Heart Attack Warning Signs: Symptoms, What to Do & Why Every Minute Counts

Heart disease is the leading cause of death in the Philippines. Many heart attacks can be treated successfully if the patient reaches a hospital quickly. The problem is that many people wait for hours at home, hoping the pain will pass. This guide explains the warning signs, what to do right away, and what happens at the hospital.

What Is a Heart Attack?

A heart attack (myocardial infarction) happens when one of the arteries that supply blood to the heart becomes blocked, usually by a blood clot that forms on a fatty plaque. Without blood, part of the heart muscle starts to die. The longer the artery stays blocked, the more heart muscle is lost. That is why doctors say "time is muscle".

Typical Warning Signs

• Chest pain or discomfort: pressure, tightness, squeezing, or heaviness in the center of the chest, lasting more than a few minutes or coming and going
• Pain that spreads to one or both arms (often the left), the neck, jaw, back, or upper stomach
• Shortness of breath, with or without chest pain
• Cold sweat, paleness, or clammy skin
• Nausea or vomiting
• Lightheadedness, sudden weakness, or fainting

The pain does not have to be severe. Many patients describe it as "heavy" or "like something is sitting on my chest" rather than sharp pain.

Symptoms Can Be Different in Women, Seniors & People with Diabetes

Not everyone has the classic chest pain. Women, older adults, and people with diabetes are more likely to have less typical symptoms, such as:

• Unusual tiredness or weakness for no clear reason
• Shortness of breath without chest pain
• Pain in the upper back, jaw, or stomach that feels like hyperacidity
• Nausea, dizziness, or a general feeling that something is very wrong

Because these symptoms are easy to mistake for acid reflux, stress, or exhaustion, many people delay getting help. If you are in a higher-risk group and these symptoms come on suddenly, treat them as a possible emergency.

What to Do Right Away

1. Stop what you are doing and sit or lie down.
2. Call 911 (the national emergency hotline) or your local emergency number, or have someone bring you to the nearest hospital with an emergency room right away.
3. Do not drive yourself. If an ambulance is not available, ask a family member or neighbor to bring you.
4. Do not wait to see if the pain goes away, and do not wait until morning.
5. Do not take medicine on your own unless a doctor or emergency responder tells you to. Aspirin is sometimes advised, but it is not safe for everyone (for example, people with bleeding problems or allergies).
6. If the person becomes unconscious and is not breathing normally, start CPR if you know how, and ask someone to look for an AED (defibrillator), which many malls and offices now have.

If possible, bring a list of the patient's maintenance medicines and any recent lab results or ECGs to the hospital.

What Happens at the Hospital

In the emergency room, the team will usually do an ECG (electrocardiogram) within minutes and take blood for troponin, a marker of heart muscle damage. Depending on the results, treatment may include:

• Medicines that thin the blood, prevent clots, and reduce the strain on the heart
• Angioplasty (PCI): a cardiologist opens the blocked artery through a thin tube inserted in the wrist or groin, often placing a stent. This is done in a cath lab.
• Clot-dissolving medicine (thrombolysis) when a cath lab is not quickly available

Not every hospital has a cath lab. In an emergency, go to the nearest hospital anyway: the ER team can stabilize you and arrange a transfer if needed. If you have heart disease or several risk factors, it is worth knowing in advance which hospitals near you have a cath lab.

Who Is at Higher Risk?

• High blood pressure
• Diabetes
• High cholesterol
• Smoking or vaping
• Being overweight and not getting enough physical activity
• A family history of early heart disease (a father or brother before 55, a mother or sister before 65)
• Chronic kidney disease
• Older age, especially men over 45 and women after menopause

The Holiday Season and Your Heart

Doctors often see more heart emergencies during the holidays. Heavy, salty meals, more alcohol, missed maintenance medicines, less sleep, and delaying a hospital visit "until after the holidays" all add up. If you have hypertension or diabetes, keep taking your medicines on schedule and read our holiday health guide.

Reducing Your Risk

• Check your blood pressure, blood sugar, and cholesterol regularly, for example during your annual physical exam
• Take your maintenance medicines as prescribed, even when you feel fine
• Stop smoking. Your risk starts to drop soon after you quit.
• Move more: aim for at least 150 minutes of moderate activity a week, such as brisk walking
• Eat more vegetables, fish, and fruit, and less salty, fried, and processed food

When to See a Cardiologist

Outside of an emergency, see a doctor or cardiologist if you have chest discomfort when walking or climbing stairs that goes away with rest, unexplained shortness of breath, palpitations, swelling of the legs, or several risk factors. A cardiologist may order an ECG, a 2D echo, or a stress test. Read more in signs you should see a cardiologist, and learn the warning signs of stroke, which often share the same risk factors.

Find a cardiologist near you on MyDoktor.ph, or browse doctors by city.

This article is for general information and does not replace advice from your doctor. If you think you or someone else is having a heart attack, call 911 or go to the nearest emergency room immediately.