Heart attack signs and symptoms in men and women: Chest pain or discomfort; Shortness of breath; Pain or discomfort in the jaw, neck, back, arm, or shoulder; Feeling nauseous, light-headed, or unusually tired.
A heart attack, also called a myocardial infarction, happens when a part of the heart muscle doesn’t get enough blood.
The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle.
Coronary artery disease (CAD) is the main cause of heart attack. A less common cause is a severe spasm, or sudden contraction, of a coronary artery that can stop blood flow to the heart muscle.
What are the symptoms of heart attack?
The major symptoms of a heart attack are
- Chest pain or discomfort. Most heart attacks involve discomfort in the center or left side of the chest that lasts for more than a few minutes or that goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
- Feeling weak, light-headed, or faint. You may also break out into a cold sweat.
- Pain or discomfort in the jaw, neck, or back.
- Pain or discomfort in one or both arms or shoulders.
- Shortness of breath. This often comes along with chest discomfort, but shortness of breath also can happen before chest discomfort.
Other symptoms of a heart attack could include unusual or unexplained tiredness and nausea or vomiting. Women are more likely to have these other symptoms. Learn more about women and heart disease.
Call 9-1-1 if you notice symptoms of a heart attack.
If you notice the symptoms of a heart attack in yourself or someone else, call 9-1-1 immediately. The sooner you get to an emergency room, the sooner you can get treatment to reduce the amount of damage to the heart muscle. At the hospital, health care professionals can run tests to find out if a heart attack is happening and decide the best treatment.
In some cases, a heart attack requires cardiopulmonary resuscitation (CPR) or an electrical shock (defibrillation) to the heart to get the heart pumping again. Bystanders trained to use CPR or a defibrillator may be able to help until emergency medical personnel arrive.
Remember, the chances of surviving a heart attack are better the sooner emergency treatment begins.
Several health conditions, your lifestyle, and your age and family history can increase your risk for heart disease and heart attack. These are called risk factors. About half of all Americans have at least one of the three key risk factors for heart disease: high blood pressure, high blood cholesterol, and smoking.2
Some risk factors cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.
Learn more about risk factors for heart disease and heart attack.
What can I do to recover after a heart attack?
Take our quiz to see how much you know about cardiac rehabilitation.
If you’ve had a heart attack, your heart may be damaged. This could affect your heart’s rhythm and its ability to pump blood to the rest of the body. You may also be at risk for another heart attack or conditions such as stroke, kidney disorders, and peripheral arterial disease (PAD).
You can lower your chances of having future health problems following a heart attack with these steps:
- Physical activity—Talk with your health care team about the things you do each day in your life and work. Your doctor may want you to limit work, travel, or sexual activity for some time after a heart attack.
- Lifestyle changes—Eating a healthier diet, increasing physical activity, quitting smoking, and managing stress—in addition to taking prescribed medicines—can help improve your heart health and quality of life. Ask your health care team about attending a program called cardiac rehabilitation to help you make these lifestyle changes.
- Cardiac rehabilitation—Cardiac rehabilitation is an important program for anyone recovering from a heart attack, heart failure, or other heart problem that required surgery or medical care. Cardiac rehab is a supervised program that includes
- Physical activity
- Education about healthy living, including healthy eating, taking medicine as prescribed, and ways to help you quit smoking
- Counseling to find ways to relieve stress and improve mental health
A team of people may help you through cardiac rehab, including your health care team, exercise and nutrition specialists, physical therapists, and counselors or mental health professionals.
- Tsao CW, Aday AW, Almarzooq ZI, Beaton AZ, Bittencourt MS, Boehme AK, et al. Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association. Circulation. 2022;145(8):e153–e639.
- Fryar CD, Chen T-C, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease: United States, 1999–2010 [PDF-494K]. NCHS data brief, no. 103. Hyattsville, MD: National Center for Health Statistics; 2012. Accessed May 9, 2019.
Myocardial ischemia is a lack of blood flow getting to your heart muscle. That means your heart muscle isn’t getting enough blood to do what it needs to do. Often, the cause is a collection of fat and cholesterol (plaque) that doesn’t let enough blood go through your coronary arteries. Medicines and surgeries can treat myocardial ischemia.
Myocardial ischemia (or cardiac ischemia) means your heart muscle is not getting enough blood (which contains oxygen and nutrients) to work as it should. If this lack of blood from your coronary arteries is severe or goes on for more than a few minutes, it can damage your heart muscle. Then it becomes a myocardial infarction (heart attack).
A heart attack is an emergency. You should call 911 for an ambulance instead of having someone drive you to the hospital.
Who does myocardial ischemia affect?
People who get myocardial ischemia often have:
How common is myocardial ischemia?
Each year, more than 1 million people in the United States die from myocardial infarction (heart attack). This is due to myocardial ischemia, a lack of blood flow and oxygen to your heart muscle.
How does myocardial ischemia affect my body?
Myocardial ischemia makes it difficult to exercise, especially in the cold. As your condition gets worse, you can have symptoms of myocardial ischemia with less and less activity. In time, it can be hard to go up a flight of stairs. Eventually, you can even have symptoms when you’re at rest.
The most common symptom of myocardial ischemia is angina (also called angina pectoris). This is chest pain (similar to indigestion or heartburn) that feels like:
- Chest discomfort.
- Heaviness.
- Tightness.
- Pressure.
- Aching.
- Burning.
- Numbness.
- Fullness.
- Squeezing.
There are two types of angina:
- Stable angina, which usually stops soon after you rest or take medication to control it.
- Unstable angina, which can happen at any time, even when you’re relaxed or sleeping. It may not go away when you take medication.
Other myocardial ischemia symptoms can also include:
- Pain or discomfort in your upper body, including your arms, left shoulder, back, neck, jaw or stomach.
- Trouble breathing or feeling short of breath.
- Sweating or "cold sweat."
- Feeling full, indigestion, or a choking feeling (may feel like heartburn).
- Nausea or vomiting.
- Feeling lightheaded, dizzy, very weak or anxious.
- Fast or irregular heartbeat.
If you have angina or any of the symptoms of ischemia listed above that last for more than five minutes, call 911 right away.
It’s possible to have ischemia ─ or even a heart attack ─ and not have any warning signs. This is called silent myocardial ischemia. This is most common in people with diabetes, but it can happen to anyone with heart disease.
What causes myocardial ischemia?
Often, a person has more than one cause of myocardial ischemia.
Causes of myocardial ischemia include:
- Coronary artery disease. This is a buildup of plaque and cholesterol inside your coronary arteries, which supply blood to your heart muscle. The buildup narrows your artery so much that the oxygen-rich blood your heart needs can’t get through, and your heart muscle becomes starved for oxygen. This causes ischemia and angina. Atherosclerotic plaque causes 70% of fatal heart attacks.
- Blood clot. When plaque that forms in your narrow coronary artery breaks apart, it can attract a blood clot. When a blood clot settles in a coronary artery that’s already narrow, it can cause a blockage (thrombosis).
- Coronary artery spasm. This happens when the coronary arteries spasm, which temporarily reduces or cuts off blood supply to your heart.
- Cocaine use.
- Coronary artery dissection. This rare condition can keep blood from getting to your heart.
Ischemia is most likely to happen when your heart needs more oxygen and nutrients than it’s getting. It happens when your heart can’t keep up with your body’s increased demand for blood.
Your body needs more blood when you’re:
- Active/exercising.
- Eating.
- Excited.
- Stressed.
- Cold.
Myocardial ischemia treatments may include medications or procedures to improve blood flow to your heart muscle. Your treatment for myocardial ischemia depends on the cause of the problem. Your healthcare provider will talk to you about the treatment that’s best for you.
What medications/treatments are used?
Medicines or treatments for myocardial ischemia may include:
Complications of coronary artery bypass graft may include:
Rarely, some of these complications can happen with angioplasty/ stent placement as well.
How long does it take to recover from this treatment?
After a coronary artery bypass graft, you’ll need to spend about a week in the hospital. After that, you’ll need six to 12 weeks to recover at home.
After angioplasty or stent placement, you’ll probably spend the night in the hospital and go home the next day.
Your healthcare provider may recommend medications or lifestyle changes to reduce your risk of myocardial ischemia.
Medicines
Lifestyle changes
- Get treatment for diabetes.
- Get treatment for high blood pressure.
- Get treatment for high cholesterol.
- Exercise 30 to 60 minutes on most days.
- Eat less fat and lots of fruits, vegetables and whole grains.
- Don’t use tobacco products.
It’s common for people with unstable angina to have a heart attack in the next three months. Heart attacks are fatal in the first few hours for up to a third of people who have them.
Most people who get through the first few days after a heart attack recover completely. However, 10% live less than a year after their heart attack.
How long does myocardial ischemia last?
Angina from myocardial ischemia lasts 10 minutes or less in most cases.
Exercise is very helpful for improving your cardiovascular health. It gets more oxygen to your heart muscle, which helps with symptoms. Healthcare providers recommend getting at least 30 to 60 minutes of exercise five or more days a week.
Other ways to stay healthy include:
- Keep taking all medicines your provider prescribed for you.
- Eat a healthy diet.
- Stay at a healthy weight.
- Avoid tobacco products.
When should I see my healthcare provider?
Contact your healthcare provider if your medicines aren’t helping you or if the side effects are severe. If you’ve had an angioplasty and stent placement or coronary artery bypass graft, you’ll most likely need to see your provider every six months during the first year after your procedure.
When should I go to the ER?
Call 911 and chew an aspirin if you think you’re having a heart attack. If you have a clot in your coronary artery, aspirin can help make it smaller.
You should also get help immediately if you’ve taken three nitroglycerin doses (one every five minutes) and still have angina.
What questions should I ask my doctor?
- How often will you need to see me once I start exercising?
- Will I need to take the medicines you prescribed for the rest of my life?
- How high is my individual risk of a heart attack?
No. Angina (chest pain) is a very common symptom of myocardial ischemia.
Is myocardial ischemia a stroke?
No. Myocardial ischemia is a lack of blood supply to your heart muscle. A stroke affects your brain.
How long can you live with myocardial ischemia?
It depends on many factors, such as:
- Whether you have a heart attack.
- How quickly you get diagnosis and treatment.
- How well you do with following your healthcare provider’s instructions for making lifestyle changes.
- How well you manage conditions that cause myocardial ischemia (usually atherosclerosis).
A note from Cleveland Clinic
Chest pain from myocardial ischemia is understandably a cause for concern, but a diagnosis and treatment plan can give you peace of mind. Following your healthcare provider’s recommendations will give you the best chance of improving your heart health. Although you may not want to think about it, it’s a good idea to know the warning signs of a heart attack. Having a plan in place in case that happens will help you be prepared to help yourself or a loved one.
Last reviewed by a Cleveland Clinic medical professional on 05/27/2022.
References
- Knuuti J, Wijns W, Saraste A, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. (//pubmed.ncbi.nlm.nih.gov/31504439/) Eur Heart J. 2020 Jan 14;41(3):407-477. Accessed 5/27/2022.
- Merck Manual Consumer Version. Acute Coronary Syndromes. (//www.merckmanuals.com/home/heart-and-blood-vessel-disorders/coronary-artery-disease/acute-coronary-syndromes-heart-attack-myocardial-infarction-unstable-angina?query=myocardial%20ischemia) Accessed 5/27/2022.
- National Heart, Lung, and Blood Institute. Coronary Artery Bypass Grafting. (//www.nhlbi.nih.gov/health-topics/coronary-artery-bypass-grafting) Percutaneous Coronary Intervention. (//www.nhlbi.nih.gov/health-topics/percutaneous-coronary-intervention) Accessed 5/27/2022.
- StatPearls. Acute Myocardial Infarction. (//www.ncbi.nlm.nih.gov/books/NBK459269/) Accessed 5/27/2022.
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