Heart attack: symptoms, risk factors, and prevention

Heart attacks are a serious, yet common medical emergency. It’s estimated that every 40 seconds, someone in the United States experiences a heart attack.  

Around 605,000 Americans are expected to have a heart attack each year, and another 200,000 will experience a recurrent or repeated episode. Heart disease is also the leading cause of death in the United States behind COVID-19 (Zhan, 2019; McNamara, 2019). 

Seek medical attention immediately if you or someone you’re with has symptoms indicative of a heart attack. Here’s how to recognize the signs. 

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A heart attack, also called a myocardial infarction, happens when the flow of blood to the heart is blocked or cut off. 

Like all organs in the body, the heart muscle has its own network of blood vessels to circulate the oxygen and nutrients needed to keep it pumping. Without that crucial blood supply, cells in the heart die, which can lead to muscle damage. The longer blood flow is cut-off, the more compromised your cardiac function will be (Ojha, 2021). 

Coronary heart or coronary artery disease is the top cause of heart attacks. As the disease progresses, plaque builds up in arteries and restricts blood flow. Eventually, this plaque build-up breaks off or ruptures, and a clot forms in your bloodstream. 

Compared to other arteries in the body, the ones that feed your heart are particularly small and narrow. If the clot is large enough, it may get stuck or completely block blood flow in the coronary artery and cause a heart attack (Ojha, 2021). 

A less common cause of heart attacks is coronary artery spasms. These constrict arteries in the heart, severely limiting or cutting off blood flow. Coronary artery spasms are linked to things like (Slavich, 2016):

• Stimulant drugs (like cocaine and acetaminophen)

• Certain medications (beta-blockers and anti-migraine drugs)  

• Emotional distress and chronic anxiety

• Cold temperature exposure 

• Alcohol withdrawal

• Marijuana use

• Chemotherapy

Cardiac arrest refers to when the heart stops beating and there are no signs of blood circulation, pulse, or breathing. A malfunction with the heart’s electrical system is usually the culprit of cardiac arrest. Heart attacks caused by blockages can trigger cardiac arrest, but heart attacks aren’t always cardiac arrest.

Like a heart attack, cardiac arrest is a medical emergency. Cardiopulmonary resuscitation (CPR) or defibrillation is typically required to get the heart beating again (Patel, 2021).

Symptoms vary from person to person, but in general, these are common symptoms of a heart attack (Ojha, 2021): 

• Chest pain: This pain (medically known as angina) is concentrated behind the breastbone. It’s often described as a feeling of heaviness or pressure in the chest. Chest discomfort or pain may last for more than 20 minutes, and shifting or changing positions doesn’t make it better. 

• Upper extremity pain: Heaviness or pressure may radiate to other areas of the upper body like the arms, left shoulder, or neck. This pain can come and go or be persistent.

• Shortness of breath: Difficulty breathing may occur before a heart attack. Shortness of breath can also be a response to any pain and discomfort in the upper body. 

• Dizziness or lightheadedness: If heart function is severely impacted, limited blood flow and oxygen to the brain can cause lightheadedness. 

• Cold sweat: Breaking out into a cold sweat is another sign of a heart attack or that the body is under stress. 

Other symptoms include fainting, heart flutters, nausea, heartburn, and abdominal pain. And as we mentioned before, some people are completely asymptomatic (Ojha, 2021). 

Are heart attack symptoms different for women?

While chest pain, upper extremity pain, shortness of breath, and dizziness are signs of a heart attack in both sexes, biological women are likely to report milder or different symptoms than men. This is why many heart attacks in women are underdiagnosed or misdiagnosed.

Women are more likely to experience these heart attack symptoms without chest pain (Keteepe-Arachi, 2017): 

• Weakness

• Shortness of breath

• Fatigue 

• Sleep disturbance

• Mild discomfort in the back, chest, arms, neck, or jaw

These symptoms should still be taken seriously and treated as a medical emergency. 

A heart attack lasts anywhere from a few minutes to several hours. Do not wait to see if any initial symptoms persist. If you suspect you’re having a heart attack, call 911 at the first warning signs. 

There are certain types of heart attacks with special features that set them apart from others. Nicknames you may hear these commonly referred to as include:

Widowmaker heart attack

A widowmaker heart attack refers to a blockage in the left anterior descending artery. This artery is a major source of blood flow to the heart. If a clot completely blocks it, then the heart's functionality is severely compromised. This type may be fatal without emergency care (Rehman, 2021).

Silent heart attack 

A silent heart attack is one that happens without any of the classic symptoms like chest pain and shortness of breath. Just because a person may not feel like anything is wrong, blood flow to the heart can still be restricted and cause damage (Qureshi, 2018).

Up to half of all heart attacks are silent, which is why diagnosing this type of attack is often missed or delayed (Gul, 2021). 

Certain risk factors may increase the likelihood of heart disease or attacks. Many are lifestyle-related, but some are uncontrollable. 

For example, the risk for heart problems increases with age. For men, the risk rises at age 45, and for women it’s after menopause. In addition, having a family history of early heart disease also ups your chances of a heart attack (Keteepe-Arachi, 2017; Ojha, 2021).

Other factors influenced by lifestyle choices and habits that could increase your risk of heart attack include (Anand, 2008):

• High cholesterol 

• High blood pressure (hypertension)

• Diabetes

• Abdominal obesity

• Low fruit and vegetable consumption

• Lack of physical activity  

You can lower your risk of a heart attack by making lifestyle changes that help keep your heart healthy.

• Engage in physical activity: Being physically active decreases the risk of cardiovascular disease. It also promotes healthy blood pressure and cholesterol levels (Nystoriak, 2018). 

• Maintain a healthy weight: Excess body weight contributes to risk factors for heart disease and attacks. Maintaining a healthy weight is protective of overall heart health (Powell-Wiley, 2021). 

• Eat a healthy diet: A diet that’s rich in fruit, vegetables, and whole grains helps with weight maintenance. The high fiber content also helps lower harmful cholesterol and antioxidants, reducing the risk of heart disease (Kwok, 2019; Aune, 2018). 

• Get regular, preventative medical care: During annual physical exams, healthcare providers can help identify and monitor risks for coronary heart disease. This is important as they can provide proactive suggestions and refer patients to a specialist if needed.

Does aspirin help prevent heart attacks? 

Aspirin is an over-the-counter medication commonly used to relieve mild pain. The drug also acts as a blood thinner. 

It was previously recommended that adults with no history of heart disease take a daily, low dose of aspirin to prevent blood clots. However, many people took this approach without consulting a healthcare provider first (USPSTF, 2021). 

As of October 2021, those guidelines have shifted. Aspirin is now only recommended for a smaller, specific group of people. You can discuss with your doctor if aspirin treatment is appropriate for you.

Heart attacks are frightening situations. Knowing the signs and symptoms can help you be prepared and act quickly if you or someone else experiences a heart attack. Call 911 and seek emergency medical care in those situations. 

The best way to lower your chances of a heart attack is upkeeping a healthy lifestyle, which includes getting regular exercise, eating a balanced diet, and maintaining a healthy weight. 

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How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

February 22, 2022

Written by

Molly Knudsen, MS, RDN

Fact checked by

Steve Silvestro, MD

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About the medical reviewer

Steve Silvestro, MD, Ro

Dr. Steve Silvestro is a board-certified pediatrician and Associate Director, Clinical Content & Education at Ro.