Health Essentials from Cleveland Clinic

Every 40 seconds, somebody in the United States has a heart attack. And they don’t all fit the chest-clutching, drop-to-the-floor stereotype you see on TV.

The classic heart attack symptom is crushing chest pain or heaviness behind the sternum. But people might experience more subtle signs, says cardiologist Mouin Abdallah, MD, director of coronary artery disease center at Cleveland Clinic. Recognizing those signs could save a life.

Early heart attack symptoms

While most heart attacks are sudden and unmistakable, some might come on more gradually, Dr. Abdallah says. Some of the common early warning signs include:

• Pressure or tightness in the chest (rather than pain).
• Pain in the arm, jaw, neck or back.
• Cold sweats.
• Shortness of breath.
• Nausea.
• Unusual fatigue.

Anybody — young or old, male or female — can experience these subtle signs, though it’s more common in women.

Heart attack treatment: Time is muscle

People who experience some of these subtle signs are often hesitant to head to the hospital. After all, nausea or neck pain can have other, not-so-serious causes. And a feeling that something “just isn’t right?” That’s frustratingly vague and hard to explain to a doctor.

But if there’s even a chance you are having a heart attack, it’s better to act fast and early than late.

A heart attack occurs when blood flow to the heart is blocked, damaging the heart muscle. Without urgent treatment, heart tissue will begin to die. “Time is muscle,” Dr. Abdallah says. “The sooner your doctor starts treatment, the better the outcome.”

Doctors can give medications and perform procedures to remove blockages and restore blood flow to the heart. And such therapy has gotten better and more effective over the years, he adds. “Treating heart attacks has been one of the great interventions in the history of medicine.”

Are you at risk of a heart attack? 

You might be at higher risk for a heart attack if you have:

• Obesity.
• Diabetes.
• A history of smoking.
• A history of heart disease or had a previous heart attack.
• High blood pressure or high cholesterol.
• Family history of heart disease.

If you fall into any of those categories, be extra cautious if you experience vague symptoms that might be related to your heart.

Yet even if you’re young and healthy, you should know the signs of a heart attack — and act fast if you experience them, Dr. Abdallah says. To take advantage of modern medicine’s life-saving treatments, you have to get to the hospital. “When in doubt, err on the safe side and go to the ER,” he says.