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8 Most Overlooked Heart Attack Signs, According to an ER Doctor

Don't ignore these subtle signals; your life could depend on it.

Although many people realize they're having a heart attack because they experience well-known symptoms such as excruciating chest pain, chest pressure, or sweating, "many cases present with extremely atypical symptoms," says Kristin Hughes, MD, a board-certified emergency medicine physician in Chicago. "And those of us in the ER are well trained to spot these common presentations." Here's what emergency-room doctors know are the unusual signs and symptoms of heart attack to look out for; they mean it's time to take quick action. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You Had COVID and Didn't Know It.


Nausea or Vomiting

Woman Feeling Nauseous

"Be careful when chalking up nausea to something you ate or GERD (gastric reflux) symptoms, as this is a commonly overlooked symptom of a heart attack," says Hughes. This is especially the case in women, elderly individuals, and people who have diabetes, who are less likely to present with typical chest pain when they're having a significant cardiac event.

RELATED: The #1 Cause of Diabetes, According to Science


Dizziness or Fatigue

Man hands on his head felling headache dizzy sense of spinning dizziness,a problem with the inner ear, brain, or sensory nerve pathway

A damaged heart can have trouble getting blood where it needs to go, resulting in this symptom. "With decreased cardiac function, the body and brain get less than the normal distribution of blood flow," says Hughes. "This can create the feeling of lightheadedness or dizziness and fatigue.

"Women, in particular, can experience an increased level of tiredness or fatigue that they might write off or brush aside," she adds. "However, this can actually be indicative of a cardiac event." 

If your fatigue is persistent or unexplained, it's always a good idea to consult your healthcare provider.


Shortness of Breath

Young man having asthma attack at home

"Individuals experiencing shortness of breath without chest discomfort should also have their heart checked out, as it frequently indicates that the lungs are filling with fluid," says Hughes. This is called pulmonary edema, which can be caused by congestive heart failure, a condition that can result from cardiac tissue that has been damaged by a heart attack. "Often, people with asthma can mistake this for an exacerbation of their frequent asthma symptoms," she adds. 


Jaw or Arm Pain

Woman Suffering From Terrible Strong Teeth Pain

Pain in the arm or jaw can be a subtle sign of a heart condition, particularly in women. In the jaw, the pain may be felt in the lower-left area. Either pain may come on suddenly, wake you up at night, or begin or worsen with exercise. 


Epigastric Abdominal Pain

Woman suffering from stomach cramps in her bedroom at home

Aside from nausea or vomiting, Hughes says to look out for epigastric abdominal pain—pain in the area right below the ribs in the upper abdomen—or indigestion that will not go away. 


How to Save Your Life

Male Doctor Examining Female Patient In Emergency Room

"Out of the hospital, cardiac arrest survival rate is 5%," says Hughes. "So it is of utmost importance to get yourself to the nearest hospital for evaluation." That can include a blood test for an enzyme called troponin, which can indicate damage to the heart, and an electrocardiogram. "When in doubt, it is absolutely the best thing to go in and get it checked out," she says. "It could mean the difference between life and death." And to further protect your health, don't miss these Signs You're Getting One of the "Most Deadly" Cancers.

Michael Martin
Michael Martin is a New York City-based writer and editor whose health and lifestyle content has also been published on Beachbody and Openfit. A contributing writer for Eat This, Not That!, he has also been published in New York, Architectural Digest, Interview, and many others. Read more about Michael