How to spot the signs of a heart attack

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What are the key heart attack symptoms and what should you do if you think you or someone else is having one? Dr Rhianna McClymont, Lead GP at Livi, explains everything you need to know

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Heart attacks, alongside other cardiovascular diseases, are sadly one of the leading causes of death globally. But by addressing the risk factors and learning to recognise the early and immediate signs of a heart attack, you can improve the chances for early detection and treatment.

What is a heart attack?

‘A heart attack (or myocardial infarction) occurs when the flow of blood to the heart muscle is interrupted, usually by a blood clot,’ says Dr Rhianna McClymont, Lead GP at Livi. ‘This means the heart muscle isn’t supplied with enough oxygen, which causes damage and stops it functioning.’

Who is more likely to have a heart attack?

There are several factors that put you at greater risk:

  • Smoking
  • Being overweight
  • Having high blood pressure or high cholesterol

There are also some uncontrollable risk factors, like family history of early heart disease. The risk of a heart attack also increases for men after age 45 and for women after menopause.

What does a heart attack feel like?

‘A heart attack is described as a feeling of tightness, squeezing or pressure across the centre or left side of the chest,’ says Dr McClymont. This pain or tightness may radiate into the left arm, neck or back and is often accompanied by other symptoms such as:

  • Shortness of breath
  • Nausea
  • Dizziness
  • Sweating
  • A feeling of intense anxiety

There are other symptoms of a heart attack as well – some that are less common and many that are less obvious. Some people experience unexplained fatigue or feel faint. People with diabetes may have few or very mild symptoms. On rare occasions, people experience no symptoms at all and are surprised when they find out they’ve had a heart attack.

What is a ‘silent’ heart attack?

‘A silent heart attack is one that happens without the characteristic tight chest pain, or with other more unusual symptoms such as indigestion. This is more common in women, older adults and those with diabetes, and it makes it more difficult to recognise a heart attack when it’s occurring,’ says Dr McClymont.

Are the symptoms and outcomes of a heart attack different for men and women?

‘Both men and women experience the typical symptoms of a heart attack like a tightness of the chest, but the signs of a heart attack in women may be slightly less recognisable – like dizziness, nausea or indigestion,’ Dr McClymont explains. ‘A heart attack presenting in an atypical way can be more difficult to diagnose.’

More research is needed to map out just how big the differences are between the symptoms women and men experience while having a heart attack. But it’s clear that women with chronic heart disease have worse outcomes than men, likely as a result of presenting without chest pain and instead experiencing symptoms like stomach pain, breathlessness, nausea and fatigue.

While around one-third of both male and female patients are initially misdiagnosed when presenting with a heart attack, women are twice as likely to be misdiagnosed.

This might, in part, be a result of women sometimes having lower levels of troponin. This is a protein released into the bloodstream during a heart attack, which helps to establish a diagnosis.

Is there anything I can do to prevent a heart attack?

While you can’t do anything about ageing or your family history, there’s a lot you can do to lower your risk of having a heart attack. Lifestyle factors that can help to significantly reduce your risk of cardiovascular disease include:

  • Stopping smoking
  • Cutting down on alcohol consumption
  • Exercising regularly
  • Maintaining a healthy weight
  • Eating a healthy diet rich in fruit, vegetables and fibre and low in saturated fat, trans fat, salt and sugar

‘Monitoring your blood pressure every now and then is also a good idea, as many people have high blood pressure without realising it,’ adds Dr McClymont.

What’s the difference between the symptoms of a heart attack and angina?

Angina is chest pain that can feel tight, dull or heavy. ‘Angina symptoms happen when blood flow to the heart is reduced – typically at times when the heart muscle requires more oxygen than normal, such as while exercising – while a heart attack occurs when blood flow to the heart is blocked,’ says Dr McClymont.

‘Angina symptoms tend to be temporary and occur mainly when the heart is experiencing increased demand or activity, and symptoms tend to be relieved when resting.’

What is sudden cardiac arrest?

‘A cardiac arrest is when the heart suddenly stops beating,’ says Dr McClymont. ‘Among other causes, this could be because of a large blood clot or an interruption to the electric impulses causing the heart to beat.’

Why is it important to know the signs of a heart attack?

‘The earlier a heart attack is diagnosed and treated, the less damage is done to the heart muscle and so the better the prognosis for the future,’ says Dr McClymont. ‘It’s very important to get symptoms assessed as quickly as possible.’

What should I do if I think someone’s having a heart attack or sudden cardiac arrest?

If you think someone is having a heart attack, you should:

  • Call 999 for immediate medical help
  • Perform CPR, if you know how to do it (read our guide on how to do CPR here)
  • 999 operators will guide you and help you with CPR until emergency help arrives

This article has been medically approved by Dr Rhianna McClymont, Lead GP at Livi

See a GP about risk of heart attack

Call emergency services immediately if you suspect you or someone else is having a heart attack. For concerns around your cholesterol, blood pressure or other heart-related symptoms, speak to a doctor.

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