Not everyone has the same heart attack symptoms when having a myocardial infarction.
- About 2 out of every 3 people who have heart attacks have chest pain, shortness of breath or feel tired a few days or weeks before the attack.
- A person who has angina (temporary chest pain) may find that it happens more often after less and less physical activity. A change in the pattern of angina should be taken seriously.
- During a heart attack, a person may feel pain in the middle of the chest that can spread to the back, jaw or arms. The pain may also be felt in all of these places and not the chest. Sometime the pain is felt in the stomach area, where it may be taken for indigestion. The pain is like that of angina but usually more severe, longer lasting and does not get better by resting or taking a nitroglycerin pill.
- About 1 out of every 3 people who have heart attacks do not feel any chest pain. These people are more likely to be women, non-Caucasian, older than 75, someone with heart failure or diabetes and someone who has had a stroke.
Other common symptoms include:
- Sudden sweating
- Shortness of breath, especially in older people
- Heavy pounding of the heart
- Abnormal heart rhythms (arrhythmias), which occur in more than 90% of the people who have had a heart attack
- Loss of consciousness, which sometimes is the first symptom of a heart attack
- Feelings of restlessness, sweatiness, anxiety and a sense of impending doom
- Bluishness of the lips, hands or feet
- Older people may have symptoms that resemble a stroke and may become disoriented
Older people, especially women, often take longer than younger people to admit they are ill or to seek medical help
During the early hours of a heart attack, heart murmurs and other abnormal heart sounds may be heard through a stethoscope.
Causes and Risk Factors
A heart attack (myocardial infarction) is usually caused by a blood clot that blocks an artery of the heart. The artery has often already been narrowed by fatty deposits on its walls. These deposits can tear or break open, reducing the flow of blood and releasing substances that make the platelets of the blood sticky and more likely to form clots. Sometimes a clot forms inside the heart itself, then breaks away and gets stuck in an artery that feeds the heart. A spasm in one of these arteries can cause the blood flow to stop.