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| Meta Title | Early warning signs of a heart attack |
| Meta Description | Warning signs of a heart attack a month before can include breathlessness, fatigue, and disrupted sleep. |
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| Boilerpipe Text | Warning signs of a heart attack that can occur a month beforehand include chest discomfort, fatigue, and shortness of breath.
A heart attack is a medical emergency in which the blood supply to the heart is suddenly blocked. Every year, around
805,000 people
in the United States have a heart attack, or myocardial infarction, roughly one heart attack every 40 seconds.
Heart attacks have distinct symptoms, meaning people can seek emergency treatment immediately upon noticing them. However, while heart attacks occur suddenly, there
may be signs
ahead of a major cardiac event, such as chest discomfort.
Being aware of these heart attack warning signs can help people seek treatment quickly, improving the chance of a swift and full recovery.
This article discusses symptoms that can point to underlying coronary artery disease, the risk of heart attack, and how to respond.
New symptoms, such as chest pain, can indicate a heart attack and require urgent treatment. However, people sometimes experience other symptoms that might indicate an increased risk for a heart attack. Having a healthcare professional check these symptoms may help diagnose and prevent heart disease sooner.
An older
2003 survey
of 515 women who survived a heart attack found that they most commonly experienced the following symptoms a month before their cardiac event:
abnormal levels of
fatigue
— 70.7% of women in the study reported this
disrupted sleep — 47.8%
shortness of breath — 42.1%
Only 29.7% reported experiencing chest discomfort. This survey looks at self-reported symptoms and only gave warning signs in women, which can differ from those in men.
A person should not wait
more than 5 minutes
to contact 911 if they suspect heart attack symptoms.
Even if physicians at a hospital determine that a heart attack is not in progress, an evaluation is vital to rule out a potentially deadly consequence.
Acute heart attack symptoms
include
:
Discomfort, squeezing, pressure, or fullness in the middle of the chest:
This may last for a few minutes, or it could start to feel better and then return.
Discomfort elsewhere:
Early heart attack symptoms in other parts of the body can affect one or both arms, the back, neck, jaw, or stomach.
Breathlessness:
This might happen before a person feels discomfort in their chest, but it often occurs alongside the chest discomfort.
Other early symptoms:
A person might break out in cold sweats, feel nauseous, or experience lightheadedness early in a heart attack.
Coronary artery disease (CAD) is the most common
cause of heart attacks
. The hearts of people with CAD do not receive enough oxygen-rich blood, as the coronary artery, which leads to the heart, becomes narrower. This is due to a buildup of a waxy plaque on the artery walls that worsens over several years.
When plaque breaks off, it can lead to a blood clot that completely blocks blood flow to the heart, meaning the heart muscles start to die without prompt treatment.
Less common causes include:
the blockage of the coronary artery due to a sudden spasm, which is more likely in smokers and users of illegal drugs, such as cocaine
a coronary artery embolism is more common in those with
atrial fibrillation
and is when a blood clot travels from the heart into the coronary artery, blocking it
a tear in the coronary artery, which happens more often in women under 50 years of age, pregnant people, or those with
Marfan syndrome
Risk factors for a heart attack
Several controllable factors can impact heart attack risk,
including
:
a diet high in sodium and saturated and trans fat
a sedentary lifestyle that does not involve much exercise or moving around
smoking
Many medical conditions that fall under the category of metabolic syndrome can also increase your risk of
heart disease
. These include
obesity
,
diabetes
, and high levels of the following:
blood sugar
cholesterol
blood pressure
triglycerides
The risk of heart attack increases with age. People with a family history of heart attack, particularly those with relatives who had heart attacks at a young age, also have an increased risk.
A heart attack requires emergency treatment to increase the chances of survival and improve the speed of recovery. There are many approaches to treatment, many of which require surgical intervention. These
include
:
Percutaneous coronary intervention:
A cardiologist threads a balloon-tipped catheter to open the blockage and places a stent to keep the blood vessel open.
Bypass surgery:
A cardiac surgeon uses a graft to bypass areas of blockage.
Heart transplant:
A person may have a heart transplant for severe heart failure due to coronary disease when a surgeon cannot perform revascularization.
Some doctors may implant a medical device after certain types of heart attacks.
A doctor may also prescribe one or several medications to reduce clotting, widen arteries, and manage how hard and fast the heart has to work. These heart attack medications include:
antiplatelets
ACE inhibitors
beta-blockers
cholesterol-lowering medications
nitrates
A person may need further medications if a heart attack causes heart failure.
There is no established life expectancy after a heart attack, as different factors affect the likelihood of survival and quality of life after the event.
However, a long, full, active life
is possible
after a heart attack for people who follow a doctor’s guidance, lead a heart-healthy lifestyle, and take medications as prescribed.
Addressing the heart attack risk factors is the most effective way to prevent a heart attack:
Quitting smoking is an important step in reducing heart attack risk.
Reducing blood pressure by limiting salt intake, exercising regularly, and taking blood pressure medications, as advised.
Keeping blood cholesterol in check by reducing cholesterol, saturated fat, and trans fat intake, moving regularly, and taking cholesterol-lowering medication prescriptions.
Aiming for a healthy
body mass index (BMI)
to prevent obesity.
Taking all possible measures to manage a diabetes diagnosis.
Reducing alcohol intake, as it can affect blood pressure.
Chest pain, discomfort in the arms, back, and neck, and breathlessness are common symptoms of heart attacks. However, heart attacks can also cause unusual levels of fatigue, sleep problems, and shortness of breath up to a month before in women.
Treatment and recovery are possible, but only for those who recognize and act on these warning signs by immediately calling 911. It is best to try and prevent heart attacks by eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, and avoiding smoking. |
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# Warning signs of a heart attack a month before

[Medically reviewed]() by [Angela Ryan Lee, MD, FACC]() — Written by [Adam Felman]() — [Updated on June 26, 2023]()
- [Early signs](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#early-signs)
- [Contacting a doctor](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#contacting-a-doctor)
- [Overall symptoms](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#overall-symptoms)
- [Causes](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#causes)
- [Treatments](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#treatments)
- [Outlook](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#outlook)
- [Prevention](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#prevention)
- [Summary](https://www.medicalnewstoday.com/articles/signs-of-heart-attack-a-month-before#summary)
Warning signs of a heart attack that can occur a month beforehand include chest discomfort, fatigue, and shortness of breath.
A heart attack is a medical emergency in which the blood supply to the heart is suddenly blocked. Every year, around [805,000 people](https://www.cdc.gov/heartdisease/facts.htm) in the United States have a heart attack, or myocardial infarction, roughly one heart attack every 40 seconds.
Heart attacks have distinct symptoms, meaning people can seek emergency treatment immediately upon noticing them. However, while heart attacks occur suddenly, there [may be signs](https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack) ahead of a major cardiac event, such as chest discomfort.
Being aware of these heart attack warning signs can help people seek treatment quickly, improving the chance of a swift and full recovery.
This article discusses symptoms that can point to underlying coronary artery disease, the risk of heart attack, and how to respond.
## [Early signs of heart attack risk]()

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New symptoms, such as chest pain, can indicate a heart attack and require urgent treatment. However, people sometimes experience other symptoms that might indicate an increased risk for a heart attack. Having a healthcare professional check these symptoms may help diagnose and prevent heart disease sooner.
An older [2003 survey](https://www.ahajournals.org/doi/full/10.1161/01.cir.0000097116.29625.7c) of 515 women who survived a heart attack found that they most commonly experienced the following symptoms a month before their cardiac event:
- abnormal levels of [fatigue](https://www.medicalnewstoday.com/articles/248002) — 70.7% of women in the study reported this
- disrupted sleep — 47.8%
- shortness of breath — 42.1%
Only 29.7% reported experiencing chest discomfort. This survey looks at self-reported symptoms and only gave warning signs in women, which can differ from those in men.
### A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. [Click here to learn more](https://www.medicalnewstoday.com/articles/232363).
[Read more about heart attacks here](https://www.medicalnewstoday.com/articles/151444).
## [When to contact a doctor]()
A person should not wait [more than 5 minutes](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.113.006126) to contact 911 if they suspect heart attack symptoms.
Even if physicians at a hospital determine that a heart attack is not in progress, an evaluation is vital to rule out a potentially deadly consequence.
## [Overall symptoms]()
Acute heart attack symptoms [include](https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.113.006126):
- **Discomfort, squeezing, pressure, or fullness in the middle of the chest:** This may last for a few minutes, or it could start to feel better and then return.
- **Discomfort elsewhere:** Early heart attack symptoms in other parts of the body can affect one or both arms, the back, neck, jaw, or stomach.
- **Breathlessness:** This might happen before a person feels discomfort in their chest, but it often occurs alongside the chest discomfort.
- **Other early symptoms:** A person might break out in cold sweats, feel nauseous, or experience lightheadedness early in a heart attack.
[Learn more about recognizing the signs of a heart attack here](https://www.medicalnewstoday.com/articles/signs-of-a-heart-attack).
## [Causes and risk factors]()
Coronary artery disease (CAD) is the most common [cause of heart attacks](https://www.nhlbi.nih.gov/health/heart-attack/causes). The hearts of people with CAD do not receive enough oxygen-rich blood, as the coronary artery, which leads to the heart, becomes narrower. This is due to a buildup of a waxy plaque on the artery walls that worsens over several years.
When plaque breaks off, it can lead to a blood clot that completely blocks blood flow to the heart, meaning the heart muscles start to die without prompt treatment.
Less common causes include:
- the blockage of the coronary artery due to a sudden spasm, which is more likely in smokers and users of illegal drugs, such as cocaine
- a coronary artery embolism is more common in those with [atrial fibrillation](https://www.medicalnewstoday.com/articles/323621) and is when a blood clot travels from the heart into the coronary artery, blocking it
- a tear in the coronary artery, which happens more often in women under 50 years of age, pregnant people, or those with [Marfan syndrome](https://www.medicalnewstoday.com/articles/179900)
### Risk factors for a heart attack
Several controllable factors can impact heart attack risk, [including](https://www.cdc.gov/heartdisease/risk_factors.htm#:~:text=Eating%20a%20diet%20high%20in,can%20lead%20to%20heart%20disease):
- a diet high in sodium and saturated and trans fat
- a sedentary lifestyle that does not involve much exercise or moving around
- smoking
Many medical conditions that fall under the category of metabolic syndrome can also increase your risk of [heart disease](https://www.medicalnewstoday.com/articles/237191). These include [obesity](https://www.medicalnewstoday.com/articles/323446), [diabetes](https://www.medicalnewstoday.com/articles/323627), and high levels of the following:
- blood sugar
- [cholesterol](https://www.medicalnewstoday.com/articles/9152)
- [blood pressure](https://www.medicalnewstoday.com/articles/270644)
- triglycerides
The risk of heart attack increases with age. People with a family history of heart attack, particularly those with relatives who had heart attacks at a young age, also have an increased risk.
## [Treatments]()
A heart attack requires emergency treatment to increase the chances of survival and improve the speed of recovery. There are many approaches to treatment, many of which require surgical intervention. These [include](https://www.nhlbi.nih.gov/health/heart-attack/treatment):
- **Percutaneous coronary intervention:** A cardiologist threads a balloon-tipped catheter to open the blockage and places a stent to keep the blood vessel open.
- **Bypass surgery:** A cardiac surgeon uses a graft to bypass areas of blockage.
- **Heart transplant:** A person may have a heart transplant for severe heart failure due to coronary disease when a surgeon cannot perform revascularization.
Some doctors may implant a medical device after certain types of heart attacks.
A doctor may also prescribe one or several medications to reduce clotting, widen arteries, and manage how hard and fast the heart has to work. These heart attack medications include:
- antiplatelets
- ACE inhibitors
- beta-blockers
- cholesterol-lowering medications
- nitrates
A person may need further medications if a heart attack causes heart failure.
## [Outlook]()
There is no established life expectancy after a heart attack, as different factors affect the likelihood of survival and quality of life after the event.
However, a long, full, active life [is possible](https://www.heart.org/en/health-topics/heart-attack/life-after-a-heart-attack) after a heart attack for people who follow a doctor’s guidance, lead a heart-healthy lifestyle, and take medications as prescribed.
## [Prevention]()
Addressing the heart attack risk factors is the most effective way to prevent a heart attack:
- Quitting smoking is an important step in reducing heart attack risk.
- Reducing blood pressure by limiting salt intake, exercising regularly, and taking blood pressure medications, as advised.
- Keeping blood cholesterol in check by reducing cholesterol, saturated fat, and trans fat intake, moving regularly, and taking cholesterol-lowering medication prescriptions.
- Aiming for a healthy [body mass index (BMI)](https://www.medicalnewstoday.com/articles/323622) to prevent obesity.
- Taking all possible measures to manage a diabetes diagnosis.
- Reducing alcohol intake, as it can affect blood pressure.
## [Summary]()
Chest pain, discomfort in the arms, back, and neck, and breathlessness are common symptoms of heart attacks. However, heart attacks can also cause unusual levels of fatigue, sleep problems, and shortness of breath up to a month before in women.
Treatment and recovery are possible, but only for those who recognize and act on these warning signs by immediately calling 911. It is best to try and prevent heart attacks by eating a heart-healthy diet, maintaining a healthy weight, exercising regularly, and avoiding smoking.
- [Heart Disease](https://www.medicalnewstoday.com/categories/heart-disease)
### How we reviewed this article:
Sources
Medical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our [editorial policy](https://www.medicalnewstoday.com/articles/process).
- Heart attack. (n.d.).
<https://www.heart.org/en/health-topics/heart-attack>
- Heart attack: What is a heart attack? (2022).
<https://www.nhlbi.nih.gov/health/heart-attack>
- Heart disease. (2023).
<https://www.cdc.gov/heartdisease/index.htm>
- Heart-healthy living: Choose heart-healthy foods. (2022).
<https://www.nhlbi.nih.gov/health/heart-healthy-living/healthy-foods>
- How much physical activity do adults need? (2022).
<https://www.cdc.gov/physicalactivity/basics/adults/index.htm>
- McSweeney, J. C., *et al*. (2003). Women’s early warning symptoms of acute myocardial infarction.
<https://www.ahajournals.org/doi/full/10.1161/01.cir.0000097116.29625.7c>
- Ornato, J. P., *et al*. (2014). Warning signs of a heart attack.
<https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.113.006126>
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[Medically reviewed]() by [Angela Ryan Lee, MD, FACC]() — Written by [Adam Felman]() — [Updated on June 26, 2023]()
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