Here's Exactly What a Heart Attack Feels Like, According to Cardiologists

Cardiologists break it down.

Here’s a sobering fact: According to the Centers for Disease Control and Prevention, someone has a heart attack every 40 seconds in the U.S. Scary, right? Something else about heart attacks that many people may not know is that an estimated one in five heart attacks are “silent,” which means they happen without the person even realizing it. That’s definitely a far cry from how they’re portrayed in movies and TV shows, with a person dramatically clutching their chest before falling to the ground.

Anytime someone has a heart attack—silent or not—Dr. Adriana Quinones-Camacho, MD, a cardiologist at NYU Langone Health, says it’s important to go to the emergency room ASAP. That’s why it’s crucial to know exactly what a heart attack feels like, as well as what you can do to prevent it from happening in the first place.

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What Is a Heart Attack and What Causes It?

Dr. Doris Chan, DO, an interventional cardiologist at NYU Langone Hospital—Brooklyn, explains that a heart attack can happen when oxygen-rich blood flow to the heart is severely or completely reduced. Dr. Quinones-Camacho adds to this, saying, “The heart is a muscle and just like other muscles in the body, it needs blood flow in order to get oxygen and nutrients.” When this doesn’t happen and the heart is deprived of oxygen, a heart attack occurs.

How can the heart get deprived of oxygen in the first place? Dr. Quinones-Camacho explains that over time, cholesterol can build up on artery walls. “Usually a heart attack happens when the plaque of cholesterol ruptures,” she says. “The rupture releases the contents into the bloodstream and this can cause blood clots to form, which then can lead to a heart attack.

Dr. Chan says that anyone is at risk for having a heart attack and she has seen people aged 20 to 100 come through the hospital doors experiencing them. But she says that there are certain factors that substantially increase the risk, which include being older (men older than 45 and women older than 55 are more at risk), having a history of smoking, having a higher body mass index and having comorbid conditions such as hypertension, hyperlipidemia, diabetes or kidney disease.

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What Does a Heart Attack Feel Like?

Dr. Chan says that there are many ways blood flow to the heart can be severely restricted or blocked—which is why not all heart attacks feel the same. “However, the most common symptoms are chest discomfort with or without sweating, shortness of breath, left arm discomfort, jaw pain, back pain and neck pain,” she says.

Typically with a heart attack, Dr. Chan says that a person will experience chest pressure, which may or may not cause them to sweat. At the same time, the person can become short of breath and feel discomfort in their left arm, jaw, neck and back.

Like in movies and TV shows, Dr. Quinones-Camacho says that heart attacks can be very sudden and dramatic. But other times, she says there are warning signs occurring days before. “Often, patients report stuttering and mild symptoms that come and go—often during physical exertion—a day or a couple of days before the more dramatic event [that being the heart attack],” she says. This is why if you are experiencing any chest pain or shortness of breath, it’s important to see a doctor right away; it could prevent a heart attack from happening.

Both doctors say that it’s important to know that this is not the only way a heart attack can manifest. “There are many atypical presentations as well, especially in women or patients with diabetes,” Dr. Chan says. This includes the so-called “silent” heart attacks. Signs of a silent heart attack, according to both doctors, can include mild chest pain or pressure (which may come and go), mild discomfort in other parts of the body (most commonly the arms, jaw, neck and back), sudden onset nausea, vomiting, fainting, shortness of breath, profuse sweating or a feeling of severe indigestion.

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What To Do if You Have a Heart Attack and How To Prevent it From Happening Again (or at All)

If you are having a heart attack—or see someone else having one—Dr. Quinones-Camacho says to call 911 and get to the emergency room ASAP. If an artery is completely closed because of a blood clot, she says immediate intervention is required to dissolve the clot. If the artery is partially clogged, she says this still requires medical attention and often the clot is dissolved by taking medication.

After being treated for a heart attack, Dr. Quinones-Camacho says there are two goals: recovering from the heart attack and preventing it from happening again. “Recovering from a heart attack is a slow process,” she explains, adding that it’s important for the patient to be closely monitored by a cardiologist. She says that there are medications that can help the heart recover and cardiac rehab is often another part of recovery.

If needed, the person who experienced the heart attack is advised to make certain lifestyle changes. “This can include not smoking, eating a healthier diet and exercising regularly,” Dr. Quinones-Camacho explains. She adds that medication is often part of the treatment plan and patients are typically either prescribed statins (which help lower cholesterol) or antiplatelet medication, like Aspirin.

“While everyone is different and this isn’t the case for everyone, there are certainly many patients who have a heart attack, change their lifestyle and take medications after it happens, and then they never have another one again,” Dr. Quinones-Camacho says. She emphasizes that making healthy changes really can have a big impact on lowering the risk of having a repeat heart attack.

Of course, what’s most ideal is never having to experience a heart attack in the first place. If a history of heart attacks runs in your family, Dr. Chan strongly recommends seeing a preventive cardiologist for early screenings. She even suggests screenings for young adults and adolescents if they have a parent or other first-degree relative who was diagnosed with early-onset heart disease.

Something everyone can be mindful of regardless of their family history is keeping cholesterol levels down through healthy diet and lifestyle habits. “Heart attacks are most often associated with moderate to the high burden of cholesterol plaque,” Dr. Chan says. By eating a heart-healthy diet, exercising regularly, and avoiding smoking or vaping, you’ll be living in a way that not only lowers your risk for heart attacks but other harmful health conditions as well.

“The number one step is prevention. Every single adult should know the risk factors and know what their blood pressure and cholesterol numbers are,” Dr. Quinones-Camacho says. If everyone lives with heart health in mind, people in the U.S. will experience heart attacks a lot less often than every 40 seconds. It’s something that would literally save lives.

Next up, see tips for keeping your heart healthy.

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