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by Dr. Audrey Sernyak

Crushing chest pain - that's how many people think a heart attack should feel. While it's true that chest pain is the most common warning sign of a heart attack, the pain itself may be mild. Not everyone has chest pain; as many as one-third of heart attacks don't cause any chest pain at all.

Who has these heart attacks that don't cause chest pain? Anyone can be a victim, but women, older adults and people with diabetes are more likely to have heart attacks with symptoms other than chest pain.

Some lesser known warning signs

Men and women both experience chest pain: pain or pressure in the shoulders, neck, jaw or arms; lightheadedness, shortness of breath, and/or sweating. A recent study in the journal Circulation, however, found that 43 percent of women did not have chest pain.

"Although women can have chest pain, it's important to recognize that they may have other symptoms and not to delay seeking treatment," said ACC interventional cardiologist Audrey Sernyak, MD, FACC.

Other "non-traditional" heart attack signs include:

  • "Fullness" or pressure in the chest that lasts longer than a few minutes, or goes away and comes back
  • Trouble breathing
  • Nausea
  • Weakness of fatigue
  • Cold sweats
  • Dizziness
  • Stomach, abdominal or back pain

The fact that these heart attacks don't cause chest pain doesn't mean they are less serious - just the opposite, in fact. Often, heart attacks without chest pain can be the most deadly. People who have this type of heart attack are twice as likely to die within a year as those who have an attack signaled by chest pain.

How long should you wait before getting help?

Almost half of all heart attack victims die, and a major reason is because the wait too long to get help. For the best chances of recovery, patients should receive heart attack treatments within an hour of experiencing symptoms.

"Women need to take their symptoms seriously. Call 911 for an ambulance immediately," said Dr. Sernyak. "The longer you wait, the more your health is at risk. Time is heart muscle. Every minute counts."

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