Classic Heart Attack Symptoms
Call 999 / 911 Immediately If You HaveCentral chest pain or tightness — 'like an elephant sitting on my chest' | Pain spreading to left arm, jaw, neck, or back | Sweating, nausea, or vomiting with chest pain | Sudden severe breathlessness | Feeling of doom. Do NOT drive yourself. Chew 300mg aspirin if available (unless allergic).
Women's Heart Attack Symptoms — Often Different
Women are more likely to have atypical symptoms and are frequently misdiagnosed or delayed. Be aware:
- Jaw or neck pain (without chest pain)
- Unexplained fatigue — sometimes for days before
- Nausea or vomiting (may be mistaken for stomach upset)
- Shortness of breath without chest pain
- Upper back or shoulder pain
- Feeling of indigestion or heartburn that doesn't respond to antacids
How Heart Attack Is Confirmed
| Test | What It Shows | Timing |
|---|---|---|
| Troponin (high sensitivity) | Heart muscle damage marker — rises within 1–3 hours | 2 samples: at arrival + 3 hours |
| ECG | ST elevation (STEMI) or changes (NSTEMI) | Immediate — within 10 minutes |
| FBC | Check for anaemia (worsens heart attack) | Immediate |
| Clotting (INR, APTT) | Before anticoagulants | Immediate |
| Angiogram (coronary) | Shows the blocked artery — definitive | Done in cath lab for STEMI |
STEMI vs NSTEMI — The Two Types
| Type | ECG Finding | Treatment |
|---|---|---|
| STEMI | ST elevation on ECG | Emergency PCI (balloon + stent) within 90 minutes |
| NSTEMI | No ST elevation; raised troponin | Urgent PCI within 24–72 hours; anticoagulants first |
Aspirin First AidIf you or someone suspects a heart attack: call 999 first, then chew (not swallow whole) 300mg aspirin. Chewing gets aspirin into the bloodstream faster. Only give if not allergic and no active bleeding.
Can a heart attack happen without chest pain?
Yes — especially in women, elderly people, and diabetics (who may have reduced pain sensation due to neuropathy). Any of the symptoms listed above, especially if sudden, should prompt an emergency call.
What is a 'silent heart attack'?
A silent heart attack causes no symptoms (or very mild ones) and is only discovered later on an ECG or echo. They are more common in diabetics. They still cause heart muscle damage and increase future heart attack risk.
After a heart attack — what tests and medications follow?
Echo (to check heart function), ongoing ECG monitoring, repeat troponin, coronary angiogram, then medications: aspirin + P2Y12 inhibitor (clopidogrel/ticagrelor), statin, beta-blocker, ACE inhibitor.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.