Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help.
Most of the deaths from heart attacks are caused by ventricular fibrillation of the heart that occurs before the victim of the heart attack can reach an emergency room. Those who reach the emergency room have an excellent prognosis; survival from a heart attack with modern treatment should exceed 90%. The 1% to 10% of heart attack victims who die later include those victims who suffer major damage to the heart muscle initially or who suffer additional damage at a later time.
Fortunately, procedures such as coronary angiogram and PTCA (coronary balloon angioplasty), and clot dissolving drugs are available that can quickly open blocked arteries in order to restore circulation to the heart and limit heart muscle damage. In order to optimally benefit heart attack victims and limit the extent of heart damage, these treatments to open blocked arteries should be given early during a heart attack.
Knowing the early warning signs of heart attack is critical for prompt recognition and treatment. Many heart attacks start slowly, unlike the dramatic portrayal is often seen in the movies.
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without chest discomfort.
- Pain and tightness can also radiate in other areas of the body. Most people associate a heart attack with pain working its way down the left arm. That can happen, but pain can also appear in other locations, including:
- upper abdomen
- teeth or jaw
- Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particular shortness of breath, nausea/vomiting, and back or jaw pain. Learn about the warning signs of heart attack in women.
- Extreme fatigue. In the days or even weeks before a heart attack, more than 70% of women experience debilitating, flulike exhaustion. You may suddenly feel too tired to cook dinner or lift your laptop.
- Mild pain. Rather than the elephant on the chest, women may feel less severe pain--and not always in the region of the heart. Pressure or achiness can occur in the breastbone, upper back, shoulders, neck, or jaw.
- Profuse sweating. You may find yourself suddenly drenched in perspiration for no apparent reason, or your face may be pale or ashen.
- Nausea or dizziness. Prior to a heart attack, women often have indigestion or even vomit. You may also feel like you're about to pass out.
- Almost 58% of women report panting or inability to carry on a conversation because they couldn't catch their breath.
- Nearly half of women have trouble falling asleep or wake up during the night in the weeks before a coronary.
- "Many women experience a sense of impending doom or fear before a heart attack," says Dr. Legato, though experts don't necessarily understand why. Nonetheless, it's real and it matters. "That's your body telling you to pay attention. Trust those instincts," she advises.