Typically when we think of someone having a heart attack, or a myocardial infarction (MI), we think of the person clutching their chest and collapsing in pain.  This is often how a MI is portrayed on TV and in movies, but in reality a MI can be much more subtle.  Crushing-drop-to-the-ground type of chest pain may not always be a part of a MI. 

Chest pain that is “typical” for a MI is pain that is located in the sternum (breast bone) or left side of the chest.  Pain may radiate to the left arm, the jaw, neck or back.   Stable angina (chest pain) typically begins with exertion or stress and is relieved after a few minutes of rest or nitroglycerin.  Unstable angina is unpredictable and often occurs at rest.  Unstable angina may be longer lasting and more severe than stable angina.  Pain may be described in many ways – pressure, burning, heaviness, crushing – to name a few.  No chest pain should be ignored, so if a person is experiencing chest pain, they need to call 911 or go to the nearest emergency room.

Chest pain may be accompanied by other symptoms such as palpitations (“heart racing” or fluttering sensations), shortness of breath, fatigue, nausea or vomiting, dizziness or lightheadedness, sweating or cold sweats.  Some people may not experience chest pain as part of their MI and may just experience some the symptoms listed above. Again, symptoms that are out of the norm or that may signal a MI should not be ignored… seek emergency care.

A person may be fortunate enough to experience warning signs of a heart attack that are more subtle and gradual.  It may begin as a tired feeling or a sense of discomfort.  People may experience discomfort in the chest, arms, back, jaw or other areas of the upper body.  Fatigue or an inability to keep up with normal activities may also give a hint that there may be trouble.  A person who is experiencing these symptoms should seek the advice of a health care professional.

What about women?  What are the signs and symptoms of a heart attack for women? 

According to the American Heart Association, chest pain is still the most common symptom of a MI in a woman.  However, women are more likely to experience other symptoms as well, such as shortness of breath, nausea or vomiting and jaw or back pain.  Women may mistakenly think that they cannot have a heart attack…  “It is a man’s disease” or “I am too young to have a heart attack” or “I am sure these symptoms are caused by something else”.  Women who are going through hormonal changes may grow accustomed to abnormal sensations and discomfort.  Women are often accustomed to taking care of others and not themselves.  Although a woman may not believe they are at risk for heart disease or heart attack, heart disease is still the number one killer of women.  So, if a woman is experiencing chest pain or other symptoms that may be warning signs of a heart attack, she should seek emergency medical care. 

Answer submitted by Melissa Leguillon, APN, CNP, Nurse practitioner, Cardiovascular Services at Provena Mercy Medical Center.