How to tell if you’re having a heart attack

How can you tell if you or someone you know is having a heart attack? Sometimes the symptoms can be surprisingly subtle.

“They can be very different from person to person, between women and men and even within an individual who has more than one heart attack,” says Dr. David Rizik, director of Interventional Cardiology for Scottsdale Healthcare Hospitals, in Scottsdale, Ariz.

Men and women may experience atypical heart attack symptoms.

In contrast to the “classic” chest-splitting, gasping-for-breath symptoms, many heart attacks begin with symptoms that are so mild they are often mistaken for indigestion or muscle ache.


Men and women may experience any or all of the following symptoms, according to the National Heart, Lung and Blood Institute:


-- Mild to strong discomfort in the center of the chest, which may be prolonged, or come and go.

-- Chest discomfort may feel like pressure, squeezing, fullness or pain.

-- Discomfort may occur in one or both arms, the back, neck, jaw and/or stomach.

-- Shortness of breath, before or with chest discomfort.

-- Cold sweats, nausea and/or lightheadedness.

Gender differences

According to the NHLBI and the Centers for Disease Control and Prevention, women are more likely to experience shortness of breath, nausea, vomiting, back or jaw pain, indigestion, flu-like symptoms and shoulder pain.

In a study published by the American Heart Assn., women rated their most frequent pre-heart attack symptoms as fatigue, sleep disturbances, shortness of breath, indigestion and anxiety. Most of the women first felt these symptoms more than one month before the heart attack.

The majority of the women in this study didn’t experience chest discomfort or pain, and those who did were more likely to describe it as pressure, aching or tightness.

Women are more likely than men to ignore or misinterpret heart attack symptoms, to delay seeking emergency treatment and to die of sudden cardiac arrest.

If it’s a heart attack

“The patient’s symptoms and an EKG (electrocardiogram) are the best way to establish a diagnosis of a heart attack,” Rizik said. “If the EKG is consistent with a heart attack, we immediately start the patient on blood-thinning agents and take them to the cardiac-catheterization lab, where a diagnostic angiogram is performed. If there’s a blocked artery, we perform an angioplasty procedure to open the blockage.”

Rizik says educating the public about the symptoms of a heart attack is of utmost importance: “Getting quick treatment is vital to preventing as much heart damage as possible.”

Did you know?

The average age for a first heart attack is 66 for men and 70 for women. But people in their 20s and 30s also have heart attacks.

Between 70% and 89% of sudden cardiac events occur in men.

An American has a cardiac event about once every 25 seconds, and an American dies of one about once a minute.

Coronary heart disease is the No. 1 killer of women and men in the United States.

Women are more likely than men to have other conditions — such as diabetes, high blood pressure and congestive heart failure — that make it even more vital that they get immediate treatment.

Sources: Centers for Disease Control and Prevention, National Institutes of Health, American Heart Assn.