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Symptoms
By Mayo Clinic staffCommon heart attack symptoms include:
- Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back)
- A feeling of fullness, nausea, indigestion, heartburn or abdominal pain
- Shortness of breath
- Sweating or a cold sweat
- Feelings of anxiety or an impending sense of doom
- Fatigue
- Trouble sleeping
- Lightheadedness or dizziness
Heart attack symptoms vary
Not all people who have heart attacks experience the same symptoms or experience them to the same degree. Many heart attacks aren't as dramatic as the ones you've seen on TV. Some people have no symptoms at all, while for others, the first sign may be sudden cardiac arrest. Still, the more signs and symptoms you have, the greater the likelihood that you may be having a heart attack. The severity of heart attack symptoms can vary too. Some people have mild pain, while others experience severe pain.
A heart attack can occur anytime — at work or play, while you're resting, or while you're in motion. Some heart attacks strike suddenly, but many people who experience a heart attack have warning signs and symptoms hours, days or weeks in advance. The earliest warning of a heart attack may be recurrent chest pain (angina) that's triggered by exertion and relieved by rest. Angina is caused by a temporary decrease in blood flow to the heart.
Many people confuse a heart attack with a condition in which your heart suddenly stops (sudden cardiac arrest). Sudden cardiac arrest occurs when an electrical disturbance in your heart disrupts its pumping action and causes blood to stop flowing to the rest of your body. A heart attack can cause cardiac arrest, but it's not the only cause of cardiac arrest.
When to see a doctor
During a heart attack, act immediately. Some people wait too long because they don't recognize the important signs and symptoms. Take these steps:
- Call for emergency medical help. If you suspect you're having a heart attack, don't hesitate. Immediately call 911 or your local emergency number. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options. Driving yourself puts you and others at risk if your condition suddenly worsens.
- Take nitroglycerin, if prescribed. If your doctor has prescribed nitroglycerin, take it as instructed while awaiting the arrival of emergency medical personnel.
- Take aspirin, if recommended. If you're concerned about your heart attack risk, ask your doctor if chewing a 162- or 325-milligram (mg) aspirin tablet if you have heart attack symptoms is a good idea. Taking aspirin during a heart attack could reduce the damage to your heart by making your blood less likely to clot. Aspirin can interact with other medications, however, so don't take an aspirin unless your doctor or emergency medical personnel recommend it. Don't delay calling 911 to take an aspirin, though. Call for emergency help first.
What to do if you see someone having a heart attack
If you encounter someone who is unconscious from a presumed heart attack, call for emergency medical help. If you have received training in emergency procedures, begin cardiopulmonary resuscitation (CPR). This helps deliver oxygen to the body and brain.
According to guidelines by the American Heart Association, regardless of whether you've been trained, you should begin CPR with chest compressions. Press down about 2 inches (5 centimeters) on the person's chest for each compression at a rate of about 100 a minute. If you've been trained in CPR, check the person's airway and deliver rescue breaths after every 30 compressions. If you haven't been trained, continue doing only compressions until help arrives.
Sudden cardiac arrest during a heart attack is commonly caused by a deadly heart rhythm in which the heart quivers uselessly (ventricular fibrillation). Without immediate treatment, ventricular fibrillation leads to death. The timely use of an automated external defibrillator (AED), which shocks the heart back into a normal rhythm, can provide emergency treatment before a person having a heart attack reaches the hospital. But, if you're alone, it's important to continue chest compressions. If there's a second person present, that person can look for a nearby AED.
- Heart attack. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/printall-index.html. Accessed March 21, 2013.
- Crawford MH, ed. Current Diagnosis & Treatment: Cardiology. 3rd ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=8. Accessed March 22, 2013.
- Field JM, et al. Part 1: Executive summary - 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl):S640.
- Understand your risk of heart attack. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HeartAttack/UnderstandYourRiskofHeartAttack/Understand-Your-Risk-of-Heart-Attack_UCM_002040_Article.jsp. Accessed March 23, 2013.
- O'Gara PT, et al. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127:529.
- Reeder GS, et al. Overview of the acute management of ST elevation myocardial infarction. http://www.uptodate.com/home. Accessed March 22, 2013.
- Thygesen K, et al. Third universal definition of myocardial infarction. Circulation. 2012;126:2020.
- Stefanini GG, et al. Drug-eluting coronary-artery stents. New England Journal of Medicine. 2013;368:254.
- Alcoholic beverages and cardiovascular disease. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcoholic-Beverages-and-Cardiovascular-Disease_UCM_305864_Article.jsp. Accessed March 22, 2013.
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