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What does a heart attack really feel like?

In real life, heart attack symptoms may be more subtle than what you see in movies

Hollywood may have you believe that it’s very obvious when someone has a heart attack.

After all, in movies and on television, people having heart attacks often clutch their chests as their faces show them experiencing sudden and excruciating pain. Then they theatrically fall to the ground. 

But in real life, a heart attack is rarely that dramatic and the symptoms may be far less obvious.

Instead of ignoring any symptoms you have because they don’t conjure up Oscar-worthy performances of what you think a heart attack should look like, it’s helpful to look at more likely signs that you may be having a heart attack. 

Jason Choi, MD, is based at Dignity Health’s Stratford Health Center and provides cardiology services to Arroyo Grande Community Hospital as well as Marian Regional Medical Center, where he previously served as Chair of Medicine. He is the current Medical Director of the Cardiac Rehabilitation Center in Santa Maria.

Choi says heart attack symptoms may be severe, but they may also be mild and subtle. 

“When we think of heart attacks, we typically picture patients that have a crushing chest pressure with pain in the left arm, jaw, neck or upper back – with shortness of breath, sweating or struggling to catch their breath,” Dr. Choi says. “These are the classic symptoms, but, what we also realize – in certain populations, like women with diabetes – that they can present differently. 

“There are different kinds of heart attacks that present in different ways.”

In some cases, a person may not even realize they’re having a heart attack. Here are some signs to look out for.

If you experience these symptoms, take them seriously and seek medical help right away.

Chest pressure or tightness.

Some people describe this feeling as if an elephant is sitting on their chest.

Pain anywhere along the chest. 

You may experience pain in your chest that radiates down your left arm or into the left side of your jaw. You may also have pain in your neck, shoulder, abdomen or upper back.

Dr. Choi says chest pain with a faster heart rate is especially concerning. 

“Chest pain from the heart often comes with exercise,” he said. “If the pain is brought on or exacerbated by walking, or an activity that raises the heart rate, and goes away with rest, our suspicion for a heart attack increases.” 

Heartburn or indigestion-like symptoms.

 It is common for heart attack symptoms to be similar to those of heartburn or acid reflux. If your pain and discomfort are accompanied by sweating or shortness of breath, or if they persist after taking a heartburn remedy, get medical attention right away.

Shortness of breath.

Some people may only experience shortness of breath without any real chest pain or tightness. This makes it difficult to tell if it’s a heart attack or if the shortness of breath is caused by another condition but it should not be ignored.

Fatigue, nausea and sweating. 

These symptoms are often attributed to something else, especially if they are not accompanied by chest pain. Women, who are less likely to have obvious signs of a heart attack such as chest pain and indigestion-like symptoms, are more likely to experience these subtle symptoms.

What should you do if you have any of these symptoms?

If you have any of these potential heart attack symptoms, it is important to seek medical attention right away. Do not drive yourself to the hospital, however. Even if you think you feel well enough to drive, your symptoms may get worse on the way. Instead, call 911 or have someone drive you to the emergency room immediately.

Can you have a heart attack and not know it?

It is possible to have a heart attack and not even know you had it. When this happens, it may be because it is a mild heart attack that doesn’t cause any noticeable symptoms. But more often there are subtle symptoms that occur that may not be attributed to a heart attack so medical treatment is not sought. Sometimes a person may realize the symptoms they’re feeling could be due to a heart attack but they decide to ignore their symptoms, hoping they’ll just go away.

“Usually people have some symptoms in retrospect, but some heart attacks are sudden and subtle,” Dr. Choi says. 

Any heart attack, no matter how minor, may cause damage to the heart so it is important to not ignore symptoms. Getting treatment as soon as possible once a heart attack starts is your best chance of minimizing any damage to the heart muscle and making a full recovery.

“Reaction time is important,” Dr. Choi says. “We like to say that ‘Time is heart muscle.’ If you have a critical blockage in your heart, with every passing minute a fraction of your heart muscle dies.”

Dr. Choi lauds the staff at Marian Regional Medical Center.

“The whole cath lab staff is trained to recognize signs of a heart attack and take action as soon as possible,” he says. “Marian has a 24/7 cath lab that is able to treat heart attacks every day of the year.”

Choi also urges the general population to do what they can to lower their risk of a heart attack, like avoiding smoking and keeping your weight under control.

To sum it up, Dr. Choi says, “if you think you’re having a heart attack, you should get it checked out. Delay in treatment can cause life-threatening problems.”

To learn about Cardiac Care services offered by Dignity Health Central Coast, visit

Jason Choi, MD

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Date Last Reviewed: December 19, 2023

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