The 4 Biggest Early Warning Signs Before A Heart Attack

In the weeks leading up to a cardiac event, many people report similar symptoms.
While knowing the risk factors for heart disease is important, it's also crucial that you're aware of the early warning signs of a heart attack.
The Good Brigade via Getty Images
While knowing the risk factors for heart disease is important, it's also crucial that you're aware of the early warning signs of a heart attack.

While it’s well-known that issues like high blood pressure, diabetes, smoking and not enough exercise are risk factors for a heart attack, many people may not know the early signs to tell if a cardiac event is on its way.

Experts say there are designated symptoms that happen in the days and weeks before a heart attack that can be a red flag.

Knowing these signs could be a lifesaver. Heart disease is the No. 1 killer of men and women in the United States. And Dr. Abha Khandelwal, a clinical associate professor of cardiovascular medicine at Stanford Health Care, said doctors are seeing an increase in mortality from heart disease during the pandemic, which underscores the importance of being armed with knowledge about your risk and the signs.

Below, experts share some of the early warning signs for a heart attack and what to do if you experience them:

1. Chest Pain Or Pressure

Angina, which is intermittent chest pain caused by the gradual buildup of plaque inside the arteries, can be a warning sign that a heart attack or cardiac event may occur in the ensuing days, according to Dr. Roger Blumenthal, the director of the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease and professor of medicine at Johns Hopkins University School of Medicine. A constriction or spasm of the arteries on the outside of the heart can also lead to this symptom.

If you notice any sort of chest discomfort — angina can also show up in forms other than pain — it’s important to call your doctor.

2. Neck, Shoulder Or Jaw Pain

Typically we associate heart attacks with immediate pain in the left arm. However, early pain signs may not be as obvious.

“Sometimes angina is synonymous with chest pain or chest pressure but sometimes, especially with older individuals, there may be other associated symptoms like ... pain that radiates through the neck or shoulder or arm,” Blumenthal said.

Khandelwal said it can also feel like a numbness that goes up to the jaw.

3. Getting Easily Winded Or Uncomfortable After Exertion

Becoming easily out of breath can be a red flag, too, Khandelwal said. This could include feeling more winded than usual after doing a simple task, like installing a new light fixture or getting your garden ready for spring.

She added that some people notice numbness in the arm or chest discomfort after extreme exertion as well.

4. Nausea Or Other Stomach Problems

Abdominal pain, nausea and overall fatigue are potential heart attack warning signs, too, according to Dr. Nikhil Sikand, a Yale Medicine cardiologist and assistant professor at Yale School of Medicine. But that doesn’t go for everyone. “Some patients may have mild or no symptoms at all,” he noted.

Chest pain in the month before a heart attack is common.
ljubaphoto via Getty Images
Chest pain in the month before a heart attack is common.

More Frequent Or Intense Symptoms In The Days Leading Up To A Heart Attack

The time ranges between symptoms and a cardiac event vary and can look very different from person to person. But Khandelwal said roughly two-thirds of her patients can look back over the month before a heart attack and point out a time when they experienced chest pain. Some people may notice worsening symptoms in the days leading up to a heart attack.

“Oftentimes, that day of, [or] the week of, leading up to [a heart attack] can be filled with more symptoms,” she said. These symptoms can be more frequent, last longer or may even be more severe.

If you notice any symptoms, it’s imperative you get help. Especially if the issues come on quickly and severely; then you should call 911 immediately, Khandelwal said.

If you have no history of heart disease and notice mild symptoms, you should still inform your doctor, she added. Your physician can help decide what to do and arrange testing if need be.

Those who get medical attention promptly — even after experiencing a heart attack — can get lifesaving treatment, Sikand noted.

Heart Attack Prevention In Your Everyday Life

While many risk factors are out of your control, many are in your hands. Simple behaviours like committing to a daily walk or cutting out certain foods can help reduce your chances of a cardiac event, along with knowing your numbers (blood pressure, cholesterol and blood sugar) and being aware of the warning signs of a heart attack.

“Before you start getting older or before you have the disease, if you can work day to day on controlling risk factors, that is the most powerful thing a person can do,” Khandelwal said.

And even if you have heart disease, it’s important to know the risk factors and do what you can to keep yourself healthy.

“Once a person has had a heart attack ... they’re much more likely to have another cardiovascular event in the ensuing year — it’s important to modify their risk factors that are lifestyle habits and get on the appropriate medical therapy,” Blumenthal said.

According to the American Heart Association, the traditional heart attack risk factors are:

  • Smoking
  • Diabetes
  • High cholesterol
  • High blood pressure
  • Obesity

Blumenthal said CardioSmart, an American College of Cardiology resource, is a great tool for folks looking to learn how to lessen their heart attack risk. Through this tool, you can find ways to help you quit smoking, learn about the benefits exercise has on your heart, get healthy-eating tips and more.

Beyond at-home mitigation strategies, you should also keep in touch with your doctor.

“In addition to a healthy diet and regular exercise, the most important thing any one person can do is follow closely with a health professional at regular intervals to identify and treat potential risk factors for heart [disease],” Sikand said.

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