It's dramatic when an actor on TV or the movies has a heart attack. But in real life, symptoms can be more subtle and hard to identify. And because heart attack and angina symptoms are so similar, it may be hard to tell what's going on.
But if you know the differences -- and the reasons behind them -- you'll learn to get treatment sooner, and maybe live longer, too.
Heart Attack Symptoms
A 2008 study in the American Journal of Critical Care found that chest pain is the most frequently reported heart attack symptom, and 61% of 256 participants said their symptoms were constant.
Your chest pain may feel like:
"If you've not experienced it before, patients often aren't sure what it is when it first comes on," says Kristin Newby, MD, a cardiologist at the Duke Heart Center in Durham, NC.
The same study found that women were about 8 years older than men when they began to have heart trouble and were more likely to report a higher intensity of five other symptoms:
The study found that 21% of the women and 10% of the men had no symptoms at all. Less typical symptoms for both men and women are:
"Men and women may respond differently to the symptoms of a heart attack, particularly if the symptoms are vague. But if you have symptoms consistent with a heart attack, don't wait at home. Go to the hospital," says Alfred Sacchetti, MD, an emergency room physician and an American College of Emergency Physicians spokesman.
It's your body's warning sign that something isn't right with your heart. Angina is temporary chest pain or pressure that happens when arteries that supply blood and oxygen to your heart become narrowed or blocked. That means your ticker is getting less blood than your body needs to work right. Strong emotions, physical activity, hot and cold temperature extremes, or a heavy meal can often trigger it.
You may notice symptoms like:
Types of Angina
Stable angina. Your narrowed arteries cause pain, pressure, and other symptoms when you move around. This may occur at regular times, and the symptoms usually go away after you rest. If you're under a doctor's care, you may take nitroglycerin to get relief.
"This is why people get pain or other symptoms when they do physical activities. They may feel fine walking around the house, but if they try to run to the mailbox before the mailman leaves, they would develop pain," says Holli A. DeVon, PhD, RN, an associate professor in the College of Nursing at the University of Illinois at Chicago.
Unstable angina. Sometimes the stable type turns into an unstable form. You may get chest pain that becomes more intense, lasts longer, or happens even when you're at rest.
"You might get chest discomfort walking up a hill, but it goes away when you sit and rest," explains Mohamud Daya, MD, associate professor of emergency services at Oregon Health and Science University in Portland. "What is really concerning is when the distance you can walk is getting shorter and shorter. That means there is less blood flow, and you are more likely to have a heart attack."
Take It Seriously
"Angina is a warning sign. It's basically giving you a heads-up there is a problem. It's telling you your heart muscle is not getting enough blood. There is a narrowing in your artery that can lead to a clot that could give you a heart attack," Sacchetti says.