5 early warning signs of a heart attack

The information in this article is for educational purposes only and is not intended to replace medical advice from your doctor. 

When someone has a heart attack on TV or in the movies, it’s always dramatic. Suddenly, they clutch their chest and fall to the ground. In reality, heart attacks — where blood flow is blocked to the heart — don’t always show up that way.

It’s true that chest pain is a common heart attack symptom for both men and women, according to the American Heart Association. But a heart attack can quietly sneak up on you in far more subtle ways.

“If you can pay attention to some of these early signs, you may be able to prevent a severe heart attack,” says Angela Turner, DO, a board-certified cardiologist at Bayfront Health in St. Petersburg, Florida.

This is why it’s so important to understand the unexpected signs that a heart attack could be on the horizon. Plus: some signs that it's time to see your health care provider.

Warning sign No. 1: You’re increasingly short of breath 

Typically, you can go for a mile walk, no problem. But lately, you can only go half that distance. Or maybe it’s becoming tough to go up and down the stairs in your home. You just don’t have the stamina for it anymore without feeling out of breath quickly. 

It’s not just that you’re suddenly out of shape or getting older. A decline in physical ability is a warning sign that your heart may be in trouble, Dr. Turner notes. And this can be true whether you exercise regularly or not. 

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Warning sign No. 2: You’re more tired than usual 

Fatigue is tricky. “So many things cause fatigue,” says Dr. Turner. Most commonly, it’s a lack of sleep. Other health conditions can also lead to significant fatigue. These include thyroid dysfunction, autoimmune disease, and sleep apnea.

But sometimes fatigue can be related to your heart. “If you’ve been sleeping well and you’re suddenly extra tired, that may be a sign of heart disease,” Dr. Turner says. 

Warning sign No. 3: You have discomfort in your arms, chest, or back 

Pain from a heart attack can travel to other parts of your body. It can move down your arms or into your back, neck, or jaw. “This can also feel like pressure,” Dr. Turner explains. 

You also may feel it in your chest. But it’s not like the lightning-bolt pain often thought of with heart attacks. 

How can you tell if aches are related to the heart? One clue is to pay attention to when the symptoms come and go. “When your symptoms happen when you’re up and moving and then get better when you stop, that tends to point the finger toward a heart problem,” says Dr. Turner. But if you’re ever unsure if your symptoms might be related to your heart, see your health care provider. 

Warning sign No. 4: You have indigestion that won’t go away 

There’s a burning discomfort in your belly. And it’s traveling upward into your chest. Your first thought may be indigestion. But it could be more serious.  

Say you’ve just had a burger and fries or a big pasta meal, and your stomach is not happy. If traditional treatments for indigestion don’t help, your heart might be involved.  

“We’ve seen patients who said they took a lot of antacids and nothing treated their indigestion. It turned out to be a heart blockage,” Dr. Turner says. 

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Warning sign No. 5: It feels like you have the flu 

Fatigue, nausea, chills, and cold sweats can make you think that you’ve come down with something. But sometimes heart disease in women can show up as flu-like symptoms. 

In these cases, people may go to the doctor thinking they’re dealing with a run-of-the-mill illness, only to find out it’s a heart problem. Experiencing confusing symptoms like this is often referred to as a “silent heart attack.” 

When to see a doctor about your heart 

Heart attacks show up in different ways for different people. “Some people may get warning signs, while for others, symptoms hit them all at once,” says Dr. Turner. 

However, it’s common for patients who’ve had a heart attack to look back and recognize that they were feeling off. “Few people feel nothing before a big heart attack,” says Dr. Turner. 

It’s important to know your body. Meaning, if you have chronic back problems, back pain might not be a red flag. But if you don’t have a history of back issues and now you’re having back pain — and don’t know why it could have appeared — that should hit your radar.  

“The heart will tend to give more subtle signs,” Dr. Turner says. “Discomfort may be more on and off, and the heart tends to show itself a little more with movement or when you’re upset or angry.” 

It’s difficult to say exactly when to seek medical help. Dr. Turner advises listening to your gut, especially if you’re experiencing something new.  

“If you’re worried that something could be going on with your heart, get checked out — don’t ignore it,” she says. Time is critical when it comes to your heart. 

Of course, if you have clear symptoms, call 911, Dr. Turner advises. For example, if you can’t breathe, or if you feel like an elephant is sitting on your chest, consider that a medical emergency. If you suspect a heart attack, you want the emergency room, not urgent care.  

“Listen to that feeling that says, ‘I know something’s not right,’” says Dr. Turner. It could save your life. 

See our sources: 
Warning signs of a heart attack: American Heart Association 
What is a heart attack? American Heart Association
Heart attack symptoms: Mayo Clinic 
Heart attack symptoms in women: American Heart Association 
Silent heart attack: Cleveland Clinic

Cited sources were last reviewed on 10/9/25

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