Not everyone experiences chest pain during a heart attack 

If you witnessed a family member who has stopped breathing and is unresponsive, would you know what to do?

An elderly woman sitting on a couch with her hand to her chest looking distressed while an elderly man sits beside her looking concernedFewer than half of Canadians say they have the skills to help in this common and life-threatening emergency.
The signs and symptoms of a heart attack vary from person to person and can be different in people of different sexes. Please note that this refers to a person’s biological sex assigned at birth, which may be different from a person’s gender, or their social and personal identity. Even a person who has had a heart attack before may not experience the same signs and symptoms if they have a second heart attack.  
Although the symptoms can be divided in to “subtle signs” and “general” symptoms, there is overlap. People may experience some signs or symptoms from each category. 

"Subtle Signs" of a Heart Attack     

  • Mild, unfocused chest discomfort that comes and goes   
  • Does not necessarily feel painful   
  • Gets better with rest and worse with activity, or gets progressively worse   
  • Extreme fatigue (tiredness)   
  • Gastric discomfort, nausea, or vomiting   
  • Flu-like symptoms   
  • Dizziness or light-headedness   
During a heart attack, many people of female sex, elderly people, and people with diabetes tend to experience " subtle signs," which are milder or more generalized and harder to recognise than the "general" signs and symptoms of a heart attack.   

These " subtle signs" may be experienced for hours, days, or even weeks prior to the heart attack and are often dismissed as nothing out of the ordinary.  

General Heart Attack Symptoms 

  • Chest pain that is not relieved by resting, changing position or medication. 
  • Discomfort or pain that spreads to one or both arms, the jaw, the shoulder, the neck, or (more commonly in females) the back or the upper part of the stomach  
  • Abnormal Breathing  
  • Cold, sweaty skin  
  • Skin, lips, and fingers that are bluish, ashen (grey), greenish or paler than normal  
  • Feelings of anxiety, denial, or impending doom  
A person who is having a heart attack may experience chest pain, which can range from mild to unbearable. The person may complain of pressure, squeezing, tightness, aching, or heaviness in the chest. The pain or discomfort is persistent, lasting longer than 3 to 5 minutes. It may be difficult to distinguish the pain of a heart attack from the pain of indigestion, heartburn, or a muscle spasm. 
If you are in any doubt over whether the symptoms are serious enough to need emergency personnel don’t delay seeking help. The longer the heart muscle is lacking oxygen, the more damage is done to the heart muscle!
Denial is a common reaction in a cardiac emergency. This should not discourage you from helping or change the care you provide. 
The signs and symptoms of angina are similar to the signs and symptoms of a heart attack, but the pain is usually triggered by physical activity or stress, usually goes away if the person rests, and is often relieved by medication (e.g., nitroglycerin).”

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