Recognizing the Symptoms of Heart Problems

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In Hollywood movies, someone having a heart attack clutches their chest and suddenly falls to the floor. Everyone in the room knows what’s going on: The person is having a heart attack.

In reality, heart attack symptoms can be much less dramatic. Most start slowly with mild pain or discomfort. The symptoms can be so subtle that you might even put off getting help.

A heart attack is often the end result of coronary artery disease, which develops slowly and is the most common form of heart disease. With time, cholesterol and other material, called plaque, build up in the arteries that feed blood to the heart. The plaque can narrow and eventually block the artery or arteries. If not enough oxygen-rich blood reaches your heart, you might feel chest pain (angina) or suffer a heart attack. Most heart attacks occur when a blood clot suddenly disrupts the heart’s blood supply, leaving you with permanent damage to the heart muscle.

Symptoms of Heart Attack 

Discomfort or pain in the center of the chest is the classic sign of a heart attack. It can last for more than a few minutes or go away, only to return later on. It can feel like an uncomfortable squeezing, pressure, pain, or fullness. Be aware of these other red flags, too: 

  • Shortness of breath
  • Tingling down the arm (usually the left one) 
  • Profuse sweating
  • Dizziness and weakness

Sometimes, heart disease and heart attack symptoms can be more subtle and mild, though no less dangerous: 

  • Heartburn, nausea, vomiting, or upper abdominal pain 
  • Back, shoulder, neck, or jaw pain 
  • Anxiety
  • Extreme fatigue 
  • Pounding heartbeat or feeling extra beats or a fluttering in the chest
  • Insomnia
  • Erectile dysfunction (being unable to get or keep an erection)

Symptoms of Heart Disease and Heart Attack in Women 

Though you might think of heart disease as a men’s health issue, it’s also the leading killer of women in the United States. There are some notable differences in symptoms between men and women: 

  • Many women who have a heart attack do not experience chest pain. 
  • More than 70% of women experience early warning signs, such as extreme weakness that can seem like the flu.
  • Women often confuse signs of a heart attack with those of a panic attack, like anxiety, shortness of breath, and indigestion.  
  • In men, plaque often collects in clumps, but in women, it may spread out evenly throughout artery walls. This can make heart disease harder to detect in women.
  • The hormone estrogen is thought to protect women against heart disease. So, if you’re past menopause (in general older than 50), you’re more at risk for a heart attack than a younger woman. 
  • 42% of women who have heart attacks die within a year, while only 24% of men do. 

When Coronary Artery Disease Leads to Heart Failure 

Coronary artery disease can weaken your heart muscle and contribute to heart failure. That’s when your heart can’t pump blood efficiently throughout your body. Heart failure symptoms include: 

  • Fatigue and shortness of breath due to blood and fluid backing up from the heart and building up in the lungs. 
  • Fluid buildup in the feet, ankles and legs. This swelling is known as edema.

You can learn more about heart failure, coronary artery disease, and heart attack through the American Heart Association. For more information on heart disease and women, go to the Women's Heart Foundation.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Mar 31, 2017

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Medical References

1. Warnings Signs of a Heart Attack, Stroke, or Cardiac Arrest. American Heart Association.

2. Coronary Artery Disease. U.S. National Library of Medicine. National Institutes of Health.

2a. Heart Disease in Women. U.S. National Library of Medicine. National Institutes of Health.

2b. Heart Failure. U.S. National Library of Medicine. National Institutes of Health.

3. Heart Attack Symptoms: An Action Plan for Women. Women’s Heart Foundation.

3a. Panic Attack or Heart Attack? Women’s Heart Foundation.

3b. Women and Heart Disease Fact Sheet. Women’s Heart Foundation.

4. Women and Heart Disease. American College of Cardiology.

5. Erectile Dysfunction Often a Sign of Heart Disease. Harvard Medical School.

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