10 Warning Signs of a Heart Attack You Must Never Ignore
Dr. Priya Borah
North East Heart Centre
Why Early Recognition Saves Lives
Every minute counts during a heart attack. The medical term is myocardial infarction (MI) — a blockage in a coronary artery cuts off blood supply to part of the heart muscle. Without treatment, that muscle begins to die.
Studies show that patients who arrive at the hospital within 90 minutes of symptom onset have dramatically better outcomes than those who wait hours. Yet a 2023 survey found that nearly 60% of Indians cannot correctly identify the main warning signs.
This guide could save your life — or someone else’s.
The 10 Warning Signs
1. Chest Discomfort or Pressure
The most recognised symptom — but it isn’t always “crushing” pain. Patients describe it as:
- Pressure, squeezing, or heaviness in the centre of the chest
- A feeling of something heavy sitting on the chest
- Burning or aching sensation
It may last more than a few minutes, or go away and come back.
2. Pain Radiating to the Arm, Jaw, Neck, or Back
Cardiac pain often travels. Left arm pain (especially the inner arm) is classic, but pain can also radiate to:
- The right arm
- Both arms simultaneously
- The jaw, neck, or throat
- The upper back or between the shoulder blades
3. Shortness of Breath
Unexplained breathlessness — with or without chest discomfort — at rest or with minimal exertion can indicate the heart is struggling.
4. Cold Sweat
Sudden, unexplained sweating that feels cold and clammy — without exercise or fever — is a significant warning sign. It reflects the body’s stress response to reduced cardiac output.
5. Nausea or Vomiting
Particularly common in women. Gastrointestinal symptoms during a cardiac event are frequently mistaken for indigestion or food poisoning, leading to dangerous delays in seeking care.
6. Dizziness or Lightheadedness
Feeling faint, dizzy, or like the room is spinning — especially alongside chest discomfort or shortness of breath — warrants immediate attention.
7. Extreme Fatigue
Unusual, overwhelming tiredness that comes on suddenly, without obvious cause. Some heart attack patients — especially women — describe feeling exhausted for days before the event.
8. Palpitations
An awareness of your heartbeat — fluttering, racing, or pounding — that is new, persistent, or accompanied by other symptoms.
9. Abdominal Pain
Pain in the upper abdomen (epigastric region) that mimics heartburn or gastritis. This is a commonly missed presentation, particularly in women and diabetics.
10. Sense of Impending Doom
A sudden, intense feeling that something is catastrophically wrong — even without specific physical symptoms. Trust this instinct. Many heart attack survivors describe this sensation.
What To Do Immediately
If you or someone around you experiences any of these symptoms — call emergency services (112 in India) without delay.
While waiting for the ambulance:
- Have the person sit or lie down in the most comfortable position
- Loosen tight clothing
- Aspirin 325 mg — chew (do not swallow whole) if the person is not allergic and has no known contraindication
- Stay calm and reassure the person
- Do NOT give food or water
- Be ready to perform CPR if the person becomes unresponsive and stops breathing normally
The “Heart Attack Isn’t Always Dramatic” Myth
Hollywood has given us the image of a man clutching his chest and collapsing. In reality:
- Symptoms often build gradually over 30–60 minutes
- Women are more likely to present with atypical symptoms (fatigue, nausea, jaw pain) without obvious chest pain
- Diabetic patients may have a “silent” MI with minimal pain due to diabetic neuropathy
- Elderly patients may present primarily with breathlessness or confusion
Risk Factors That Increase Your Likelihood
If you have any of the following, you are at higher risk and should be especially vigilant:
- High blood pressure
- Diabetes or prediabetes
- High cholesterol
- Smoking — even occasional
- Family history of early heart disease (father/brother before 55, mother/sister before 65)
- Obesity or central adiposity (waist circumference > 90 cm in men, > 80 cm in women)
- Sedentary lifestyle
- Chronic stress or sleep disorders
Prevention: The Best Strategy
The majority of heart attacks are preventable. Our preventive cardiology programme includes:
- Comprehensive cardiovascular risk assessment
- Lipid, glucose, and BP management
- Personalised lifestyle and nutrition guidance
- Stress ECG and advanced imaging where appropriate
Book a cardiac check-up today. Early detection is always more effective — and far less costly — than emergency treatment.
Written by Dr. Priya Borah, MD DNB (Cardiology), Consultant Cardiologist specialising in cardiac imaging and women’s heart health. This article is for educational purposes only.