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1. Shard Calculation

Query:

Response:

Calculated Shard: 129 (from laksa187)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa129.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.ncbi.nlm.nih.gov/books/NBK355294/\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.ncbi.nlm.nih.gov/books/NBK355294/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/","crawl_time":1748280470,"first_indexed_time":1554471220,"http_code":200,"src_unparsed":"gov,nih!nlm,ncbi,www,\/books\/NBK355294\/ s443","src_root_hash":"7295144728021232729","history_drop_reason":"tooold","meta_title":"Coronary artery disease: Learn More – Signs of a heart attack - InformedHealth.org - NCBI Bookshelf","meta_descriptions":["The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.)."],"attrs_boilerpipe_text":"The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.). Sometimes, people have a heart attack that is caused by coronary artery disease (CAD) that they already knew about. But heart attacks can happen without any previous symptoms, too. Some people think that heart attacks are a lot more common in men. That isn’t true, though. But women tend to be older when they have heart attacks. More women die of a heart attack than of  breast cancer , for example. Possible signs of a heart attack The typical signs of a heart attack are: A strong feeling of tightness or pressure in the chest A stabbing, burning or heavy pain behind the breastbone Pain that spreads to the left or right arm, the back, neck or upper abdomen (belly) as well Pain or numbness in the upper body that may spread to the shoulder blades, the front or back of the neck, and the jaw The symptoms often start suddenly, but can also be more gradual. The pain lasts for more than five minutes and doesn’t get better when the person rests. Other possible symptoms include: Weakness, dizziness, loss of consciousness Intense anxiety or fear of death The symptoms of a heart attack vary from person to person. Heart attacks don't always cause tightness and pain in the chest. For example, chest tightness is less common in women, older people, and people with  diabetes  or  heart failure . They are more likely to have other symptoms such as shortness of breath, nausea or vomiting. Possible areas of pain during a heart attack Suspected heart attack? Call an ambulance! Heart attacks are a medical emergency! Every minute counts. Life-saving measures should be started as soon as possible in order to limit damage. It is important to call the emergency services immediately ( 112 in Germany  and many other countries,  911 in the U.S. ) if you suspect someone might be having a heart attack. If signs of a heart attack occur at night, do NOT wait until the next morning to do something about it. How can other people help? While waiting for the ambulance to arrive, people who are with the patient can put them in a comfortable lying position, with their upper body slightly raised, open a window to let in fresh air and, if they have medication for stable angina, such as nitrates, give them that. If the person passes out, they stop breathing and their heartbeat stops, they will need  CPR (resuscitation)  as a first aid measure. If several people are there and there's an \" external defibrillator (AED) ,\" it should be used. Known CAD: Temporary symptoms or emergency? It can be difficult for people who have CAD to tell the difference between temporary symptoms, a short-term worsening and an emergency. It is likely to be an emergency if the symptoms don't go away when you rest after physical strain such as climbing the stairs, don't go away even after taking emergency medication (such as nitrate sprays), last for longer than a couple of minutes, or there are also other signs of a heart attack. Even if you aren't sure: Do NOT wait. Call the emergency services straight away! Sources Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).  Nationale Versorgungsleitlinie Chronische KHK . Langfassung. AWMF-Registernr.: nvl-004. 2019. IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services. Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations. Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.","attrs_markdown":"**Warning:** The NCBI web site requires JavaScript to function. [more...](https:\/\/www.ncbi.nlm.nih.gov\/guide\/browsers\/#enablejs \"Learn how to enable JavaScript\")\n\n![U.S. flag](https:\/\/www.ncbi.nlm.nih.gov\/coreutils\/uswds\/img\/favicons\/favicon-57.png)\n\nAn official website of the United States government\n\nHere's how you know\n\n![Dot gov](https:\/\/www.ncbi.nlm.nih.gov\/coreutils\/uswds\/img\/icon-dot-gov.svg)\n\n**The .gov means it's official.**   \n Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.\n\n![Https](https:\/\/www.ncbi.nlm.nih.gov\/coreutils\/uswds\/img\/icon-https.svg)\n\n**The site is secure.**   \n The **https:\/\/** ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.\n\n[![NIH NLM Logo](https:\/\/www.ncbi.nlm.nih.gov\/coreutils\/nwds\/img\/logos\/AgencyLogo.svg)](https:\/\/www.ncbi.nlm.nih.gov\/)\n\n[Log in](https:\/\/account.ncbi.nlm.nih.gov\/?back_url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK355294%2F)\n\nShow account info\n\nClose\n\n#### Account\n\nLogged in as:  \n **username**\n\n- [Dashboard](https:\/\/www.ncbi.nlm.nih.gov\/myncbi\/)\n- [Publications](https:\/\/www.ncbi.nlm.nih.gov\/myncbi\/collections\/bibliography\/)\n- [Account settings](https:\/\/www.ncbi.nlm.nih.gov\/account\/settings\/)\n- [Log out](https:\/\/www.ncbi.nlm.nih.gov\/account\/signout\/?back_url=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fbooks%2FNBK355294%2F)\n\n[Access keys](https:\/\/www.ncbi.nlm.nih.gov\/guide\/browsers\/#ncbi_accesskeys) [NCBI Homepage](https:\/\/www.ncbi.nlm.nih.gov\/) [MyNCBI Homepage](https:\/\/www.ncbi.nlm.nih.gov\/myncbi\/) [Main Content](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#maincontent) [Main Navigation](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/)\n\n# [Bookshelf](https:\/\/www.ncbi.nlm.nih.gov\/books\/ \"Bookshelf home\")\n##\n\n- [Browse Titles](https:\/\/www.ncbi.nlm.nih.gov\/books\/browse\/)\n- [Advanced](https:\/\/www.ncbi.nlm.nih.gov\/books\/advanced\/)\n- [Help](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK3833\/)\n- [Disclaimer](https:\/\/www.ncbi.nlm.nih.gov\/books\/about\/disclaimer\/)\n\nNCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.\n\nInformedHealth.org \\[Internet\\]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-.\n\n[![Cover of InformedHealth.org](https:\/\/www.ncbi.nlm.nih.gov\/corehtml\/pmc\/pmcgifs\/bookshelf\/thumbs\/th-pmh_iqwig-lrg.png)](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/ \"Table of Contents Page\")\n\n## InformedHealth.org \\[Internet\\].\n[Show details](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#__NBK355294_dtls__)\n\nCologne, Germany: [Institute for Quality and Efficiency in Health Care (IQWiG)](https:\/\/www.informedhealth.org\/); 2006-.\n\n- [Contents](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/)\n\n[\\< Prev](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2170.behandlung-p5\/ \"Previous page in this title\")[Next \\>](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2170.folgen-gb\/ \"Next page in this title\")\n\n# Coronary artery disease: Learn More – Signs of a heart attack\nLast Update: February 18, 2022; Next update: 2025.\n\n**The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.).**\n\nSometimes, people have a heart attack that is caused by coronary artery disease (CAD) that they already knew about. But heart attacks can happen without any previous symptoms, too.\n\nSome people think that heart attacks are a lot more common in men. That isn’t true, though. But women tend to be older when they have heart attacks. More women die of a heart attack than of [breast cancer](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2276\/), for example.\n\n[Go to:](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/ \"Go to other sections in this page\")\n\n## Possible signs of a heart attack\nThe typical signs of a heart attack are:\n\n- A strong feeling of tightness or pressure in the chest\n- A stabbing, burning or heavy pain behind the breastbone\n- Pain that spreads to the left or right arm, the back, neck or upper abdomen (belly) as well\n- Pain or numbness in the upper body that may spread to the shoulder blades, the front or back of the neck, and the jaw\n\nThe symptoms often start suddenly, but can also be more gradual. The pain lasts for more than five minutes and doesn’t get better when the person rests.\n\nOther possible symptoms include:\n\n- Shortness of breath\n- Nausea, vomiting\n- Sweating or cold sweats\n- Paleness\n- Weakness, dizziness, loss of consciousness\n- Intense anxiety or fear of death\n\nThe symptoms of a heart attack vary from person to person. Heart attacks don't always cause tightness and pain in the chest. For example, chest tightness is less common in women, older people, and people with [diabetes](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2486\/) or [heart failure](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2635\/). They are more likely to have other symptoms such as shortness of breath, nausea or vomiting.\n\n![Illustration: Possible areas of pain during a heart attack](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/bin\/anzeichen_herzinfarkt_enjpg.jpg)\n\nPossible areas of pain during a heart attack\n\n[Go to:](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/ \"Go to other sections in this page\")\n\n## Suspected heart attack? Call an ambulance\\!\nHeart attacks are a medical emergency! Every minute counts. Life-saving measures should be started as soon as possible in order to limit damage. It is important to call the emergency services immediately (**112 in Germany** and many other countries, **911 in the U.S.**) if you suspect someone might be having a heart attack. If signs of a heart attack occur at night, do NOT wait until the next morning to do something about it.\n\n[Go to:](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/ \"Go to other sections in this page\")\n\n## How can other people help?\nWhile waiting for the ambulance to arrive, people who are with the patient can\n\n- try to calm them,\n- put them in a comfortable lying position, with their upper body slightly raised,\n- loosen tight clothing,\n- open a window to let in fresh air and,\n- if they have medication for stable angina, such as nitrates, give them that.\n\nIf the person passes out, they stop breathing and their heartbeat stops, they will need [CPR (resuscitation)](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i3105\/) as a first aid measure. If several people are there and there's an \"[external defibrillator (AED)](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i3103\/),\" it should be used.\n\n[Go to:](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/ \"Go to other sections in this page\")\n\n## Known CAD: Temporary symptoms or emergency?\nIt can be difficult for people who have CAD to tell the difference between temporary symptoms, a short-term worsening and an emergency. It is likely to be an emergency if the symptoms\n\n- also occur at rest,\n- don't go away when you rest after physical strain such as climbing the stairs,\n- don't go away even after taking emergency medication (such as nitrate sprays),\n- last for longer than a couple of minutes, or\n- there are also other signs of a heart attack.\n\nEven if you aren't sure: Do NOT wait. Call the emergency services straight away\\!\n\n[Go to:](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/ \"Go to other sections in this page\")\n\n## Sources\n- Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). [Nationale Versorgungsleitlinie Chronische KHK](https:\/\/www.leitlinien.de\/themen\/khk\/pdf\/khk-5aufl-vers1-lang.pdf). Langfassung. AWMF-Registernr.: nvl-004. 2019.\n- Canto JG, Shlipak MG, Rogers WJ et al. [Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain](https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/10866870). JAMA 2000; 283(24): 3223-3229. \\[[PubMed: 10866870](https:\/\/pubmed.ncbi.nlm.nih.gov\/10866870)\\]\n- IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.\n  \n  Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.\n  \n  Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.\n\n- [Possible signs of a heart attack](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_i2170_folgen-7v_possiblesignsofahear_)\n- [Suspected heart attack? Call an ambulance\\!](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_i2170_folgen-7v_suspectedheartattack_)\n- [How can other people help?](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_i2170_folgen-7v_howcanotherpeoplehel_)\n- [Known CAD: Temporary symptoms or emergency?](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_i2170_folgen-7v_knowncadtemporarysym_)\n- [Sources](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_i2170_folgen-7v_gi-sources_9_)\n\n© IQWiG (Institute for Quality and Efficiency in Health Care)\n\nBookshelf ID: NBK355294\n\n[Contents](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/)\n\n[\\< Prev](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2170.behandlung-p5\/ \"Previous page in this title\")[Next \\>](https:\/\/www.ncbi.nlm.nih.gov\/books\/n\/pmh_iqwig\/i2170.folgen-gb\/ \"Next page in this title\")\n\n- Share on Facebook\n- Share on Twitter\n\n### Views\n- [PubReader](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/?report=reader)\n- [Print View](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/?report=printable)\n- [Cite this Page](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#_ncbi_dlg_citbx_NBK355294)\n\n### In this Page\n- [Possible signs of a heart attack](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#i2170.folgen-7v.possiblesignsofahear)\n- [Suspected heart attack? Call an ambulance\\!](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#i2170.folgen-7v.suspectedheartattack)\n- [How can other people help?](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#i2170.folgen-7v.howcanotherpeoplehel)\n- [Known CAD: Temporary symptoms or emergency?](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#i2170.folgen-7v.knowncadtemporarysym)\n- [Sources](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/#i2170.folgen-7v.gi-sources.9)\n\n### Informed Health Links\n- [About](https:\/\/www.informedhealth.org\/informed-health.2169.en.html)\n\n### Related information\n- [PubMed](https:\/\/www.ncbi.nlm.nih.gov\/books\/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=4229942)\n  Links to PubMed\n\n### Recent Activity\n[Clear]()[Turn Off]()[Turn On]()\n\n- [Coronary artery disease: Learn More – Signs of a heart attack - InformedHealth.o...](https:\/\/www.ncbi.nlm.nih.gov\/portal\/utils\/pageresolver.fcgi?recordid=6834a496d9d99c2562677cae)\n  Coronary artery disease: Learn More – Signs of a heart attack - InformedHealth.org\n\nYour browsing activity is empty.\n\nActivity recording is turned off.\n\n[Turn recording back on]()\n\n[See more...](https:\/\/www.ncbi.nlm.nih.gov\/sites\/myncbi\/recentactivity)\n\nFollow NCBI\n\n[Connect with NLM](https:\/\/www.nlm.nih.gov\/socialmedia\/index.html)\n\nNational Library of Medicine  \n [8600 Rockville Pike  Bethesda, MD 20894](https:\/\/www.google.com\/maps\/place\/8600+Rockville+Pike,+Bethesda,+MD+20894\/@38.9959508,-77.101021,17z\/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323)\n\n[Web Policies](https:\/\/www.nlm.nih.gov\/web_policies.html)  \n [FOIA](https:\/\/www.nih.gov\/institutes-nih\/nih-office-director\/office-communications-public-liaison\/freedom-information-act-office)  \n [HHS Vulnerability Disclosure](https:\/\/www.hhs.gov\/vulnerability-disclosure-policy\/index.html)\n\n[Help](https:\/\/support.nlm.nih.gov\/?pagename=bookshelf%3Abooks%3Abook-part%3A%2FNBK355294%2F)  \n [Accessibility](https:\/\/www.nlm.nih.gov\/accessibility.html)  \n [Careers](https:\/\/www.nlm.nih.gov\/careers\/careers.html)\n\n- [NLM](https:\/\/www.nlm.nih.gov\/)\n- [NIH](https:\/\/www.nih.gov\/)\n- [HHS](https:\/\/www.hhs.gov\/)\n- [USA.gov](https:\/\/www.usa.gov\/)\n\n[Preferences](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/)[Turn off](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK355294\/)\n\nExternal link. 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Meta Title	Coronary artery disease: Learn More – Signs of a heart attack - InformedHealth.org - NCBI Bookshelf
Meta Description	The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.).
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Boilerpipe Text	The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.). Sometimes, people have a heart attack that is caused by coronary artery disease (CAD) that they already knew about. But heart attacks can happen without any previous symptoms, too. Some people think that heart attacks are a lot more common in men. That isn’t true, though. But women tend to be older when they have heart attacks. More women die of a heart attack than of breast cancer , for example. Possible signs of a heart attack The typical signs of a heart attack are: A strong feeling of tightness or pressure in the chest A stabbing, burning or heavy pain behind the breastbone Pain that spreads to the left or right arm, the back, neck or upper abdomen (belly) as well Pain or numbness in the upper body that may spread to the shoulder blades, the front or back of the neck, and the jaw The symptoms often start suddenly, but can also be more gradual. The pain lasts for more than five minutes and doesn’t get better when the person rests. Other possible symptoms include: Weakness, dizziness, loss of consciousness Intense anxiety or fear of death The symptoms of a heart attack vary from person to person. Heart attacks don't always cause tightness and pain in the chest. For example, chest tightness is less common in women, older people, and people with diabetes or heart failure . They are more likely to have other symptoms such as shortness of breath, nausea or vomiting. Possible areas of pain during a heart attack Suspected heart attack? Call an ambulance! Heart attacks are a medical emergency! Every minute counts. Life-saving measures should be started as soon as possible in order to limit damage. It is important to call the emergency services immediately ( 112 in Germany and many other countries, 911 in the U.S. ) if you suspect someone might be having a heart attack. If signs of a heart attack occur at night, do NOT wait until the next morning to do something about it. How can other people help? While waiting for the ambulance to arrive, people who are with the patient can put them in a comfortable lying position, with their upper body slightly raised, open a window to let in fresh air and, if they have medication for stable angina, such as nitrates, give them that. If the person passes out, they stop breathing and their heartbeat stops, they will need CPR (resuscitation) as a first aid measure. If several people are there and there's an " external defibrillator (AED) ," it should be used. Known CAD: Temporary symptoms or emergency? It can be difficult for people who have CAD to tell the difference between temporary symptoms, a short-term worsening and an emergency. It is likely to be an emergency if the symptoms don't go away when you rest after physical strain such as climbing the stairs, don't go away even after taking emergency medication (such as nitrate sprays), last for longer than a couple of minutes, or there are also other signs of a heart attack. Even if you aren't sure: Do NOT wait. Call the emergency services straight away! Sources Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale Versorgungsleitlinie Chronische KHK . Langfassung. AWMF-Registernr.: nvl-004. 2019. IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services. Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations. Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.
Markdown	Warning: The NCBI web site requires JavaScript to function. [more...](https://www.ncbi.nlm.nih.gov/guide/browsers/#enablejs "Learn how to enable JavaScript") ![U.S. flag](https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png) An official website of the United States government Here's how you know ![Dot gov](https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg) The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. ![Https](https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg) The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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A service of the National Library of Medicine, National Institutes of Health. InformedHealth.org \[Internet\]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. [![Cover of InformedHealth.org](https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pmh_iqwig-lrg.png)](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/ "Table of Contents Page") ## InformedHealth.org \[Internet\]. [Show details](https://www.ncbi.nlm.nih.gov/books/NBK355294/#__NBK355294_dtls__) Cologne, Germany: [Institute for Quality and Efficiency in Health Care (IQWiG)](https://www.informedhealth.org/); 2006-. - [Contents](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/) [\< Prev](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2170.behandlung-p5/ "Previous page in this title")[Next \>](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2170.folgen-gb/ "Next page in this title") # Coronary artery disease: Learn More – Signs of a heart attack Last Update: February 18, 2022; Next update: 2025. The most common signs of a heart attack are severe chest tightness and shortness of breath. But there may be other symptoms as well. A heart attack is a medical emergency. If you think someone might be having a heart attack, it is very important to call the emergency services right away (112 in Germany and many other countries, 911 in the U.S.). Sometimes, people have a heart attack that is caused by coronary artery disease (CAD) that they already knew about. But heart attacks can happen without any previous symptoms, too. Some people think that heart attacks are a lot more common in men. That isn’t true, though. But women tend to be older when they have heart attacks. More women die of a heart attack than of [breast cancer](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2276/), for example. [Go to:](https://www.ncbi.nlm.nih.gov/books/NBK355294/ "Go to other sections in this page") ## Possible signs of a heart attack The typical signs of a heart attack are: - A strong feeling of tightness or pressure in the chest - A stabbing, burning or heavy pain behind the breastbone - Pain that spreads to the left or right arm, the back, neck or upper abdomen (belly) as well - Pain or numbness in the upper body that may spread to the shoulder blades, the front or back of the neck, and the jaw The symptoms often start suddenly, but can also be more gradual. The pain lasts for more than five minutes and doesn’t get better when the person rests. Other possible symptoms include: - Shortness of breath - Nausea, vomiting - Sweating or cold sweats - Paleness - Weakness, dizziness, loss of consciousness - Intense anxiety or fear of death The symptoms of a heart attack vary from person to person. Heart attacks don't always cause tightness and pain in the chest. For example, chest tightness is less common in women, older people, and people with [diabetes](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2486/) or [heart failure](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2635/). They are more likely to have other symptoms such as shortness of breath, nausea or vomiting. ![Illustration: Possible areas of pain during a heart attack](https://www.ncbi.nlm.nih.gov/books/NBK355294/bin/anzeichen_herzinfarkt_enjpg.jpg) Possible areas of pain during a heart attack [Go to:](https://www.ncbi.nlm.nih.gov/books/NBK355294/ "Go to other sections in this page") ## Suspected heart attack? Call an ambulance\! Heart attacks are a medical emergency! Every minute counts. Life-saving measures should be started as soon as possible in order to limit damage. It is important to call the emergency services immediately (112 in Germany and many other countries, 911 in the U.S.) if you suspect someone might be having a heart attack. If signs of a heart attack occur at night, do NOT wait until the next morning to do something about it. [Go to:](https://www.ncbi.nlm.nih.gov/books/NBK355294/ "Go to other sections in this page") ## How can other people help? While waiting for the ambulance to arrive, people who are with the patient can - try to calm them, - put them in a comfortable lying position, with their upper body slightly raised, - loosen tight clothing, - open a window to let in fresh air and, - if they have medication for stable angina, such as nitrates, give them that. If the person passes out, they stop breathing and their heartbeat stops, they will need [CPR (resuscitation)](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i3105/) as a first aid measure. If several people are there and there's an "[external defibrillator (AED)](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i3103/)," it should be used. [Go to:](https://www.ncbi.nlm.nih.gov/books/NBK355294/ "Go to other sections in this page") ## Known CAD: Temporary symptoms or emergency? It can be difficult for people who have CAD to tell the difference between temporary symptoms, a short-term worsening and an emergency. It is likely to be an emergency if the symptoms - also occur at rest, - don't go away when you rest after physical strain such as climbing the stairs, - don't go away even after taking emergency medication (such as nitrate sprays), - last for longer than a couple of minutes, or - there are also other signs of a heart attack. Even if you aren't sure: Do NOT wait. Call the emergency services straight away\! [Go to:](https://www.ncbi.nlm.nih.gov/books/NBK355294/ "Go to other sections in this page") ## Sources - Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). [Nationale Versorgungsleitlinie Chronische KHK](https://www.leitlinien.de/themen/khk/pdf/khk-5aufl-vers1-lang.pdf). Langfassung. AWMF-Registernr.: nvl-004. 2019. - Canto JG, Shlipak MG, Rogers WJ et al. [Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain](https://www.ncbi.nlm.nih.gov/pubmed/10866870). JAMA 2000; 283(24): 3223-3229. \[[PubMed: 10866870](https://pubmed.ncbi.nlm.nih.gov/10866870)\] - IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services. Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations. Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods. - [Possible signs of a heart attack](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_i2170_folgen-7v_possiblesignsofahear_) - [Suspected heart attack? Call an ambulance\!](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_i2170_folgen-7v_suspectedheartattack_) - [How can other people help?](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_i2170_folgen-7v_howcanotherpeoplehel_) - [Known CAD: Temporary symptoms or emergency?](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_i2170_folgen-7v_knowncadtemporarysym_) - [Sources](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_i2170_folgen-7v_gi-sources_9_) © IQWiG (Institute for Quality and Efficiency in Health Care) Bookshelf ID: NBK355294 [Contents](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/) [\< Prev](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2170.behandlung-p5/ "Previous page in this title")[Next \>](https://www.ncbi.nlm.nih.gov/books/n/pmh_iqwig/i2170.folgen-gb/ "Next page in this title") - Share on Facebook - Share on Twitter ### Views - [PubReader](https://www.ncbi.nlm.nih.gov/books/NBK355294/?report=reader) - [Print View](https://www.ncbi.nlm.nih.gov/books/NBK355294/?report=printable) - [Cite this Page](https://www.ncbi.nlm.nih.gov/books/NBK355294/#_ncbi_dlg_citbx_NBK355294) ### In this Page - [Possible signs of a heart attack](https://www.ncbi.nlm.nih.gov/books/NBK355294/#i2170.folgen-7v.possiblesignsofahear) - [Suspected heart attack? 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