Heart attack signs: 7 early warning symptoms through chest pain

Every year, millions of cases of heart attacks are recorded worldwide, with many deaths occurring because patients do not recognize the signs of a heart attack or delay going to the hospital. According to statistics, only about a quarter of people can fully recognize the warning symptoms of this dangerous condition. More worryingly, not everyone with chest pain experiences severe pain as depicted in movies, leading many to be complacent and miss the "golden hour" for treatment.

Tiptory believes that understanding the signs of a heart attack, distinguishing common chest pain from heart-related pain, and knowing how to handle emergencies can significantly reduce the risk of permanent heart damage and increase the chances of survival. The article below will help you recognize early warning symptoms, understand when to call for immediate help, and what absolutely not to hesitate about if you suspect a heart attack.

Part 1: When to call for a heart attack emergency?

Symptom 1: Pay attention to chest pain

Recognizing abnormal chest pain

• Chest pain is the most common sign of a heart attack, but the sensation of pain can vary from person to person.
• You may experience one or more of the following:
  • A squeezing, heavy, or tight feeling in the chest.
  • Chest tightness, discomfort, or sharp pain.
  • A feeling of fullness in the center of the chest or the left side of the chest.
• The pain may last for several minutes, subside, then recur multiple times. If the symptoms do not improve or appear continuously, a heart attack should be considered.

Don't be complacent if the pain is mild

• Many people believe that a heart attack always causes severe pain, but this is not always the case.
• Some cases only have a dull ache, mild tightness, or discomfort in the chest, which can be easily mistaken for fatigue, muscle pain, or digestive disorders.
• Even if the chest pain is not severe, you should not monitor it at home if the symptoms appear suddenly, last for a long time, or are accompanied by shortness of breath, sweating, nausea, or dizziness.

Beware of pain behind the breastbone

• Pain behind the breastbone is a typical sign of a heart attack.
• Patients often feel pain in the middle of the chest, right behind the breastbone, and it can radiate to the neck, shoulder, jaw, or left arm.
• Many people mistake this pain for bloating, acid reflux, or stomach pain, leading to delays in seeking medical attention.
• If you are unsure of the cause of the pain, Tiptory recommends contacting a medical facility or calling emergency services for timely evaluation.

You can still have a heart attack without chest pain

• Not everyone who has a heart attack experiences chest pain.
• In fact, many people only have symptoms such as:
  • Sudden shortness of breath.
  • Unusual weakness.
  • Nausea or vomiting.
  • Cold sweats.
  • Dizziness or feeling faint.
• Therefore, do not rule out the possibility of a heart attack just because you don't have chest pain. When multiple signs of a heart attack appear at the same time, go to the hospital or call for emergency help as soon as possible to reduce the risk of dangerous complications.

Symptom 2: Monitor pain radiating to the upper body

Pay attention to pain radiating beyond the chest area

• The signs of a heart attack not only appear in the chest but can also radiate to many other parts of the body.
• The pain usually starts in the chest and then spreads to one or more areas such as:
  • Neck.
  • Jaw.
  • Shoulder and left arm.
  • Upper back.
  • Upper abdomen.
• This is a fairly typical sign of a heart attack, especially when it occurs along with chest pain, shortness of breath, or cold sweats.

Recognizing the characteristics of the pain

• Radiating pain often feels dull, aching, or heavy rather than sharp and severe.
• Some people only feel shoulder aches, left arm pain, or jaw stiffness, which can be easily mistaken for muscle pain, spinal degeneration, or fatigue from work.
• If the pain appears suddenly, lasts for several minutes, or recurs without clear reason, you should not be complacent.

Distinguishing from common muscle pain

• Pain from exertion or injury usually appears after heavy lifting, intense exercise, or impact, and tends to decrease with rest.
• Conversely, pain related to a heart attack can appear even at rest, is not related to physical activity, and is often accompanied by other signs of a heart attack such as:
  • Shortness of breath.
  • Nausea.
  • Cold sweats.
  • Dizziness or lightheadedness.

Do not delay emergency treatment

• If you experience chest pain accompanied by pain radiating to your neck, jaw, back, or left arm, and cannot find a clear cause, go to a medical facility or call for emergency help immediately.
• Do not wait for symptoms to disappear on their own, as treating a heart attack as early as possible will help preserve heart muscle and increase the chance of recovery.

Symptom 3: Be cautious of dizziness, lightheadedness

Don't underestimate dizziness or lightheadedness

• The signs of a heart attack are not just chest pain but can also manifest as dizziness, lightheadedness, or loss of balance.
• Some patients feel their head spinning, unsteady on their feet, or feel like they are about to faint, even when resting.
• These symptoms can appear before, during, or at the same time as other signs of a heart attack.

Fainting can be a dangerous warning sign

• When the heart does not pump enough blood to the brain due to a heart attack, the patient may faint or lose consciousness for a short period.
• If fainting occurs along with chest pain, shortness of breath, cold sweats, or abnormal heartbeats, call for emergency help immediately as this could be a life-threatening condition.

Do not confuse with common causes

• Dizziness and lightheadedness can stem from many other causes such as low blood pressure, low blood sugar, dehydration, or vestibular disorders.
• However, if the symptoms appear suddenly, last for a long time, or are accompanied by multiple signs of a heart attack, you should not self-diagnose or wait for the symptoms to resolve on their own.
• Tiptory recommends seeking medical attention early for examination and accurate diagnosis.

Women are often more prone to this symptom

• In women, a heart attack can manifest with atypical symptoms such as dizziness, unusual fatigue, or a feeling of impending faint, instead of just chest pain.
• Therefore, if these symptoms appear, especially in individuals with risk factors such as high blood pressure, diabetes, dyslipidemia, or a history of cardiovascular disease, seek medical attention as soon as possible.

Symptom 4: Don't ignore shortness of breath

Monitor unusual shortness of breath

• Shortness of breath is one of the signs of a heart attack that can appear very early but is often overlooked.
• Patients may feel:
  • Sudden rapid breathing or breathlessness.
  • A feeling of not getting enough air.
  • Difficulty breathing even when sitting or not exercising.
• Unlike shortness of breath after exercise or heavy labor, symptoms due to a heart attack often appear suddenly and without a clear cause.

Recognizing shortness of breath due to a heart attack

• Many people describe a feeling as if they have just done intense exercise, even though they are actually sitting or resting.
• This condition can be accompanied by chest pain, pain radiating to the shoulder or left arm, cold sweats, nausea, or dizziness.
• In some cases, shortness of breath appears before chest pain or is the most prominent sign of a heart attack.

Shortness of breath can be the only symptom

• Not everyone who has a heart attack experiences typical chest pain.
• Some people only experience prolonged or worsening shortness of breath without chest pain.
• This is common in older adults, women, and people with diabetes, making diagnosis more difficult.

Seek immediate treatment for unexplained shortness of breath

• If you suddenly experience shortness of breath while resting or performing light activity, especially when accompanied by other signs of a heart attack such as chest pain, pain radiating to the neck or arm, dizziness, or cold sweats, call for emergency help or go to the hospital immediately.
• Do not wait for symptoms to disappear on their own, as treating a heart attack in the first few hours will help reduce heart muscle damage and increase the chance of recovery.

Symptom 5: Be cautious of nausea, sweating

Don't underestimate unusual nausea

• Nausea is an often overlooked but quite common sign of a heart attack, especially in women and the elderly.
• Patients may feel:
  • Persistent nausea.
  • Vomiting or feeling like vomiting.
  • Epigastric discomfort, easily mistaken for indigestion.
• If symptoms appear suddenly, unrelated to eating or stomach problems, you should be aware of the risk of myocardial infarction.

Cold sweats are a dangerous warning sign

• When a myocardial infarction occurs, many people suddenly experience cold sweats, clammy and pale skin, even without physical activity or in non-hot weather.
• This is the body's reaction when the heart does not receive enough blood and oxygen.
• This condition is often accompanied by chest pain, shortness of breath, dizziness, or a feeling of exhaustion.

When nausea is accompanied by many other symptoms

• The risk of myocardial infarction increases if nausea or vomiting occurs along with:
  • Chest pain or a feeling of pressure in the chest.
  • Pain radiating to the shoulder, left arm, neck, or jaw.
  • Shortness of breath.
  • Dizziness or near fainting.
  • Cold sweats.
• This is a situation that requires urgent medical evaluation and should not be self-treated at home.

Do not confuse with digestive illnesses

• Nausea and vomiting can be caused by food poisoning, gastritis, or many other reasons.
• However, if symptoms appear suddenly, especially in individuals with cardiovascular disease, hypertension, diabetes, or dyslipidemia, you should not be complacent.
• Call emergency services or go to the hospital immediately if nausea, cold sweats, and other signs of myocardial infarction appear simultaneously, as early intervention can help limit heart muscle damage and increase survival rates.

Symptom 6: Do not ignore intense anxiety

Recognizing unusual anxiety

• Some people experience signs of myocardial infarction with intense anxiety or panic without a clear cause.
• Patients often describe feeling:
  • Restlessness, unease.
  • Rapid heartbeat, difficulty calming down.
  • A premonition that something very serious is about to happen.
• In medicine, this is also known as a sense of impending doom, a symptom that can be found in people with myocardial infarction.

Do not assume it's just stress

• Anxiety or panic can stem from many causes, but if it appears suddenly and is accompanied by other signs of myocardial infarction, particular caution is needed.
• Pay attention if anxiety is accompanied by:
  • Chest pain or chest tightness.
  • Shortness of breath.
  • Cold sweats.
  • Dizziness or lightheadedness.
  • Nausea or vomiting.
• The combination of these symptoms can signal a cardiovascular emergency.

Action needed immediately when suspicious signs appear

• If you or someone around you suddenly experience intense, unexplained panic, especially when accompanied by chest pain or other signs of myocardial infarction, call emergency services or go to the hospital immediately.
• Do not reassure yourself that this is just an anxiety attack or stress, as early assessment and treatment of myocardial infarction are crucial in protecting the heart muscle and reducing the risk of death.

Symptom 7: Call emergency services immediately if you suspect a heart attack

Do not hesitate if you suspect myocardial infarction

• If you or someone around you shows signs of myocardial infarction, call emergency services immediately instead of waiting for the symptoms to resolve on their own.
• The sooner treatment is received, the more it will help restore blood flow to the heart, reduce heart muscle damage, and increase the chance of survival.
• Even if you only suspect myocardial infarction, you should consider it a medical emergency.

Do not delay thinking symptoms will resolve on their own

• Many people tend to wait a few hours to see if their condition improves or assume it's just angina, stomach pain, or common fatigue.
• This hesitation can lead to prolonged oxygen deprivation to the heart, increasing the risk of heart failure, arrhythmias, and other dangerous complications.
• Even if the symptoms are mild, you should not be complacent.

Recognize situations requiring immediate emergency call

• Contact emergency services if one or more of the following signs of myocardial infarction appear:
  • Chest pain that is prolonged or recurs frequently.
  • Pain radiating to the neck, jaw, shoulder, back, or left arm.
  • Sudden shortness of breath.
  • Cold sweats, nausea, or vomiting.
  • Dizziness, lightheadedness, or fainting.
• These are all warning signs that need to be addressed as soon as possible.

Time determines survival

• Many deaths from myocardial infarction occur before the patient reaches the hospital, mainly due to delayed emergency calls or self-imposed delays in treatment.
• Do not drive yourself to the hospital if you suspect myocardial infarction is ongoing. Call emergency services for assistance and medical intervention on the way to the hospital if necessary.

Part 2: Earliest signs of myocardial infarction

Symptom 1: Early examination for chest pain

Don't be complacent with angina attacks

• Angina is chest pain or discomfort caused by the heart muscle not receiving enough blood and oxygen.
• Patients may feel:
  • Tightness or heaviness in the chest.
  • A burning sensation.
  • Pressure or fullness in the chest.
• These symptoms are easily mistaken for heartburn or acid reflux, leading many people to overlook the risk of heart disease.

Angina can be a warning sign of myocardial infarction

• Angina is often associated with coronary artery disease – the leading cause of myocardial infarction.
• If chest pain occurs, even if mild or fleeting, you should seek early medical attention to determine the cause.
• Early detection and treatment of coronary artery disease can help reduce the risk of future myocardial infarction.

Pain can radiate to many other areas

• Not everyone only experiences pain in the center of the chest.
• Signs of myocardial infarction or angina can spread to:
  • Arms or shoulders.
  • Neck.
  • Jaw.
  • Throat.
  • Upper back.
• Because symptoms can appear in various locations, patients sometimes find it difficult to pinpoint the exact source of the pain.

Monitor the duration and severity of the pain

• Stable angina usually subsides after a few minutes of rest or after using medication as prescribed by a doctor.
• If the pain lasts longer than a few minutes, becomes more severe, or does not improve after rest or medication, call emergency services immediately as this could be a sign of myocardial infarction requiring urgent treatment.

Pay attention when pain occurs after exertion

• Some people only experience angina when exerting themselves, climbing stairs, or exercising, and it then subsides with rest.
• However, if the pain occurs more frequently, lasts longer, or even occurs at rest, you need to see a doctor as soon as possible as this could be a sign of progressive heart disease.

Do not confuse with indigestion

• A burning sensation or pain in the upper chest is sometimes attributed to indigestion or acid reflux, but it can also be angina.
• You should seek medical attention if you frequently experience unexplained chest pain. Early diagnosis will help detect coronary artery disease and effectively prevent myocardial infarction.

Symptom 2: Check for abnormal heartbeats

Recognizing arrhythmia

• Arrhythmia is a condition where the heart beats irregularly, too fast, too slow, or skips a beat.
• You may notice symptoms such as:
  • Pounding heart or palpitations.
  • A fluttering sensation in the chest.
  • A feeling of the heart "skipping a beat" or missing a beat.
• This can be a sign of many heart conditions, including myocardial infarction.

Do not ignore accompanying symptoms

• If arrhythmia occurs with signs of myocardial infarction, the risk of an emergency is higher.
• Pay special attention if you also have symptoms such as:
  • Chest pain or a feeling of pressure in the chest.
  • Shortness of breath.
  • Dizziness or lightheadedness.
  • Fainting.
  • Very fast heart rate or prolonged palpitations.
• These symptoms may indicate that the heart is not functioning effectively and needs immediate evaluation.

See a doctor to determine the cause

• Not every case of arrhythmia is related to a heart attack, but you should not self-diagnose the cause.
• Your doctor may order tests such as:
  • Electrocardiogram (ECG).
  • 24-48 hour Holter monitor.
  • Echocardiogram or other specialized tests if necessary.
• Accurate diagnosis will help detect cardiovascular disease early and choose appropriate treatment methods.

Arrhythmia can be a sign of a serious condition

• Arrhythmia is quite common, especially in older adults, but it is not always benign.
• If the condition occurs frequently, is prolonged, or worsens, you should see a cardiologist to find the cause.
• Call emergency services immediately if arrhythmia is accompanied by chest pain, shortness of breath, fainting, or other symptoms of a heart attack, as this could be a life-threatening condition requiring urgent treatment.

Symptom 3: Pay attention to confusion or disorientation

Recognizing confusion or disorientation

• Symptoms of a heart attack do not always manifest as chest pain.
• Especially in older adults, patients may suddenly experience:
  • Confusion or loss of focus.
  • Disorientation regarding time, place, or surrounding people.
  • Difficulty understanding speech or slower reactions than usual.
• These changes may be related to the heart not pumping enough blood and oxygen to the brain.

Do not confuse with stroke symptoms

• Confusion, disorientation, or altered consciousness can also be symptoms similar to stroke.
• If symptoms appear suddenly, especially when accompanied by:
  • Chest pain.
  • Shortness of breath.
  • Dizziness or fainting.
  • Abnormal heartbeat.
• You need to call emergency services immediately for evaluation as this could be a sign of a heart attack, stroke, or another acute cardiac emergency.

Elderly individuals need to be especially vigilant

• In older adults, heart attacks often present atypically, making them easy to overlook.
• Instead of severe chest pain, patients may only experience confusion, unusual fatigue, excessive sleepiness, or reduced communication ability.
• These symptoms should not be considered normal signs of aging.

See a doctor immediately for any unusual changes in cognition

• If you or a loved one suddenly experience unexplained confusion, disorientation, or cognitive impairment, take the person to a medical facility immediately.
• Do not self-monitor at home, especially if these symptoms are accompanied by signs of a heart attack or neurological symptoms, as early diagnosis and treatment will help reduce the risk of serious complications.

Symptom 4: Do not underestimate unusual fatigue

Recognizing unusual fatigue

• Unusual fatigue can be a sign of a heart attack that appears before chest pain occurs.
• Patients often feel:
  • Exhausted even after performing light tasks.
  • Lack of energy, lethargic all day.
  • Very tired despite adequate rest.
• If this condition appears suddenly and without clear cause, you should not be complacent.

Women are more likely to experience this symptom

• Women often have atypical heart attack symptoms more than men.
• Instead of just chest pain, many people may feel:
  • Prolonged fatigue.
  • Shortness of breath.
  • Nausea.
  • Dizziness or cold sweats.
• This makes the disease easily mistaken for stress, lack of sleep, or overwork.

Fatigue may appear before a heart attack

• In some cases, feelings of exhaustion may begin several days before a heart attack occurs.
• If you notice unusual fatigue that is not related to exercise, late nights, or other medical conditions, closely monitor for accompanying symptoms such as:
  • Chest pain.
  • Shortness of breath.
  • Rapid heartbeat or palpitations.
  • Pain radiating to the shoulder, arm, neck, or jaw.

Proactively seek medical attention for unexplained fatigue

• Prolonged fatigue can be related to many different medical conditions, but it can also be an early warning sign of cardiovascular disease.
• You should see a doctor soon if fatigue appears suddenly, worsens, or is accompanied by other symptoms of a heart attack. Early detection and treatment will help reduce the risk of dangerous complications and protect long-term cardiovascular health.

Part 3: How to provide first aid for a heart attack at home

Step 1: Call emergency services immediately

Contact emergency services immediately if a heart attack is suspected

• If you or someone around you experiences symptoms of a heart attack, call emergency services immediately.
• Do not wait to see if symptoms improve on their own, as every minute of delay can increase the extent of heart muscle damage.
• While waiting for medical personnel to arrive, remain calm and follow all instructions from the emergency dispatcher.

Follow the instructions of medical personnel

• After receiving the information, emergency personnel may instruct you on how to assist the patient until the ambulance arrives.
• Please:
  • Fully answer questions about symptoms and onset time.
  • Follow the given instructions correctly.
  • Do not independently apply uninstructed treatments.

Prioritize calling an ambulance over self-transport to the hospital

• When a heart attack is suspected, an ambulance is a safer option than driving yourself or having a family member take you to the hospital.
• Medical personnel in the ambulance can:
  • Monitor vital signs.
  • Provide initial treatment if the patient's condition worsens.
  • Notify the hospital in advance to prepare for reception and emergency treatment.
• Only go to the hospital yourself if there is no other option.

The earlier the treatment, the higher the chance of survival

• The effectiveness of heart attack treatment is highest when the patient receives intervention within the first hour after the onset of heart attack symptoms.
• This is a critical time to restore coronary artery blood flow, limit heart muscle damage, and reduce the risk of complications or death.
• Consider any prolonged chest pain or suspected heart attack symptoms as an emergency situation, and call emergency services immediately instead of delaying or self-treating at home.

Step 2: Stop all activities immediately

Stop all activity immediately upon experiencing symptoms

• When heart attack symptoms or chest pain appear, immediately stop all ongoing activities.
• Do not try to walk, climb stairs, carry heavy objects, or continue working, as this can force the heart to work harder and worsen the condition.

Rest in a comfortable position

• Sit or recline in a position that helps you breathe easily and feel most comfortable.
• Avoid lying completely flat if you are short of breath, as this position can worsen the feeling of breathlessness.
• If someone is nearby, ask them for help and to monitor your condition while waiting for emergency services.

Stay calm and breathe steadily

• Anxiety or panic can make the heart beat faster and increase the heart muscle's oxygen demand.
• Try to:
  • Inhale slowly through your nose.
  • Exhale slowly through your mouth.
  • Maintain a steady breathing rhythm, do not hold your breath or breathe rapidly.
• Staying calm does not treat a heart attack, but it can help reduce the strain on the heart while waiting for medical attention.

Loosen tight clothing

• Loosen your collar, tie, belt, or any tight clothing to help you feel more comfortable and breathe more easily.
• If you are wearing multiple layers of clothing or obstructive accessories, remove them if possible.
• After resting and loosening their clothes, the patient still needs emergency care or to be taken to the hospital immediately if chest pain or other signs of a heart attack do not subside.

Step 3: Take heart medication as prescribed

Take medication as prescribed by the doctor

• If you are being treated for cardiovascular disease and your doctor has prescribed medication such as vasodilators or nitroglycerin, use the correct dosage as instructed when chest pain occurs or a heart attack is suspected.
• Continue to wait for the ambulance after taking the medication, as medication cannot replace emergency care and hospital treatment.

Only use your own medication

• Only use medications that have been specifically prescribed for you by your doctor.
• Do not arbitrarily increase the dose or use it more often than instructed if symptoms do not improve, unless previously advised by your doctor.
• If chest pain persists or signs of a heart attack continue after taking medication, immediately inform emergency personnel.

Do not use other people's medication

• Do not borrow or use other people's heart medication, even if they have similar symptoms.
• Each medication and dosage is prescribed based on the specific health condition of each individual.
• Using the wrong medication can cause low blood pressure, arrhythmia, or make the condition more dangerous.

Prioritize emergency care over self-treatment

• Medication only helps reduce symptoms in some cases and cannot address the cause of a heart attack.
• If you suspect you have signs of a heart attack, call emergency services immediately, use medication as directed by your doctor, and quickly go to the hospital for timely diagnosis, monitoring, and treatment.

Step 4: Only use aspirin when appropriate

Aspirin may be used in some cases

• When a heart attack is suspected, medical personnel or doctors may instruct the use of aspirin to help reduce platelet aggregation, limit blood clot development, and improve blood flow to the heart.
• If instructed to use it, patients are often advised to chew and then swallow the aspirin tablet for faster action.
• However, aspirin does not replace calling emergency services or hospital treatment.

Not everyone should take aspirin

• Do not use aspirin on your own if:
  • You are allergic to aspirin or related drugs.
  • Your doctor has previously advised against using aspirin.
  • You have a high risk of bleeding or have certain medical conditions that make aspirin unsuitable.
• In these cases, self-medication can do more harm than good.

Prioritize calling emergency services before taking medication

• If signs of a heart attack such as chest pain, shortness of breath, pain radiating to the arm, neck, or jaw appear, call emergency services immediately.
• While waiting for emergency services, only take aspirin if you are instructed by medical personnel or have been previously prescribed by a doctor for this situation.
• Do not delay going to the hospital just because you have taken aspirin, as specialized treatment in the initial hours is the determining factor in reducing myocardial damage and increasing the chance of recovery.

Step 5: See a doctor even if symptoms have subsided

Do not be complacent when symptoms disappear

• Even if chest pain or other signs of a heart attack subside after a few minutes, you still need to go to a medical facility for examination.
• The alleviation of symptoms does not mean that the heart is completely safe or that the danger has passed.
• Only a doctor can accurately determine the cause through clinical examination and necessary tests.

A heart attack can lead to dangerous complications

• After a heart attack, blood clots can still exist or continue to form in the blood vessels.
• This increases the risk of serious complications such as:
  • Recurrent heart attack.
  • Stroke due to embolism.
  • Arrhythmia or heart failure.
• Therefore, medical follow-up after symptom reduction is very important.

The doctor will comprehensively assess the cardiovascular condition

• Upon arriving at the hospital, you may be prescribed:
  • Electrocardiogram (ECG).
  • Cardiac enzyme test.
  • Echocardiogram or other imaging diagnostic techniques if needed.
• These tests help determine whether you are experiencing a heart attack, chest pain, or another cardiovascular disease that requires treatment.

Do not delay seeking medical attention

• If you have experienced signs of a heart attack, even if the symptoms subsided quickly on their own, seek medical attention as soon as possible.
• Do not self-assess your health status based solely on feeling better, as many dangerous cardiovascular complications can still progress silently and only be detected through assessment by medical professionals.

Part 4: Chest pain but not a heart attack?

Note 1: Differentiating indigestion and heart attack

Recognizing symptoms of indigestion

• Indigestion is discomfort in the upper abdomen, often occurring after eating and can be prolonged or recur frequently.
• Some people also feel a slight tightness in the chest, making it easy to confuse the symptoms with chest pain or signs of a heart attack.

Common signs of indigestion

• Indigestion often comes with one or more of the following symptoms:
  • Heartburn or burning sensation behind the breastbone.
  • Feeling of fullness, bloating.
  • Frequent burping.
  • Acid reflux or sour taste in the mouth.
  • Pain or discomfort in the epigastric region.
  • Feeling full quickly or reduced appetite.

Differentiating indigestion from a heart attack

• Although both can cause chest discomfort, indigestion and a heart attack are two completely different conditions.
• You need to be vigilant if chest pain:
  • Occurs at rest or is unrelated to meals.
  • Feels like a squeezing or heavy sensation in the chest.
  • Radiates to the neck, jaw, shoulder, or left arm.
  • Is accompanied by shortness of breath, cold sweats, nausea, or dizziness.
• These could be signs of a heart attack; you should not assume it's just a digestive disorder.

See a doctor when the cause cannot be determined

• If indigestion-like symptoms appear for the first time, are prolonged, recur frequently, or do not improve after rest or dietary adjustments, you should see a doctor to determine the cause.
• Prioritize ruling out a heart attack first, especially in individuals with risk factors such as hypertension, diabetes, dyslipidemia, or a history of cardiovascular disease. Early diagnosis will help with timely management and reduce the risk of dangerous complications.

Note 2: Recognizing symptoms of acid reflux

Understanding Gastroesophageal Reflux Disease

• Gastroesophageal Reflux Disease (GERD) occurs when the lower esophageal sphincter between the esophagus and stomach does not function effectively, causing acid and stomach contents to reflux into the esophagus.
• This condition can cause a burning sensation in the chest, which can easily be mistaken for chest pain or signs of a heart attack if not properly evaluated.

Common symptoms of GERD

• People with Gastroesophageal Reflux Disease often experience symptoms such as:
  • Heartburn or burning sensation behind the breastbone.
  • Feeling of food stuck in the throat or chest.
  • Nausea, especially after meals.
  • Sour burps or a sour, bitter taste in the mouth.
• These symptoms often recur if the condition is not managed.

Symptoms often appear after eating

• Symptoms of GERD are often more pronounced:
  • After a large meal.
  • When lying down immediately after eating.
  • When bending over or lifting heavy objects.
  • At night, especially when lying down to sleep.
• Changing position can cause more stomach acid to reflux and increase the burning sensation.

Do not confuse with a heart attack

• Although gastroesophageal reflux disease can cause chest pain or a burning sensation, you should not conclude that it is merely a digestive illness.
• If chest pain is accompanied by:
  • Severe chest pain or a feeling of pressure in the chest.
  • Shortness of breath.
  • Cold sweats.
  • Pain radiating to the shoulder, arm, neck, or jaw.
  • Severe dizziness or nausea.
• These can be signs of a heart attack and require immediate emergency care or a visit to the hospital.

See a doctor if symptoms persist

• If reflux symptoms occur frequently, affect daily life, or do not improve after lifestyle changes, you should see a specialist for diagnosis and treatment.
• Always prioritize ruling out myocardial infarction first in cases of unexplained chest pain, as early diagnosis can help prevent dangerous cardiovascular complications.

Note 3: Distinguish between asthma and heart attack

Recognizing asthma symptoms

• Asthma is a respiratory condition that can cause chest tightness, pressure, or a constricting sensation in the chest, leading many to confuse it with angina.
• Symptoms usually appear when the airways constrict and become inflamed, making air circulation more difficult.

Common signs of an asthma attack

• People with asthma often experience one or more of the following symptoms:
  • Shortness of breath or rapid breathing.
  • Wheezing, a whistling sound when breathing.
  • Persistent coughing, especially at night or in the early morning.
  • Feeling of chest tightness or pressure.
• These symptoms often appear after exposure to allergens, cold air, dust, or after exercise.

Monitoring the progression of an asthma attack

• Mild asthma attacks usually improve within a few minutes with rest or after using bronchodilators as prescribed by a doctor.
• If shortness of breath persists, worsens, or does not respond to rescue medication, you need to go to a medical facility immediately for timely treatment.

Do not confuse with myocardial infarction

• Although both asthma and myocardial infarction can cause chest tightness and shortness of breath, signs of myocardial infarction are often accompanied by:
  • Chest pain or a heavy pressure sensation in the center of the chest.
  • Pain radiating to the left arm, shoulder, neck, or jaw.
  • Cold sweats.
  • Nausea, dizziness, or lightheadedness.
• If you are unsure of the cause of chest pain or shortness of breath, especially in individuals with cardiovascular disease or cardiovascular risk factors, consider it an emergency until evaluated by a doctor.

Proactively seek medical attention for unusual symptoms

• Do not self-diagnose asthma if chest tightness or shortness of breath appears for the first time, has an unusual progression, or is accompanied by signs of myocardial infarction. Early examination will help determine the correct cause and provide timely treatment, avoiding missed diagnoses of dangerous cardiovascular conditions.

Note 4: Distinguishing between panic attacks and heart attacks

Recognizing panic attack symptoms

• Panic attacks are episodes of intense anxiety that occur suddenly and can cause many symptoms similar to signs of a heart attack.
• Patients often experience symptoms such as:
  • Rapid heart rate or palpitations.
  • Profuse sweating.
  • Trembling, feeling weak or about to faint.
  • Shortness of breath or rapid breathing.
  • Chest tightness or angina.
• Because of these similarities, many people find it difficult to distinguish between a panic attack and a heart attack.

Monitor the duration of symptoms

• Symptoms of a panic attack usually appear very quickly, reaching their peak severity within a few minutes, then gradually subside.
• If symptoms persist, worsen, or do not improve after about 10 minutes, you need to be evaluated by a doctor immediately to rule out myocardial infarction or other emergency conditions.

Do not conclude it's just anxiety

• Even if you have had a panic attack before, you should not assume that all chest pain or shortness of breath is psychological.
• Be especially vigilant if additional signs of myocardial infarction appear, such as:
  • Severe chest pain or a heavy pressure sensation in the center of the chest.
  • Pain radiating to the shoulder, left arm, neck, or jaw.
  • Increasing shortness of breath.
  • Cold sweats.
  • Nausea, dizziness, or fainting.
• These symptoms should be treated as an emergency until the cause is determined by a doctor.

Prioritize safety when uncertain about the cause

• If you cannot distinguish between a panic attack and a heart attack, go to a medical facility or call emergency services immediately, especially if symptoms persist or appear for the first time.
• Do not self-diagnose or delay seeking medical attention, as early detection of myocardial infarction is crucial in reducing myocardial damage and increasing survival rates.

Part 5: Who is most susceptible to a heart attack?

Note 1: The older you are, the more vigilant you need to be

Age increases the risk of heart attack

• The risk of myocardial infarction increases with age.
• Generally:
  • Men aged 45 and older have a higher risk of cardiovascular disease compared to younger individuals.
  • Women aged 55 and older, especially after menopause, also have a significantly increased risk of myocardial infarction.
• Therefore, middle-aged and older adults should actively monitor their cardiovascular health and have regular check-ups.

Older adults may not have typical symptoms

• Not everyone who experiences a heart attack will have severe chest pain.
• In older adults, the condition may manifest with atypical symptoms such as:
  • Shortness of breath.
  • Fainting or lightheadedness.
  • Nausea.
  • Unusual fatigue or weakness.
• These signs are easily mistaken for aging or other medical conditions, leading to delayed diagnosis.

Beware of silent myocardial infarction

• Some older adults may experience a silent myocardial infarction, meaning there is no obvious chest pain.
• Instead, the patient may suddenly experience:
  • Confusion or decreased memory.
  • Unusual behavioral changes.
  • Decreased concentration or judgment.
• These symptoms can be mistaken for dementia or neurological disorders, while the actual cause is cardiovascular.

Proactively seek medical attention for unusual signs

• Individuals from middle age onwards, especially if they have high blood pressure, diabetes, dyslipidemia, or a history of cardiovascular disease, should see a doctor immediately if any signs of myocardial infarction appear.
• Do not overlook small health changes in older adults, as early detection and treatment of myocardial infarction can help reduce the risk of serious complications and improve long-term prognosis.

Note 2: Control weight to protect your heart

Overweight and obesity increase the risk of heart attack

• Being overweight or obese is one of the factors that increases the risk of myocardial infarction and many other cardiovascular diseases.
• Excess body fat makes the heart work harder and increases the risk of:
  • High blood pressure.
  • Dyslipidemia.
  • Type 2 diabetes.
• These are all factors that can lead to coronary artery disease and increase the risk of signs of myocardial infarction.

Lack of physical activity affects cardiovascular health

• A sedentary lifestyle makes blood circulation less efficient and increases the risk of fat accumulation in artery walls.
• To protect your heart, you should:
  • Maintain regular physical activity.
  • Limit prolonged sitting.
  • Incorporate exercises suitable for your physical condition, such as brisk walking, cycling, or swimming.
• Regular exercise also helps control weight and reduce the risk of myocardial infarction.

Diet high in saturated fat increases risk

• Eating too many foods containing saturated fats can increase LDL cholesterol ("bad cholesterol"), promoting the formation of atherosclerotic plaques in the coronary arteries.
• To reduce the risk of angina and myocardial infarction, you should:
  • Limit fried foods, fatty meats, organ meats, and processed foods.
  • Increase intake of green vegetables, fruits, whole grains, and sources of unsaturated fats such as fish, nuts, and vegetable oils.
  • Control portion sizes to maintain a healthy weight.

Maintain a healthy lifestyle to prevent heart disease

• Weight management combined with a scientific diet and regular exercise are effective measures to reduce the risk of cardiovascular disease.
• You should monitor your weight, waist circumference, and have regular health check-ups, especially if you have additional risk factors such as high blood pressure, diabetes, or dyslipidemia. Proactively changing your lifestyle early will help reduce the risk of myocardial infarction symptoms appearing in the future.

Tip 3: Quit smoking to protect your heart

Quit smoking as soon as possible

• Smoking is one of the leading risk factors for myocardial infarction and cardiovascular diseases.
• The toxins in cigarette smoke damage blood vessel walls, promoting the formation of plaques and blood clots, thereby increasing the risk of coronary artery obstruction.
• Even people who have never experienced angina can develop symptoms of myocardial infarction if they maintain a smoking habit for a long time.

Avoid passive smoke exposure

• Not only smokers, but those regularly exposed to passive cigarette smoke also have a higher risk of cardiovascular disease.
• Inhaling smoke for an extended period can:
  • Damage blood vessels.
  • Increase blood pressure.
  • Reduce blood oxygen levels.
  • Increase the risk of myocardial infarction.
• Therefore, limit exposure to smoky environments and create a smoke-free living space.

Benefits of quitting smoking

• Quitting smoking offers many benefits for cardiovascular health, including:
  • Improved blood circulation.
  • Reduced risk of blood clot formation.
  • Assisted blood pressure control.
  • Reduced risk of angina, myocardial infarction, and stroke.
• The sooner you quit smoking, the greater the benefits for your heart and blood vessels.

Persistent changes to reduce long-term risk

• Quitting smoking can be challenging, but it is one of the lifestyle changes that yields the most significant results in preventing cardiovascular disease.
• Combine smoking cessation with a healthy diet, regular exercise, and control other risk factors such as high blood pressure, diabetes, and dyslipidemia to reduce the risk of myocardial infarction symptoms appearing in the future.

Tip 4: Control underlying conditions to protect your heart

Underlying conditions that increase the risk of myocardial infarction

• Several chronic diseases can significantly increase the risk of myocardial infarction and severe cardiovascular events.
• You should pay special attention if you have one or more of the following conditions:
  • High blood pressure.
  • High blood cholesterol or dyslipidemia.
  • Diabetes.
  • Personal or family history of myocardial infarction or stroke.
• The more risk factors you have, the higher the likelihood of myocardial infarction symptoms appearing.

Good control of underlying conditions helps reduce risk

• Regular treatment and monitoring of underlying conditions can help limit blood vessel damage and reduce the risk of angina as well as myocardial infarction.
• You should:
  • Maintain blood pressure within target limits as advised by your doctor.
  • Control cholesterol and blood sugar.
  • Take medication as prescribed.
  • Have regular health check-ups and cardiac screenings.

Diabetic patients need to be especially vigilant

• People with diabetes may experience silent myocardial infarction, with atypical or very mild symptoms.
• Instead of severe angina, patients may only experience:
  • Shortness of breath.
  • Unusual fatigue.
  • Nausea.
  • Cold sweats.
  • Dizziness or lightheadedness.
• This makes the condition easy to be detected late if not carefully monitored.

Seek medical attention immediately if suspicious symptoms arise

• If you have an underlying condition and experience any symptoms of myocardial infarction, even mild ones, go to a medical facility or call for emergency help immediately.
• Do not wait for clear symptoms before seeking medical attention, as early detection and treatment of myocardial infarction are crucial for reducing heart muscle damage, limiting complications, and improving recovery.

Important Notes When Suspecting a Heart Attack

Don't hesitate to call for emergency help if you have suspicious symptoms

• Many people hesitate because they worry they are not actually having a heart attack or are afraid of bothering others.
• However, delaying examination or calling for emergency help can lead to myocardial infarction progressing more severely, increasing the risk of complications and death.
• If you suspect myocardial infarction symptoms, prioritize going to a medical facility or calling for emergency help immediately.

Do not dismiss any symptom, however mild

• Even if angina, shortness of breath, or other symptoms are mild, you should not be complacent.
• If symptoms do not subside or become more severe after 5–10 minutes of rest, seek urgent medical help.
• Early treatment is a crucial factor in reducing heart muscle damage and improving the chances of recovery.

Having had a heart attack increases the risk of recurrence

• People who have had a myocardial infarction have a higher risk of experiencing a second heart attack compared to those who have never had one.
• Therefore, you need to:
  • Adhere to treatment as directed by your doctor.
  • Effectively control blood pressure, blood sugar, and blood lipids.
  • Maintain a healthy lifestyle and attend follow-up appointments on schedule.
• At the same time, proactively recognize myocardial infarction symptoms early to respond promptly if the condition recurs.

Do not use a defibrillator yourself unless trained

• Automated external defibrillators (AEDs) should only be used by individuals who have been instructed or trained in their operation.
• If someone is suspected of having a myocardial infarction or cardiac arrest, call for emergency help immediately and follow the instructions of medical personnel or trained professionals.

Beware of silent myocardial infarction

• Not all cases of myocardial infarction have warning symptoms.
• Some people may experience silent myocardial infarction, meaning there is no angina or only very subtle signs such as fatigue, shortness of breath, or mild discomfort.
• This condition is more common in people with diabetes, the elderly, and those with cardiovascular disease. Therefore, if you are in a high-risk group and notice any unusual changes in your health, seek medical attention early for evaluation and timely treatment.

References

1. American Heart Association. (2025). Heart Attack Symptoms, Risk Factors, and Recovery. American Heart Association.
2. American College of Cardiology. (2025). 2025 ACC/AHA Guideline for the Management of Acute Coronary Syndromes. Journal of the American College of Cardiology.
3. European Society of Cardiology. (2023). 2023 ESC Guidelines for the Management of Acute Coronary Syndromes. European Heart Journal, 44(38), 3720–3826.
4. National Heart, Lung, and Blood Institute. (2024). Heart Attack. National Institutes of Health.
5. National Institute for Health and Care Excellence. (2020, updated periodically). Acute Coronary Syndromes. NICE Guideline.
6. Centers for Disease Control and Prevention. (2024). Heart Disease Facts. U.S. Department of Health and Human Services.
7. World Health Organization. (2023). Cardiovascular Diseases (CVDs). World Health Organization.
8. American Diabetes Association. (2025). Standards of Care in Diabetes—2025. Diabetes Care, 48(Supplement_1).
9. Braunwald, E. (Ed.). (2022). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine (12th ed.). Elsevier.
10. Libby, P., Bonow, R. O., Mann, D. L., Tomaselli, G. F., & Bhatt, D. L. (Eds.). (2022). Braunwald's Heart Disease Review and Assessment (12th ed.). Elsevier.
11. Kumar, P., & Clark, M. (2023). Kumar and Clark's Clinical Medicine (11th ed.). Elsevier.
12. Merck Manual Professional Edition. (2025). Acute Myocardial Infarction (MI). Merck & Co., Inc.

Content edited by: Leigh Kennedy Ly.

Information consulted and verified by expert: Matthew Turner.