Your symptoms may be mild and come on slowly over the course of several hours, or they may be sudden and intense. Chest pain or pressure, in particular, can develop gradually and come and go, often getting worse with exertion and better with rest. (1) While chest pain may be the most common heart attack symptom, not all people experience chest pain during a heart attack. According to the National Heart, Lung, and Blood Institute, there’s evidence that about one-third of people with heart attacks experience no chest pain. People with diabetes and older adults are more likely to experience a heart attack without chest pain. (2) Heart attack symptoms in men and women are often different. While the range of symptoms varies, the more symptoms you have, the more likely it is that you’re having a heart attack. (1) If you think you may be having a heart attack, it’s important to take action immediately. This means, above all, calling for emergency help. (1)

Chest Pain

Most heart attacks involve pain or discomfort in the center or left-center of your chest. This pain can range from mild to severe. The pain may feel like tightness, fullness, heavy pressure, crushing, or squeezing. It can also feel like heartburn or indigestion. Chest pain usually lasts more than a few minutes. Sometimes it goes away and comes back, with exertion making it worse and rest making it better.

Upper Body Discomfort

You may also feel pain or discomfort in your arms, jaw, neck, back (especially between your shoulders), or upper part of your stomach (above your belly button). Sometimes, pain begins in your chest and then spreads to these other areas of your upper body.

Shortness of Breath

You may experience trouble breathing or the sensation of being winded when you’re at rest or doing very slight activity that wouldn’t normally cause breathlessness. Outside of chest pain, shortness of breath is one of the most common warning signs of a heart attack. This may be the only symptom you experience, or it can happen before or along with chest or upper body pain. (1,2)

Other Common Symptoms

Other common warning signs that may signal a heart attack include:

Light-headedness or sudden dizzinessCold sweat or clammy skinNausea and vomitingHeart flutter or palpitations (especially in women)Cough (especially in women)Heartburn (especially in women)Sleep disturbances (especially in women)Anxiety (especially in women)Extreme fatigue or exhaustion (may occur for days or even weeks leading up to a heart attack, especially in women) (1,2,3,4)

Silent Heart Attack Symptoms

Sometimes a heart attack doesn’t cause obvious symptoms. This is known as a silent heart attack. Still, a silent heart attack may offer some warning signs, even if they’re brief and mild. These typically include variations on classic heart attack symptoms, such as:

Chest discomfort that lasts a few minutes, or comes and goesDiscomfort in your neck, jaw, arms, back, or stomachShortness of breathCold sweatNauseaLight-headedness (5)

Silent heart attacks are more common in women than in men. (4)

What to Do During a Heart Attack

A heart attack is a medical emergency. The faster you get to a hospital, the better your chances of surviving the heart attack and minimizing damage to your heart muscle. Even if you’re not sure your symptoms indicate a heart attack, you should seek emergency medical care. Never worry about a false alarm or causing anyone embarrassment. Follow these steps if you or someone around you is having heart attack symptoms:

Call 911 Immediately

Don’t wait more than five minutes before calling for help. If you take nitroglycerin for chest pain that comes on with exertion and goes away with rest, take it immediately. If your chest pain doesn’t go away within five minutes, call 911. An ambulance is the best way to get to the hospital, since you can be monitored and start treatments while on your way. If you cannot call 911 for some reason, have someone drive you to the hospital. Never drive yourself unless there is absolutely no other choice. (1,2)

After you call 911, the operator may tell you to take an aspirin. Aspirin may help to slow or reduce clotting and blockage around the site of a ruptured plaque deposit in your artery. This can limit damage to your heart and help save your life. But aspirin won’t cure a heart attack or make your symptoms go away, so never delay calling 911 to take an aspirin. You may be told not to take aspirin if you take a medication that can interact with it. (1,2)

Sit Down and Stay Calm

Try to relax and remain calm while you wait for help to arrive. If you’re at home alone, open the front door and sit on the floor near the entrance. This will help the paramedics easily find you in case you lose consciousness before the ambulance arrives, and give them a flat surface on which to begin CPR if necessary.

Note the Time

If you’re able to do so, record the time your heart attack symptoms began and what you were doing when they started. This information may help the doctors treating you when you reach the hospital. Additional reporting by Quinn Phillips.