Signs of a heart attack

The typical signs of a heart attack are:

• A strong feeling of tightness or pressure in the chest
• A stabbing, burning or heavy pain behind the breastbone
• Pain that spreads to the left or right arm, the back, neck or upper abdomen (belly) as well
• Pain or numbness in the upper body that may spread to the shoulder blades, the front or back of the neck, and the jaw

The symptoms often start suddenly, but can also be more gradual. The pain lasts for more than five minutes and doesn’t get better when the person rests.

Other possible symptoms include:

• Shortness of breath
• Nausea, vomiting
• Sweating or cold sweats
• Paleness
• Weakness, dizziness, loss of consciousness
• Intense anxiety or fear of death

The symptoms of a heart attack vary from person to person. Heart attacks don't always cause tightness and pain in the chest. For example, chest tightness is less common in women, older people, and people with diabetes or heart failure. They are more likely to have other symptoms such as shortness of breath, nausea or vomiting.

Heart attacks are a medical emergency! Every minute counts. Life-saving measures should be started as soon as possible in order to limit damage. It is important to call the emergency services immediately (112 in Germany and many other countries, 911 in the U.S.) if you suspect someone might be having a heart attack. If signs of a heart attack occur at night, do NOT wait until the next morning to do something about it.

While waiting for the ambulance to arrive, people who are with the patient can

• try to calm them,
• put them in a comfortable lying position, with their upper body slightly raised,
• loosen tight clothing,
• open a window to let in fresh air and,
• if they have medication for stable angina, such as nitrates, give them that.

If the person passes out, they stop breathing and their heartbeat stops, they will need CPR (resuscitation) as a first aid measure. If several people are there and there's an "external defibrillator (AED)," it should be used.

It can be difficult for people who have CAD to tell the difference between temporary symptoms, a short-term worsening and an emergency. It is likely to be an emergency if the symptoms

• also occur at rest,
• don't go away when you rest after physical strain such as climbing the stairs,
• don't go away even after taking emergency medication (such as nitrate sprays),
• last for longer than a couple of minutes, or
• there are also other signs of a heart attack.

Even if you aren't sure: Do NOT wait. Call the emergency services straight away!