7 Heart Attack Indicators Before They Strike

Unusual fatigue, sudden shortness of breath, chest discomfort, and even new sleep and digestion issues can point to a looming heart attack weeks before it happens. Knowing what to look for gives you the chance to get medical help early, which could minimize the damage or stop a heart attack from happening at all.

Why Women Face Worse Heart Attack Outcomes

Early Warning Signs of a Heart Attack

Heart attacks don’t always strike suddenly and violently out of nowhere. The earliest signs of a heart attack can present weeks before the event itself, giving you time to seek medical attention if you notice them.

“Even one of these symptoms can be enough to visit the emergency department if it’s new or different from something you’ve experienced before,” says Nisha Parikh, MD, MPH, a cardiologist at Northwell Health in Hyde Park, New York.

Dr. Parikh stresses that while many of these symptoms may not seem worthy of an emergency on their own, the suddenness of these symptoms during ordinary tasks is what makes them alarming.

1. Fatigue

Significant changes in your energy and tolerance for physical activity can be an indication of an impending heart attack.

“It’s different from regular tiredness because it’s the kind of fatigue or exhaustion that feels out of proportion to the amount of work you’re doing,” says Parikh. “If you’re exercising and you feel significantly more tired than usual, don’t ignore this glaring symptom.”

2. Shortness of Breath

“It can also be due to reduced blood flow to the lungs,” says Parikh. “Many of my patients have experienced this symptom in the middle of the night, and it wakes them up.”

3. Chest Discomfort

This classic symptom of a heart attack can differ dramatically based on your sex. While movies often portray it as sudden, crushing pain, Parikh says it’s not always so obvious.

“The pain can be mild to severe, and many people describe it as an anxious or nervous feeling in their chest,” she says. “Symptoms of an anxiety attack can mimic this same symptom of a heart attack.”

Even if your chest discomfort isn’t persistent, you shouldn’t dismiss it.

4. Sleep Disturbances

The relationship between sleep and heart attacks is complicated.

First, insomnia and overall poor sleep quality are significant risk factors for a heart attack because of the stress they place on heart health. Experts also say early symptoms and actual heart attacks most commonly occur at night.

“Many heart attacks actually occur at 3 a.m. because that’s when adrenaline and cortisol levels surge,” says Parikh. “More often than not, we see heart attacks occurring at this time of day.”

5. Indigestion, Nausea, or Stomach Pain

“Oftentimes, that digestive discomfort happens because the bottom of the heart isn’t getting as much blood flow [as it should]. That part of your heart sits on the diaphragm and the stomach. That lack of blood flow can lead to nausea.”

Parikh says diarrhea and general changes in bowel movements can be an early indicator of a heart attack as well.

“Any abnormal nausea during your routine exercise habits can also be a big sign of an impending heart attack,” says Parikh.

6. Dizziness or Lightheadedness

“Dizziness can be related to reduced blood flow to the brain,” says Parikh. “We underestimate how hard the heart works to pump blood throughout the body, including the brain.”

“Women are more likely [than men] to experience this lightheadedness, and even fainting,” says Parikh.

7. Pain in Other Areas

“While men classically experience chest pain, women tend to experience pain in other areas [as an indicator of heart attack],” says Parikh. “And this pain can be gradual, developing in the jaw, down their left arm, and in the upper back.”

When to See a Doctor

On their own, these early warning signs can be easy to dismiss, but experts urge you to acknowledge when they arise suddenly and respond accordingly.

“Don’t wait for the classic symptom of chest pain,” says Parikh. “In real life, heart attack symptoms are more varied. And you shouldn’t wait until you’re experiencing multiple symptoms. If you’re experiencing even one of these symptoms and it’s new or different from what you’ve experienced before, you should take it seriously.”

Parikh recommends learning about your personal risk factors for heart attack and heart disease in order to better evaluate potential early signs.

Key factors include:

• A family history of heart disease and heart attack
• Smoking
• Having prediabetes or diabetes
• Having high LDL cholesterol
• Having high triglycerides
• Having high blood pressure
• Being a man and over 50 years old
• Being a woman and over 60 years old

Women should be especially vigilant about subtle symptoms, as they are less likely to experience intense chest pain and face higher rates of delayed or missed diagnoses.