Symptoms of a heart attack
Heart attack symptoms vary from one person to another. The most common signs of a heart attack are:
Women are less likely to recognise symptoms of a heart attack and often delay calling 999
- Pain or discomfort in your chest that suddenly occurs and doesn’t go away.
- The pain may spread to your left or right arm or may spread to your neck, jaw, back or stomach. For some people the pain or tightness is severe, while other people just feel uncomfortable.
- You may also feel sick, sweaty, light-headed or short of breath.
It’s possible to have a heart attack without experiencing ‘classic’ chest pain. This is more common in the elderly, women, or those with diabetes as the condition can cause nerve damage which can affect how you feel pain.
During a heart attack there is also the risk of having a cardiac arrest. This is when your heart stops pumping blood and normal breathing stops.
The difference between a heart attack and cardiac arrest
A heart attack is when one of the coronary arteries becomes blocked. The heart muscle is robbed of its vital blood supply and, if left untreated, will begin to die because it is not getting enough oxygen. If you are having a heart attack you will be conscious.
A cardiac arrest is when a person’s heart stops pumping blood around their body and they stop breathing normally. If you are in cardiac arrest you will be unconscious and need to receive CPR immediately.
Don't delay seeking medical help
We know that women tend to wait longer before calling 999 after first experiencing heart attack symptoms.
This might be because women are less likely to recognise the symptoms, they’re reluctant to cause a fuss, or they don’t want to be embarrassed if it turns out that their situation isn’t serious.
An average of 3 women die of a heart attack every hour. Delaying calling 999 can dramatically reduce your chance of survival.
Should I take an aspirin?
The first thing to do if you think you're having a heart attack is to phone 999 immediately for an ambulance.
Not everyone who has a heart attack experiences chest pain
You should then sit and rest while you wait for the ambulance to arrive. Do not get up and look around for an aspirin. This may put unnecessary strain on your heart.
Chew an adult aspirin tablet (300mg) if one is easily available, unless you’re allergic to aspirin or you’ve been told not to take it.
If you don’t have an aspirin next to you, or if you don’t know if you’re allergic to aspirin, just stay resting until the ambulance arrives. If possible, get someone to open the door for the paramedic as this saves time.
What are the causes of a heart attack?
Most heart attacks happen when the inside of one or more of your coronary arteries become narrowed due to a gradual build-up of fatty deposits called atheroma.
If a piece of this fatty material breaks off, a blood clot forms to try and repair the damage to the artery wall. This blood clot can block your coronary artery, causing part of your heart muscle to be starved of blood and oxygen. This is a heart attack.
You might also hear a heart attack called acute coronary syndrome, myocardial infarction (MI) or coronary thrombosis.
Other rarer causes of a heart attack include spontaneous coronary artery dissection (SCAD) where one or more of the coronary arteries tear.
How is a heart attack diagnosed?
The ambulance team will do a test called an electrocardiogram (ECG) to try to find out if your symptoms are due to a heart attack. This has to be done quickly so that it doesn’t delay your transfer to hospital.
The test involves putting small sticky patches called electrodes on your arms, legs and chest. These are connected by wires to a machine which records the electrical impulses in your heart that make it pump. The paramedics may be able to diagnose if you’re having a heart attack from the specific changes that are seen on your ECG results.
You may need further tests to diagnose a heart attack if the ECG isn’t conclusive.
What treatment will I need?
If you have a heart attack you need to have treatment as soon as possible.
Early treatment to get the blood flowing to the damaged part of your heart muscle again can save your life and limit the amount of permanent damage to your heart muscle.
Many people who have a heart attack need to have emergency treatment to unblock the coronary artery.
- You might have a treatment called primary angioplasty, which is a procedure to re-open the blocked coronary artery and usually involves inserting one or more stents to help keep the narrowed artery open.
- Or you might have thrombolysis, which means giving you a ‘clot-busting’ medicine to dissolve the blood clot that is blocking the coronary artery.
In some types of heart attack people do not receive either of these two treatments because it may not be safe or appropriate.
You will usually stay in hospital for about two to five days, depending on what treatment you have had and how well you begin to recover.
What happens to my heart after a heart attack?
A heart attack can be a frightening experience and it can take time to come to terms with what has happened. It’s natural to be worried about your recovery and future.
Many people make a full recovery and within a few months are able to return to their normal activities. Some people may find that they are not able to do as much as they previously did, but attending cardiac rehabilitation will increase your chances of getting back to normal as quickly as possible.
Will it happen again?
Having one heart attack does increase the risk of having another, but this risk is greatly reduced with the correct treatment. And, if you take the medicines your doctors have prescribed for you and follow a healthy lifestyle, you can significantly reduce your risk.
Preventing a heart attack
Living a healthy lifestyle can help prevent you from developing coronary heart disease and having a heart attack.
There are a number of lifestyle factors that can increase your chances of getting coronary heart disease. These include:
But the good news is that you can do something about them. Find out more about making changes to your lifestyle to keep your heart healthy
If you're 40-74 you should ask your doctor or nurse for a heart health check to assess your risk of having a heart attack in the next 10 years.
Identifying and managing a condition such as high blood pressure or high cholesterol could help lower your risk of a heart attack in the future. You are considered to have a family history of heart and circulatory diseases if:
- your father or brother was under the age of 55 when they were diagnosed with heart and circulatory disease, or
- your mother or sister was under the age of 65 when they were diagnosed with heart and circulatory disease.
For women, your hormones may give you some protection from heart and circulatory diseases in your pre-menopause years. Post menopause, your risk rises - and continues to rise as your get older. It is then important to be aware of the lifestyle factors that can increase your chances of developing heart and circulatory diseases.
After a heart attack you are usually referred to a cardiac rehabilitation service for specialist advice, support and physical activity, if there is one available in your area.
Cardiac rehab is a mix of exercise, education, relaxation and psychological support. It aims to help you recover and get back to living your life as fully as possible.
Read more content about heart attacks:
Heart attack booklet
This booklet is for people who have had a heart attack, and their family and friends. It explains what a heart attack is and how it is treated, including primary coronary angioplasty. It also has information about recovery from a heart attack, and what you can do to help yourself stay healthy.
Order or download
This booklet is also available to download in large print
Read more about heart attacks in Heart Matters magazine
Researching heart attack, saving lives
Sadly, not everyone survives a heart attack. But things are changing. Research helps us improve the treatment and prevention of heart attacks. That's why we fund scientists, like BHF Professor Steve Watson, to help us understand more about how we can treat heart attacks.