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Heart attack - What are the symptoms of a heart attack?

BMJ Group Medical Reference

Feeling a bad pain in your chest is the most common sign that you're having a heart attack.

If you have severe chest pain and you're not sure what is causing it, don't waste time. Call 999. Acting quickly might save your life. Once you get to hospital, doctors can run tests and treat you straight away.

Not everyone has bad chest pain

Not everyone who has a heart attack has bad chest pain. Some people have mild pain at first. Some have no pain at all. If you don't have pain, it's not easy to tell if you're having a heart attack. You might not know you need medical help. Up to one-quarter of all people who have a heart attack don't realise they've had one.[12]

There are other warning signs, such as having mild pain in your chest, arms, back, neck, jaw, or stomach. If you know about these it can help you decide if you're having a heart attack. It's worth learning about these symptoms, especially if you've already had a heart attack or if your doctor has told you you're at risk of having one.

Below you'll find a list of the most common symptoms of a heart attack.

Once you get to hospital, tests can tell doctors whether you're having a heart attack. If you are, they'll probably do more tests to find out what type of heart attack you've had. To learn more, see Tests for a heart attack.

Warning signs of a heart attack

Pain

The pain of a heart attack can stop you in your tracks. It can feel as if someone has tied a belt around your chest and is pulling it tighter and tighter until your breath is gone. People have described the pain as crushing, tightening, constricting, and pressing.

Your heart is a muscle and needs oxygen to keep working properly. During a heart attack, blood and oxygen can't get through to your heart. This causes pain around it.

You may have warning signs a few days before you have a heart attack. You may have chest pain that is uncomfortable but not severe. You may have a pain that feels like your chest is being crushed and you can't get enough air. If you have a type of chest pain called angina, the pain might keep getting worse. Angina is usually caused by hardening of the arteries (atherosclerosis). It happens because your heart isn't getting enough blood.

During a heart attack, you'll usually have pain in the centre of your chest. It often spreads down one arm, usually the left. Sometimes the pain is in both arms. Sometimes it spreads up into your jaw. The pain doesn't go away if you rest. It doesn't disappear if you take painkillers or medicine prescribed for a type of chest pain called angina. The pain usually lasts half an hour or more.

If you think you're having a heart attack, get help straight away. Don't delay.

Doctors call this kind of chest pain typical or classic. But for many people, heart attack pain is mild. Some people have no pain at all. If you're a woman, are older or have diabetes, you're less likely to have typical chest pain.[12]

To learn more, see How to tell the difference between a heart attack and other pain.

Feeling short of breath

If you feel short of breath, it could be because your pain is severe. It could be because you're anxious. It may also be a sign that your heart is not pumping properly.

Normally, the left side of your heart fills up with blood that is returning from your lungs. If the left side of your heart is damaged, pressure builds up and fluid is forced out of your blood vessels and into your lungs. When this fluid is forced into your lungs, it makes it hard for you to breathe.

Feeling faint or dizzy

Your blood pressure can drop during a heart attack. If your blood pressure gets too low, your brain doesn't get enough blood. This makes you feel dizzy or faint. You might even black out.

During a heart attack, your blood pressure may drop for a number of reasons. For example, your heart may be beating too quickly or too slowly because the nerves that control how fast your heart beats have been damaged. Your blood pressure can also drop if your heart is so badly damaged it stops working properly.

Sweating, nausea, and vomiting

During a heart attack, your body is in a state of emergency. Some of the nerves that control the functions of your body (such as your temperature) can go into overdrive. You may sweat or look very pale.

Your nervous system may also play a part in making you vomit or feel sick during a heart attack. We don't know the exact reason for these symptoms.

Irregular heartbeat

Doctors call an irregular heartbeat arrhythmia. When your heart is beating very fast, you may feel a fluttering in your chest or even a rapid thumping. Your heart can also beat too slowly after a heart attack. This happens if the nerves that control the speed of your heartbeat are damaged.

Blue tinge to your skin

Sometimes people's skin looks bluish when they're having a heart attack. During a heart attack your body shuts down the blood vessels in your hands and feet and directs blood to more important parts of your body. So your hands and feet may look pale and feel cold. If you have a blue tinge around your lips, your blood is not picking up enough oxygen in your lungs. If this happens, you may be given extra oxygen to breathe on the way to hospital.

Losing consciousness

Most people stay awake during a heart attack. But if someone passes out and can't be woken, it means their heart isn't beating well enough to supply their brain with the oxygen it needs. If this happens, the person needs emergency treatment.

The most dangerous type of abnormal heartbeat is called ventricular fibrillation. It happens when the walls of the lower parts of the heart are quivering instead of beating, and the heart can't pump blood properly. An abnormal heartbeat is the most common cause of death during or after a heart attack. Doctors and paramedics can get a regular rhythm going again by using a machine that delivers an electric shock to your heart. But they must do this within a few minutes of the abnormal heart rhythm starting.

In the meantime, other people can keep the blood flowing through your body if they know how to do a type of first aid called CPR. It stands for cardiopulmonary resuscitation. You need training to do CPR well.

The more people who know about CPR, the better. If you learn CPR you may be able to help save someone's life. Your doctor will be able to give you information on local classes.

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Last Updated: December 18, 2012
This information does not replace medical advice.  If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
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