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Heart attack - Symptom

Alternative Names

Myocardial infarction; MI; Acute MI; ST-elevation myocardial infarction; non-ST-elevation myocardial infarction

Symptoms:

A heart attack is a medical emergency. If you have symptoms of a heart attack, call 911 or your local emergency number right away.

DO NOT try to drive yourself to the hospital.
DO NOT DELAY. You are at greatest risk of sudden death in the early hours of a heart attack.

Chest pain is the most common symptom of a heart attack. You may feel the pain in only one part of your body, or it may move from your chest to your arms, shoulder, neck, teeth, jaw, belly area, or back.

The pain can be severe or mild. It can feel like:

A tight band around the chest
Bad indigestion
Something heavy sitting on your chest
Squeezing or heavy pressure

The pain usually lasts longer than 20 minutes. Rest and a medicine called nitroglycerin may not completely relieve the pain of a heart attack. Symptoms may also go away and come back.

Other symptoms of a heart attack include:

Anxiety
Cough
Fainting
Light-headedness, dizziness
Nausea or vomiting
Palpitations (feeling like your heart is beating too fast or irregularly)
Shortness of breath
Sweating, which may be very heavy

Some people (the elderly, people with diabetes, and women) may have little or no chest pain. Or, they may have unusual symptoms (shortness of breath, fatigue, weakness). A "silent heart attack" is a heart attack with no symptoms.

Signs and tests:

A doctor or nurse will perform a physical exam and listen to your chest using a stethoscope.

The doctor may hear abnormal sounds in your lungs (called crackles), a heart murmur, or other abnormal sounds.
You may have a rapid pulse.
Your blood pressure may be normal, high, or low.

A troponin blood test can show if you have heart tissue damage. This test can confirm that you are having a heart attack.

Coronary angiography is often done right away or when you are more stable. You may also have tests such as anelectrocardiogram (ECG).

This test uses a special dye and x-rays to see how blood flows through your heart.
It can help your doctor decide which treatments you need next.

Other tests to look at your heart that may be done while you are in the hospital:

Heart, section through the middle

Heart, front view

Acute MI

Post myocardial infarction ECG wave tracings

Progressive build-up of plaque in coronary artery

Posterior heart arteries

Anterior heart arteries

Heart attack symptoms

Reviewed last on: 5/23/2011
Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr., et al. ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am coll Cardiol. 2007;50:e1-e157.

Kushner FG, Hand M, Smith SC Jr, King SB 3rd, Anderson JL, Antman EM, et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients WithST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention(updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2009 Dec 1;120(22):2271-306. Epub 2009 Nov 18.

Antman EM. ST-segment elevation myocardial infarction: pathology, pathophysiology, and clinical features. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsever; 2011:chap 54.

Cannon CP, Braunwald E. Unstable angina and non-ST elevation myocardial infarction. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsever; 2011:chap 56.

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