Early Signs of a Heart Attack
Hollywood portrays heart attacks as sudden, intense chest pain. But the reality is subtle warning signs can start months before an actual heart attack occurs, says Zi-Jian Xu, M.D., a cardiologist with Sutter Health.
When Symptoms Can Begin
It depends. For some people, symptoms begin months or even longer before a heart attack occurs, Dr. Xu says. Others might not experience anything before a heart attack happens.
There are two main ways that people present with heart attacks, Dr. Xu says:
- Sudden: A person may or may not have any symptoms previously, but suddenly a plaque deposit ruptures, triggering a chain of events and a sudden heart attack.
- Gradual: The other presentation happens slowly as coronary disease progresses. In this situation, an artery is getting narrower over time. When the artery is narrowed down more than 70%, you’ll start to have warning symptoms, especially with physical exertion.
Early Heart Attack Symptoms
Dr. Xu says many patients experience early symptoms, including:
- Cold sweats
- Heaviness or discomfort
- Heart palpitations
- Radiating chest pain
- Shortness of breath
Others — women more so than men — may experience some atypical symptoms as well, including:
- Back or abdominal pain
- Declining stamina
- Fatigue
- A general sense of unease
- Vague discomfort
Both types of symptoms can be experienced months before an actual heart attack occurs.
Know Your Risk
It’s important to know your risk for heart disease to assess early symptoms. When Dr. Xu works with a patient, he discusses their risk factors, such as:
- Age and disease history
- Blood pressure
- Cholesterol levels
- Family and personal history
Once you know your risk, you can work with your doctor to assess your symptoms. Dr. Xu will ask patients if their symptoms are typical, how often and when they occur, what activities cause them, and if they’re happening in conjunction with other symptoms, like shortness of breath or rapid heartbeat.
When To See a Doctor
It’s important not to ignore symptoms or wait until they become severe. If you have a concern, talk to your doctor. If heart disease is caught early, there are many lifestyle changes you can make to reduce your risk of further problems:
- Don’t smoke. If you’re a smoker, quit now.
- Eat a healthy diet with plenty of fruits and vegetables.
- Get regular exercise (for most people, about 150 minutes per week).
- Maintain a healthy weight, drink alcohol in moderation (if at all).
If a young, healthy patient doesn’t have other risk factors, the likelihood of heart attack is low. It may not be appropriate to jump into testing. If your symptoms don’t go away or get worse, go back to a doctor for further evaluation or seek a second opinion.
If you’re concerned about heart attack risks, schedule an appointment with your doctor.