What are the most common symptoms of myocardial infarction (heart attack)?

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From the Guidelines

The most common symptoms of a myocardial infarction (heart attack) include chest pain, dyspnea, pain or discomfort in the back, neck, jaw, or stomach, sweating, nausea, or lightheadedness, with variations in presentation among women, people with diabetes, and older individuals. According to the 2024 American Heart Association and American Red Cross guidelines for first aid 1, these symptoms can manifest differently in various populations. For instance, women, people with diabetes, and older individuals may experience symptoms such as dyspnea, back, neck, jaw, or stomach pain, sweating, nausea, or lightheadedness, rather than the classic chest pain.

  • Key symptoms to recognize include:
    • Chest pain or discomfort
    • Dyspnea
    • Pain or discomfort in the back, neck, jaw, or stomach
    • Sweating
    • Nausea
    • Lightheadedness It is crucial to note that the presentation of these symptoms can vary significantly among different individuals, and some may not exhibit the typical chest pain associated with a heart attack. The use of emergency medical services (EMS) transportation is associated with reduced ischemic time and treatment delays compared to transportation by personal vehicle 1. Therefore, it is essential to seek emergency medical attention immediately if these symptoms occur, as prompt treatment can significantly improve survival and reduce heart damage.

From the Research

Common Symptoms of Myocardial Infarction

The symptoms of myocardial infarction (MI) include:

  • Chest pain, which travels from left arm to neck 2
  • Shortness of breath 2, 3
  • Sweating 2, 4
  • Nausea 2, 5
  • Vomiting 2, 5
  • Abnormal heart beating 2
  • Anxiety 2, 4
  • Fatigue 2, 3
  • Weakness 2, 3
  • Stress 2
  • Depression 2
  • Pain or discomfort in arms or shoulders 5
  • Feeling weak, lightheaded, or faint 5
  • Pain or discomfort in the jaw, neck, or back 5

Variation in Symptoms by Sex

Women who experience acute myocardial infarction often present with atypical chest pain and other symptoms, such as dyspnea, weakness, and fatigue 3, 6

Diagnostic Accuracy of Signs and Symptoms

The diagnostic value of signs and symptoms can be assessed using diagnostic meta-analyses, and the most useful symptoms in the diagnosis of AMI were pain radiating to both arms, absence of chest wall tenderness, pain radiating to the right arm, and sweating 4

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Myocardial Infarction: Symptoms and Treatments.

Cell biochemistry and biophysics, 2015

3
Research

Chest Pain: Common Side Effect.

Clinical journal of oncology nursing, 2021

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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