Heart Attack Warning Signs: What to Look For and When to Act
A heart attack happens when blood flow to part of the heart muscle is suddenly blocked. Every minute that passes without treatment, more heart muscle is lost. Recognising the warning signs — and acting on them immediately — is the single most important thing a person can do.
The classic warning signs
Most people experience chest discomfort as the first sign. It is often described as pressure, heaviness, tightness or squeezing in the centre of the chest, rather than a sharp stabbing pain. It may last several minutes, or come and go.
Alongside chest discomfort, common symptoms include pain spreading to one or both arms, the jaw, neck, back or upper abdomen; shortness of breath; breaking into a cold sweat; nausea or vomiting; and sudden light-headedness. A sense of unexplained dread or anxiety is also commonly reported.
Symptoms that are easy to miss
Not every heart attack announces itself dramatically. Some are quiet enough that people carry on with their day.
Women more often experience shortness of breath, nausea, extreme fatigue, or pain in the back or jaw, sometimes without significant chest pain at all. People with diabetes may feel little or no pain because long-standing diabetes can affect the nerves that carry pain signals. Older adults may simply feel breathless, weak or confused.
These presentations are no less serious. They are simply harder to recognise, which is why they are often acted on too late.
What to do if you suspect a heart attack
Call your local emergency number immediately. Do not drive yourself to hospital, and do not wait to see whether the symptoms settle.
While waiting for help, sit or lie down and stay as calm and still as possible. If the person becomes unresponsive and is not breathing normally, begin chest compressions if you know how.
Emergency medical teams can begin treatment on the way to hospital, which is why calling an ambulance is safer than making your own way there.
Why time matters so much
Heart muscle begins to die within minutes of an artery being blocked. Restoring blood flow quickly — usually through emergency angioplasty — limits how much muscle is permanently lost. This is why cardiologists often repeat the phrase 'time is muscle'.
The delay that costs the most is rarely the hospital's. It is usually the hours a person spends at home hoping the discomfort will pass.
Frequently asked questions
Can a heart attack happen without chest pain?
Yes. Sometimes called a silent heart attack, it can present mainly as breathlessness, fatigue, nausea or discomfort elsewhere in the upper body. This is more common in women, in people with diabetes, and in older adults.
How is a heart attack different from angina?
Angina is chest discomfort caused by reduced blood flow, usually brought on by exertion and relieved by rest. A heart attack involves a sudden, complete blockage, and the symptoms do not settle with rest. Any new, worsening or prolonged chest discomfort should be assessed urgently.
What should I do while waiting for the ambulance?
Stop all activity, sit or lie down, and try to stay calm. Unlock the door so help can reach you. Do not eat or drink. Take medication only if it has previously been prescribed to you for this situation.
Are heart attacks becoming more common in younger people?
Cardiologists in India are seeing heart attacks at younger ages than a generation ago, linked to rising rates of diabetes, high blood pressure, smoking, sedentary work and stress. Age alone should never rule out the possibility.
Have a question about your heart health?
Consultations with Dr. Ray are held at Fortis Hospital, Anandapur, Kolkata.
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