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The Beginnings of a Heart Attack: Here’s How Knowing the Early Signs Can Save Your Life

The clutching of the chest and screams of pain portrayed in a Hollywood heart attack might add to the drama of a movie — but they may also make viewers miss deadly symptoms in real life.

The well-known symptom of extreme chest pain is only one of the many indicators that you could be having a heart attack. More importantly, this symptom may be a sign that a heart attack is in its later stages, and by being aware of symptoms, you could have received help hours ago.


"If you're having a heart attack, remember: time is muscle. The longer you wait to seek care, the more damage you'll experience to your heart, which may be unrecoverable. Your chances of survival significantly improve the sooner you seek medical treatment. It's critical to be aware of the earliest possible indicators of a heart attack — and to act fast, says Ralph Smith, BSN, RN, CCCC, AACC, cardiovascular registry and accreditation manager at Chester County Hospital.

While knowing the signs is key, it's just as important to understand your risk of having a heart attack in order to take steps to prevent one in the first place.

Here's what you should know about heart attack risk factors — and how to recognize the early signs of a heart attack.

Know Your Individual Risk Factors

Years — or even decades — before a heart attack, your body can begin changing in ways that put you at risk for heart disease down the road.

A heart attack occurs when blood flow to your heart becomes severely reduced or cut off completely. This restricts the amount of oxygen that makes it to your heart, which is necessary for it to survive.

A blood flow blockage can occur if your coronary arteries — the arteries that supply blood to the heart — become narrowed by a buildup of cholesterol, fat, and other substances called plaque. This process is called atherosclerosis, and it happens over the course of several years.

Atherosclerosis has no symptoms, so you wouldn't be aware of this potentially deadly concern right away. However, there are a number of factors that can put you at risk for atherosclerosis and heart disease. By knowing them, you can take steps to prevent your risk of a future heart attack.

Risk factors of a heart attack include:

  • A family history of heart disease
  • High blood pressure
  • Being overweight or obese
  • An inactive lifestyle
  • Smoking
  • Diseases, such as metabolic disease and diabetes
  • For women, a history of preeclampsia (high blood pressure and signs of kidney or liver damage during pregnancy), gestational diabetes, or having a baby with a low birth weight

Some of these risk factors are out of your control, such as family history. But others are related to your lifestyle choices, including your diet, activity levels, and tobacco use. Around 80% of cardiovascular disease, including heart attacks, are preventable, and small lifestyle changes can make a big difference.

If you have any of these risk factors, talk to your health care provider. Together, you can find ways to prevent your risk of a heart attack in the future. After all, the best way to stop a heart attack is to never let it happen in the first place.

Learn more about your heart attack risk factors.

Recognize the Less-Obvious Symptoms

Even if you take preventative measures to keep your heart healthy, a heart attack can still occur. Your next line of defense is your knowledge — and there may be more information out there than you're aware of. When it comes to signs of a heart attack, chest pain is just the tip of the iceberg.

Heart attacks have beginnings, and even mild symptoms of a heart attack need medical attention. Not all heart attack patients have crushing chest pain, and it's important to know the early signs.

The early signs and symptoms of a heart attack include:

  • Chest pressure, squeezing, aching, burning, or extreme discomfort
  • Difficulty breathing
  • Excessive weakness or fatigue
  • Feelings of fullness
  • Nausea or vomiting
  • Pain down one or both arms
  • Back pain
  • Jaw pain
  • Anxiety

Keep in mind — all individuals can experience a heart attack differently. For example, women are more likely to experience some of the milder symptoms of a heart attack and may end up chalking it up to acid reflux or the flu. Also, people with diabetes may have very mild warning signs due to the way diabetes affects their nerves.

The important thing to remember is to act quickly. When your life is on the line, stay proactive and seek medical attention if you think you're having a heart attack.

Don't Delay — Act Quickly

Ralph Smith, BSN, RN, CCCC, AACC
Cardiovascular Registry and Accreditation Manager

If you're having a heart attack, you're working against a dangerous clock, and it's essential that you take action as quickly as possible. The longer you wait to seek care, the more damage that can occur to your heart muscle — and you may not be able to recover from that damage.

"If you believe you're having a heart attack, always call 9-1-1. It can be tempting to have a loved one drive you to the hospital, but Emergency Medical Services (EMS) providers can deliver immediate care that your loved one cannot, especially while they're at the wheel. EMS providers have a relationship with the hospital, which provides the added benefit of coordinated care," adds Smith.

An ambulance essentially brings the entire emergency department to you. Skilled EMS providers administer coordinated care that may be required during transportation, and early treatment can save lives.

EMS providers can perform cardiopulmonary resuscitation (CPR) and use medical equipment, such as an automatic external defibrillator (AED) machine — all while making sure you get to the hospital for further treatment. An AED machine is portable and can restore your normal heartbeat with an electric pulse or shock the heart. They'll also alert the hospital and cardiology team that you're on your way so everyone can be prepared.

Heart attacks can be scary, not to mention life-threatening. However, you have many tools at your disposal to keep your heart healthy, and it's up to you to use them. Take the time to know your risk factors, and talk to your health care provider if you have questions.

Remember — the signs of a heart attack may not be as dramatic in Hollywood, but they can be just as dangerous. Knowing the less-obvious symptoms may just save your life.

Do you have questions about heart attack prevention and early symptoms of a heart attack? Call 610-738-2300 to be connected with a nurse navigator at the Penn Heart and Vascular Center at Chester County Hospital to learn about your risk factors and other ways to keep your heart healthy.

Related Information from Chester County Hospital:

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