Symptoms of a heart attack, like chest pain, shortness of breath and cold sweats, develop when blood flow to part of the heart is blocked. This leads to reduced oxygen in the affected area, and is most commonly caused by a clot or blockage in a heart artery.

Heart attack symptoms and the way they present can vary from person to person. Diabetics, women and older adults may present with mild or atypical symptoms, like excessive fatigue and back pain.

If you suspect your symptoms are related to a heart attack, you should call 911 and seek medical attention urgently. Heart attack symptoms that are treated promptly will reduce the risk of permanent heart damage and improve chances of survival.

Main symptoms

The main symptoms of a heart attack include:

Chest pain, which can be described as crushing, tightening, heaviness, pressure or stabbing sensation
Pain that radiates to the shoulder, neck, jaw, back or arm (most commonly on the left side)
Feeling dizzy or lightheaded
Palpitations
Shortness of breath
Stomach pain or burning
Nausea
Cold sweats and pallor
Unusual fatigue or weakness
Loss of consciousness

These symptoms usually happen or intensify with physical exercise, stress, or following a meal, as these types of situations put more strain on the heart and generally affect circulation. It is also important to note that not all heart attacks will start with classic chest pain.

Although these are the most common heart attack symptoms, this condition can present in different people, as follows:

1. Heart attacks in women

Women may present with symptoms that can vary in comparison to men. The chest discomfort, malaise, irregular heartbeat or arm heaviness experienced can feel milder, for example. Many symptoms felt by women are typically non-specific and they may be confused with other situations like indigestion or sickness, which may delay diagnosis.

Women have a lower risk of heart attack than men, but overall risk increases after menopause due to decreased levels of estrogen. Estrogen can play a role in heart function - it is a hormone that can affect vessel dilation and blood flow. It's important to seek medical attention if you have any persistent symptoms or if they get worse following physical activity, stress, or eating.

2. Heart attacks in young patients

The above-mentioned symptoms (chest pain or tightness, arm tingling, nausea, etc.) are often not caught in younger patients, as heart attacks usually culminate in very sudden cardiac arrest. It can happen so unexpectedly that death can occur before the person even has a chance to seek medical attention. Elderly people usually have decreased heart function over time, which allows for the development of collateral circulation (growth of new vessels that help to support weakened vessels). Collateral circulation is not typically present in younger people.

Heart attacks usually occur in men over 40 and women over 50 due to damage to blood vessels that occurs silently over time. This damage can occur from conditions like high cholesterol, obesity, high blood pressure, and diabetes.

Heart attacks that occur to people under 40 are usually caused by genetic influences, resulting in changes in metabolism and circulation. This risk becomes greater, however, if the young person is obese or partakes in an unhealthy lifestyle (e.g. smoking, excessive alcohol intake, decreased physical activity, etc.)

3. Heart attacks in older adults

Elderly people have a higher risk of suffering from a silent heart attack. As mentioned, damaged vessels can be supported through the development of collateral circulation, which can help maintain blood flow to the heart. For this reasons, heart attack symptoms may start off as mild and persist for many days. The most commonly-seen symptoms in older adults are sweats, breathlessness, paleness, changes in heart rate, and chest discomfort.

Every case is different, however, and symptoms in older adults can vary. Chest pain can range from mild to intense, or the crushing sensation may be light or heavy. Pain may occur in the upper abdomen, which may be confused with gastritis or heartburn.

Older adults have a greater risk of developing heart disease overtime due to changes in circulation, changes in the natural pacemaker, or due to changes in the heart's overall functioning. The risk for heart disease can, however, decrease with a healthy lifestyle that includes physical activity and a diet rich in vegetables and low in carbohydrates and fat,

What to do

If you or someone you know presents with any symptoms of a heart attack, whether they are mild or severe, you should call 911 immediately and seek urgent medical attention. You should avoid driving if you think you are experiencing a heart attack. Acting quickly and getting prompt treatment can reduce the risk for permanent heart damage and increase the likelihood of survival.

Emergency medical services (EMS) can arrive via ambulance and start life-saving treatment immediately. EMS paramedics are also trained in CPR and resuscitation efforts if your heart attack symptoms lead to a myocardial infarction or heart failure. While waiting for EMS, be sure to remain calm and still, to reduce stress on your heart and other organs.

If you have a previous heart condition and have PRN medications to take, like nitro spray, take these medications as directed by your doctor. You should not take aspirin if you suspect you are having a heart attack, unless previously recommended by your doctor.