A heart attack occurs after a sudden blockage of oxygen-rich blood coming into the heart, causing pain in the middle of the chest, the left side, or other parts of the upper body.

According to the Centers for Disease Control and Prevention (CDC), one person in the United States experiences a heart attack every 40 seconds. Learning to spot and recognize signs of a heart attack, including where in the body people feel the pain of a heart attack, can help those in need seek treatment as quickly as possible.

This article will explain where heart attack pain begins in the body and when to contact a doctor. It will also detail causes, treatment, and overall risk factors.

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Illustration by Wenzdai Figueroa

Heart attack pain can happen in the center or left of the chest. People experiencing heart attack pain often notice that it lasts for several minutes. Sometimes, the pain gets better and then comes back. It may feel like squeezing, intense pressure, or fullness.

Pain due to a heart attack can also occur in:

  • one arm
  • both arms
  • the back
  • the neck
  • the jaw
  • the stomach

According to the National Heart, Lung, and Blood Institute (NHLBI), women are more likely to experience pain in the arms, back, and shoulders. These might not happen alongside chest pain.

Heart attacks do not always cause pain or other symptoms. About 1 in 5 heart attacks are silent heart attacks, meaning they can cause damage without a heart attack’s trademark pain.

What is a heart attack?

Some arteries bring oxygen to part of the heart to keep the muscle alive. However, a range of health conditions can mean that these arteries become blocked, and the oxygen no longer reaches the heart. This is a heart attack, or myocardial infarction.

Read more about heart attacks here.

Heart attacks are life threatening and require immediate medical treatment. People who notice pain in the areas mentioned above should call 911 immediately.

The Heart Failure Society of America uses the FACES acronym to look for the following early signs of heart failure alongside pain in the aforementioned places.

Spotting the early signs of heart failure with FACES

  • F for fatigue
  • A for activities limited
  • C for chest congestion
  • E for edema or ankle swelling
  • S for shortness of breath
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Heart attacks can happen due to coronary artery disease (CAD), which is the most common heart disease in the United States. This happens when not enough oxygen-filled blood can reach the heart, usually due to the buildup of a waxy substance called plaque along the walls of the blood vessels. This buildup is atherosclerosis and can take many years to develop.

Plaque can break open in the part of the artery, leading to a blood clot. This can, in turn, block the blood flow to the heart, leading to a heart attack.

Other causes of a heart attack can include:

  • stimulants such as cocaine causing coronary arteries to narrow
  • lack of oxygen in the blood, known as hypoxia
  • smoking increases the risk of blood clots, alongside other chemicals in cigarette smoke damaging the lining of coronary arteries
  • high blood pressure
  • high cholesterol

Several lifestyle factors increase a person’s risk for CAD and a heart attack, including:

  • a high sodium diet
  • a diet high in saturated fats
  • smoking
  • a sedentary lifestyle

Several medical conditions that fall under the umbrella of metabolic syndrome can increase heart disease risk, such as:

  • high cholesterol
  • consistently raised blood sugar
  • high blood pressure
  • high levels of triglycerides in the blood
  • overweight
  • obesity

It is possible to manage these conditions to reduce heart attack risk. However, other factors such as age, family history, and bacterial and viral infections can also play a role in heart attacks.

Heart attack treatments aim to remove the blockage and restore blood flow to the heart.

This often involves:

  • Thrombolysis: A doctor administers drugs that dissolve blood clots.
  • Balloon angioplasty: A doctor inserts a tiny inflatable balloon into a blood vessel through a tube called a catheter and then inflates it to open a blocked artery.
  • Stent procedure: Doctors may add a stent, which is a wire mesh tube that props open an artery during angioplasty.
  • Surgery: This might include revascularization, or a coronary bypass, which helps restore blood flow to the heart. Severe heart attacks might lead to a heart transplant, in which a surgeon replaces the damaged heart with a donated heart. A heart surgeon might replace damaged, faulty, or diseased valves with an artificial, functioning valve.

A doctor may choose to perform one or several of these treatments depending on the type and cause of the heart attack.

Heart disease is the leading cause of death in the United States, and many types of heart disease can cause heart attacks.

With treatment, many people have full, active lives after having a heart attack. However, about 1 in 5 people 45 years and older who have a heart attack will have another within 5 years of the first.

There are steps people can take to reduce their risk of experiencing another heart attack, such as taking certain medications, managing risk factors, and making some lifestyle adjustments.

Heart attacks can cause serious harm and concern, but people can take steps to prevent them. These can even reduce the risk of a heart attack in those who already live with CAD.

Some forms of prevention include those listed below.

Eating a heart-healthy diet

A diet that is good for the heart can include:

  • cutting down on high fat meats
  • cutting down on dairy
  • choosing low sodium foods
  • increasing fiber intake
  • increasing fresh fruit, vegetables, whole grain alternatives, lean meats, and legumes
  • substituting high saturated fats for less saturated fats such as vegetable oils

Quitting smoking

Smoking affects the entire body and can damage the heart and blood vessels, increasing the risk of a heart attack.

Engaging in regular exercise

Getting the heart used to working harder can help protect it against heart disease. The current Physical Guidelines for Americans suggest 150 minutes of moderate intensity exercise a week, plus 2 days a week of physical activity, such as lifting weights to strengthen muscles.

Reducing stress

A prolonged state of stress can increase the risk of heart disease. However, managing stress has links to better blood pressure and blood sugar management, lower cholesterol, and reduced inflammation — all of which make a heart attack less likely.

Some stress-reducing activities include:

  • getting regular exercise
  • spending time with people who make you feel good, such as friends or family
  • sleeping 7—9 hours every night
  • practicing deep breathing and relaxation
  • listening to relaxing music
  • finding a hobby that boosts your mood

Read more about how to improve heart health here.

Cardiac rehabilitation can help people recover from a heart attack. This can help an individual relieve heart attack pain and other symptoms, regain physical strength, and develop better habits for heart health. Counseling can also help people who have experienced a heart attack relieve stress.

The process can take 2–8 months, but it usually lasts around 3 months.

One of the first signs of a heart attack is pain in the center or the left side of the chest, as well as in either arm, both arms, the back, neck, jaw, or stomach. Heart attacks happen due to an artery blockage, but they often develop over many years due to CAD.

A heart attack requires emergency treatment, which can take the form of clot-busting medications, angioplasty, or more invasive surgery. Recovery can take between 2 and 8 months.

It is important to live a heart-healthy lifestyle, including a balanced, nutritious diet, plenty of regular exercise, and ways to manage stress. This can help people prevent heart attacks.