Typical signs of heart attack can include tightness and pain in the chest. But other signs can also include lightheadedness and pain in the neck or jaw.

Every year, an estimated 805,000 people in the United States have a heart attack, according to the Centers for Disease Control and Prevention (CDC).

A heart attack, also known as a myocardial infarction, happens when blood flow to the heart is blocked. If there’s not enough blood flowing to your heart muscle, it can damage the affected part of your heart and cause the muscle to die. This can be life threatening.

Chest pain is the most common heart attack warning sign, but there can be other symptoms, too, such as shortness of breath or lightheadedness. Symptoms may be severe or mild, and can vary from one person to the next.

Sometimes, a heart attack can be mistaken for heartburn or an anxiety attack. In addition, heart attack symptoms can vary between men and women.

This article will take a closer look at the warning signs of a heart attack, what it typically feels like, and how the symptoms can vary between men and women.

A heart attack usually involves pain in the center or left side of the chest that lingers for several minutes or comes and goes. The pain can feel different from one person to the next. It’s often described as:

  • tightness
  • pressure
  • squeezing
  • burning

However, sometimes there are other symptoms in addition to chest pain. And, in some cases, these symptoms may be present without chest pain.

Symptoms that often accompany — or are present without chest pain — include:

  • shortness of breath, sometimes developing before chest pain
  • lightheadedness
  • sudden weakness or fatigue
  • pain in one or both arms, more often the left arm
  • pain in the upper back, shoulders, neck, or jaw
  • nausea and vomiting
  • sweating
  • feelings of anxiety or impending doom

If you are experiencing shooting pain from your shoulder down your arm, this can be a sign of a heart attack. Men, more than women, are known to experience heart attack-related pain down their left arm and under their left armpit, but it’s possible to experience pain in either arm when having a heart attack.

Pain in the back during a heart attack is usually located in the upper back. The pain may feel like someone has tied a rope around you and is squeezing it tightly, leading to feelings of pressure, generally in the chest as well.

Neck pain can be a sign of a heart attack if it comes on suddenly and is severe. This pain may be felt in areas near the neck as well, including the jaw or chin. It is usually accompanied by pain in the chest, upper back, or arm as well.

To make matters even more complicated, some heart attacks occur without any traditional symptoms or even any noticeable symptoms at all.

These so-called silent heart attacks could represent nearly a quarter of all heart attacks in the United States, according to the American Heart Association.

A silent heart attack may resolve on its own if, for example, the clot blocking blood flow dissolves or becomes dislodged and is absorbed into the body. But a silent heart attack can still cause damage.

If a doctor discovers that you had a silent heart attack, you may want to consider cardiac rehabilitation and the type of care that any other person who’s had a heart attack receives.

A silent heart attack may be discovered months or years after the fact if you have an electrocardiogram (EKG) to check your heart’s electrical system. Evidence of a heart attack can often be seen in the electrical patterns picked up by the EKG.

Even though a heart attack is a sudden event, some symptoms can come on mildly and slowly.

You may feel unusually tired for a few days leading up to the onset of more serious symptoms. Some people who’ve experienced a heart attack report feelings of anxiety and dread for a few days before the onset of other symptoms. This tends to be more common among women but can happen with men, too.

Mild to moderate pain in one or both arms, along with shortness of breath and nausea, may also occur in the lead-up to a major heart attack.

Chest pain or pressure is a common heart attack symptom among both men and women.

However, the feeling of chest discomfort can be somewhat different for men and women. For men, the pain is often described as a heavy weight on the chest. It tends to be located in the center of the chest, but it can be felt from armpit to armpit. Some describe it like an elephant sitting on your chest while the pain radiates down your arm.

In contrast, chest pain for women is often described as pressure or tightness instead of the “heavy weight on the chest” pain that men describe.

There are also some non-classic heart attack warning signs that are more common among women. These include:

  • unusual or extreme fatigue, which may develop several days before other symptoms and may make you feel like you’re coming down with the flu
  • pain or discomfort in the upper abdomen that may feel like heartburn or indigestion
  • throat and jaw pain, often without any chest pain (jaw pain can coincide with a heart attack because the nerves that serve the heart and those that serve the jaw are close together)
  • dizziness, lightheadedness
  • upper back pain that may feel like burning, tingling, or pressure
  • pain, tingling, or discomfort in either or both arms
  • nausea and vomiting
  • symptoms that come on gradually

Women are often reluctant to seek medical attention for heart attack symptoms, partly because of delays in recognizing heart attack symptoms since they’re not commonly talked about.

While women are slightly less likely than men to have heart attacks before menopause, the odds essentially are equal after menopause.

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Illustration by Bailey Mariner

Because certain symptoms, such as nausea or fatigue, can signal any number of health concerns, it’s important to be aware of other possible heart attack symptoms.

If you suddenly become nauseated and are having trouble catching your breath or you have serious jaw pain, call 911. Tell the 911 dispatcher you may be having a heart attack.

You may be reluctant to call 911 if you’re not sure whether you or a loved one is having a heart attack, but it’s better to err on the side of caution.

A heart attack is often a life threatening emergency. The faster you get medical attention, the better chance you have of a good recovery.

When to call 911

Any time you have pain or pressure in your chest that lasts more than a few minutes and is different to pain you’ve felt before, it’s important to get medical attention as soon as possible. This is especially important if you have other symptoms, too, such as:

  • shortness of breath
  • nausea or vomiting
  • lightheadedness
  • a sudden cold sweat
  • back, neck, arm, or jaw pain
  • extreme fatigue

While you’re waiting for an ambulance to arrive, make sure to stay on the phone with the 911 dispatcher, and unlock the front door for emergency personnel to come in.

The 911 dispatcher may tell you to chew on an aspirin while you wait for them. This may not be safe to do if you take blood-thinning medications.

Try to remember how and when your symptoms began so you can provide this information to the emergency personnel.

Some people are at a higher risk of a heart attack than others. If you have any of the following risk factors, it’s especially important to pay attention to any warning signs of a heart attack:

Chest pain is the most common heart attack warning sign. What it feels like, though, can be somewhat different for men versus women. With men, the pain is often described as a heavy weight on the chest, and tends to be located in the center of the chest.

With women, chest pain that’s associated with a heart attack is often described as pressure or tightness. In some cases, there may only be other symptoms and very little or no chest pain.

Other heart attack symptoms that are more common among women include abdominal discomfort, dizziness, extreme fatigue, and jaw pain.

It’s very important not to ignore any symptoms that feel like a heart attack. Even if you’re not having a heart attack, it’s better to be evaluated than to risk serious, life threatening complications.

Trust your instincts and pay attention to what your body is telling you. If your chest pain or symptoms last more than a few minutes, don’t hesitate to call 911 immediately.