Symptoms that suggest a heart attack, other causes of chest pain and when to call 112.
Chest pain is one of the most common reasons for emergency visits, and not every chest pain is a heart attack. But because most of the heart muscle can be saved when a heart attack is treated in the first hours, recognising the symptoms saves lives.
Symptoms that suggest a heart attack
- Pressure, tightness or heaviness in the middle of the chest, usually lasting longer than 15 – 20 minutes
- Pain spreading to the left arm, shoulder, jaw, neck or back
- Cold sweat, nausea, shortness of breath, dizziness
- Pain that does not ease with rest or that increases with exertion
In women, older adults and people with diabetes, symptoms may be atypical: shortness of breath alone, unusual fatigue, upper abdominal pain or nausea can be a warning sign of a heart attack.
Other causes of chest pain
Acid reflux (burning, sour taste), rib and chest muscle strain (pain that increases with movement or touch and is localised), panic attack (palpitations, trembling, feeling unable to breathe), pneumonia and pleurisy (pain that increases with deep breaths) can all cause chest pain. A sudden tearing pain radiating to the back, or sudden pain with shortness of breath, suggests problems of the aorta or lung vessels; these are emergencies too.
What to do
- If the pain lasts longer than 10 – 15 minutes, call 112. Do not try to drive yourself; the ambulance starts treatment on the way.
- Sit in a comfortable position and loosen tight clothing.
- If 112 directs you and you have no aspirin allergy or bleeding risk, chew one aspirin tablet.
- On reaching the emergency room, show your medicines and previous heart reports.
Door-to-balloon in 60 minutes
In our hospital a patient arriving with chest pain is met at the door, has an ECG within the first 10 minutes and, if needed, the angiography laboratory opens with a team ready 24/7. Our target is to keep the time from the door to opening the blocked vessel under 60 minutes.
If you have recurrent pain or pain on exertion, book a cardiology appointment without waiting for an emergency. This article is general information and does not replace diagnosis.
Daily habits that protect your heart
Most of the risk of a heart attack comes from modifiable factors: smoking, high blood pressure, high cholesterol, diabetes, inactivity and obesity. At least 150 minutes of brisk walking a week, a diet based on vegetables and fish, less salt and regular sleep lower cardiovascular risk markedly. After 40, have your blood pressure, cholesterol and glucose checked once a year; people with early heart disease in the family should have a cardiology assessment at a younger age.
Remember: even if the symptoms pass, chest pain that has occurred once must be assessed by a doctor. Some heart attacks are silent and can only be recognised afterwards with an ECG and blood tests. A cardiology consultation is far cheaper and safer than a late emergency visit.