16 / 02 / 2021

Heart attack signs and what to do

It is important to recognize the signs of a heart attack, which can vary by person. Sometimes a person may have a heart attack without realizing it and not seek the emergency medical care they need. That could lead to lasting heart damage

The medical name for a heart attack is a myocardial infarction (MI).

A heart attack usually happens because a coronary artery becomes blocked, reducing or stopping the nourishing blood supply to the heart muscle.

Chest pain is the most recognized sign of a heart attack, but the symptoms someone experiences can depend on their gender and age.

It is essential to identify a heart attack as early as possible and seek prompt medical attention. Treatment can minimize damage and increase the chances of a full recovery.

This article looks at the various symptoms of heart attacks, how these may vary in females and older adults, and when to seek medical attention. It also looks at risk factors, treatment, and prevention.

What are the signs of a heart attack?

Most people know that chest pain is a typical heart attack symptom. However, a heart attack can affect the entire body, not just the heart.

Individuals of different ages and sexes may experiences heart attack symptoms differently.

Chest pain

Heart attacks typically involve some level of pain or discomfort in the chest’s middle or left side. It may feel like sharper pain, or more like squeezing, fullness, or uncomfortable pressure.

Difficulty breathing

Usually, this accompanies chest pain, but shortness of breath may also begin before any chest discomfort.

Upper body pain

A person may feel pain or discomfort in one or both arms, which can radiate to the shoulders. There may also be pain in the neck, jaw, or back.

Feeling lightheaded

Someone may feel weak, faint, or break out into a cold sweat.

Signs of a heart attack in females

Heart attack symptoms may show up differently in females, and may seem less evident or unrelated to heart problems.

The following are common heart attack symptoms in females that can occur with or without chest pain:

  • sleep disturbances
  • weakness that occurs suddenly
  • extreme shortness of breath
  • nausea, indigestion, or other digestive upsets
  • all over body aches
  • a general feeling of being unwell
  • discomfort in the back or upper body

Because heart attacks are commonly associated with chest pain, females often misread their symptoms and delay consulting a doctor.

It is crucial that everyone, especially females, recognize heart attack symptoms that may be atypical and seek immediate medical help when necessary.


If the heart does not receive oxygenated blood, it cannot function normally, which can cause a heart attack. This can happen when a coronary artery is partially or fully blocked.

The most common cause of blocked coronary arteries is coronary heart disease.

When coronary heart disease occurs, fats and cholesterol can form deposits or plaques on the arterial walls, called atherosclerosis.

Over time, the plaques narrow the arteries, and eventually, this obstructs blood flow.

Use of recreational drugs, such as cocaine, can also cause heart attacks.

Risk factors

Several factors increase an individual’s risk of a heart attack. These include being age 65 or over, being male, or having a family history of heart disease.

Race also plays a part, as people of African, Mexican, and American Indian descent are at higher risk.

There are also modifiable factors that increase the risk of heart attacks. These include:

  • smoking
  • alcohol consumption
  • obesity
  • lack of exercise
  • high cholesterol and blood pressure
  • diabetes
  • stress

The good news is that people can change, treat, or control the modifiable risk factors to reduce the chances of having a heart attack.

Diagnosis and tests

Anyone who thinks they are having a heart attack should immediately seek medical attention.

A doctor will diagnose heart attack based on symptoms, age, general health, and family history. They will also carry out tests including:

  • electrocardiography (ECG) to measure the heart’s electrical activity
  • blood tests to measure cardiac markers that indicate damage to the heart
  • imaging tests, such as chest X-rays and echocardiograms
  • coronary angiography to locate blockages in the arteries

If the tests show that an individual has had a heart attack, doctors may recommend the following procedures:

  • coronary angioplasty to open blocked arteries
  • stent procedure to support an artery with a wire mesh tube
  • bypass surgery to create new routes for blood to flow around the blockage
  • implantable devices such as a pacemaker to help the heart beat normally
  • artificial heart valve surgery to replace abnormal or leaky heart valves

A doctor may also treat a heart attack with medications to thin the blood, break up clots, relax the blood vessels, and help with pain relief.


Although people cannot control all the risk factors of heart attacks, such as gender, age, and genetics, habit changes could help with prevention. These include:

  • stopping smoking
  • choosing a healthful diet that’s low in sodium, saturated fats, and sugar
  • limiting alcohol intake
  • exercising regularly
  • controlling blood sugar
  • maintaining healthy cholesterol and blood pressure

Symptoms of a heart attack

As heart attacks can be fatal, it is crucial to recognize the warnings as soon as possible and contact emergency services.

Symptoms include:

  • a feeling of pressure, tightness, pain, squeezing, or aching in the chest
  • pain that spreads to the arms, neck, jaw, or back
  • a feeling of crushing or heaviness in the chest
  • a feeling similar to heartburn or indigestion
  • nausea and sometimes vomiting
  • feeling clammy and sweaty
  • shortness of breath
  • feeling lightheaded or dizzy
  • in some cases, anxiety that can feel similar to a panic attack
  • coughing or wheezing, if fluid builds up in the lungs

The symptoms can vary in their order and duration — they may last several days or come and go suddenly.

The following may also develop:

  • Hypoxemia: This involves low levels of oxygen in the blood.
  • Pulmonary edema: This involves fluid accumulating in and around the lungs.
  • Cardiogenic shock: This involves blood pressure dropping suddenly because the heart cannot supply enough blood for the rest of the body to work adequately.

Females and males sometimes experience heart attacks differently. Learn about heart attack symptoms in females here.


A heart attack is life threatening and needs emergency attention.

Nowadays, many people survive heart attacks, due to effective treatment. Delaying treatment, however, dramatically reduce the chances of survival.

Call 911 immediately

  • Be ready to explain what has happened and where you are.
  • Stay calm and follow all instructions from the emergency team.

While waiting for the team to arrive, talk to the person, and reassure them that help is on the way.


If the person stops breathing, take the following steps:

Do manual chest compressions:

  • Lock your fingers together and place the base of your hands in the center of the chest.
  • Position your shoulders over your hands, lock your elbows, and press hard and fast, at a rate of 100–120 compressions per minute. Press to a depth of 2 inches.
  • Continue these movements until the person starts to breathe or move, until someone else can take over, or until you are exhausted.
  • If possible, take turns without pausing the compressions.

Use an automatic external defibrillator (AED)

  • AEDs are available in shopping malls and many other public places.
  • An AED provides a shock that may restart the heart.
  • Remain calm and follow the instructions. Most newer AEDs talk you through the steps.


Medical treatment

When the emergency team arrives, they will take over the person’s care.

Give the team as much detail as possible about the person’s health and what was happening before the event.

The team will try to stabilize the person’s condition, including providing oxygen.

In the hospital, a medical team will perform tests and provide appropriate treatment.

Many approaches can help, but three common options are:

  • medications, including those to dissolve blood clots
  • percutaneous coronary intervention, a mechanical method of restoring blood flow to any damaged tissue
  • coronary artery bypass grafting, commonly called a heart bypass, diverts blood around damaged areas of the arteries to improve blood flow

The healthcare team will also work with the individual to develop a treatment plan designed to prevent future attacks.


Some people experience complications after a heart attack. Depending on how severe the event was, these may include:

  • Depression: This is common after a heart attack, and engaging with loved ones and support groups can help.
  • Arrhythmia: The heart beats irregularly, either too fast or too slowly.
  • Edema: Fluid accumulates and causes swelling in the ankles and legs.
  • Aneurysm: Scar tissue builds up on the damaged heart wall, which causes thinning and stretching of the heart muscle, eventually forming a sac. This can also lead to blood clots.
  • Angina: Insufficient oxygen reaches the heart, causing chest pain.
  • Heart failure: The heart can no longer pump effectively, leading to fatigue, difficulty breathing, and edema.
  • Myocardial rupture: This is a tear in a part of the heart, due to damage caused by a heart attack.

Ongoing treatment and monitoring can help reduce the risk of these complications.


There are various ways to lower the risk of a heart attack. AHO advises people to make heart health a priority.

Ways to do this include:

  • avoiding or quitting smoking
  • having a balanced, healthful diet
  • getting regular exercise
  • managing diabetes, high cholesterol levels, high blood pressure, and other conditions
  • limiting alcohol intake
  • maintaining a healthy body weight
  • whenever possible, avoiding stress or practicing ways to reduce it

Knowing the symptoms of a heart attack can help a person get prompt treatment, and this increases the chances of a positive outcome.



In the hospital, a doctor will ask about symptoms. When making a diagnosis and drawing up a treatment strategy, they will take into account the person’s:

  • age
  • overall health
  • medical history
  • family history

They will also need to carry out tests, which include:

  • imaging tests, such as X-rays, CT scans, and echocardiograms
  • electrocardiography, to measure electrical activity in the heart
  • blood tests, which can confirm that a heart attack has occurred
  • cardiac catheterization, which enables a doctor to examine the inside of the heart



Recovering can take time, depending on the severity of the heart attack and other factors, such as the cause and the person’s age.

Some factors involved include:

  • Cardiac rehabilitation: The healthcare team will help the person make a plan to restore their health and prevent another heart attack.
  • Resuming physical activity: A healthcare provider can help develop a suitable activity plan.
  • Returning to work: The timing of this depends on the person’s job and the severity of the heart attack.
  • Driving: A doctor will advise about the timing, which varies from person to person.
  • Sex: Most people can resume sexual activity after 4–6 weeks. Erectile dysfunction can result from medication use, but treatment can help resolve this.

Many people experience depression during recovery from a heart attack, but counseling, support groups, and treatments can help.


Risk factors

As the AHA note, the following can increase the risk of a heart attack:

  • older age
  • male sex
  • high cholesterol levels
  • high blood pressure
  • other health conditions, such as obesity or diabetes
  • having a diet high in processed foods and added fats, sugars, and salt
  • low activity levels
  • genetic factors and family history
  • smoking
  • a high alcohol intake
  • high levels of stress

Often, a heart attack results from a combination of factors.

In addition, the AHA report that Black people, Latin Americans, Native Americans, Native Hawaiians, and some Asian Americans have increased risks of high blood pressure and dying of heart disease, compared with their white counterparts.