With a heart attack, which is when the blood flow to the heart is blocked and thus limits the body’s oxygen supply, the first symptom that likely comes to mind is chest pain. But that isn’t the only way a heart attack can manifest. Also known as a myocardial infarction, a heart attack can affect anyone of any age, so it’s best to prepare yourself with the knowledge you need to recognize and address this medical emergency.
Below, we outline the more surprising symptoms associated with a heart attack, along with what you should do if you or someone you know is experiencing one.
Heart attack symptoms, both common and unexpected
When you think “heart attack,” classic symptoms such as chest discomfort might first come to mind. Heart attacks can present differently in men and women and in people with certain diseases, like diabetes.
Heart attack symptoms could include:
- Chest discomfort, pain or pressure that radiates up to your jaw, your back and/or your left shoulder
- Bad indigestion or nausea
- Extreme fatigue
- Shortness of breath
- Feeling generally unwell
“Essentially anything from the belly button up,” says Dr. Khadijah Breathett, a heart failure transplant cardiologist and tenured associate professor of medicine at Indiana University. “Constant pressure should raise concern that you should see your doctor, and it’s OK if it’s something else. We’d rather have an individual come see a health care professional and get evaluated rather than toughing it out at home, because that is what contributes to the escalating risk of death.”
What to do during a heart attack
If you or someone you know is experiencing any of the above symptoms, these are the steps you should follow.
1. Call 911, no matter what
If you feel any of the above symptoms, even if you aren’t sure it’s a heart attack, you should call 911 immediately, doctors recommend.
“If you feel unwell, or you’re starting to have chest discomfort, seek medical attention quickly, because the sooner you get treated, the better,” says Dr. Grant Reed, an interventional cardiologist and director of Cleveland Clinic’s STEMI program. “A lot of patients ignore their symptoms, and by the time they come in, their heart muscle has already died.”
The No. 1 indicator of how well you’re going to do after a heart attack is how fast you recognize your symptoms, Reed adds. There’s a strong relationship between when you start to have your heart attack (which is generally when symptoms start) and how fast doctors can open up the blocked coronary artery that’s causing it — the shorter the time, the better the outcomes, not just regarding survival but also the likelihood of heart failure or needing to be readmitted to the hospital.
When you get to the hospital, medical professionals will likely perform an electrocardiogram, which will determine the diagnosis of a heart attack. If it is a heart attack, you’ll be taken to the cardiac catheterization laboratory, where a coronary angiography will be performed. If you have a blockage in your coronary artery, the doctors will offer treatment with a balloon and a stent to keep the artery open.
Many people are hesitant to seek emergency medical care due to a lack of insurance or immigration status. In the US, hospitals are required to treat all people who come in with life-threatening emergencies.
“It’s a lot better to be treated and deal with the financial ramifications after the fact,” Reed says, adding that, in most cases, the costs can be sorted out with the hospital.
2. Have an ambulance take you to the hospital
If you suspect you’re having a heart attack, don’t drive yourself to the hospital: Call an ambulance. You could lose consciousness and hurt yourself or others on the road, says Dr. Joel Beachey, a cardiologist at Mayo Clinic Health System in Eau Claire, Wisconsin. The same goes for having a loved one drive you — if your symptoms worsen, they won’t be able to help you while they’re driving, and may be distracted.
Paramedics can provide the best and fastest care while you’re on the way to the hospital, including giving you an assessment and providing some treatment, Beachey says.
If you’re with someone who is having heart attack symptoms and becomes unconscious, you should first call 911 and then engage in CPR, Breathett says. (You can find free CPR training at your local American Heart Association branch and many other places.)
3. Take aspirin, if you have it
If you’re having heart attack symptoms and have access to aspirin, take a full dose of 325 mg after calling the ambulance, says Beachey. (If you have baby aspirin, which comes in an 81 mg dose, take four of those.) He recommends chewing it instead of swallowing, so it gets into your system faster.
The reason? When you’re having a heart attack, a plaque inside your arteries becomes unstable and ruptures, which forms a blood clot that can close off the supply to that artery. Taking aspirin can help break down some of that blood clot.
4. Advocate for yourself
In an ideal world, healthcare providers would take all patient concerns seriously when it comes to heart attack symptoms, but studies show women and people of color are less likely to receive adequate treatment for heart attacks and heart disease. For example, older Black women were 50% less likely to be treated when they arrived at a hospital with a heart attack or coronary artery disease symptoms than white women, including after accounting for education, income, insurance status and other heart health complications like diabetes and high blood pressure, a 2019 study found.
“It’s been very clear over most of our history in the US that women and people of color are not heard,” Breathett says. “Their symptoms get dismissed, and they have worse outcomes. As a health care system, we have a lot more work to do to change that system so that each person can get equitable care irrespective of their demographic.”
Until that time comes, patients need to be their own advocates and speak up for themselves, she adds. If they aren’t being heard, they have the right to seek care elsewhere.
One tip recommended by a resident on TikTok: If you feel a provider isn’t taking your symptoms seriously, for heart health or otherwise, you can ask the provider, “What is your differential diagnosis?”
A differential diagnosis is a term to describe the different diseases that could be contributing to your symptoms. You’re basically asking the provider to explain why they’ve ruled out a heart attack and what else it could be.
“That might help a person realize, ‘Oh, I haven’t effectively tested to make sure this is not cardiac disease,'” Breathett says.
You can also bring a family member or friend to help ask questions on your behalf. Write down questions in advance if possible, so you can have them addressed during your brief visit. And call back with any questions that weren’t answered. If you’re not satisfied or feel that you’re not being heard, seek out another care team.
5. Work on prevention
You’ve heard it a million times, but that’s because it’s true: The best way to prevent a heart attack is by maintaining a healthy diet, doing moderate exercise for 120 to 150 minutes per week, keeping your cholesterol and blood pressure under control and not smoking.
Heart attacks can happen to people of any age, race or gender. You should get regular physical exams with your primary care provider to assess your risk and make lifestyle changes that can help with prevention. Some people might also benefit from taking a baby aspirin every day as a preventative measure, but you’ll need to talk to your care provider about that.
Exercise is important even if you have a history of heart trouble, says Beachey.
Knowing what to do to prevent and respond to a heart attack is just one of the many important elements of your health you should know about. Read on to discover the best workouts to strengthen your heart, the difference between the types of cholesterol and how your diet affects your health. Plus, if you’re looking for new ways to monitor your metrics, check out CNET’s list of recommended fitness trackers and blood pressure monitors.
While anyone can suffer a heart attack, there are ways to reduce your risk of having one. Maintaining a healthy diet and doing regular, moderate exercise are two examples. Keeping your cholesterol under control and regular health exams can also help.
If you think that you might be having a heart attack, calling 911 is vital. Don’t be tempted to drive yourself to the hospital — you could lose consciousness and hurt yourself or others en route.
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