“If you’re experiencing symptoms that you’ve never had before, such as significant discomfort, then absolutely come into the emergency room and get it evaluated,” says Shikhar Saxena, MD, a cardiologist who teaches at the University of Nebraska Medical Center.
Sure, no one likes to go to the ER, says Richard A. Stein, MD, a cardiologist with New York University Langone Medical Center. But he suggests you call 911 if you have chest pain that:
- Is new
- Happens repeatedly, but after you've used much less energy doing something active
- Wakes you up at night
How do you know if your symptoms are due to something less serious, like acid reflux? Location is a clue, says Karol E. Watson, MD, co-director of the UCLA Center for Cholesterol and Lipid Management.
A heart problem usually makes you hurt “on the left side of the upper chest,” Watson says. Any pain from the navel to the nose, pain you might describe as "discomfort," or the kind that comes on with emotional or physical stress and goes away with rest, could be heart-related, she says.
Don't assume a simple case of gas is the culprit. See a doctor immediately to rule out a heart attack or angina.
Sometimes the symptoms come on intensely and suddenly. But some people say their pain or pressure built slowly, or seemed minor. To make things more confusing, men and women can have slightly different warning signs, or feel them in different places.
You may be having a heart attack if you feel:
- Pain, pressure, or squeezing in your chest, particularly a little to the left side
- Pain or pressure in your upper body like your neck, jawline, back, stomach, or in one or both of your arms (especially your left)
- Shortness of breath
- Suddenly sweaty or clammy
- Nausea or vomiting
The pain often lasts for a few minutes. It can get worse with physical activity or emotional stress, and it doesn't go away with rest, Stein says.
Heart attack symptoms in women are sometimes more subtle. They can also be more widespread around the upper body, and there's more of a chance for heavy sweating or stomach symptoms too, Watson says. “Women may also have unusual shortness of breath or unusual fatigue -- like where you feel you can’t even move -- more than men.”
Heart attacks can also have “vague, non-specific symptoms, like you just don’t feel right, or having a feeling of impending doom,” Saxena says.
“Almost 15% of patients have no symptoms, so they never know they’re having a heart attack. That’s more common in elderly people and those with diabetes,” Stein says.
This emergency has many possible symptoms, but they tend to be the same for both men and women.
Call 911 right away if you notice any of these warning signs in yourself or someone else:
- Face drooping on one side, like a lopsided smile
- Trouble walking
- Weakness or numbness in an arm or leg, particularly on one side of the body
- Confusion, like you can’t think clearly or do something you can normally do
- Slurred speech
- Tongue doesn't work on one side
- Severe, sudden headache
“One of the obvious signs of a stroke is weakness anywhere in the body, but the signs could be subtle,” Watson says.
If you’re worried that someone is having a stroke, “have them hold up both arms. If one arm is weak, it will drop. With you by their side to help, have them walk across the room. Look for strange changes in their gait.”
Unlike a heart attack, stroke symptoms are less likely to be brought on by anxiety, Stein says.
Strokes can cause permanent damage to your brain, so it’s important to get medical care ASAP if you even think somebody might be having one, Saxena says. “Some patients will not have the typical symptoms, and may just have non-specific confusion.”
If you have blocked or narrowed arteries to your heart, you can have pain in your chest, or angina. Only a doctor can tell if the hurt you feel is from this or if you’re having a heart attack -- so get it checked out immediately, Saxena says.
Some common symptoms of angina include:
- Your chest hurts during physical activity, because your heart has to work harder to keep pumping.
- You have chest pains often that last 5 minutes or less.
- Your discomfort feels like bad indigestion.
- The pain spreads from your chest out to your arms, back, or upper body.
- You get relief from resting or from taking heart medicine like nitroglycerin.
If you're a woman, you may have other symptoms, like feeling out of breath, nausea or vomiting, and sharp pain in your stomach or chest. You can get angina when they have blockages in very small arteries. For men, the blockage is usually in your larger heart arteries.
Stress, smoking, extreme temperatures, and heavy meals can trigger the pain. It doesn’t cause damage to your ticker, but it's an early warning of heart disease, so get it checked out, Watson says.
Always err on the side of caution if you think you’re having a heart attack, stroke, or angina, Saxena says. “People tend to downplay these symptoms. These are serious issues, so talk to your doctor or go to the emergency room.”