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Heart Disease Health Center

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Recognizing Heart Attack, Stroke, and Angina


A heart attack can be hard to distinguish from angina, which is temporary chest pain or pressure that happens when heart muscle isn't getting enough oxygen. Angina usually occurs because arteries that supply blood and oxygen to the heart have become narrowed or blocked. Strong emotion, physical exertion, hot and cold temperature extremes, or a heavy meal can trigger angina.

Symptoms include:

  • Pressure, pain, squeezing, or a sense of fullness in the center of the chest
  • Pain or discomfort in the shoulder, arm, back, neck, or jaw

If you have stable angina, symptoms usually happen with predictable triggers. They usually stop if you rest or take nitroglycerin that your doctor has prescribed. Follow your doctor's orders for when to call 911. For instance, patients are often instructed to take nitroglycerin pills within a certain amount of time and then call 911 if symptoms don't go away or if they get worse.

If you have unstable angina, the chest pain comes at unexpected times, even with little physical exertion. Symptoms don't go away with rest or medication. It can be hard to distinguish unstable angina from heart attack symptoms. If your chest pain doesn't improve after you've taken nitroglycerin, or if it worsens, call 911.

If you get chest pain for the first time, call 911. If you've never been prescribed nitroglycerin, don't take anyone else's, says Alfred Sacchetti, MD, an emergency physician and spokesman for the American College of Emergency Physicians.


A stroke is also known as a "brain attack." Arteries to the brain become blocked or rupture, causing brain cells to die. Getting medical treatment within an hour after symptoms begin can reduce disability following a stroke. Strokes can cause permanent brain damage and paralysis.

If you or someone near you has stroke symptoms, call 911 right away and get to an emergency room as soon as possible, preferably within an hour, experts say. Every minute counts; the longer a stroke continues, the greater the potential damage.

Stroke symptoms include:

  • Sudden numbness or weakness of the face, arm, or leg, especially if it occurs on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes, double vision
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

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