Heart Attack Warning Signs: 7 Emergency Symptoms You Should Know

What Happens in a Heart Attack?

The coronary arteries supply blood to the heart. Over years, cholesterol, inflammatory cells and calcium can build up in the artery wall as plaque (atherosclerosis). If the surface of a plaque cracks, a clot forms and may block the artery completely. The area of heart muscle served by that artery is starved of oxygen and begins to die. A smaller number of heart attacks are caused by a spasm of the artery, a tear in the artery wall or a blockage in a very small vessel.

Seven Warning Signs

1. Chest pain, pressure, tightness or heaviness

The classic symptom is a feeling of pressure, squeezing, fullness or heaviness in the centre or left of the chest, lasting more than a few minutes or coming and going. Many people describe it as "an elephant sitting on my chest". It is not usually sharp or stabbing, and it does not typically change with breathing or movement of the chest wall.

2. Pain that spreads

Discomfort may radiate to one or both arms (most often the left), the shoulders, back, neck, jaw or teeth, or the upper abdomen. Jaw or arm pain without obvious chest pain can still be a heart attack.

3. Shortness of breath

Difficulty breathing, with or without chest discomfort, can be the main symptom, particularly in older adults, women and people with diabetes. It may occur at rest or with minimal exertion.

4. Cold sweat

Breaking out in a clammy, cold sweat with no obvious reason such as heat or exercise is a common sign, because the body responds to the stress of a heart attack with adrenaline.

5. Nausea, vomiting or indigestion

Many people mistake a heart attack for acidity, especially when pain is felt in the upper abdomen. Nausea, vomiting or a sense of "burning" that is not relieved by antacids should raise suspicion, especially if it comes with other signs.

6. Dizziness, light-headedness or fainting

A drop in blood pressure or abnormal heart rhythm may cause sudden light-headedness, a feeling of impending doom, or collapse.

7. Unusual fatigue and palpitations

Extreme tiredness for no clear reason, which may begin days before the attack, along with a racing, fluttering or irregular heartbeat, can be early warnings.

Symptoms in Women, Older Adults and People With Diabetes

Women are more likely than men to have symptoms other than chest pain: shortness of breath, nausea, back or jaw pain, unusual fatigue, dizziness and indigestion. Because these seem vague, women sometimes delay seeking care. Older adults and people with diabetes may have "silent" heart attacks with minimal or no chest pain because nerve damage reduces pain sensation. In these groups, any new unexplained breathlessness, weakness or sweating should be taken seriously.

What to Do Immediately

1. 1Call for emergency help at once. Dial 112 or the hospital's ambulance number. Do not drive yourself. An ambulance team can begin treatment and send an ECG ahead to the hospital.
2. 2Stop activity and sit or lie in a comfortable position, with your head and shoulders raised if you are breathless.
3. 3Chew an aspirin (300 mg regular, or 162 to 325 mg) unless you are allergic or have been told by a doctor never to take it. Chewing helps it act faster. If unsure, wait for medical advice.
4. 4Loosen tight clothing.
5. 5If prescribed nitroglycerin, take it as directed. Do not take another person's medicine.
6. 6Stay calm and keep still. Ask someone to stay with you and to unlock the door for paramedics.
7. 7If the person becomes unresponsive and is not breathing normally, begin CPR with hard, fast chest compressions in the centre of the chest at about 100 to 120 per minute, and use an automated external defibrillator if available.

How a Heart Attack Is Diagnosed

On arrival, the team will record an ECG within minutes. Certain patterns, known as ST-elevation, indicate a complete blockage that needs immediate treatment. Blood tests for troponin, a protein released from damaged heart muscle, confirm injury and are repeated over a few hours. An echocardiogram shows how well the heart is pumping, and coronary angiography uses dye and X-rays to show the blocked artery.

Treatment

Emergency medicines. Aspirin and other antiplatelet drugs, blood thinners, pain relief, oxygen if needed, and medicines to ease the heart's workload.

Reopening the artery. The main options are:

• Primary angioplasty (PCI): a thin catheter is passed through the wrist or groin artery to the blockage, a balloon opens it and a stent is placed to keep it open. This is the treatment of choice when it can be done quickly.
• Clot-dissolving medicine (thrombolysis): given when angioplasty is not available in time.
• Bypass surgery (CABG): used for extensive or complex blockages in several arteries.

After the heart attack. Patients usually stay in hospital for several days with ECG monitoring. Long-term medicines typically include aspirin, a second antiplatelet agent for a period, a statin, a beta-blocker, an ACE inhibitor or similar drug and treatment for diabetes and blood pressure. Cardiac rehabilitation, including supervised exercise, education, diet and emotional support, improves recovery.

Reducing Your Risk of a Heart Attack

1. 1Do not smoke or use tobacco. Risk begins to fall soon after quitting.
2. 2Know your numbers. Check blood pressure, cholesterol, blood sugar and weight regularly.
3. 3Eat for your heart: vegetables, fruits, whole grains, pulses, nuts, fish and healthy oils, with little salt, sugar and trans fat.
4. 4Exercise at least 150 minutes per week, with a doctor's advice if you have symptoms or risk factors.
5. 5Maintain a healthy weight, especially around the waist.
6. 6Control diabetes, hypertension and cholesterol with lifestyle and medicines as prescribed.
7. 7Limit alcohol and avoid binge drinking.
8. 8Manage stress and sleep well. Chronic stress and sleep apnoea increase cardiovascular risk.
9. 9Take preventive medicines such as statins or aspirin only when advised by a doctor.
10. 10Get regular health check-ups, especially after age 40, or earlier with a family history of early heart disease.

Common Myths

• "Heart attacks only happen to older people." Increasingly, adults in their thirties and forties are affected, especially smokers and those with diabetes or family history.
• "If the pain is not in the chest, it cannot be the heart." Pain in the jaw, back or stomach can be heart-related.
• "A normal ECG rules out a heart attack." The first ECG may be normal. Repeated ECGs and troponin tests are needed.
• "Cough CPR works." Coughing repeatedly is not a proven treatment and wastes time.
• "I am fit, so I am safe." Athletes and fit people can also have heart attacks, especially with hidden risk factors.

Heart Attack, Cardiac Arrest and Angina

A heart attack is a circulation problem, a blocked artery, while cardiac arrest is an electrical problem in which the heart suddenly stops beating effectively. A heart attack can cause cardiac arrest. Angina is chest discomfort from reduced blood flow to the heart, typically on exertion, and eases within minutes of rest. New or worsening angina is a warning sign and needs urgent assessment.

Care at Trustmed Hospital

At Trustmed Hospital in Badshahpur, Gurugram, our emergency care team is available 24 hours with an ambulance service, ECG and laboratory support, and our ICU monitors patients who need close observation. Our general medicine team provides cardiac risk checks and follow-up. In an emergency, call +91-8700232311 or book an appointment for a heart health check.

Key Takeaways

• Heart attack symptoms can be subtle, especially in women, older adults and people with diabetes.
• Call an ambulance immediately, chew an aspirin if safe, and do not drive yourself.
• Every minute without treatment damages more heart muscle.
• Controlling blood pressure, sugar and cholesterol, and avoiding tobacco, lowers your risk substantially.

Quick Checklist

1. 1Write down the emergency number and your medicine list and keep them handy.
2. 2Learn hands-only CPR.
3. 3Know your family history of heart disease.
4. 4Book a heart health check if you are over 40 or have risk factors.

Frequently Asked Questions