What it is
A heart attack happens when blood flow to part of the heart muscle is blocked or severely reduced. This is often related to coronary artery disease, in which the arteries that feed the heart become narrowed over time. Without enough blood flow, heart muscle can be damaged.
Commonly described symptoms include pressure, tightness, squeezing or aching in the chest. Some people also notice discomfort in the arms, shoulder, back, neck, jaw or upper stomach, shortness of breath, a cold sweat, nausea, lightheadedness or unusual tiredness.
Symptoms can look different from person to person. Some people, including many women, older adults and people with diabetes, may notice less typical signs such as fatigue, nausea or back or jaw discomfort without obvious chest pain. Symptoms can come on suddenly or build gradually, and they can come and go.
How it’s traditionally been approached
Because a suspected heart attack is an emergency, the traditional approach is to call 911 and be evaluated by emergency medical teams as quickly as possible. Emergency responders and hospital staff typically assess symptoms, check heart rhythm and run tests to find out what is happening.
In a hospital, evaluation often includes an electrocardiogram (ECG or EKG), blood tests and sometimes imaging. These help clinicians understand whether the heart muscle is affected and what kind of care may be appropriate. Treatment decisions are made by licensed clinicians for each individual person.
After an emergency, follow-up care has traditionally involved a cardiologist, and often a cardiac rehabilitation and prevention program. These focus on understanding risk factors, daily habits and long-term heart health. Some people also explore family history and, in certain situations, genetic heart testing, which is discussed with a qualified professional.
How the right cardiologist may help
The right cardiologist may help you make sense of symptoms, risk factors and test results in plain language. A visit generally includes a conversation about your symptoms, your personal and family history, a physical exam and possibly tests such as an ECG, imaging or bloodwork, if your cardiologist feels they are appropriate.
A cardiologist may also help you understand whether family history suggests it is worth discussing genetic heart testing. Genetic tests show risk or carrier status. They do not diagnose heart disease on their own and must be interpreted with your history, exam, imaging and bloodwork by a qualified cardiologist, electrophysiologist or genetic counselor. A negative result does not rule out risk, and a variant of uncertain significance is not a diagnosis.
Questions you might bring to a visit: What symptoms should make me call 911? What do my risk factors mean for me? Is my family history relevant, and would genetic counseling make sense? Could cardiac rehab or prevention support be appropriate? If testing is discussed, ask about GINA, which protects against genetic discrimination in US health insurance and employment but does not cover life, disability or long-term-care insurance. Also confirm coverage with your insurer and provider, since it varies.
The whole-person view
Body, mind and stress affect each other. Worry about chest symptoms can raise anxiety, and anxiety or stress can produce physical sensations that feel alarming. Neither one means a symptom should be ignored, so it is always reasonable to get unusual symptoms checked by a professional.
After a scare or a diagnosis, many people feel fear, grief or a loss of trust in their body. Body-based support such as Somatic Experiences may help some people feel more settled, and talk therapy through Therapists.plus may help with worry, stress and adjusting to change. These can complement, not replace, care from your cardiology team.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: anxiety panic and ocd →Therapists.plus: mind body connection →
Keep in mind
- If you think you or someone else is having a heart attack, call 911 right away. Do not wait to see if symptoms pass and do not drive yourself.
- This page is educational and is not medical advice or a diagnosis; only a licensed clinician can evaluate your symptoms and decide what is appropriate for you.
- Licensed professionals should guide all care related to heart symptoms, testing and treatment. Coverage for evaluations, genetic testing and cardiac procedures varies by insurer, state and diagnosis.
- If you are in emotional distress or crisis, call or text 988 (Suicide & Crisis Lifeline).
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Frequently asked questions
What are the most common symptoms of a heart attack?
Commonly reported symptoms of a heart attack include chest pressure, tightness or aching, shortness of breath, cold sweats, nausea and discomfort in the arm, back, neck, jaw or upper stomach. Symptoms vary from person to person. If you suspect a heart attack, call 911.
Can symptoms of a heart attack be different in women?
Yes, symptoms can be different, and some women notice signs other than chest pain. These may include unusual fatigue, nausea, shortness of breath or discomfort in the back, jaw or upper stomach. Any worrying symptom is worth taking seriously, so call 911 if you are concerned.
Can a heart attack happen without chest pain?
Yes, it is possible to have a heart attack with little or no chest pain. Some people notice only shortness of breath, tiredness, nausea or discomfort elsewhere in the upper body. If something feels seriously wrong, call 911 rather than waiting.
What should I do if I think I am having symptoms of a heart attack?
Call 911 right away. Emergency responders can begin evaluating you and get you to appropriate care. Do not drive yourself, and follow the instructions of the 911 dispatcher and your clinicians.
Can symptoms of a heart attack come and go?
Yes, symptoms can come on suddenly, build gradually, or come and go. Even if discomfort eases, it should still be taken seriously. Call 911 for possible heart attack symptoms and talk with a cardiologist about any recurring symptoms.
Does genetic heart testing show whether I will have a heart attack?
No, genetic heart testing cannot tell you whether you will have a heart attack. It may show risk or carrier status for certain inherited conditions and must be interpreted alongside your history, exam, imaging and bloodwork by a qualified professional. Genetic counseling before and after testing is recommended, and family (cascade) testing may be discussed if a disease-causing variant is found.
Educational resource. CardioGenes shares general information and connects people with independent cardiologists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.