When is chest pain a heart attack

Chest pain can be frightening, and for good reason — it’s one of the main warning signs of a heart attack (myocardial infarction). But not every ache in the chest means you’re having one. Understanding how to tell the difference and what to do if you suspect it’s your heart, could save your life or someone else’s.

Symptoms

There are a number of symptoms associated with having a heart attack.

Chest-related symptoms

These are the most common warning signs.

Pressure, squeezing, tightness, or fullness in the centre or left side of the chest
Burning, aching, or heavy sensation that may feel like heartburn or indigestion
Pain that comes and goes or persists for more than a few minutes
Feeling of weight or constriction, as if “something heavy is sitting on the chest”
Pain that increases with exertion or stress and does not ease with rest
Discomfort that may wake you from sleep or occur at rest
No chest pain at all (in some people — especially women, older adults, and those with diabetes)

Pain or discomfort in other areas

Heart attack pain often radiates or spreads beyond the chest.

Left arm or shoulder pain, sometimes radiating down to the wrist or fingers
Right arm or both arms aching or heaviness
Neck pain or a choking or constricted feeling in the throat
Jaw pain (especially lower jaw), sometimes mistaken for a dental problem
Back pain, particularly between the shoulder blades or in the upper back
Upper abdominal pain that may mimic indigestion or reflux
Pain in the left side of the body including the shoulder, elbow, or back
Tightness or pressure in the upper chest, collarbone area, or shoulders

Breathing and respiratory symptoms

Shortness of breath is one of the most important accompanying signs.

Shortness of breath at rest or with mild activity
Difficulty taking a deep breath or feeling like you “can’t get enough air”
Rapid, shallow breathing
Breathing discomfort that worsens when lying flat (orthopnoea)
Worsening breathlessness at night, sometimes waking you up
Wheezing or coughing without another explanation

General physical symptoms

These often appear together with chest pain but can also occur alone.

Cold, clammy sweating (diaphoresis)
Nausea or vomiting, sometimes with upper abdominal pain
Indigestion or heartburn-like sensation that doesn’t respond to antacids
Paleness or greyish skin tone
Sudden fatigue or weakness, especially in women
Dizziness or light-headedness
Fainting or feeling about to pass out
Rapid or irregular heartbeat (palpitations)
Low blood pressure, causing weakness or confusion

Nervous system and emotional symptoms

Heart attacks can also trigger stress-related or nervous-system symptoms.

Anxiety or panic, often described as a sense of impending doom
Restlessness or agitation
Feeling detached or confused
Sweaty, cold hands and feet
Shakiness or trembling

Symptoms more common in women

Women often have subtler or “non-classic” signs, which can delay diagnosis.

Unusual fatigue that builds over several days or comes on suddenly
Shortness of breath without chest pain
Upper back, jaw, or neck pain rather than central chest pain
Light-headedness or dizziness
Nausea, vomiting, or indigestion
Sleep disturbance or insomnia in the days leading up to the event
Flu-like feelings or sudden weakness

Warning patterns to take seriously

If any of these apply, assume a heart attack until proven otherwise:

Pain or discomfort that lasts more than 5–10 minutes
Pain that spreads to the arm, neck, jaw, or back
Recurrent chest pressure or heaviness that comes with activity or stress
Pain not relieved by rest, position change or antacids
Chest discomfort with sweating, nausea, or shortness of breath
Sudden extreme fatigue without explanation
Episodes of fainting, paleness or collapse

Symptoms more common in older adults and people with diabetes

These groups may have “silent” heart attacks, meaning little or no chest pain.

Mild breathlessness or tiredness that is out of proportion to exertion
Sudden confusion or fainting
Weakness, dizziness, or collapse
Mild chest pressure mistaken for indigestion or muscle pain
Sweating or nausea without obvious reason
New-onset fatigue or sleepiness

When to call for help

Call 000 (Australia) or your local emergency number immediately if:

You experience any of the above symptoms for more than a few minutes
You’re unsure whether it’s heartburn or something serious
You have a known heart condition and symptoms feel worse or different
You have risk factors such as smoking, high blood pressure, diabetes, obesity or family history of heart disease

Heart attacks in women may be different

Women are often misdiagnosed because their heart attack symptoms can differ. Instead of crushing chest pain, they may feel:

Discomfort in the jaw, neck, back or upper stomach
Unusual tiredness or sleep disturbance
Shortness of breath without chest pressure
Light-headedness or nausea

Don’t ignore these symptoms or put them down to stress or “just getting older.” Trust your instincts and get checked.

What to do if you think it’s a heart attack

Call 000 (in Australia) immediately — don’t try to drive yourself.
Stop and rest. Sit upright to ease strain on your heart
Chew one regular-strength aspirin (300 mg) if not allergic or told otherwise (when you call 000) as it helps to thin the blood and may limit damage.
Unlock your front door so help can reach you quickly.
Stay calm and breathe slowly. Panic increases your heart’s workload.
Use prescribed nitroglycerin spray or tablets if you have angina and have been advised to do so.
Do not eat or drink unless told otherwise by emergency staff.

When in doubt — get it checked out

Every minute counts during a heart attack.

Paramedics can start lifesaving treatment on the way to hospital but early intervention can mean the difference between a full recovery and serious damage.

If chest pain lasts more than a few minutes or if it’s accompanied by sweating, shortness of breath or nausea, call 000 immediately.

It’s always better to be safe than sorry.

Other conditions that mimic heart attack symptoms

These other conditions may be the actual cause of your pain but you need to get it checkout by a doctor to be sure. Never self-diagnose. Always call an ambulance on 000 in Australia if you think it’s a heart attack.

Angina (heart-related)

Similar to heart attack pain but usually triggered by exertion or stress
Relieved by rest or nitroglycerin tablet
Temporary (minutes) and predictable

Heartburn or reflux

Burning pain rising from stomach to throat, especially after eating or lying down
May improve with antacids

Muscle or rib pain

Sharp or sore and localised pain
Worse with movement or touching the area
Doesn’t cause sweating or breathlessness

Anxiety or panic attack

Tight chest with rapid heartbeat,
Breathlessness
Tingling in the face
Feeling of fear
Usually occurs during acute stress, resolves as you calm down

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Last reviewed and updated: 10 November 2025