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.

6 days 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?

7 months 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.

8 months 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.

8 months 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..

9 months ago, said...

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

10 months 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.

11 months 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

about 1 year 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.

about 1 year 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!

about 1 year ago, said...

Great article with detail information and reasoning beyond the symptoms so it's easier to remember and explain to someone.

about 1 year ago, said...

I have all these symptoms...

about 1 year ago, said...

Oh my god, this sounds just like what happend my dear husband, he'd been saying ah it's only heart burn and then he died suddenly before our eyes, we done cpr, but to no avail, oh god we lost him 43 days ago and im so so lost without him he was only 56 years old, i miss him so much he has taken a my heart with him, life is so unfair.

over 1 year ago, said...

all except last one. I'll contact Dr. immediately..drgelb

over 1 year ago, said...

read this after having a heart attack at 42 years old , not overweight at all , fit but not very active due to a bad back , first symptom i had was pain in my face like a massive tooth ache ,3 hours later i was having stents in my heart. now 10 months later i am starting to suffer pain in my left arm and shoulder and in my mind i think this may be the signs of heart attack number 2. the warning signs on this page are true so take heed , no matter how old ,weight fitness etc ,anyone can have a heart attack !

over 1 year ago, said...

I'm writing to say the article I read took a few minutes, and saved my life. I am in the know more than I was 5minutes ago. Thank you

over 1 year ago, said...

i have a lot of stress my daughter has been in the hospital. my dr. put me on meloxicam for arthritis . i was cleaning house and had to stop my heart started racing then i got indigestion and my shoulder hurts. i took a break so lying down now i feel better the antacid is working.

about 2 years ago, said...

What do i do if i sometimes get palpitations , especially after exertion , and attimes a feel a big crape at my lower chest , plaese what do i do . thanks Boma

over 2 years ago, said...

Very informative. Due to there being such varied symptoms, it makes sense why some people misdiagnose that they are having a heart attack.

over 2 years ago, said...

The article seems to be a very thorough explanation of symptoms to be concerned about.

over 2 years ago, said...

Interesting. Had open heart surgery 2006. Now 85.6 years old. Good time to listen!

over 2 years ago, said...

It's good to read about possible symptoms of heart attack, especially the less well known symptoms. But I think the key is, if in doubt, have a doctor check it out. Don't waste time trying to figure it out on your own. Each of these symptoms could be something other than heart attack. It takes an expert to tell. And that doesn't mean a relative or neighbor who once had similar symptoms.

over 2 years ago, said...

Heart attacks can be devastating to the life of the victim, if not the final act of the victim's life. There's no amount of reminding or repeating the warning signals that's excessive. We need to keep them in the forefront of our conscious minds so that we can call them up if the need arises. Robert C. Visconti