A heart attack is a medical emergency in which every minute counts. The faster blood flow is restored to the heart muscle, the more of it can be saved. Yet many people wait hours before getting help because their symptoms do not match what they expected. Knowing the warning signs, including the ones that are more common in women, can save a life.
What happens during a heart attack
A heart attack, or myocardial infarction, happens when blood flow to part of the heart muscle is blocked, usually by a blood clot that forms on a fatty plaque inside a coronary artery. Without oxygen-rich blood, that area of muscle begins to die. Emergency treatment aims to reopen the artery as quickly as possible.
A heart attack is different from cardiac arrest, when the heart suddenly stops beating effectively. A heart attack can lead to cardiac arrest, which is why calling for help immediately is so important.
Common warning signs
Symptoms can start suddenly or build up over minutes or hours. They may come and go.
- Chest discomfort: pressure, squeezing, fullness or pain in the center or left side of the chest, lasting more than a few minutes or going away and coming back
- Pain in other areas: one or both arms, the back, neck, jaw or stomach
- Shortness of breath, with or without chest discomfort
- Breaking out in a cold sweat
- Nausea or vomiting
- Lightheadedness or sudden dizziness
- Unusual tiredness
Not everyone has severe chest pain. Some people describe only mild discomfort, heaviness or indigestion-like feelings.
Heart attack symptoms in women
Chest pain or discomfort is still the most common symptom in women. However, women are somewhat more likely than men to also have:
- Shortness of breath
- Nausea or vomiting
- Back, jaw or neck pain
- Extreme fatigue that is new or unusual
- Lightheadedness
Because these symptoms can seem less dramatic, women sometimes delay seeking care or have their symptoms put down to stress, anxiety or a stomach problem. If something feels wrong, treat it as an emergency.
Silent heart attacks
Some heart attacks cause few or no noticeable symptoms and are discovered later on a heart tracing (ECG) or scan. They are more common in people with diabetes, older adults and people who have nerve damage that affects how pain is felt.
What to do if you think someone is having a heart attack
1. Call 911 immediately
Do not wait to see if symptoms go away, and do not drive yourself to the hospital. Emergency medical teams can start treatment on the way and alert the hospital to prepare.
Keep reading
The rest of this guide is free. Watch a short ad to unlock it and support independent health writing.
Preparing your ad…
2. Chew aspirin if advised
The emergency dispatcher may advise chewing a regular-strength aspirin (325 mg) or four low-dose (81 mg) aspirin, unless you are allergic, have been told not to take aspirin, or have a bleeding problem. Follow the dispatcher’s instructions.
3. Rest and stay calm
Sit or lie in a comfortable position and loosen tight clothing. If you have been prescribed nitroglycerin for chest pain, take it as directed.
4. Be ready to start CPR
If the person becomes unresponsive and is not breathing normally, start hands-only CPR: push hard and fast in the center of the chest, about 2 inches deep, at a rate of 100 to 120 compressions a minute. If an automated external defibrillator (AED) is available, use it and follow its voice prompts.
How heart attacks are treated
At the hospital, the team will use an ECG and blood tests for heart muscle damage (such as troponin) to confirm the diagnosis. Treatment may include:
- Opening the artery: coronary angioplasty with a stent (percutaneous coronary intervention) is the main treatment for many heart attacks. In some settings, clot-dissolving medicine is used.
- Medicines: blood thinners, antiplatelet drugs, beta-blockers, statins and others to limit damage and prevent another event.
- Bypass surgery for some people with severe or complex blockages.
- Cardiac rehabilitation afterwards, a supervised program of exercise, education and support that improves recovery.
Risk factors you can change
- High blood pressure
- High LDL cholesterol
- Smoking and vaping
- Diabetes
- Excess weight and physical inactivity
- An unhealthy diet high in saturated fat, salt and sugar
- Heavy alcohol use
- Chronic stress and poor sleep
Risk factors you cannot change include age, male sex, family history of early heart disease and having had a previous heart attack. Women’s risk rises after menopause, and conditions such as preeclampsia and gestational diabetes during pregnancy also raise long-term risk.
How to lower your risk
- Know your numbers: blood pressure, cholesterol and blood sugar.
- Do not smoke, and avoid secondhand smoke.
- Aim for at least 150 minutes of moderate activity each week.
- Eat plenty of vegetables, fruit, whole grains, beans, nuts and fish.
- Keep a healthy weight.
- Take prescribed medicines as directed.
- Ask your clinician whether aspirin is right for you. Daily aspirin is no longer recommended for everyone and should only be used on medical advice.
The American Heart Association has more information on warning signs.
Frequently asked questions
Can a heart attack feel like heartburn?
Yes. Some heart attacks cause a burning or indigestion-like discomfort. If you are unsure, especially if you have risk factors or other symptoms, call 911.
How long do heart attack symptoms last?
Symptoms often last more than a few minutes, but they can also come and go. Any chest discomfort that lasts or returns needs urgent evaluation.
Can young people have heart attacks?
Yes, although it is less common. Smoking, drug use, high cholesterol, diabetes and a strong family history raise the risk at younger ages.
The bottom line
A heart attack does not always look like it does in movies. Chest pressure, shortness of breath, sweating, nausea and pain in the arm, back or jaw are all warning signs. Call 911 right away. Fast action saves heart muscle and lives.
This article is for general information and is not a substitute for advice from a qualified healthcare professional.