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.
Doctors say, in general, the three most commonly reported symptoms when men have a heart attack are:
- Chest pain
- Chest discomfort
- Chest pressure
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.”
Every Second Matters
About half of sudden cardiac deaths happen outside a hospital, meaning that people don't act on early warning signs, the CDC says.
A 2010 study published in the Journal of Cardiovascular Nursing found that most men wait 6 hours before calling 911 when having heart attack symptoms.
“The really bad news is that is too late,” says Holli A. DeVon, PhD, RN, who led the study. “We say you should call 911 within 5 minutes. That is the goal. And we are missing that goal by hours, not minutes.”
DeVon, an associate professor in the College of Nursing at the University of Illinois at Chicago, says the faster you get to the hospital, the better the outcome.
Once you're there, doctors can begin treatments like clot-dissolving drugs or angioplasty to restore blood flow to the heart muscle and limit damage. “If you get to the hospital in a few minutes rather than a few hours, you are more likely to have a better outcome with less complications, and you are less likely to die,” she says.
When to Call 911
If you think you're having a heart attack, don't try to drive yourself to the hospital. Call 911 instead.
That's because emergency responders offer more than just a ride. They can give you oxygen, heart medications, and pain relievers; monitor your heart rhythm and vital signs; and transmit potentially lifesaving information to the hospital to get a jump start on tests and treatment. Plus, arriving at the emergency room by ambulance generally allows you to bypass the wait that typically characterizes walk-ins.
Despite the benefits, doctors say they often hear male patients express hesitation about calling 911 because they are:
- Unsure what they are feeling
- Concerned about the cost of an ambulance ride or hospital visit
- Embarrassed that the diagnosis might be something simple like heartburn
DeVon says none of those things matter if your life is in danger. “For patients who do have a heart attack, it really can be life and death,” she says. “They don’t need to feel embarrassed. This is exactly what emergency medical services were designed to do -- get people to the hospital quickly. They are there to help you.”
What to Do After Calling 911
- Limit activity to decrease stress on your heart.
- Have someone collect your medications so paramedics and doctors know what you're taking.
- Chew one adult-strength (325 milligrams) or two to four low-dose (81 milligrams) aspirin. Coated aspirin is slow to act and won’t help in this instance. Chewing gets the aspirin into your system faster, where it works to stop blood from clotting.