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His Guide to a Heart Attack: Symptoms in Men

WebMD Feature

In the movies, you never doubt when a man's having a heart attack. He clutches his chest, screams, or moans, and falls to the ground. If he's lucky, help is on its way.

In real life, the signs aren't always so clear. Some people do experience Hollywood-type symptoms, says Mohamud Daya, MD, an associate professor of emergency medicine at Oregon Health and Science University in Portland. But others don’t. “Some people say they just feel uneasy discomfort or vague discomfort, not pain that really hurts. Sometimes it feels more like heaviness or pressure,” Daya explains.

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Doctors say, in general, the three most commonly reported symptoms when men have a heart attack are:

No Two Heart Attacks the Same

“Some chest symptoms almost invariably accompany a heart attack, but everyone experiences it a little bit differently,” says Kristin Newby, MD, a cardiologist at the Duke Heart Center in Durham, NC. “Describing it as pain or pressure or tightness or burning or any of those symptoms are probably all reflecting each individual’s perception of the same thing.”

Chest pain or discomfort can come on fast or slow. Symptoms can come and go or last for more than a few minutes. In a study published in the American Journal of Critical Care in 2008, men reported more severe chest pain than women. They were also more likely to say their symptoms were brought on by exertion.

However, that same study found that 10 percent of men experienced no chest pain at all. And diabetics can have heart attacks without feeling pain. It’s also possible to experience a cluster of other symptoms. While less common than chest pain, these can include:

  • Discomfort or pain in other areas, such as one or both arms, the neck, jaw, back, or stomach
  • Shortness of breath, lightheadedness, nausea, or sweating
  • Abdominal discomfort that may feel like heartburn

“You have a spectrum of presentations. We tend to make medicine black and white,” Daya says. "It really isn’t. People can have minor symptoms or very major symptoms. That’s the challenge.”

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