Myocardial infarction symptoms: 5 early warning signs of left chest pain

Each year, in the United States alone, there are approximately 805,000 heart attacks, with more than 600,000 being first-time occurrences. Notably, nearly 47% of sudden deaths occur outside of a hospital, largely because patients do not recognize or dismiss initial warning symptoms. This is also one of the leading causes of death worldwide.

Many people believe that left chest pain is merely a sign of fatigue, muscle pain, or digestive disorders. However, heart attack symptoms can appear very subtly, not just as severe pain but also as chest tightness, shortness of breath, or pain radiating to the shoulder, arm, or jaw. Early recognition of these signs can make the difference between timely emergency treatment and dangerous complications.

In this article, Tiptory will help you recognize common heart attack symptoms, differentiate them from other causes of left chest pain, and know when to call for immediate emergency help to reduce the risk of complications and protect your and your loved ones' cardiovascular health.

Part 1: Most typical heart attack symptoms

Symptom 1: Recognizing chest pain due to a heart attack

Pay attention to any chest pain or discomfort

• Chest pain is one of the most common heart attack symptoms. According to the U.S. Centers for Disease Control and Prevention (CDC), up to 92% of surveyed individuals knew that chest pain is a symptom of a heart attack, but only about 27% fully recognized other warning signs and knew when to call for emergency help.
• If you experience pain, tightness, pressure, or discomfort in the chest area, especially if it occurs suddenly or lasts for several minutes, you should not be complacent as this could be a sign of a dangerous cardiovascular condition.

Differentiating chest pain due to a heart attack from other causes

• Many people initially mistake left chest pain caused by a heart attack for stomach pain, acid reflux, or heartburn.
• Pain from a heart attack is often described as a heavy weight on the chest or a crushing sensation. This feeling usually does not subside with antacids or changes in posture.
• If the pain radiates to the left shoulder, arm, neck, jaw, or back, the risk of heart-related issues needs to be considered.

Not everyone who has a heart attack experiences chest pain

• Although chest pain is a typical symptom, some people can still have a heart attack without this sign.
• Research published in the Journal of the American Medical Association shows that about 31% of men and 42% of women who have a heart attack do not experience typical chest pain symptoms.
• People with diabetes also have a higher risk of experiencing atypical heart attack symptoms, such as shortness of breath, unusual fatigue, nausea, cold sweats, or dizziness. Therefore, if multiple unusual symptoms appear at once, seek medical attention or call for emergency help immediately for assessment and timely treatment.

Symptom 2: Don't ignore pain radiating to the upper body

Monitor pain radiating to other areas of the body

• Heart attack symptoms do not only appear in the chest area but can also radiate to many other parts of the body. Pain often occurs in the shoulder, arm (especially the left arm), upper back, neck, jaw, or even teeth.
• The pain can be dull, tight, heavy, or spread in waves. This is a sign that the heart is lacking blood and needs emergency treatment as soon as possible.

Don't assume only chest pain means a heart attack

• Many people who experience a heart attack have no left chest pain at all, but only feel pain in the shoulder, neck, or jaw. This leads to many cases being mistaken for muscle pain, cervical spondylosis, or dental problems.
• If pain in the upper body appears suddenly, lasts for several minutes, or is accompanied by shortness of breath, cold sweats, nausea, or dizziness, you need to consider the possibility of a heart attack and call for emergency help immediately.

Pay special attention to unexplained toothache or back pain

• Persistent toothache without dental problems or unusual upper back pain can also be heart attack symptoms, especially in older adults, women, and people with cardiovascular disease.
• If these symptoms occur along with fatigue, shortness of breath, or chest tightness, you should go to a medical facility for a cardiovascular check as soon as possible. Early recognition of heart attack symptoms helps increase the chance of effective treatment and reduces the risk of dangerous complications.

Symptom 3: Don't be complacent about mild symptoms

Heart attack symptoms often start subtly

• Not every heart attack occurs suddenly with severe left chest pain. In fact, many cases begin with mild symptoms such as chest tightness, chest discomfort, fatigue, shortness of breath, or pain radiating to the shoulders, neck, and jaw.
• Because initial symptoms are often unclear, many people easily mistake them for fatigue, muscle pain, or digestive disorders, leading to delays in seeking emergency care.

Do not endure it or wait for symptoms to disappear on their own

• If you suspect you have heart attack symptoms, you should not try to endure it or continue working as usual.
• When symptoms last longer than 5 minutes, recur repeatedly, or worsen, call for emergency help immediately to receive timely assistance. Treatment within the "golden hour" can help limit heart muscle damage and increase the chances of recovery.

Early intervention reduces the risk of complications

• Every minute of delay can increase the extent of heart muscle damage due to ischemia.
• If left chest pain, a feeling of pressure in the chest, shortness of breath, cold sweats, nausea, or pain radiating to the upper body occurs and does not subside, consider it an emergency and go to a medical facility immediately, even if the initial symptoms are mild. Early recognition of heart attack symptoms is crucial for protecting lives and reducing the risk of long-term sequelae.

Symptom 4: Differentiating angina and heart attack

Consider if the patient has a history of angina

• If the person experiencing left chest pain has been diagnosed with coronary artery disease or has previously had angina, assess whether the current pain is similar to previous episodes.
• Angina occurs when the heart muscle does not receive enough oxygen, often appearing with exertion, climbing stairs, strenuous activity, or stress, and tends to subside with rest.

Monitor response to medication

• Many people with angina are prescribed vasodilators like nitroglycerin to alleviate symptoms.
• If the left chest pain quickly subsides after rest or taking prescribed medication, it is likely stable angina.
• Conversely, if the pain persists, is more severe, or does not decrease after taking medication, this could be a heart attack symptom requiring urgent treatment.

Do not be complacent if the pain lasts unusually long

• When left chest pain does not improve after a few minutes of rest or after taking angina medication, the patient may be facing a heart attack or acute coronary syndrome.
• In this case, call for emergency help immediately and take the patient to the nearest medical facility. Early emergency care helps restore blood flow to the heart muscle, reduce heart damage, and increase the chance of successful treatment. Do not drive to the hospital yourself if symptoms are worsening.

Symptom 5: Be wary of abdominal pain and nausea

Do not underestimate upper abdominal pain

• Heart attack symptoms do not always manifest as left chest pain. Some people only feel pain or burning in the epigastric region (upper abdomen), which is easily mistaken for stomach pain or gastroesophageal reflux.
• The pain usually appears suddenly, lasts for a long time, and can be accompanied by a feeling of chest tightness or radiate to the back, shoulders, and jaw.

Differentiate from heartburn or stomach pain

• Discomfort from a heart attack can resemble heartburn, but it usually does not subside after taking antacids or stomach medication.
• If upper abdominal pain persists, recurs, or appears with other cardiac symptoms, you should consider the possibility of a heart-related issue instead of just focusing on treating digestive problems.

Nausea and vomiting can also be warning signs

• Some people who have a heart attack, especially women, the elderly, and people with diabetes, may only experience nausea or vomiting without typical left chest pain.
• If nausea and vomiting are accompanied by shortness of breath, cold sweats, extreme fatigue, dizziness, or pain radiating to the shoulders, neck, or jaw, call for emergency help immediately for assessment and timely treatment. Early detection of heart attack symptoms helps reduce the risk of serious complications and increases the chance of recovery.

Symptom 6: Call for emergency help immediately if you suspect a heart attack

Call for emergency help immediately if there are heart attack symptoms

• If you suspect yourself or someone else has heart attack symptoms, call your local emergency number immediately or quickly contact the nearest medical facility.
• Do not delay waiting for symptoms to subside on their own or trying home remedies. Every minute of delay increases the risk of heart muscle damage and dangerous complications.
• Receiving emergency care and treatment within the first hour of symptom onset significantly increases the chance of survival, reduces the extent of heart muscle damage, and greatly improves recovery potential.

Do not self-medicate with aspirin without a doctor's order

• Although aspirin may be used in some cases of heart attack, you should not take it on your own without guidance from medical personnel.
• A doctor or emergency responder will assess the cause of left chest pain, medical history, risk of bleeding, and contraindications before deciding whether to administer aspirin.
• Self-administering aspirin in inappropriate situations can increase the risk of bleeding or mask the condition, making treatment difficult.

Prioritize getting to the hospital as soon as possible

• If you experience prolonged left chest pain, shortness of breath, cold sweats, and pain radiating to the shoulder, arm, neck, or jaw, consider this an emergency.
• While waiting for an ambulance, keep the patient in a comfortable position, limit movement, and closely monitor symptoms. Correct initial management plays a crucial role in reducing complications and improving the effectiveness of myocardial infarction treatment.

Part 2: Symptoms of Silent Myocardial Infarction

Sign 1: Recognizing symptoms in women

Women often experience atypical heart attack symptoms

• Compared to men, women are more likely to experience atypical heart attack symptoms. This can lead to the condition being mistaken for fatigue, flu, or stress, resulting in delayed emergency care.
• Therefore, even without obvious left chest pain, women should be vigilant about unusual body changes.

Easily overlooked symptoms

• Pay attention if one or more of the following symptoms appear:
  • Sudden feeling of weakness or exhaustion, even without physical activity.
  • Unexplained body aches.
  • Feeling tired, sluggish, or unwell, similar to having the flu.
  • Difficulty sleeping, insomnia, or unusual sleep disturbances in the days leading up to the heart attack.

Don't wait for severe chest pain

• Many women who experience a heart attack do not have typical left chest pain or only feel mild chest discomfort. Instead, they may experience shortness of breath, nausea, dizziness, cold sweats, or prolonged fatigue.
• If these symptoms appear suddenly or are accompanied by shortness of breath, pain radiating to the shoulder, neck, jaw, or arm, call emergency services immediately. Early recognition of heart attack symptoms in women helps increase the chances of timely treatment and reduces the risk of dangerous complications.

Sign 2: Beware of sudden shortness of breath

Shortness of breath can be an early sign of a heart attack

• Shortness of breath is one of the important but often overlooked heart attack symptoms. This symptom can appear even before left chest pain, causing many people not to consider a cardiovascular condition.
• If you suddenly feel difficulty taking a deep breath, shortness of breath, or rapid breathing even while resting or engaging in light activity, you need to be especially cautious.

Recognizing unusual shortness of breath

• People experiencing a heart attack often describe the feeling as:
  • Unable to get enough air into the lungs.
  • Shortness of breath, rapid breathing even without much physical activity.
  • Feeling like you've just run or exerted yourself for a long time.
  • Prolonged shortness of breath that doesn't improve with rest.

Shortness of breath accompanied by other symptoms requires immediate emergency care

• The risk of myocardial infarction increases if shortness of breath is accompanied by one or more symptoms such as:
  • Left chest pain or heavy chest pressure.
  • Pain radiating to the shoulder, arm, neck, jaw, or back.
  • Cold sweats.
  • Dizziness, lightheadedness, or fainting.
  • Nausea and unusual fatigue.
• If the above symptoms appear, call emergency services or go to the nearest medical facility immediately. Early detection of heart attack symptoms and treatment within the "golden hour" helps limit myocardial damage, reduce complications, and increase the chances of recovery.

Sign 3: Note dizziness and cold sweats

Don't ignore dizziness or lightheadedness

• Heart attack symptoms are not limited to left chest pain but can also manifest as dizziness, lightheadedness, faintness, or near-fainting.
• These symptoms occur when the heart doesn't pump enough blood and oxygen to the brain. If they appear suddenly, especially while resting or performing light activity, you need to go to a medical facility quickly for examination.

Unusual anxiety can also be a warning sign

• Some people experiencing a heart attack feel restless, anxious, or have an inexplicable sense of dread without finding a cause.
• If anxiety appears along with left chest pain, shortness of breath, or extreme fatigue, consider the possibility that these are heart attack symptoms rather than just ordinary stress.

Cold sweats are a symptom that requires special attention

• Sudden cold sweats, even without physical activity or in non-hot weather, are a common symptom of a heart attack.
• If cold sweats are accompanied by dizziness, shortness of breath, nausea, or pain radiating to the shoulder, arm, neck, or jaw, call emergency services immediately. Early recognition of heart attack symptoms and timely treatment helps reduce the risk of myocardial damage, limit complications, and increase the chances of recovery.

Sign 4: Beware of unusually fast heart rate

Abnormal heart rate can be a warning sign

• Heart attack symptoms are not limited to left chest pain or shortness of breath. Some people also experience a fast, strong, or irregular heart rate.
• This symptom can appear suddenly, even while resting, causing the patient to feel uncomfortable or anxious.

Recognizing an unusual heart rate

• Pay special attention if the following symptoms appear:
  • Feeling the heart beating very strongly, like "pounding" in the chest.
  • Unusually fast heart rate despite no physical activity or stress.
  • Feeling palpitations, a racing heart, or a heart rate that fluctuates between fast and slow.
  • Feeling an irregular heart rate or skipped beats.

Do not be complacent with this symptom

• A fast heart rate or palpitations are not always a heart attack, but if accompanied by left chest pain, shortness of breath, dizziness, cold sweats, or pain radiating to the shoulder, arm, neck, or jaw, this could be a heart attack symptom requiring immediate emergency care.
• If symptoms persist, recur frequently, or appear suddenly without a clear cause, go to a medical facility for a cardiovascular check-up as soon as possible. Early detection helps increase the chances of effective treatment and reduces the risk of dangerous complications.

Part 3: Who is most susceptible to myocardial infarction?

Note 1: Understand cardiovascular risk factors

Recognize factors that increase the risk of myocardial infarction

• To prevent myocardial infarction, you need to understand that the risk of the disease is influenced by many different factors. Some factors can be changed through a healthy lifestyle, while others cannot.
• Early recognition of risk factors helps you actively protect your cardiovascular health and reduce the likelihood of heart attack symptoms appearing in the future.

Modifiable risk factors

• You can reduce your risk of cardiovascular disease by:
  • Quitting smoking and avoiding passive smoking.
  • Controlling blood pressure, cholesterol, and blood sugar.
  • Maintaining a healthy weight.
  • Exercising regularly according to your ability.
  • Adopting a diet rich in vegetables, fruits, whole grains, and limiting saturated fats, salt, and sugar.
  • Limiting alcohol, getting enough sleep, and managing stress.

Non-modifiable risk factors

• Some factors that increase the risk of myocardial infarction but cannot be intervened, include:
  • The older you are, the greater the risk.
  • Family history of early cardiovascular disease.
  • Gender and hormonal changes, especially in postmenopausal women.
  • Certain medical conditions or genetic factors that increase the risk of coronary artery disease.

Actively change your lifestyle to protect your heart

• While you cannot change all risk factors, you can significantly reduce your risk of disease through daily choices.
• Maintaining a scientific lifestyle, regular health check-ups, and monitoring cardiovascular indicators will help detect risks early, prevent left chest pain, heart attack symptoms, and many other serious cardiovascular complications.

Note 2: Non-modifiable risk factors

Age increases the risk of myocardial infarction

• The older you are, the greater the risk of cardiovascular disease and myocardial infarction as the cardiovascular system gradually declines over time.
• Men aged 45 and above and women aged 55 and above are considered to be at higher risk, especially if they also have conditions such as hypertension, diabetes, or dyslipidemia.

Family history is a factor that needs special attention

• If your parents, siblings, or direct relatives have had a heart attack or coronary artery disease at a young age, you are at a higher risk of developing the disease than the general population.
• In this case, regular cardiovascular check-ups and good control of modifiable risk factors are recommended to reduce the likelihood of heart attack symptoms appearing.

Autoimmune diseases can increase cardiovascular risk

• People with autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosus have a higher risk of cardiovascular disease because chronic inflammation can damage blood vessel walls.
• If you belong to this group, you should regularly monitor your cardiovascular health and follow your doctor's treatment instructions to reduce the risk of myocardial infarction.

Preeclampsia is a risk factor in women

• Women who have experienced preeclampsia during pregnancy have a higher risk of cardiovascular disease and myocardial infarction in the years after childbirth.
• After childbirth, it is advisable to maintain a healthy lifestyle, regularly check blood pressure and cardiovascular indicators to detect abnormalities early and reduce the risk of left-sided chest pain or other cardiovascular events in the future.

Note 3: Control risk factors

Quit smoking to reduce the risk of myocardial infarction

• Smoking is one of the leading risk factors for cardiovascular disease and myocardial infarction. The toxic substances in cigarette smoke damage blood vessel walls, promote atherosclerosis, and increase the risk of blood clot formation.
• Quitting smoking and avoiding passive smoke inhalation is one of the most effective ways to protect your heart and reduce the risk of heart attack symptoms.

Maintain stable blood pressure

• High blood pressure makes the heart work harder and damages arterial walls over time.
• Measure blood pressure regularly, adhere to treatment if prescribed, and maintain a low-salt diet and regular exercise to reduce the risk of myocardial infarction.

Maintain regular physical activity

• Lack of physical activity increases the risk of obesity, high blood pressure, diabetes, and coronary artery disease.
• Adults should maintain at least 150 minutes of moderate-intensity physical activity per week or follow their doctor's guidance if they have a heart condition.

Effectively manage diabetes

• Prolonged high blood sugar can damage blood vessels and increase the risk of myocardial infarction.
• People with diabetes need to control blood sugar, attend follow-up appointments, and combine a healthy diet and regular exercise to protect cardiovascular health.

Maintain a healthy weight

• Being overweight or obese increases the burden on the heart and is associated with other risk factors such as high blood pressure, dyslipidemia, and diabetes.
• Maintaining a suitable Body Mass Index (BMI) helps reduce the risk of left-sided chest pain, myocardial infarction, and other cardiovascular diseases.

Control blood cholesterol

• High LDL cholesterol ("bad cholesterol") can accumulate in arterial walls, forming plaques and reducing blood flow to the heart.
• Prioritize fiber-rich foods, limit saturated fats, and have regular lipid profile checks to reduce the risk of heart attack symptoms in the future.

Reduce stress and avoid stimulants

• Prolonged stress can increase blood pressure, heart rate, and negatively affect cardiovascular health.
• Additionally, the use of stimulants or illicit drugs can cause coronary artery spasms, arrhythmias, and increase the risk of myocardial infarction even in young people.
• Managing stress through adequate sleep, exercise, meditation, or relaxation activities is a practical solution for long-term heart protection.

Note 4: Reduce the risk of myocardial infarction

Maintain daily activity

• Regular physical activity improves blood circulation, controls blood pressure, reduces cholesterol, and enhances cardiovascular health.
• You can start with simple habits like a brisk walk for about 15 minutes after lunch and dinner, then gradually increase the duration and intensity as appropriate for your physical condition.
• Incorporating daily activity is one of the most effective ways to reduce the risk of myocardial infarction and limit the appearance of heart attack symptoms.

Adopt a heart-healthy diet

• Prioritize fresh foods such as green vegetables, fruits, whole grains, legumes, fish, and lean meat.
• Limit high-salt intake, trans fats, processed foods, and sugary or refined carbohydrate beverages.
• Increase unsaturated fats from olive oil, nuts, avocados, and fatty fish to support cardiovascular protection.
• A scientific diet helps control weight, cholesterol, and reduces the risk of left-sided chest pain due to coronary artery disease.

Quit smoking as early as possible

• Quitting smoking improves vascular function and significantly reduces the risk of cardiovascular disease in a short period.
• Even after many years of smoking, quitting still provides clear benefits in preventing myocardial infarction and other cardiovascular complications.

Adhere to your doctor's treatment instructions

• If you are at high risk for cardiovascular disease or have had a myocardial infarction, take medication as prescribed and attend follow-up appointments on schedule.
• Do not arbitrarily stop medication or change dosages without consulting your doctor, even if symptoms have improved.
• Combining medication with a healthy lifestyle will help reduce the risk of recurrent myocardial infarction, limit left-sided chest pain, and protect long-term cardiovascular health.

Part 4: How to provide emergency care for myocardial infarction in the hospital

Step 1: Seek emergency care as soon as possible

Myocardial infarction is an urgent medical emergency

• Myocardial infarction is a dangerous condition that can be life-threatening if not treated promptly.
• When heart attack symptoms appear, such as left-sided chest pain, shortness of breath, pain radiating to the shoulder or arm, cold sweats, or dizziness, you need to go to the Emergency Department or call for emergency services immediately.
• The shorter the time from symptom onset to treatment, the higher the chance of preserving the heart muscle and recovering.

You will be prioritized for examination and treatment

• When myocardial infarction is suspected, medical staff will quickly assess the situation and prioritize immediate treatment upon your arrival at the Emergency Department.
• Initial steps typically include monitoring vital signs, performing an electrocardiogram (ECG), cardiac enzyme tests, and other necessary investigations to determine the cause of left-sided chest pain.
• Based on the assessment results, the doctor will decide on the appropriate treatment method to restore blood flow to the heart muscle as soon as possible.

Early treatment increases the chance of survival

• Many cases of myocardial infarction can be effectively managed if detected and treated within the "golden hour."
• Do not wait for symptoms to disappear on their own or delay going to the hospital. Timely emergency care helps reduce heart muscle damage, limit dangerous complications, and significantly improve recovery after treatment.

Step 2: Electrocardiogram (ECG) for diagnosis

ECG is a crucial test when myocardial infarction is suspected

• When you have heart attack symptoms such as left-sided chest pain, shortness of breath, or pain radiating to the shoulder, arm, or jaw, your doctor will usually order an electrocardiogram (ECG or EKG) immediately upon admission.
• This is one of the initial tests that helps detect early signs of myocardial ischemia or myocardial infarction, and also supports the doctor in determining urgent treatment directions.

How does an electrocardiogram work?

• An electrocardiogram records the electrical activity of the heart through small electrodes attached to the chest, arms, and legs.
• These electrical signals are recorded by the machine as a graph, helping the doctor assess heart rate, electrical conduction speed, and detect abnormalities related to the heart muscle.
• This procedure is quick, painless, and usually takes only a few minutes to complete.

ECG results help assess heart muscle damage

• When a myocardial infarction occurs, the damaged heart muscle tissue transmits abnormal electrical signals. These changes are usually clearly visible on the electrocardiogram results.
• Based on the ECG image combined with clinical symptoms and cardiac enzyme tests, the doctor can determine whether the patient is experiencing a myocardial infarction and assess the extent of damage to choose the appropriate treatment method.

ECG is not the only test

• Although ECG plays a very important role, a normal result does not completely rule out myocardial infarction, especially in the very early stages.
• If left-sided chest pain or other heart attack symptoms persist, the doctor may order multiple electrocardiograms combined with blood tests and other diagnostic methods to ensure accurate results.

Step 3: Blood tests to detect heart damage

Blood tests help identify myocardial infarction

• When there are heart attack symptoms such as left-sided chest pain, shortness of breath, or pain radiating to the shoulder, arm, or jaw, the doctor often orders blood tests to check if the heart muscle is damaged.
• This is an important method to confirm the diagnosis, especially when symptoms or electrocardiogram results are not clear enough.

Troponin is an important biomarker

• When the heart muscle is damaged due to myocardial infarction, heart muscle cells release troponin into the blood.
• Elevated troponin levels are one of the reliable pieces of evidence that the heart muscle is or has been damaged.
• This indicator can often remain in the blood for about 2 weeks, helping doctors detect even cases of myocardial infarction that occurred earlier but were not diagnosed.

Multiple tests may be needed

• In the very early stages after the onset of heart attack symptoms, troponin levels may not increase immediately.
• Therefore, doctors often order multiple blood draws within the first few hours to monitor changes in this indicator, thereby increasing diagnostic accuracy.

Combine with other diagnostic methods

• Troponin testing is not evaluated in isolation but is often combined with clinical symptoms, electrocardiogram (ECG), and other laboratory or imaging diagnoses.
• If you experience left chest pain or other signs of myocardial infarction, go to a medical facility immediately for testing and timely treatment. Early diagnosis helps reduce myocardial damage and improves the chances of recovery.

Step 4: Prepare for coronary angiography

Cardiac catheterization helps accurately assess cardiovascular condition

• If myocardial infarction is suspected or abnormalities are found after an electrocardiogram and blood tests, the doctor may order cardiac catheterization to evaluate the coronary artery system in detail.
• This procedure is usually performed in a cardiac catheterization lab to identify the cause of left chest pain and the extent of heart damage, thereby selecting the appropriate treatment method.

How is the procedure performed?

• A doctor will insert a small, flexible catheter into a blood vessel, usually through an artery in the wrist or groin area, then guide it to the heart under X-ray guidance.
• The procedure is usually performed under local anesthesia and is closely monitored throughout. This is a common technique with a high level of safety when performed by a specialized team.

What does cardiac catheterization help the doctor assess?

• During the procedure, the doctor may:
  • Perform coronary angiography with contrast dye to detect narrowed or blocked areas causing myocardial infarction.
  • Measure pressure in the heart chambers to assess heart function.
  • Collect blood samples from heart chambers when necessary to check oxygen levels.
  • Perform a myocardial biopsy in some special cases to aid diagnosis.
  • Assess the heart's pumping ability to determine the extent of damage after myocardial infarction.

Results help build a treatment plan

• Based on the cardiac catheterization results, the doctor may decide to continue treatment with medication, percutaneous coronary intervention (stenting), or coronary artery bypass surgery if necessary.
• Performing the procedure at the right time helps detect the cause of signs of myocardial infarction early, improve blood flow to the heart muscle, and reduce the risk of long-term complications.

Step 5: Perform a stress test

Stress test helps assess the heart after myocardial infarction

• After the condition of myocardial infarction has stabilized, the doctor may order a stress test in the following weeks to check the heart's function.
• The goal of the test is to assess blood flow to the heart muscle during exercise, detect any persistent myocardial ischemia, and support the development of a long-term treatment plan.

How is the process performed?

• The patient will walk or jog slowly on a treadmill with increasing intensity in stages.
• Throughout the test, electrodes are attached to the chest to record an electrocardiogram (ECG), while the doctor monitors heart rate, blood pressure, and symptoms such as left chest pain, shortness of breath, or dizziness.
• If the patient cannot exercise, the doctor may use medication to create a similar response to exertion.

Results guide long-term treatment

• A stress test helps determine if the heart is receiving enough blood during activity and also detects arrhythmias or signs of recurrent myocardial ischemia.
• Based on the results, the doctor will assess the effectiveness of current treatment and decide whether medication adjustments are needed, additional specialized tests, or cardiac intervention if necessary.

Follow instructions before and after the test

• Please attend your stress test appointment as scheduled and inform your doctor if you experience signs of myocardial infarction, left chest pain, shortness of breath, or unusual fatigue before the test day.
• After completing the test, continue to maintain a healthy lifestyle, take medication as prescribed, and have regular follow-ups to reduce the risk of recurrent myocardial infarction and protect long-term cardiovascular health.

Share signs of myocardial infarction

Help loved ones recognize less common signs

• Not everyone who has a myocardial infarction experiences typical left chest pain. Some people only have symptoms such as shortness of breath, nausea, jaw pain, back pain, unusual fatigue, dizziness, or cold sweats.
• Share these signs of myocardial infarction with family and friends so that everyone can recognize them early, react appropriately, and reduce the risk of missing dangerous cases.

Do not hesitate when unusual symptoms appear

• If you experience left chest pain, shortness of breath, or any symptom suspected of myocardial infarction, especially if these signs have never occurred before, call emergency services immediately.
• Do not try to endure it, self-monitor at home, or wait for symptoms to disappear on their own. The sooner treatment is received, the higher the chance of preserving heart muscle and recovering.

Limit activity if myocardial infarction is suspected

• If you suspect you are having a myocardial infarction, stop all activity immediately and sit or lie down in a comfortable position, following the instructions of medical personnel if possible.
• Do not try to walk, climb stairs, drive, or do strenuous work, as exertion can make the heart work harder, increasing the degree of myocardial damage.

Ask those around you for emergency assistance

• Ask family, colleagues, or those nearby to call emergency services and stay to help until medical personnel arrive.
• Being taken to the hospital by ambulance allows the patient to be monitored and treated immediately en route if the condition becomes serious.
• Recognizing signs of myocardial infarction early, calling emergency services promptly, and limiting activity are crucial steps to increase the chance of survival and reduce the risk of long-term complications.

References

1. American Heart Association. (2025). Heart attack (myocardial infarction): Symptoms, diagnosis, and treatment. American Heart Association.
2. American College of Cardiology. (2025). Acute myocardial infarction and acute coronary syndromes. American College of Cardiology.
3. Centers for Disease Control and Prevention. (2024). Heart disease facts. U.S. Department of Health and Human Services.
4. National Heart, Lung, and Blood Institute. (2024). Heart attack. National Institutes of Health.
5. European Society of Cardiology. (2023). 2023 ESC Guidelines for the management of acute coronary syndromes. European Heart Journal.
6. Levine, G. N., Bates, E. R., Blankenship, J. C., Bailey, S. R., Bittl, J. A., Cercek, B., Chambers, C. E., Ellis, S. G., Guyton, R. A., Hollenberg, S. M., Khot, U. N., Lange, R. A., Mauri, L., Mehran, R., Moussa, I. D., Mukherjee, D., Nallamothu, B. K., & Ting, H. H. (2016). 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction. Journal of the American College of Cardiology, 67(10), 1235–1250.
7. Ibanez, B., James, S., Agewall, S., Antunes, M. J., Bucciarelli-Ducci, C., Bueno, H., Caforio, A. L. P., Crea, F., Goudevenos, J. A., Halvorsen, S., et al. (2018). 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 39(2), 119–177.
8. Thygesen, K., Alpert, J. S., Jaffe, A. S., Chaitman, B. R., Bax, J. J., Morrow, D. A., & White, H. D. (2019). Fourth universal definition of myocardial infarction (2018). European Heart Journal, 40(3), 237–269.
9. O'Gara, P. T., Kushner, F. G., Ascheim, D. D., Casey, D. E., Chung, M. K., de Lemos, J. A., Ettinger, S. M., Fang, J. C., Fesmire, F. M., Franklin, B. A., et al. (2013). 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction. Circulation, 127(4), e362–e425.
10. Merck Manual Professional Edition. (2025). Acute myocardial infarction (AMI). Merck & Co., Inc.
11. Mayo Clinic Staff. (2025). Heart attack: Symptoms and causes. Mayo Clinic.
12. MedlinePlus. (2024). Heart attack. U.S. National Library of Medicine.

Content edited by: Sidney Bailey Hoang.

Information consulted and verified by expert: Olivia Thompson.