What are the symptoms of a heart attack?

Dear Reader and Neil O., 

It’s great that you’re both curious about the symptoms of heart attacks, especially because they concern such an important organ. When it comes to symptoms, you're right that they may vary between those assigned male at birth (AMAB) and those assigned female at birth (AFAB). Additionally, these symptoms may be confused with other conditions or may not be present at all. This could lead to a person not realizing they’re having a heart attack and therefore experiencing what’s commonly called a silent heart attack. Keep reading to learn more about which symptoms to look out for and understand which habits you can implement that may help lower your risk. 

Heart attacks are a condition where blood flow to the heart is either stopped entirely or significantly reduced. When they occur, they’re most often recognized by pain in the center of the chest or described as a sensation of pressure or squeezing in the chest, shoulder, and arm across the left side of the body. These chest pains can vary in intensity depending on the person. In addition to chest pains, common heart attack symptoms can include: 

• Pain that moves to your back, neck, arm, jaw, teeth, or upper stomach 
• Fatigue 
• Indigestion or heartburn 
• Cold sweat 
• Shortness of breath 
• Dizziness 
• Nausea 

List adapted from Mayo Clinic  

Not everyone is equally susceptible to experiencing heart attacks. There are certain risk factors associated with heart attacks, which include: 

• Increasing age 
• Smoking and tobacco use 
• High blood pressure 
• High cholesterol and obesity 
• Diets high in saturated fats and sugars 
• Lack of exercise 
• Diabetes 
• Family history of heart attacks 
• Stress 

List adapted from Mayo Clinic 

While heart attack symptoms can vary from person to person, trends have been found linking some of them to a person’s sex assigned at birth. For those who are AFAB, heart attack symptoms may be mistaken for other conditions such as the flu, acid reflux, or simply a product of aging. These conditions share symptoms with heart attack symptoms such as vomiting, shortness of breath, pressure on the upper back, fainting, and jaw or back pain. These symptoms may be present for both those who are AFAB or those who are AMAB, but they've been recognized more often in those who are AFAB. One note to add is that research on heart attacks is limited to the male and female binary. Further research must be done to understand if these symptoms are also different for people who are trans or intersex. 

All of this said, chest pain and heaviness can also be associated with many other conditions such as: 

• Lung infections or blood clots 
• Injury of the chest wall muscles 
• Digestive issues 
• Panic attacks 
• Blood vessel tears 

List adapted from Mass General Brigham 

When it comes to silent heart attacks, some people may not even realize they’ve had one until the damage is identified months later by a health care provider. Silent heart attacks are classified by their mild or non-existent symptoms or by symptoms that aren’t usually associated with the condition. It’s been found that 50 to 80 percent of heart attacks are classified as silent. Those AFAB have been found to experience silent heart attacks more often because they more commonly experience symptoms that are shared with other conditions. Being aware of the various symptoms may allow a person to identify the condition and seek immediate medical assistance to avoid the most bodily harm. 

Chest heaviness may not be an indication of a heart attack. However, it’s recommended to err on the side of caution and seek medical care immediately if you’re unsure of the cause. Additionally, it’s recommended to incorporate other lifestyle habits that can help you minimize your risk of experiencing a heart attack, silent or otherwise. These habits can include stress management, eating nutritious foods, avoiding smoking, and getting around 30 minutes of moderate physical activity every day.  

Wishing you both an abundance of heart health!