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7 Silent Signs of a Heart Attack

Chest pain or pressure, cold sweat, extreme weakness—you know those heart attack signs. But there are more subtle symptoms that can be easy to miss.

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Cardiologist Stacey E. Rosen, MD, says this is one of the most common symptoms she sees, especially in female heart-attack patients. “In my 25 years of practice, people on the verge of a heart attack report feeling tired and not able to do their usual activities,” says Dr. Rosen, the vice president for women’s health at the Katz Institute for Women’s Health at North Shore-LIJ Health System in New Hyde Park, NY. During a heart attack, blood flow to the heart is reduced, putting extra stress on the muscle, which could make you feel exhausted. If you’re feeling fatigued, it’s smart to talk to your doctor about why. He or she will decide if an electrocardiogram (EKG), which checks heart activity, or another test, is necessary. Here are some other tests for your heart that could save your life.

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Soreness in the back, arms, or chest

Noticeable pain or soreness in the back, chest, or either arm is often a silent heart attack sign. Because the pain is often not accompanied by the typical chest heaviness associated with heart attack, people tend to ignore it, says Dr. Rosen. “I’ve had patients say they only felt the pain when they were working out, so they assumed it was just from exercise, but that’s not right,” she says. “If the symptom is something new, that’s worrisome and you should see a doctor.”

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Shortness of breath

If a flight of stairs is usually no problem but suddenly you find yourself gasping for air at the top, it could signal a heart attack. “Women especially tell me they noticed feeling fatigued or breathless while walking up steps or carrying groceries when they normally wouldn’t,” says Dr. Rosen. If you feel short of breath right after waking up, that’s also a sign that something could be wrong, says Annapoorna Kini, MD, a cardiologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. The heart plays a key role in transporting oxygen to the rest of your body and removing carbon dioxide from tissues, so blocked blood flow to the heart could affect your breathing, according to the Mayo Clinic. Here are some other ways heart attack symptoms are different for women.

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Heartburn or belching

If you have an occasional heartburn flare-up after a heavy pizza lunch, it’s probably nothing to worry about. But if it’s out of the ordinary or heartburn has never bothered you before, call your doctor because it could signal a heart attack. Angina, a heartburn-like chest pain, is caused by lack of blood flow to the heart, which is what happens during a heart attack, says Ryan Madanick, MD, assistant professor of medicine at UNC School of Medicine in Chapel Hill, NC.


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Stomach upset

Heart attack symptoms can sometimes mimic stomach problems like nausea, vomiting, or overall GI upset—especially in women, says Dr. Rosen. “If you don’t feel well, always call your doctor. It could be that taco you had at 10 p.m., but it could also be a heart attack,” she says. Make sure you’re aware of these non-medical signs you might be at risk of a heart attack.

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Throat, neck, or jaw discomfort

Unexplained discomfort in the neck or jaw or tightness in the throat you’ve never felt before can indicate a heart attack, says Dr. Kini—those are signs you should immediately contact a doctor. It’s especially important for people with diabetes to pay attention to subtle changes like this because they have trouble feeling sensations and are less likely to feel more typical symptoms like chest pain, says Dr. Rosen.

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An overall feeling that something’s wrong

“Heart attack patients have told me they have a feeling of doom—like something’s just not right,” says Dr. Rosen. “Listen to that little voice in your head. If something feels off, it’s always better to be overly cautious and call a doctor.” In addition, Dr. Rosen says some of her patients have reported feeling “less mentally sharp” right before a heart attack. Also, make sure to try these everyday ways to reduce your risk of a heart attack.

  • Stacey E. Rosen, MD, cardiologist and vice president for women's health at the Katz Institute for Women's Health at North Shore-LIJ Health System in New Hyde Park, NY.
  • Annapoorna Kini, MD, cardiologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City.
  • Mayo Clinic: "Shortness of breath."
  • Ryan Madanick, MD, assistant professor of medicine at UNC School of Medicine in Chapel Hill, NC.
Medically reviewed by Oscar H. Cingolani, MD, on August 01, 2019