In movies and TV, heart attacks are typically depicted as a big dramatic scene: a character clutches their chest and collapses while the music swells. The reality of a heart attack can look different. While some are intense and sudden, others are subdued in comparison.
Knowing the signs of a heart attack can help you act fast to save a life.
What is a heart attack?
A heart attack, also called myocardial infarction, happens when blood flow is reduced or completely cut off, causing damage to heart tissue. The narrowing or blockage of blood vessels is caused by plaque buildup of cholesterol and fat. As the heart muscle deteriorates, blood flow to the rest of the body becomes disrupted.
A heart attack is a medical emergency. If you or someone around you is experiencing heart attack symptoms, don't ignore them. Calling 911 is the fastest way to get treatment, as emergency medical services have training and tools to triage and monitor people experiencing heart attacks and cardiac arrest, the sudden loss of heart function. Arriving at the hospital in an ambulance usually means getting care faster than going by other means. Time is critical to preserving heart muscle — minutes can be the difference between surviving or dying from a heart attack.
Early warning signs of a heart attack
The body can give off warning signs of a heart attack in the days or hours leading up to a heart attack.
"Possible signs can be chest pressure or tightness that comes and goes, increasing shortness of breath with activity, or unusual fatigue," says Dr. Omar Awar, a cardiologist with Houston Methodist.
Some other heart attack warning signs that may be more subtle and may increase in intensity:
- Cold sweat
- Feeling lightheaded
- Pain in your jaw, arm, neck or back
- Shortness of breath
Since some of these symptoms can be associated with other situations or conditions — sleeping poorly, having the flu or a stomach bug — people may want to downplay the situation. But it's important to listen to your body and seek care.
"When experiencing these symptoms, patients should seek immediate medical care," Dr. Awar says.
Heart attack symptoms in women vs. men
Another way movies and TV portray heart attacks inadequately is that the character is so often a man. In fact, women are just as likely to experience heart attacks. Cardiovascular disease is the No. 1 cause of death for both women and men, according to the Centers for Disease Control and Prevention (CDC).
"A heart attack can present suddenly and without warning, irrespective of gender or risk factors," Dr. Awar says. "People having a heart attack will often experience discomfort in their chest (pressure, tightness, pain) or other parts of their upper body (shoulders, arms, neck, back, jaw, stomach); shortness of breath; nausea or heartburn; sweating; or dizziness."
Dr. Awar says that while heart attack symptoms for women and men are more similar than not, there are differences.
"The most common symptom for women and men remains chest discomfort," Dr. Awar says. "However, women are more likely than men to present with symptoms other than chest discomfort and are more likely to have their symptoms go unrecognized. Women also have a higher chance of experiencing symptoms in their sleep, at rest, or with mental stress, rather than with physical exertion."
Heart attacks can be preventable
The World Health Organization estimates that 80% of premature heart attacks and strokes can be prevented. While we can't control our age or family history of heart disease, there are actions we can take to help lower our risk.
Dr. Awar also emphasizes lifestyle choices, including a heart-healthy diet, such as the DASH and Mediterranean diets, and regular aerobic exercise (150 minutes/week). Quitting tobacco use and avoiding excessive alcohol consumption can also help lower your heart attack risk.
For people with a family history of heart disease, Dr. Awar says it's best to stay proactive about your heart health.
"Talk to your doctor about further testing that can be performed to help identify abnormal markers in lipid metabolism, elevated inflammatory signals in the body that can lead to heart disease and early signs of atherosclerosis (plaque build-up in arteries that can lead to heart attack and stroke)," Dr. Awar says.