Heart attack

Symptoms and getting help for a heart attack

A heart attack (sometimes called myocardial infarction) usually causes severe pain in the centre of the chest. The pain usually feels like a heaviness or tightness, which may also spread to the arms, neck, jaw, back or stomach. The pain may affect only the neck, jaw, arms or stomach. A person having a heart attack may also sweat, feel light-headed, feel sick, or be short of breath or have an overwhelming feeling of anxiety.

Many of the people we interviewed had severe chest pain which spread to their arm, and they called '999' for an ambulance or they called their GP.

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One woman said the pain was so severe that she couldn't speak. Others likened it to having their chest in a vice that was slowly being tightened, or an elephant balancing on their chest. For some people the pain was not severe at first but it kept coming back. It was only when it got more severe that they realised that they had to get help.

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Sometimes mild pain was accompanied by shortness of breath, sweating, or feeling sick. One woman had mild chest pain, which she thought might be her hiatus hernia but was sufficiently concerned to contact NHS direct. During the call she felt sick and started sweating, and the nurse agreed that it might be a heart attack and called an ambulance.

Several people who had milder chest pain mistook it for indigestion and took antacid medicine, and only when that didn't work, rang their GP or went to accident and emergency.

You can have a heart attack without having chest pain. One 52-year-old woman said she had pains in her arms, she was sick and said she had never felt so unwell.

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Another said she had sensations in her chest and throat and pain in her left arm, and she thought she was having a panic attack. One 37-year-old woman felt sick, started sweating, felt short of breath and had pins and needles in her arms and legs.

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When there is no chest pain, people may not realise they are having a heart attack. But it was very rare for people, even though they might not have typical symptoms, not to realise that there was something serious going on. One man in his early forties kept getting bouts of severe back pain, which he did not relate to his heart, but when it got really bad he decided to go to casualty.

Another man had what he described as five-minute episodes of discomfort in the centre of his stomach, which he found debilitating rather than painful. Two days later he had what he thought was indigestion, becoming nauseous and experiencing an overwhelming feeling of tiredness. It was at this point that he was diagnosed as having had a heart attack. 

One 37-year-old woman describes the pains she had in her teeth and arms. Another man, a hospital consultant, explained that he had what felt like severe heartburn but none of the classic symptoms of a heart attack.

Occasionally, a heart attack is 'silent' and produces little discomfort. People may not know they have had one until they have a medical investigation for other symptoms or a routine medical examination (see 'Initial emotions').

A few people said they had no symptoms and had felt well before their heart attack. Several described breathlessness, chest pain when walking up a hill or exercising, arm pains, or felt lethargic or more tired than usual in the lead up to having a heart attack. But many did not recognise the significance of these symptoms until after their heart attack. They had thought at the time that they were caused by asthma, indigestion or other gastric conditions.

Last reviewed June 2017.

Last updated June 2017.


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