What Are the Signs of An Impending Heart Attack?

A heart attack, also called myocardial infarction (MI), happens when the blood flow from the coronary arteries to the heart is reduced or blocked completely. When this occurs, it starves the heart muscle of oxygen and nutrients, resulting in damage to the heart.

If you think you might be having a heart attack, call 9-1-1 immediately. Do not drive yourself to a hospital.

Symptoms of a heart attack include:

• Chest pain (angina) or discomfort 
  • May feel like pressure, squeezing, or fullness
  • Lasts for more than a few minutes
  • May go away and come back
• Pain, tingling, or discomfort in one or both arms, the back, neck, jaw, or stomach
• Shortness of breath
• Racing or irregular heartbeat
• Cold sweat/clammy skin
• Nausea 
• Vomiting
• Belching
• Heartburn
• Lightheadedness
• Dizziness
• Extreme fatigue

Both women and men tend to have chest pain or discomfort when a heart attack occurs, but women are more likely to experience shortness of breath, nausea, vomiting, dizziness or lightheadedness, extreme fatigue, and back or jaw pain.

The main cause of heart attacks is coronary artery disease, a condition that develops over time in which plaque builds up along the walls of the coronary arteries, narrowing the channels through which blood flows. If a plaque ruptures, this can result in a blood clot which can block off the artery and prevent blood from reaching parts of the heart muscle, causing a heart attack.

Other less common causes of heart attack include:

• Temporary spasm of a coronary artery 
• Spontaneous coronary artery dissection, which is a tearing of the coronary artery wall

If a heart attack is suspected, diagnostic tests may include:

• Electrocardiogram (ECG)
• Blood tests 
  • Cardiac troponin test
• Echocardiogram (“echo”)
• Cardiac catheterization (angiogram)
• Chest X-ray
• Cardiac computerized tomography (CT) scan 
• Cardiac magnetic resonance imaging (MRI) 

Treatment for a heart attack in a hospital’s emergency department may include:

• Oxygen
• Pain medications
• Aspirin
• Anticoagulants to prevent blood clots
• Beta-blockers
• Nitroglycerin
• Angiotensin converting enzyme (ACE) inhibitors
• Statins
• Thrombolytics (clot busters) given intravenously (IV)
• Stenting (inserting devices inside heart blood vessels to keep them open)

Surgical treatment for heart attack involves a coronary artery bypass graft (CABG).

Complications of a heart attack include:

• Abnormal heart rhythms (arrhythmias)
• Heart failure 
• Pericarditis (inflammation of the lining around the heart)
• Tears in the heart muscle or heart walls
• Problems with the heart valves
• Blood clots in the lung (pulmonary embolism)
• Strokes

A heart attack is not necessarily fatal. 

About one in five patients 45 years and older have another heart attack within five years of their first. Life expectancy after a heart attack depends on several factors, such as: 

• Ethnicity: African Americans typically have a shorter post-heart attack life expectancy by about 6% compared with people of European descent. 
• Gender: Women lose about 10% more of their life expectancy post-heart attack compared with men

If you are at risk for having a heart attack, you may be able to prevent one from occurring or recurring in some cases. 

• Take all medications for your heart or for blood clots as directed
• Eat a healthy diet low in fat and high in fiber (plant-based diets may be especially helpful for people with heart disease)
• Maintain a healthy weight
• Exercise regularly
• Don’t smoke tobacco
• Manage high blood pressure, high cholesterol, and diabetes