The heart attack is also called myocardial infarction, and it represents the sudden disruption in
the blood supply to the specific parts of the heart muscle. This causes necrosis (ischemic death)
of the heart muscle cells, which is accompanied with numerous symptoms. Here is the list of 10
most common symptoms of heart attack.
1. Chest Pain
Books have been written about the chest pain, its possible causes, intensity, location, sharpness,
and other qualities. It is one of the most common symptoms in medical practice and it can have
many causes. The chest pain caused by heart attack has some specific qualities. This pain is dull,
and not sharp, so the person cannot usually point the finger at the location of the pain, but they
rather show it with their palms. The pain can be very mild to extremely severe, depending on the
severity and the size of the affected region of the heart muscle. The chest pain is usually the first
symptom of heart attack, it can start during physical activity or during rest, and it lasts longer
than 20 minutes. However, there are numerous variations, which make this symptom very
unreliable. For example, persons with a long history of diabetes mellitus can survive a heart
attack with no symptoms, as their nerve fibers which transduce the pain impulses can be severely
2. Abdominal Pain
Abdominal pain can appear during the heart attack alone or with other symptoms, such as chest
pain and nausea. It is a very valid symptom to consider as a possible sign of heart attack in
persons with increased cardiovascular risk. Patients with acute heart attack usually experience
abdominal pain when the bottom wall of the heart is affected.
3. Nausea and Vomiting
Sudden occurrence of nausea with or without vomiting and/or abdominal pain in persons with
increased cardiovascular risk can be a sign of heart attack. Similarly to abdominal pain, these
symptoms are an indication that the bottom wall of the heart is affected by infarction, and the
accompanying inflammation can expand to the nerve called Vagus, which innervates the
stomach and the bowels. That is how the stomach gets irritated during this type of heart attack.
Very commonly, numbness of the jaw and/or left arm can appear as the first symptom of heart
attack. The right arm is never affected, so that is used as a distinction between possible heart
attack and some other disorders in which both arms get numb.
5. General Feeling of Weakness
The chest pain itself can weaken the body, but also, if the large portion of the heart muscle is
affected, the person will usually become weak, as the ability of the heart to supply the other
organs with the blood is lowered.
6. Fear of Death
Another interesting symptom, which can point out towards possible heart attack is, as patients
describe it “fear of death”. This symptom can appear even if the other symptoms are mild and the
person has no idea about the risk for heart attack.
7. Excess Sweating
Excess sweating is very common in persons experiencing acute heart attack. It comes partially
from the pain, and from the fear and activation of sympathetic nervous system.
If the heart function is affected by heart attack to such extent that the brain cannot receive
enough blood, the person can experience fainting or even loss of consciousness. Persons with
heart attack should always be transported in lying or secured sitting position, in order to avoid
injuries caused by potential fainting and falls.
9. Heart Palpitations
The heart has its own nervous system which generates impulses and induces contractions at
regular intervals. If the infarction affects some parts of this nervous system, mild or severe
arrhythmias may appear, which can manifest as heart palpitations.
Due to pain and fear, sympathetic nervous system stimulates the release of adrenaline and
noradrenaline, which produces nervousness, stronger fear, and even anxiety. Antianxiety
medications can be given in some extreme cases of anxiety caused by heart attack.
NHLBI Health Topics [Internet]. Bethesda (MD): National Heart, Lung, and Blood Institute,
NIH (US); 2013. Heart Attack. [Updated 2014 Jun 11].
Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in
Health Care (IQWiG); 2006-. Coronary artery disease: Signs of a heart attack. 2006 Sep 13
[Updated 2013 Oct 6].
Tullmann DF, Dracup K. Knowledge of heart attack symptoms in older men and women at risk
for acute myocardial infarction. J Cardiopulm Rehabil. 2005 Jan-Feb;25(1):33-9.
Wong C-K, White HD. Recognising “painless” heart attacks. Heart. 2002;87(1):3-5.
Potokar JP, Nutt DJ. Chest pain: panic attack or heart attack? Int J Clin Pract. 2000