Heart health: symptoms and risks to know

Call 999 now in the UK, 911 in the US, or your local emergency number for sudden chest pain that does not go away, chest pain spreading to your arm, neck or jaw, or chest pain with sweating, sickness or breathlessness. Call for severe difficulty breathing too.

A heart attack happens when blood flow to the heart is blocked. It needs emergency treatment in hospital. Do not drive yourself: call an ambulance and follow the emergency operator’s instructions.

How a heart attack can feel

The familiar image of someone suddenly clutching their chest does not cover every heart attack. Symptoms can begin slowly, feel mild or come and go. Chest discomfort remains the most common symptom and may feel like pressure, heaviness, squeezing or indigestion.

Both women and men often have chest pain. Women are more likely than men to also have shoulder, back or arm pain, shortness of breath, unusual tiredness or weakness, an upset stomach or anxiety. These can occur with or without chest pain. Do not wait for every symptom on a list before calling for suspected heart-attack symptoms.

In the US, MedlinePlus advises calling 911 even if you are not sure that symptoms are a heart attack. Emergency teams can begin care when they arrive. In the UK, the NHS also advises calling first for the emergency symptoms above.

Why women can face delays in care

The US National Heart, Lung, and Blood Institute reports that women may be less likely to be referred for tests for coronary heart disease. Women arriving at hospital with heart-related symptoms may face delays in an initial heart tracing, or ECG, and may be less likely to receive care from a heart specialist.

It also reports that women are more likely than men to have heart attacks not caused by coronary artery disease, which can make recognition harder. These findings describe gaps in care. Continue to seek help if you have symptoms.

When speaking to an emergency team, say what the symptoms are, when they began and whether they have changed. You can say, “I am concerned these could be heart symptoms.” If you are helping someone else, pass on their description as clearly as you can.

Pregnancy history belongs in a heart-health conversation

Gestational diabetes, pre-eclampsia or eclampsia, and a preterm birth are among the pregnancy-related factors linked with a higher risk of coronary heart disease. Mention these at future health appointments, even if the pregnancy itself was some time ago.

Heart attacks are uncommon during pregnancy, but can occur during pregnancy and soon after birth. Pregnancy does not make the emergency symptoms above safe to wait out. Call emergency services if those signs develop.

For a routine appointment, bring any pregnancy records you have and ask, “Does this history change the follow-up I need?” You can ask your maternity team what information to pass to your GP or primary-care doctor after a pregnancy ends.

Risks you can discuss before symptoms

Smoking, high blood pressure, high cholesterol and diabetes increase heart-attack risk. A close relative’s heart attack is relevant too. Discuss these details with your clinician before you have chest symptoms.

Stopping smoking, regular activity and a balanced diet can help reduce risk. The NHS also advises managing blood pressure and cholesterol and reducing salt and saturated fat. These steps reduce risk, but cannot prevent every heart attack. Ask for support with changes that are realistic for you.

Get recurring chest symptoms checked

Book a GP appointment in the UK, or see your doctor in the US or elsewhere, if chest pain comes and goes or goes away quickly but still worries you. A routine appointment is for symptoms without the emergency signs above; persistent sudden pain or associated emergency symptoms need an emergency call.

If a heart attack is suspected, hospital assessment includes an ECG and blood tests. Ask the treating team what the tests are looking for and what to do if symptoms return after you leave.