• Pain or discomfort in other areas of the upper body including the arms, left shoulder, back, neck, jaw, or stomach
• Difficulty breathing or shortness of breath
• Sweating or “cold sweat”
• Fullness, indigestion, or choking feeling (may feel like “heartburn”)
• Nausea or vomiting
• Light-headedness, dizziness, extreme weakness or anxiety
• Rapid or irregular heart beats

Calling 9-1-1 is almost always the fastest way to get life-saving treatment. Due to the possible benefits of taking aspirin early on during a heart attack, emergency personnel may tell you to chew an aspirin if there is no medical reason for you to avoid aspirin. When they arrive, emergency personnel can promptly begin treatment, and they are trained to revive someone whose heart has stopped. Also, you’re likelier to get treated faster at the hospital if you arrive by ambulance. If you are having symptoms, do not drive yourself unless there is absolutely no other option.

Symptoms of coronary artery disease in women:

Studies show that women's symptoms are less likely identified as heart disease related. The symptoms of coronary artery disease and heart attack can be different for women than they are in men. Women are also less likely to recognize the symptoms of a heart attack and seek treatment. By learning and recognizing the symptoms, women can become assertive in their treatment. The most common symptoms of heart disease in women are:

• Pain or pressure over the chest that travels to the arm or jaw
• A burning sensation in the chest or upper abdomen
• Shortness of breath, irregular heartbeat, dizziness, sweating, fatigue and nausea.

On average, symptoms of heart disease appear 10 years later in women than men. Women tend to have heart attacks 10 years later than men do.

In addition, women often report their symptoms before having a heart attack, although the symptoms are not typical “heart” symptoms. In a multi-center study of 515 women who had an acute myocardial infarction (MI), the most frequently reported symptoms were unusual fatigue, sleep disturbances, shortness of breath, indigestion and anxiety. The majority of women (78%) reported at least one symptom for more than one month before their heart attack. Only 30% reported chest discomfort, which was described as an aching, tightness, pressure, sharpness, burning, fullness or tingling.

Reference: McSweeney J, Cody M, O’Sullivan P, Elberson K, Moser D, Garvin B. Women’s Early Warning Symptoms of Acute Myocardial Infarction. Circulation. 2003; 108(21):2619-2623

For more information on heart attack in women, click here

Types of Angina

Stable angina: A type of angina brought on by an imbalance between the heart’s need for oxygen-rich blood and the amount available. It is "stable," which means the same activities bring it on; it feels the same way each time; and is relieved by rest and/or oral medications. Stable angina is a warning sign of heart disease and should be evaluated by a doctor. If the pattern of angina changes, it may progress to unstable angina.

Unstable angina: This type of angina is considered an acute coronary syndrome. It may be a new symptom or a change from stable angina. The angina may occur more frequently, occur more easily at rest, feel more severe, or last longer. Although this angina can often be relieved with oral medications, it is unstable and may progress to a heart attack. Usually more intense medical treatment or a procedure is required. Unstable angina is an acute coronary syndrome and should be treated as an emergency.

Variant angina (also called Prinzmetal's angina or coronary spasm): A coronary artery can go into spasm, disrupting blood flow to the heart muscle (ischemia). It can occur in people without significant coronary artery disease. However, two thirds of people with variant angina have severe disease in at least one vessel, and the spasm occurs at the site of blockage. This type of angina is not common and almost always occurs when a person is at rest - during sleep. You are at increased risk for coronary spasm if you have: underlying coronary artery disease, smoke, or use stimulants or illicit drugs (such as cocaine). If a coronary artery spasm is severe and occurs for a long period of time, a heart attack can occur.

What’s the difference between angina and a heart attack?

Angina is a warning symptom of heart disease – but it is not a heart attack. The symptoms of a heart attack (also called myocardial infarction or “MI”) are similar to angina.

Know in advance:

• The symptoms of a heart attack.
• If you are at risk for a heart attack. Ask your doctor about your risk and what you should do to reduce your risk. Be sure to ask about aspirin and nitroglycerin.
• Who to call for emergency help. Do not call a friend or family member. Call for an ambulance to take you to the nearest emergency room (Dial 9-1-1 in most areas).

Share this information with your family members and caregivers so they can recognize the symptoms of a heart attack and when to seek emergency treatment.

Remember:

• Learn to recognize your symptoms and the situations that cause them.
• Call your doctor if you begin to have new symptoms or if they become more frequent or severe.

If angina occurs:

• Stop your activity. Sit down and rest.
• If you have nitroglycerin, place 1 nitroglycerin tablet under your tongue and let it dissolve, or spray the nitroglycerin under your tongue.
• Wait 5 minutes.
• If you are still experiencing angina after 5 minutes, call 9-1-1 to get emergency help. DO NOT DELAY.
• Due to the possible benefits of taking an aspirin early on during a heart attack, emergency personnel may tell you to chew an aspirin if there is no medical reason for you to avoid aspirin.
• Do not drive yourself to the hospital. In many cases, the emergency personnel can begin to give you heart-saving care right away.
• To prevent damage to your heart muscle, do not delay seeking medical treatment.

For more information:

• The American Heart Association: What is Angina?*
• Heart Attack
• Coronary Artery Disease Overview 158339, The Cleveland Clinic Foundation, 2006

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