7 Heart Attack Indicators Before They Strike

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1. Fatigue

Significant changes in your energy and tolerance for physical activity can be an indication of an impending heart attack.

“It’s different from regular tiredness because it’s the kind of fatigue or exhaustion that feels out of proportion to the amount of work you’re doing,” says Parikh. “If you’re exercising and you feel significantly more tired than usual, don’t ignore this glaring symptom.”

While the overall cause of this fatigue is decreased blood flow to the heart, this precursor symptom is more common in women than men.

2. Shortness of Breath

Shortness of breath is a common early sign of a heart attack. When restricted blood flow prevents your heart from pumping oxygen properly, your body compensates by making you breathe faster. Fluid can also build up in your lungs, making it hard to catch your breath.

“It can also be due to reduced blood flow to the lungs,” says Parikh. “Many of my patients have experienced this symptom in the middle of the night, and it wakes them up.”

Parikh says it can feel like you’re not getting enough air with each breath. Shortness of breath is often accompanied by other symptoms like chest pain.

3. Chest Discomfort

This classic symptom of a heart attack can differ dramatically based on your sex. While movies often portray it as sudden, crushing pain, Parikh says it’s not always so obvious.

“The pain can be mild to severe, and many people describe it as an anxious or nervous feeling in their chest,” she says. “Symptoms of an anxiety attack can mimic this same symptom of a heart attack.”

Even if your chest discomfort isn’t persistent, you shouldn’t dismiss it.

“Even mild discomfort in your chest can be an early sign, and it can occur at rest and may come and go,” says Parikh.

4. Sleep Disturbances

The relationship between sleep and heart attacks is complicated.

First, insomnia and overall poor sleep quality are significant risk factors for a heart attack because of the stress they place on heart health. Experts also say early symptoms and actual heart attacks most commonly occur at night.

“Many heart attacks actually occur at 3 a.m. because that’s when adrenaline and cortisol levels surge,” says Parikh. “More often than not, we see heart attacks occurring at this time of day.”

Sleep disturbances and trouble breathing at night are common early warning signs of a heart attack, particularly for women.

5. Indigestion, Nausea, or Stomach Pain

Parikh says digestive symptoms can be early signs of a heart attack and are more common in women. They can look like acid reflux, general abdominal discomfort, and even belching or vomiting.

“Oftentimes, that digestive discomfort happens because the bottom of the heart isn’t getting as much blood flow [as it should]. That part of your heart sits on the diaphragm and the stomach. That lack of blood flow can lead to nausea.”

Parikh says diarrhea and general changes in bowel movements can be an early indicator of a heart attack as well.

“Any abnormal nausea during your routine exercise habits can also be a big sign of an impending heart attack,” says Parikh.

6. Dizziness or Lightheadedness

“Dizziness can be related to reduced blood flow to the brain,” says Parikh. “We underestimate how hard the heart works to pump blood throughout the body, including the brain.”

Dizziness or lightheadedness can be related to several other symptoms, including changes in your heartbeat, changes in body temperature, and shortness of breath.

“Women are more likely [than men] to experience this lightheadedness, and even fainting,” says Parikh.

7. Pain in Other Areas

“While men classically experience chest pain, women tend to experience pain in other areas [as an indicator of heart attack],” says Parikh. “And this pain can be gradual, developing in the jaw, down their left arm, and in the upper back.”

While intense chest pain usually signals a heart attack itself, pain or discomfort in other areas of your upper body is more likely to present in the weeks preceding an event, says Parikh.