator will ask. If the person isn't breathing or you don't find a pulse, only then should you begin CPR.

• If you're untrained in CPR, only do hands-on CPR (compressions but no rescue breathing). That means pushing hard and fast on the chest at a rate of at least 100 compressions per minute. The emergency operator may help guide you on hand placement and rate.

• If you're trained in CPR, follow the guidelines as you were instructed.

Acute vs. chronic signs and symptoms

A heart attack occurs when one or more arteries that send blood and oxygen to the heart are blocked. Fatty, cholesterol-containing deposits build up over time, forming plaques in these coronary arteries. If a plaque ruptures, a blood clot can form and block arteries, causing a heart attack.

Symptoms may appear hours (acute), days (chronic), or even weeks (chronic) before a heart attack, though sometimes the symptoms only occur immediately with it (acute). This list represents both. About two-thirds of people experience one or more of the following:

• Unstable angina (chest pain that does not follow a pattern, happens while at rest, and does not respond to medications)

• Radiating chest pain (usually to the left neck and jaw, and/or left arm)

• Heaviness, pressure, or squeezing in the chest

• Sudden dizziness, lightheadedness, or anxiousness

• Heart palpitations 

• Cold sweats, and possibly skin color changes

• Shortness of breath

• Significant fatigue

• Trouble sleeping or getting comfortable

• Possibly nausea and vomiting

• Possibly feelings of unease or impending doom

Another one-third of people, predominantly women, persons with diabetes, and the old-old, experience unusual symptoms:

• Back pain

• Stomach pain

• Right-sided pain (like the right shoulder)

• Feeling like something is stuck in their throat

• Nausea and vomiting

• Sudden anxiety or onset of feelings of unease or impending doom

As you can see, symptoms of a heart attack vary. Some people have mild symptoms. Others have severe symptoms. Some people have no symptoms.

It’s important to note that not all people who have heart attacks experience the same symptoms or the same severity of symptoms.

Chest pain is the most commonly reported symptom among both women and men, however.