What Does a Heart Attack Start Like?

One of the first symptoms of a heart attack includes chest pain or discomfort (angina). This may feel like squeezing or fullness, and can last for more than a few minutes and may go away and come back.

A heart attack (also called myocardial infarction or MI), happens when blood flow from the coronary arteries to the heart is reduced or blocked. This starves the heart muscle of oxygen and nutrients and results in damage to the heart. 

A heart attack may start with symptoms such as: 

• Chest pain or discomfort (angina) 
  • May feel like squeezing or fullness
  • Lasts for more than a few minutes
  • May go away and come back
• Pain, tingling, or discomfort in other parts of the upper body, such as one or both arms, the back, neck, jaw, or stomach
• Shortness of breath 
• Cold sweats/clammy skin
• Nausea 
• Dizziness or lightheadedness

Other signs of a heart attack may be considered “silent” signs because people may not recognize them as symptoms of a heart attack, such as: 

• Racing or irregular heartbeat
• Vomiting
• Belching
• Heartburn
• Extreme fatigue

Both men and women have chest pain or discomfort, but women are more likely to experience shortness of breath, nausea, vomiting, extreme fatigue, dizziness or lightheadedness, and back or jaw pain during a heart attack.

A heart attack is a medical emergency. If you think you might be having a heart attack, call 9-1-1 and get to a hospital’s emergency department immediately. Do not attempt to drive yourself.

The main cause of most heart attacks is coronary artery disease, a condition that develops over time in which plaque builds up along the walls of the coronary arteries, narrowing the arteries and reducing or blocking blood flow. If a plaque ruptures, a blood clot can occur which can block off the artery and prevent blood from reaching parts of the heart muscle, causing a heart attack.

Less common causes of a heart attack include:

• Transient coronary artery spasm
• Tearing of the coronary artery wall (spontaneous coronary artery dissection)

If a heart attack is suspected, is it diagnosed with a patient history and physical exam, along with diagnostic tests such as:

• Blood tests 
  • Cardiac troponin test
• Electrocardiogram (ECG)
• Echocardiogram (“echo”)
• Cardiac catheterization (angiogram)
• Chest X-ray
• Cardiac computerized tomography (CT) scan 
• Cardiac magnetic resonance imaging (MRI) 

A heart attack is a medical emergency. Call 9-1-1 and get to a hospital’s emergency department immediately (do not drive yourself) if you experience symptoms of a heart attack.

Immediate treatment for a heart attack in a hospital’s emergency department may include:

• Oxygen
• Aspirin
• Anticoagulants 
• Beta-blockers
• Angiotensin converting enzyme (ACE) inhibitors
• Nitroglycerin
• Statins
• Pain medicines
• Thrombolytics (clot busters) given intravenously (IV)
• Stenting

Coronary artery bypass graft (CABG) surgery may be needed. It is a surgical procedure in which a blocked coronary artery is bypassed using a healthy blood vessel from another part of the body.