While that scenario happens in some cases, you should know that mild chest pain, discomfort in the jaw, and lightheadedness are among other, less-dramatic signs that can signal a heart attack.
And if you don't respond quickly to those warning signals and delay getting treatment, you're putting yourself at risk for heart damage and even death.That's why the U.S. National Heart, Lung, and Blood Institute (NHLBI), the National Council on the Aging, the American Heart Association and other groups have launched a new public education campaign called "Act in Time to Heart Attack Signs."
Too few Americans get to a hospital fast enough when they have a heart attack; anyone with symptoms should call 9-1-1 immediately. Yet studies show that many people wait two hours or more before they seek emergency care, according to the NHLBI.
Each year, about 1.1 million Americans suffer a heart attack and about 460,000 of them die. Nearly half of those deaths occur within one hour of the start of symptoms, the NHLBI says.
"We are certainly aware that the number one cause of death and disability in older Americans is due to premature heart attack and stroke," says Roba Whiteley, the National Council on the Aging's vice president of marketing and communications.
"But people don't know what the signs and symptoms are and it can be quite confusing," she says.
Heart attacks happen when blood flow to the heart is nearly or completely blocked. And it's during the crucial first hour after symptoms appear that "clot-busting" drugs and other treatments, such as angioplasty, are most effective in opening clogged arteries and restoring blood flow, says Mary Hand, coordinator of the NHLBI's National Heart Attack Alert Program.
"The sooner the artery is opened and the blood flow in the blocked artery is reestablished, the much better outcome the patients have, both in terms of surviving and in terms of saving their heart muscle," Hand says.
Yet only one-in-five heart attack patients gets to a hospital emergency room fast enough to benefit from these treatments.
Some of the less-familiar signs of a heart attack include: chest discomfort or pain; discomfort in the arm or arms, as well as the back, neck, jaw or stomach; shortness of breath; a cold sweat; nausea, or lightheadedness.
Many people don't know that these milder symptoms may indicate a heart attack; they dismiss them signs as indigestion, the flu or even a pulled muscle.
One reason people are unaware of these subtle signs is that too few doctors take the time to discuss them with their patients, Hand says. One focus of the "Act in Time" campaign is to get physicians to talk to their patients about heart attack symptoms and how to respond to them.
Lack of knowledge isn't limited to a heart attack's warning signs.
Many women are slow to seek help when having a heart attack simply because they believe they're not at risk.
"Women, still, as a rule, don't think that they're going to get heart disease or a heart attack. They're more concerned about breast cancer. And yet one-in-three women are going to die from heart disease and approximately one-in-seven will die from breast cancer," Hand says.
And sadly, some people delay calling for help because they worry about being embarrassed if their symptoms turn out to be a false alarm.
The "Act in Time" campaign isn't aimed just at people who may be at risk for a heart attack, either. Hand says everyone needs to know the signs of a heart attack so they can be ready to help family members, friends and co-workers.
Hand also encourages everyone to have a "heart attack action plan," much the same way you make an emergency plan for a house fire.
"We actually want people to think through and talk with their family members about what they should do if they get these symptoms and to make sure everybody is on board with what we're asking them to do. That is, call 9-1-1, get to the hospital right away," Hand says.
Older Americans should be sure to discuss their action plans not just with family members, but neighbors, friends, caretakers or housekeepers, the National Council on the Aging's Whiteley says.
What To Do
You can get a free wallet card and brochure, available in English and Spanish, that give the warning signs of a heart attack, and advice on how to respond, by visiting the Act in Time Web page or phoning 301-592-8573.