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Pain beyond the chest, fatigue or dizziness, nausea or indigestion, cold sweats and anxiety are five lesser-known red flags of a heart attack that you should not ignore
Heart attacks can often be missed as the signs vary in both men and women. While men have the ‘classic’ chest pain, women could experience fatigue, nausea, or back pain. (Getty Images)
When most of us picture a heart attack, we imagine a dramatic scene—someone clutching their chest in sudden, crushing pain. But in reality, many heart attacks start quietly, with symptoms that are vague, confusing, or dismissed as minor discomfort. Cardiologists warn that this is why countless patients arrive at hospitals too late for the most effective treatment.
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In India, over 2 million people die of cardiovascular disease annually; recognising these early warning signs could be the difference between life and death. With sedentary lifestyles, high rates of diabetes, and rising stress levels, Indians are at particular risk. And while chest pain is still the most common symptom, it is far from the only one.
Based on some recent research and reports, here are five lesser-known red flags of a heart attack that you should never ignore.
- Radiating Pain Beyond The Chest
Chest discomfort remains a primary warning sign, but in many cases the pain does not stay in the chest. It can spread to the jaw, neck, shoulders, back, arms, or even the upper abdomen. Some people describe it as a dull ache, others as pressure, heaviness, or burning.
Why it matters: These radiating pains occur because the nerves around the heart share pathways with other parts of the body. The brain sometimes misinterprets the source of pain, which is why someone having a heart attack may complain only of jaw ache or shoulder stiffness.
In India, where back pain and acidity are common complaints, this symptom is often brushed aside. If the pain comes suddenly, worsens with exertion, or feels unusual, it should be treated as an emergency.
- Fatigue, Breathlessness, or Dizziness
Women, in particular, often report unexplained exhaustion or breathlessness in the days or weeks before a heart attack. Light-headedness or sudden dizziness is another overlooked clue.
Why it matters: These symptoms suggest that the heart is struggling to pump blood efficiently. The body responds with fatigue and shortness of breath, even during mild activities such as climbing stairs or walking short distances.
A homemaker feeling too exhausted to complete routine chores, or an older adult finding it unusually hard to walk to the market, may not connect these changes to their heart. But cardiologists warn that ignoring these cues is dangerous.
- Indigestion, Nausea, or Acidity
In India, where digestive complaints are common, this is one of the most misdiagnosed signs. Heartburn, bloating, nausea, or vomiting can all be early symptoms of a heart attack.
Why it matters: Reduced blood flow to the heart sometimes manifests as gastrointestinal discomfort. Patients often mistake it for spicy food or gas trouble. But if the indigestion is new, persistent, or paired with other signs like sweating or fatigue, it could signal something far more serious.
Doctors stress that recurring “acidity” that does not respond to antacids should never be ignored, particularly in people over 40 with risk factors such as diabetes, high cholesterol, or hypertension.
- Cold Sweats Or Clammy Skin
Breaking into a cold sweat without exertion is another red flag. Patients often describe it as a sudden, sticky, clammy feeling, sometimes accompanied by paleness or chills.
Why it matters: This reaction is triggered by the nervous system, which senses distress when blood flow to the heart is blocked. The body goes into survival mode, producing sweat as it tries to cope with the crisis.
It is easy to dismiss this as weather-related or a sign of stress. But unexplained sweating—especially when combined with dizziness or chest discomfort—should always be taken seriously.
- A Sense Of Dread Or Anxiety
Perhaps the most surprising sign is psychological rather than physical: a sudden, overwhelming feeling that “something is terribly wrong.” Patients describe it as a sense of doom or intense unease.
Why it matters: This is not just panic—it can be the brain responding to reduced oxygen supply. Many people later report that they felt anxious, restless, or fearful just before their heart attack began.
While it is natural to link such feelings to stress or anxiety disorders, experts warn that if this sensation is accompanied by physical symptoms like jaw pain, sweating, or nausea, it must not be ignored.
Why Heart Attacks Are Often Missed
One of the greatest challenges is that these symptoms vary widely between men and women. Men are more likely to experience the “classic” chest pain, while women often present with fatigue, nausea, or back pain. Older adults and diabetics may have very mild symptoms—or none at all.
So-called “silent heart attacks” are particularly dangerous. Nearly one in five heart attacks may occur without noticeable chest pain, only to be discovered later through scans or ECG.
How To Reduce The Risk Of A Heart Attack
Ditch the ghee-laden parathas for heart-friendly foods. Instead, opt for whole grains like brown rice or millets, and load up on vegetables such as spinach, carrots, and beetroot. Fatty fish like mackerel, rich in omega-3s, can lower cholesterol. Cut salt to curb blood pressure; India’s average intake (10g/day) doubles the limit prescribed by the World Health Organization (WHO). Try fermented foods like idli or labneh, packed with probiotics that support heart health.
A brisk 30-minute walk daily can cut heart attack risk by 30%. Yoga, like Surya Namaskar, boosts circulation and reduces stress. Aim for 150 minutes of moderate exercise weekly. Even climbing stairs counts in our busy lives.
Smoking, including bidis, is a heart attack trigger—India’s 100 million smokers face double the risk. Quit now; try nicotine patches or apps for support. Keep alcohol to one drink daily for women, two for men—excess harms arteries.
Chronic stress from deadlines or traffic jams spikes cortisol, straining your heart. Practice meditation or deep breathing for 10 minutes daily. Maintain a healthy weight; India’s obesity rates have doubled since 2010. Even a 5% weight loss can lower blood pressure and cholesterol.
High blood pressure (above 120/80 mmHg) and LDL cholesterol (over 70 mg/dL) are silent threats. Maintain your blood pressure and cholesterol. Regular check-ups can catch the issues early. If prescribed, take statins or beta-blockers diligently—studies show they cut heart attack risk by 25%.
Jaw pain, nausea, or back pain can signal a heart attack, especially in women. Seek emergency help if symptoms last. With these steps, you can keep your heart ticking strong in a fast-paced world.
About the Author
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev…Read More
Shilpy Bisht, Deputy News Editor at News18, writes and edits national, world and business stories. She started off as a print journalist, and then transitioned to online, in her 12 years of experience. Her prev… Read More
September 05, 2025, 10:44 IST
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