7 Early Warning Signs of a Heart Attack


It may seem as if a heart attack comes out of the blue, but there are numerous symptoms that can sound the alert -- if you know what to watch for. According to a recent Harvard study, only 25 percent of heart attack victims had no prior symptoms. The trouble is, these danger signs aren't necessarily the symptoms you've been warned about. Here are seven early warning signs that could save a life -- yours or that of someone you love. Although these symptoms are often caused by problems other than an impending heart attack, if you notice them occuring, be sure to promptly contact a medical provider.

1. Rapid, pounding, or irregular heartbeat

Sudden, unexplained episodes of rapid, irregular heartbeat and pulse can predate a heart attack by weeks or months. Skipped beats or arrhythmias that aren't accompanied by an increase in heart rate are less serious, though they still need medical attention. However, an irregular heartbeat accompanied by an increase in the number of beats per minute -- what's known as supraventricular and ventricular tachycardia -- can indicate a serious problem.

Scary stat: Ventricular tachycardia, particularly after exercise, is closely associated with sudden death, so it's important to get help fast.

Top clues: The symptoms are easy to confuse with a panic attack. Your heart may feel like it's pounding, as if you'd just run for the bus or had a terrible fright. And the episodes are likely to come on suddenly. Typically, there's no obvious trigger for the sudden heartbeat acceleration and arrhythmia, but there is a type of ventricular tachycardia that's triggered by vigorous exercise in someone with heart disease. When these episodes last longer than a minute or two, dizziness and weakness may follow.

What to do: Call the doctor right away.

2. Nausea, stomachache, and indigestion

If you've been battling stomachache, nausea, or indigestion without any obvious cause, you might be mistakenly attributing cardiovascular symptoms to a gastrointestinal problem. Blockages of fatty deposits in an artery can reduce or cut off the blood supply to the heart, causing angina, which feels like squeezing, cramping, or pain. Although most people associate angina with chest pain, in many cases the body sends those pain signals down into the abdomen. Poor circulation and lack of oxygen circulating in the blood (caused by a weak heart or blocked arteries) can lead to ongoing nausea, indigestion, or vomiting, particularly in women or those over 60.

Scary stat: This symptom is particularly common in women, who are more likely to avoid going to the emergency room. This is one reason that 42 percent of women who have heart attacks die within one year, compared to 24 percent of men. And under age 50, women's heart attacks are twice as likely as men's to be fatal.

Top clues: The pain worsens with exertion and gets better with rest. You've been relying on antacids, antinausea medication, or other indigestion remedies for more than a few days. The symptoms are episodic, easing and then returning, rather than feeling like one long bout of indigestion.

What to do: If your nausea symptoms are definitely being brought on by physical activity, don't delay in contacting your doctor, and ask about being evaluated for angina and coronary artery disease. If your indigestion symptoms aren't related to exertion, keep an eye on them. You'll still want to eventually get a checkup for further evaluation and treatment.

More early warning signs of a heart attack

3. Extreme fatigue

A sense of crushing fatigue that lasts for days, weeks, or even months can signal heart trouble months before a heart attack occurs. This isn't run-of-the-mill fatigue but the debilitating kind you'd typically associate with having the flu.

Scary stat: More than 70 percent of women in a National Institute of Health study reported extreme fatigue in the weeks or months before having a heart attack.

Top clues: Fatigue comes on suddenly, often with exertion, and doesn't seem linked to other factors such as lack of sleep or illness. It may also progress over the course of the day, with some women feeling exhausted by afternoon. A heavy feeling in the legs is another sign. Women should be particularly alert for unexplained, long-lasting fatigue.

What to do: Call your doctor and schedule a checkup. Be sure to mention the connection with exertion.

4. Anxiety attacks and insomnia

A decrease in oxygen levels -- caused by changes in the heart due to heart disease -- may trigger subtle changes that lead to anxiety, insomnia, and agitation that can't be explained by normal circumstances. Looking back, people who've had a heart attack often realize they began to experience anxiety and sleep problems in the months before the attack. This may be the body's way of trying to let you know that something's not right.

Scary stat: Two landmark studies, one published in Circulation and a follow-up study in the Annals of Behavioral Medicine, found a strong association between self-reported symptoms of serious anxiety and a risk of fatal coronary heart disease.

Top clues: A new onset of sleep problems when you haven't experienced this problem before is a signal to watch out for. It can take the form of trouble falling asleep or unexplained middle-of-the-night waking. Racing thoughts or unexplained feelings of dread or impending doom are also clues.

What to do: Ask yourself whether the anxiety is related to recent events or triggers, or whether it seems abnormal in proportion to life events. Sudden, unexplained anxiety or insomnia should be discussed with your doctor.

More early warning signs of a heart attack

5. Pain in the shoulder, neck, jaw, or arm

While chest pain is a well-known sign of heart attack, it's much easier to miss this sign if the pain mimics typical shoulder, neck, or jaw pain. Damaged heart tissue or angina -- pain from a blocked artery -- sends pain signals up and down the spinal cord to junctures with nerves that radiate out from the cervical vertebrae. The pain may travel up the neck to the jaw and even to the ear, or radiate down the shoulder to the arm and hand, or it may center between the shoulder blades. The pain may feel sharp, or it may be a dull ache such as you'd feel with a pulled muscle. This is a symptom doctors have only recently begun to focus on, due to patient reports post-heart attack that this was one of the only symptoms they noticed in the days and weeks leading up to the attack.

Scary stat: For 50 percent of the men who die from heart attacks, the attack itself is their first noticed symptom. Recognizing the pain of heart attack is key to fast treatment, yet it's often missed if it's not felt in the chest.

Top clues: The pain comes and goes, rather than persisting unrelieved, as with a pulled muscle. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then later it moves to your ear and jaw. Numbness, tightness, or tingling may accompany the pain. You should be especially concerned about symptoms that are brought on by physical activity and go away with rest.

What to do: Pain that doesn't go away after several days merits a medical checkup. If the pain seems to move or radiate upward and out, this is important to tell to your doctor.

6. Breathlessness, dizziness, or a feeling of being unable to draw a deep breath

When you can't draw a deep breath, you probably assume it's your lungs, but it could be the result of too little oxygen circulating in your blood from a weakened heart. Officially known as dyspnea, shortness of breath is often the first sign of serious heart disease.

Scary stat: In a landmark study in Circulation, 40 percent of women heart patients reported shortness of breath for up to six months prior to having a heart attack.

Top clues: You feel like you're not getting enough oxygen, just as you would at high altitude. You might also feel light-headed and dizzy. An ongoing concern or suspicion that you're developing asthma or lung disease can also be a sign your heart's acting up.

What to do: Shortness of breath can indicate a problem with the lungs, the heart, or both, so this symptom is always a reason to call the doctor.

7. Unusual, excessive sweating

Unusual sweatiness when you haven't been exerting yourself more than usual has only recently been recognized as a sign that frequently precedes heart attacks. In women, it may feel similar to the hot flashes or night sweats typical of menopause.

Scary stat: According to a University of Chicago study, excessive perspiration in many areas of the body, such as the chest, back, scalp, palms, or soles of the feet (in addition to the underarms), is often the first indicator that something's wrong -- before a heart attack begins.

Top clues: Flu-like symptoms, like clammy skin or sweatiness, that aren't accompanied by a fever, that last longer than a week, or that come and go over a long period of time, are signs that there's some other underlying cause, which may be heart disease.

What to do: If symptoms persist and seem unusual, call your doctor to talk through your concerns.

Melanie Haiken

Melanie Haiken discovered how important it is to provide accurate, targeted, usable health information to people facing difficult decisions when she was health editor of Parenting magazine. See full bio

24 days ago, said...

I am 75 years old female my Son is 54 Male

11 months ago, said...

My partner feels as if he is going to have a heart attack very soon. Feeling of doom. Extreme fatigue. And a problematic heart valve issue since childhood is causing us great concern. I took him to get an EKG 2 days ago and it was clean. We found a cardiologist but the appointment is 3 weeks away. Should we go to the hospital? Any help is appreciated

11 months ago, said...

The sad thing is, most insurances today have a 10k or more deductible. You just can't afford to run to ER with these symptoms as most times they are not heart related. Our healthcare system in this country not user friendly unless you are super rich or have golden health insurance. Many times these symptoms are just anxiety, thyroid, hormonal, stress. Sometimes cardiac....many times the ER will send you home after ekg comes back okay.

11 months ago, said...

I have had months and months of every symptom listed on this list minus the excessive sweating. In the past year I have had event recorders and hotter monitor tests and EKGs done that have shown no heart issues at all, yet I experience all these symptoms. I'm a 22 year old female at a normal weight of 117 lbs. do you think this is more likely really bad anxiety, or potentially heart attack warning signs?

12 months ago, said...

My heart rate is normal but I sometimes feel chest pain but I don't know if its anxiety causing it or a heart attack and I bearly even feel chest pains anymore. My chest pain started when I drank some coffee and since then my chest pain is still going. Should I worry about this? Please help!

over 1 year ago, said...

I have all those symptoms but the unusual excessive sweating, does that mean I'm at risk of having a heart attack?

over 1 year ago, said...

Within the last 2 weeks I feel as if I can't get enough air in my lungs, also feels like I have gas on my stomach and if I could get sick it would feel better. This happens every time I drink anything (including water) and or eat. Could me coming off of my pain medication and antidepressants cause this? I have been clean for 2 months.

over 1 year ago, said...

I started out a few weeks/couple of months ago having believed to have felt a lump in my breast i got it checked, (thankfully okay) however i had been woken in the night with a burning pain in my left side under my armpit. I also had feelings (that had gone on for several weeks before) that my left arm just felt heavy, sonetimes warm rushing feeling or cold numb and tingly feeling. Both accompanied with dull constant ache. These come and go and have done for months now. I feel my upper chest, left side just below collar bone feels filled with gas, my chest left side hurts as if been pressured, squeezed. The pain cones from the centre upwards and occasionally accross the top of both my shoulders. Mainly staying on the left. I feel nauseous, i constantly feel like i have heartburn, my appetite is depleted as i feel sick, I cannot get comfortable in bed to sleep because of the pain abd sensation in my arm/chest, mybheart sometimes fastens and i have cold cheeks (recently just come on). I have often in recent weeks gone back to bed feeling drained and exhausted even if i have done little or nothing through the day. I have a busy household but this is why I am more concerned now as my youngest child is only 5 but has conditions. I am going through an anxious time but is it best to still get this checked or just wait to see if what the doctor suggests works and wait for my heart trace in 2 days.

over 1 year ago, said...

I occasionally experience chest pain that gets worse, starts to go away and comes back. It has only lasted longer than 10 minutes, once. That time, the pain radiated to my left shoulder and jaw. I was told by a nurse that if it didn't last longer than 15 minutes, it's nothing to worry about but I'm not so sure. I had chest pain again yesterday but again, it only lasted a few minutes. It almost always happens when I'm at rest and woke me up twice in one night. Should I worry about this?

about 2 years ago, said...

Ok, so I have been to the doctor and er. I have many of the signs above but today have had a consistent dull ache in my chest and shoulder. I don't want to jump the gun though because I have so much stress right now. I don't want to go to the ER just to have them laugh at me cuz it's stress. Idk what to do.

about 2 years ago, said...

can gas like burping excessively and sweating profusely at work till my hair is drenched (I attribute it to no flow of air on the second floor at work, they turn off the air at 4pm) so I dont have to be exerting myself to sweat. I have episodes of gas occaisionally like today an burp constant. A little tightness in the chest area. My arm is bad with degenerative arthritis and my shoulder is pretty much gone, but the pain comes and goes I dont know if it is the weather but sometimes it hurts so bad all the way down my right arm back of the shoulder.and to the hand that I cannot function. I am 65 and under considerable stress with no partner or home of my own and work strenousely as a custodian and need to retire. Suggestions anyone of perhaps heart problems unawares.

about 2 years ago, said...

I'm reading this because this morning, I was reading and it felt like my heart was having a spasm, starting at the bottom and worked to the top, lasting longer than any svt I've ever experienced and though I tried to cough, I couldn't. Almost immediately I had the urge to deficate and its been over 5 hours and I still feel the need to go, though I can't. I've had a couple of little cramps since in my chest, like gas, not really painful, but the dizziness, neck pain, headache and left ear pain that has come and gone, becoming irritating. I'm on toprol as a beta blocker , I took aspirin, just trying to figure out if I should call 911, drive myself to the ER or give it time as I've not been diagnosed with any other cardiac issues and of course, I don't want to freak out my 11 yr old daughter. Just wondering if this could be an episode of afib or if that feeling was not my heart but maybe gastric.. The feeling of urgency to use the restroom is most bothersome..

over 2 years ago, said...

Stop eating sugar! Then cut out fatty foods. Eat more plants and vegetables. Enough said!

over 2 years ago, said...

I have my sister, she is just diagnosed heart problem. She is given medication from hospital and will go to hospital on Thursday again. And the doctors from Cecilia Makhiwane are highly recommending her to be admitted on her check up. Please help in terms of diet and sitting posture and more medication. She is suffering most on short breath and her chest sounds like she have an asthma.

over 2 years ago, said...

Just had some kind of episode. Started shaking and sweating pain down both arms and shortness of breath. Can't deside if I shou go to e.r. Feeling a little better

over 2 years ago, said...

My friend started feeling chest pains at work where she is a nurse. Proceeded to the emergency room. Had two heart attacks and die within four hours. 45 year old female in England.

over 2 years ago, said...

I have been in bed for sixty days with fatigue but insomnia, chest pain, cold extremities and an impending sense of doom! I am being somewhat dismissed as a drama queen but I feel awful!