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We all know how heart attacks look in the movies — a person stops suddenly, clutches their chest, and falls to the ground. But what about in real life? How do I know if I’m having a heart attack?

Read on for some typical symptoms of heart attacks and what to do if you think you’re having one.

What Is a Heart Attack?

A heart attack (medical name: myocardial infarction) is a life-threatening emergency. It happens when the arteries that provide oxygen-rich blood to the heart muscle become narrowed or completely blocked. This causes the muscle to be starved of oxygen, and the muscle then begins to die.

Heart attacks are common and according to the American Heart Association, in the U.S. a heart attack occurs every 40 seconds in both men and women.

Heart Attack Causes and Risk Factors

The coronary arteries are the blood vessels that supply blood to the heart muscle. These arteries are on top of the muscle and then become tiny arteries that go directly into the muscle. They bring the oxygen the heart muscle needs to survive.

Heart attacks can occur when your coronary arteries become narrowed by cholesterol plaques surrounding the arteries. Plaque is made up of cholesterol and other substances that collect around the arteries over years to decades; doctors call this buildup atherosclerosis. Our arteries are like pipes, and interestingly, the plaques do not grow inside the “pipe”, but rather around it. One type of heart attack is caused when the plaques “squeeze” the artery to the point that it is narrowed and can no longer deliver blood effectively to the heart muscle. Another type is called a “plaque rupture” heart attack and is caused when tiny cracks form inside the “pipe” which allow the surrounding plaque to suddenly rush into the artery and completely block the flow of blood.

Genetics, medical conditions, and lifestyle habits increase your odds of developing heart artery blockages.

Risk factors for heart attacks include:

• Being older than 45 for men and 55 for women.
• A family history of early heart disease in your parents, and especially if a sibling has had heart artery blockages.
• Smoking.
• Diabetes.
• High blood pressure.
• High cholesterol.
• A diet high in carbohydrates, and/or saturated fat, and salt.
• Being overweight or obese.
• A sedentary lifestyle.
• Diseases that cause inflammation, like psoriasis, rheumatoid arthritis, and Lupus
• A history of radiation to the chest for cancer treatment

Am I Having a Heart Attack?

Heart attack symptoms can occur suddenly or slowly. They can happen when you’re active or when you’re resting.

Sometimes, it’s hard to tell if you’re having a heart attack. You may only feel mild pain or discomfort at first. It’s important to pay attention to your body and not dismiss or ignore your symptoms.

“Often in the movies you’ll see someone describing an elephant sitting on their chest,” says Joshua Levenson, MD. “But it’s important to remember that many people, especially women, have atypical symptoms by just feeling nauseous, having an upset stomach, or just something that isn’t feeling right.”

Heart attack symptoms include:

• Chest discomfort — a feeling of pressure in the center of your chest may be constant or come and go. The pressure may feel like something squeezing your chest, an uncomfortable fullness, or outright pain.
• Dizziness — you may feel lightheaded or even faint if you’re having a heart attack.
• Extreme anxiety — you may feel like you’re having a panic attack.
• Nausea — people often experience waves of nausea or vomiting when they’re having a heart attack. You may mistake it for a bad case of heartburn or indigestion.
• Pain or discomfort elsewhere in the body — if you’re having a heart attack, you may feel pain in your arms, back, neck, jaw, or even stomach.
• Sweating — you may break out in a cold sweat.
• Trouble breathing — you may have shortness of breath, with or without pain in your chest.

Note: Heart attack symptoms can be different for men and women. Both may experience chest pain and discomfort. However, women often have symptoms that you may not immediately connect with a heart attack.

These subtle signs of heart attack in women can include back or jaw pain, shortness of breath, and nausea. Many people don’t realize these are potential heart attack symptoms. They may think they have acid reflux or the flu.

What Should You Do if You Think You’re Having a Heart Attack?

You need to act quickly if you’re experiencing symptoms of a heart attack — it can be a matter of life or death. Even if you’re not sure you’re having a heart attack, you should get your symptoms checked out. It’s always better to err on the side of caution.

Call 911

If you or someone you’re with has heart attack symptoms, call 911 right away. This is the fastest way to get potentially lifesaving treatment. Don’t drive yourself or another person with heart attack symptoms to the hospital unless there’s no other choice.

The first responder team can begin treatment as soon as they arrive. They’re also trained to revive someone if their heart stops on the way to the hospital. Heart attack patients generally get faster treatment if they arrive at the hospital by ambulance.

Wait for the ambulance

Try to stay calm and still while you wait for the ambulance.

Do not take aspirin until speaking with the 911 operator. They may direct you to take aspirin, or they may have you wait until the ambulance arrives and allow the first responders to decide if it is ok to take.

If someone around you is having a heart attack, perform CPR only if the person stops breathing or is barely breathing (no need to check pulse). The American Heart Association says it is ok to do CPR even if you aren’t trained, and there is no need to do rescue breathing—just chest compressions are ok; also, the 911 operator can guide you in proper technique.

Preventing a Heart Attack

Everyone can do things to reduce their risk of heart attack. Although you can’t change your genetic makeup, you can incorporate the following changes into your lifestyle:

• Eat a heart-healthy diet — The best diet includes lean protein, whole grains, healthy fats, fruits, and vegetables. Limit red and cured meats, processed foods, sugary snacks, and foods high in salt.
• If you use any nicotine products, quit — Your risk of coronary heart disease can drop by up to 50% within one year after you quit nicotine, including smoking, dipping, and vaping.
• Start moving — About 150 minutes of brisk walking or other moderate aerobic activity per week can help reduce your risk of heart attack. Even better: Mix in some resistance or weight training twice a week.
• Talk to your doctor — Discuss your risk of heart disease with your doctor and get advice on a heart-healthy lifestyle.

Editor's Note: This article was originally published on September 3, 2024, and was last reviewed on October 2, 2024.