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The signs of a heart attack

Some people first find out they have a heart problem when they have a heart attack. Often though, people who have heart attacks have already had coronary artery disease for years. This causes recurring pain in the chest called angina or shortness of breath during exercise or exertion.

The most common signs of a heart attack are pain and shortness of breath.

The pain can spread from the chest down the left or right arm, and there can be pain in the back, in the neck or stomach.

The pain can be mild or very strong.

A heart attack often starts with sudden pain in the chest. But the symptoms can often start to be noticeable only slowly. People who have had heart attacks describe the pain as acute, burning or pressing. The pain goes on for more than five minutes and it does not get better when the person rests.

Another sign that it could be a heart attack is if the nitrate medication that a person with coronary artery disease uses for his or her chest pain does not work.

People who have a heart attack are often very afraid, their faces become pale and they break out in sweat. Many people who are having a heart attack have trouble breathing, and have nausea or vomiting. Often these symptoms are much stronger than the chest pain. Particularly for women, these could be the main signs of a heart attack. This is one of the reasons that women more often do not realise they are having a heart attack.

Many women mistakenly believe that heart attacks mostly affect men. But heart attacks are one of the main causes of death in women in industrialised countries. More women die from heart attacks than from breast cancer, for example.

The early signs of a heart attack are not just different from person to person. They can also be different from an earlier heart attack. It is also sometimes possible that a person is not aware of the heart attack. That is called a silent heart attack.

The typical signs of a heart attack that are less frequent than chest pain and shortness of breath include:

A feeling of tightness or pressure in chest
Pain or numbness in the upper body that spread to the shoulderblades, the neck and the jaw
Lightheadedness or fainting
Dizziness, nausea, vomiting
Sweating
Paleness and cold sweating

Emergency medical help is essential for a heart attack, so that life-saving treatment can be started as quickly as possible. Every minute counts. For this reason anyone who suspects a heart attack should ring emergency immediately. In Germany the emergency number is 112, in the USA it is 911. Calling the general practitioners' on-call service is not enough. If heart attack signs occur at night, people should not wait till the next morning to get them checked.

Important: When someone calls emergency for a heart attack, they should make it clear that it is a heart attack and an emergency doctor is needed.

While waiting for the emergency service to arrive, you can help a person having a heart attack by: