Heart attacks occur most frequently between 6 and 10 a.m. This may be due to
Higher amounts of the hormone epinephrine (adrenaline) in blood in early morning
An increased systolic blood pressure
Increased blood thickness or "stickiness"
Most individuals experience symptoms with a heart attack. In fact, about two-thirds of people experience symptoms beginning in days to weeks before the heart attack, including
Vague chest discomfort
Malaise (a feeling of general discomfort or uneasiness)
Shortness of breath
Nausea and/or vomiting
Need To Know:
Silent Heart Attacks
Up to 20 percent of people experience "silent" heart attacks that have no symptoms. These heart attacks are only diagnosed afterward during a routine electrocardiogram (ECG) or if the heart attack causes complications.
Symptoms Or "Warning Signs" Of A Heart Attack
Severe chest pain is the most common symptom of a heart attack. This is described as pressure, fullness, burning, or a squeezing sensation, which lasts for more than a few minutes or goes away and then comes back. This pain usually occurs while the individual is at rest or engaged in only mild physical activity.
Qualitatively, the pain is similar to the pressure, tightness, or burning sensation experienced with stable angina.
Compared with stable angina, chest pain due to a heart attack
Is generally more severe
Lasts longer (30 to 60 minutes or more compared with 5 to 10 minutes)
May spread more widely to sites including the left and/or right arm, back, neck, jaw, teeth, and throat
Unlike stable angina, the pain with a heart attack is not relieved by rest. There may be little or no response to nitroglycerin, a medication that dilates coronary arteries and typically relieves angina.
Other symptoms include:
Atypical chest pain or abdominal pain
Nausea or vomiting
Sweating and paleness
Palpitations, which is an awareness of the heart beating more rapidly, forcefully, or irregularly
Restlessness or sense of impending doom
Shortness of breath and unexplained difficulty breathing
Need To Know:
Women and heart attacks
Women account for nearly half of all heart attack deaths. Heart disease is the number one killer of both women and men.
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Women are less likely than men to believe they're having a heart attack and more likely to delay in seeking emergency treatment.
Not all of these symptoms occur in every attack and some may occur, go away, and then return.
What To Do If These "Warning Signs" Occur?
A person who experiences one or more signs of a heart attack that last more than several minutes, or that go away and then return, needs immediate medical attention. Call 911 or the emergency medical services. If ambulance services are not available, the individual should be driven to the nearest hospital. The patient should NOT attempt to drive there alone.
It's common for a person having a heart attack to protest calling for emergency help. Don't let that stop you from calling an ambulance.
Let the person's family know where he or she is being taken.
Have a family member provide a list of all medications and dosages that patient is taking, including drugs for angina or other heart conditions. Bring the prescription bottles, if possible.
Begin cardiopulmonary resuscitation (CPR) if necessary and if the bystander is properly trained.
What Causes These Symptoms?
The pain from a heart attack comes is caused when oxygen-starved heart muscle cells release chemical substances onto nearby nerve endings. This stimulates the body's nervous system, which triggers other symptoms.
Stimulating a portion of the nervous system called the sympathetic nervous system leads to the sweating (diaphoresis), cool and clammy skin, increased heart rate, and palpitations often observed with a heart attack.
Stimulation of another portion of the body's nervous system - the parasympathetic nervous system - causes the weakness, nausea, and vomiting that sometimes accompany a heart attack.
Shortness of breath may be caused by a build-up of fluid in lung airways that happens when the pumping action of the heart has been impaired.