Although you're probably familiar with the classic heart attack scenario from movies and TV, most people don't just clutch their chests and fall to the ground. Heart attacks usually start slowly, with mild pain or discomfort, or even more subtle flu-like symptoms. Heart attack symptoms can be subtle, and it's not always easy to tell what's happening. But if someone is having a heart attack, every second counts: There's a limited window of time before heart muscle is permanently damaged. Delaying treatment also increases the risk of sudden death from an irregular heart rhythm.
To give someone the best possible chance of recovery, it's wise to familiarize yourself with the warning signs of a heart attack. Remember that all heart attacks are not equal: Even if you've seen someone have a heart attack before, a second heart attack or a heart attack in someone else might not have the same symptoms.
Pay special attention to heart attack symptoms in women
Although many people mistakenly believe that cardiovascular disease isn't a problem for women, it's still a leading cause of death. Unfortunately, women tend to have different heart attack symptoms than men, so heart disease may go unrecognized until it's too late. In a study of 515 women who'd had heart attacks, the most frequently reported symptoms were unusual fatigue, sleep disturbances, shortness of breath, indigestion, and anxiety. Less than one-third reported any chest discomfort.
How to respond if you see signs of a heart attack
In general, it's best to call 911 if you have any reason to suspect that someone is having a heart attack. Waiting even an hour or two may limit treatment options and reduce the chance of a full recovery. It's common for someone having a heart attack to downplay the situation because he or she is embarrassed and doesn't want to cause a scene. Take charge and call for help even if the person tries to talk you out of it. Don't wait to see if heart attack symptoms go away -- and call even if the symptoms do disappear or come and go. If it turns out to be something less serious than a heart attack, at least you'll have some peace of mind.
Bear in mind that not all of the following warning signs occur in every heart attack.
The five signs of heart attack
Heart attack sign #1: Chest discomfort or pain
The most commonly reported heart attack symptom among men is chest discomfort, often described as a heaviness, tightness, or even a burning sensation. The feeling usually starts in the center of the chest and may or may not radiate to other areas of the body. It may go away and then come back, or it may be continuous.
If you're aware of someone experiencing any persistent chest discomfort, call 911 right away. Even if it's angina rather than a full-blown heart attack, he needs to see a doctor.
Heart attack sign #2: Discomfort in other parts of the body
Sometimes the pain of a heart attack doesn't occur in the chest. Instead, he or she might complain of discomfort or pain in one or both arms or back, neck, jaw, or even stomach. Women are more likely than men to experience pain in the jaw or back during an attack. It can be hard to tell if the discomfort is related to a heart attack or something else entirely, but if the pain came on suddenly or the person is experiencing another symptom as well, call 911.
Heart attack sign #3: Shortness of breath
It's common to be a little short of breath after exertion. But if someone is having difficulty breathing when at rest, it's cause for concern. Have him stop whatever he's doing and sit or lie down. If the shortness of breath persists for more than two minutes, call 911.
Heart attack sign #4: Nausea, sweating, pallor, or clamminess
These more subtle signs of heart attack can sometimes be mistaken for the flu. Women are more likely than men to report flu-like symptoms. If these symptoms come on suddenly or are accompanied by other signs of a heart attack, call 911.
Heart attack sign #5: A general feeling of extreme weakness or fatigue
As with nausea and sweating, weakness or fatigue can be symptoms of other conditions. But if the weakness or tiredness comes on suddenly -- espe cially if it's a woman experiencing it -- call 911.
J. McSweeney, M. Cody, P. O'Sullivan, K. Elberson, D. Moser, B. Garvin, "Women's early warning symptoms of acute myocardial infarction," Circulation , 2003.