Still, that’s not to say that heart attacks occur out of the blue without any warning. While they can strike without symptoms, that scenario is way less common than you think.
“Most patients do have symptoms prior to their heart attacks,” says James Park, M.D., FACC, director of the Heart and Vascular Program at Texas Health Dallas. “It’s just that sometimes, men will ignore the symptoms or chalk it up to some other malady.” (Here’s what a heart attack really feels like, according to six real guys who had one).
Think about it: If you felt crushing pain in your chest, chances are, yeah, you’ll probably get it checked out. But if the signs are more subtle? That’s when many guys tend to put off looping in a doctor.
You don’t want to be one of them. Taking unusual symptoms seriously can help you catch a heart attack before it happens—and even save your life. Here are six unexpected ones to watch for, plus what you should do if you have them.
Extreme fatigue is a known, telltale sign of an impending heart attack for women. And though studies can’t say for sure whether the same is true for men, you should pay attention if your usual routine suddenly seems unusually hard—or you’re too worn out to do your normal tasks altogether, says Robert Segal, M.D., FAAC, founder of Manhattan Cardiology.
Feeling extra tired can signal weakness of the left ventricle of your heart, the main muscle responsible for pumping blood from the heart to the rest of the body, Dr. Segal says. If it stops working, the heart isn’t able to pump properly, which can result in a heart attack.
And if the left ventricle isn’t pumping as strongly as should be, your heart might not be able to circulate enough blood throughout your body, or to fill up properly with fresh blood in between heartbeats. The result? Exhaustion—even after you sleep, since your tissues aren’t getting enough fresh, oxygenated blood.
Erections occur when more blood flows into your penis, making it firm and hard. But if those blood vessels are damaged, blood flows less freely, meaning you’re less likely to get an erection, or maintain an erection, when you’re aroused. That’s a main cause of erectile dysfunction.
Problem is, your blood vessels down there are damaged, there’s a good chance the ones near your heart could be damaged as well, Dr. Segal explains.
A major cause of this blood vessel damage is plaque buildup. When that occurs in the vessels to your heart, you could be at risk of a heart attack, he says.
Having a one-time performance problem probably isn’t a big deal—it could just mean you’re tired or stressed. But if the issue persists after a few sessions in the sack, it could be a sign of something more serious.
A cramping or burning sensation in your calves that slowly moves up to your thighs and hips could be bad news. It’s a common sign of peripheral artery disease—a narrowing of the arteries that limits blood flow to your limbs, stomach, and head.
That discomfort is caused by less blood flowing through your legs. “Most patients will admit to not being able to walk normal distances without symptoms, or having to stop to rest before they can walk again without symptoms,” Dr. Park says.
But your extremities aren’t your only parts at risk. PAD is similar to coronary artery disease, where plaque builds up around the heart’s major blood vessels. So the plaque buildup that contributes to the narrowing of your arteries in your limbs may also be occurring in arteries by your heart, too, the Mayo Clinic says.
And that buildup can significantly up your risk for a heart attack, says Dr. Park.
Snoring like a buzz saw, waking up gasping for air, or feeling tired during the day despite going to bed at a reasonable time could all be signs that you have sleep apnea, a sleep disorder marked by pauses in breathing. And if left untreated, it could increase your chance for a heart attack.
All of those pauses in breathing can seriously stress your body, raising your blood pressure, causing your heart to beat irregularly, and upping the risk for heart disease, Dr. Segal says. And all of those things can make a heart attack more likely.
Sometimes nausea, indigestion, or a “burping” feeling that won’t go away is just a sign of a stomach bug. But it can also signal a problem with your heart.
“The nervous system sometimes confuses signals coming from various parts of the body,” says Dr. Park. The nerves in your gastrointestinal tract are closely intertwined with the nerves from the heart. As a result, a problem that could be brewing in your heart can sometimes translate as stomach discomfort, he explains.
There’s a way to tell a stomach bug from something more serious, though. Usually, though, nausea caused by an impending heart attack will get worse with physical exertion and ease up when you rest.
Findings show that women with anxiety are more likely to have reduced blood flow to the heart compared to those without anxiety. And though the same hasn’t been shown for men, it’s still important for guys to consider the relationship between anxiety and heart attack risk, Dr. Segal says.
That’s because many symptoms of anxiety—like chest pain, shortness of breath, and heart palpitations—are also signs of a heart attack, especially if you’re not in the middle of dealing with a stressful situation that might normally cause these kinds of symptoms.
“This can potentially mask heart problems in many patients and lead to significant delays in diagnosis and treatment,” explains Dr. Segal. In other words, you’re probably not going call 911 if you think your racing heart is just a mood thing.
Anxiety can put extra strain on your heart too. That’s because feeling tense causes your blood vessels to constrict and speeds up your heart rate, which could both trigger a heart attack, says Dr. Segal.
Unlike the classic crushing chest pain, these symptoms don’t guarantee that your heart is in immediate danger. But they could indicate that trouble could be brewing down the road, so make an appointment to see your doctor as soon as you can.
“If you’re fortunate enough to have symptoms, listen to your body and get them checked out,” Dr. Park says.
If your doctor suspects that a heart attack could be looming, he might recommend an EKG, a test measures the heart’s electrical activity and shows if your heart is damaged. He might also call for a coronary angiogram, which detects blockages in your arteries.
And if you experience any classic symptoms that signal you’re having a heart attack right now, call 911 ASAP. These include chest pressure or tightness, shortness of breath, lightheadedness, breaking out into a cold sweat, or discomfort in the arms, neck, or jaw.