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 doesn’t go away, chest pain that spreads to your arm, neck or jaw, or chest pain with sweating, feeling sick or breathlessness. Call for severe difficulty breathing too.

A heart attack happens when the blood supply to the heart is blocked. It needs emergency treatment in hospital. Don’t drive yourself. Call an ambulance and follow the operator’s instructions.

How a heart attack can feel

The familiar picture of someone suddenly clutching their chest doesn’t fit every heart attack. Symptoms can start slowly, feel mild, or come and go. Chest discomfort is still the most common symptom. It 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 pain in the shoulder, back or arm, shortness of breath, unusual tiredness or weakness, an upset stomach or anxiety. These can happen with or without chest pain. If you think it’s a heart attack, don’t wait to have every symptom on a list before calling.

In the US, MedlinePlus advises calling 911 even if you’re not sure it’s a heart attack. Emergency teams can start 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 sent for tests for coronary heart disease. Women who arrive at hospital with heart symptoms may wait longer for a first heart tracing (ECG). They may also be less likely to be seen by a heart specialist.

It also reports that women are more likely than men to have heart attacks that aren’t caused by blocked heart arteries (coronary artery disease). This can make them harder to recognise. These findings describe gaps in care. Keep asking for help if you have symptoms.

When you talk to an emergency team, say what your symptoms are, when they started and whether they’ve changed. You can say, “I’m worried these could be heart symptoms.” If you’re helping someone else, pass on what they tell you as clearly as you can.

Pregnancy history belongs in a heart-health conversation

Gestational diabetes, pre-eclampsia or eclampsia, and a premature birth are among the pregnancy problems linked with a higher risk of coronary heart disease. Mention these at future health appointments, even if the pregnancy was a while ago.

Heart attacks are rare in pregnancy, but they can happen during pregnancy and soon after birth. Being pregnant doesn’t mean it’s safe to wait and see with the emergency symptoms above. Call emergency services if those signs appear.

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 on to your GP or family doctor after your pregnancy ends.

Risks you can discuss before symptoms

Smoking, high blood pressure, high cholesterol and diabetes raise the risk of a heart attack. A close relative who has had a heart attack is relevant too. Talk about these things with your clinician before you have any chest symptoms.

Stopping smoking, being active and eating a balanced diet can help lower your risk. The NHS also advises keeping your blood pressure and cholesterol in check and cutting down on salt and saturated fat. These steps lower your risk, but they can’t prevent every heart attack. Ask for help 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. Sudden pain that doesn’t go away, or pain with other emergency symptoms, needs an emergency call.

If doctors think you may have had a heart attack, hospital checks include an ECG and blood tests. Ask the team what the tests are looking for and what to do if symptoms come back after you leave.