Do Heart Attack Pains Come And Go

A heart attack occurs when there is a lack of blood supply to the heart muscles. This can cause a wide array of symptoms, including chest pain. This pain is usually felt in the centre of the chest, to the left hand side and is described as a crushing pain. It will remain there until the heart regains blood supply, or until painkillers are given.

A heart attack (medically known as a myocardial infarct) will cause lasting pain. Chest pains that come and go are called angina. The mechanism behind the pain is similar in these conditions, and angina is a warning sign that your heart needs some help!

So what is the difference between the two? Well, angina is caused by a temporary lack of blood supply to the heart, whereas in a heart attack the blood supply is lost for longer. Therefore it follows that anginal pain is temporary because the blockage is transient - once the blood is flowing to the heart muscles again the pain resolves. This is not the case with a heart attack as the blockage of blood supply is permanent. 

What is a heart attack

Your heart, like any other muscle, gets its oxygen supply through arteries. These arteries are called coronary arteries. There are various coronary arteries, each supplying different areas of the heart. If these arteries are blocked then the blood supply to that area of muscle is stopped, leading to injury of that muscle. In some cases, that area of muscle may even die! This is called a myocardial infarct or an MI. 

Common causes

There are various risk factors for heart attacks. This can range from lifestyle factors to other medical conditions you may suffer from. Common conditions associated with heart attacks include:

  • Angina - this is when there is intermittent blockage of the coronary arteries. Angina can be either stable (only comes on when you exert yourself) or unstable (comes on at rest)
  • Coronary artery disease- this is when there is a build up of fats, cholesterol and other substances within the coronary arteries (atherosclerosis). This leads to narrowing of the arteries and is a common cause of angina as well as heart attacks
  • Diabetes - people with diabetes can also have associated nerve damage and therefore might not feel the chest pain that is classically associated with heart attacks
  • High blood pressure - over time a high blood pressure can cause damage to the arterial system
  • Obesity 
  • High levels of fats/cholesterol 

Some lifestyle factors include:

  • Diet - diets that are high in fat and cholesterol will lead to an increased risk of heart attack
  • Sedentary lifestyle  
  • Tobacco smoking 
  • Illicit drug use - stimulants (especially cocaine and amphetamines) increase the risk of coronary artery spasms. This means the artery collapses on itself, therefore blocking the blood supply further along the route

Other risk factors to be aware of are ones that you can’t control. It’s important to know about these as it will help medical professionals when it comes to diagnosis and treatment. These non-modifiable factors include:

  • Ethnicity - certain ethnic backgrounds are more prone to heart attacks
  • Age - the risk of heart attacks increase as you age
  • Family history 

Warning signs that you have a heart attack

Warning signs include:

  • Feeling like you’re about to die
  • Shortness of breath
  • Sudden onset of the pain
  • Pain not resolving with rest
  • Palpitations 
  • Losing consciousness

How to diagnose

The first part of any diagnosis is the history alongside the clinical findings. The medical professionals will ask you about the nature of the pain, when it started and if there was any trigger. They will likely listen to your heart sounds and also perform an electrocardiogram (ECG). 

An ECG is a bedside examination in which leads are connected to the chest and limbs in order to trace the electrical activity within the heart. If there is an area of the heart that is damaged, an ECG will usually detect this. 

Having said this, sometimes an ECG is not able to pick up areas of damage for various reasons (e.g. it’s too early for there to be changes present, incorrect placement of leads, posterior part of the heart being affected). Therefore if there is strong suspicion of a heart attack then the clinicians will take a blood sample. This will test for a protein called troponins. Troponins are released when the heart is distressed1 (which it will be if part of it is dying). 

How does it feel to have a heart attack

Heart attacks typically present with a central, crushing chest pain. This is often felt towards the left hand side of the chest and can radiate either up the jaw or into the left arm. Other symptoms are as described in the ‘warning signs’ segment. 

Do heart attack pains come and go

No. Pain caused by a heart attack will be sudden and continuous. If there is chest pain that is coming and going this could be anginal in nature. 

How to manage heart attack pain

Painkillers can be used, however, the best way to manage pains associated with heart attacks is to get treatment for the heart attack as explained below. 

How to treat heart attack pain 

The initial management of a heart attack includes the following:

  • Aspirin - to reduce any blood clots that are forming
  • Morphine - for pain relief
  • Glyceryl trinitrate - to relax vessels and increase blood flow to the heart

Further treatment can be done in the form of percutaneous coronary intervention (PCI). PCI can be performed up to 12 hours after the onset of symptoms.2 This aims to open up the artery through the use of catheters. They are usually inserted via an artery in the groin, allowing the doctors to access the coronary arteries and insert a stent. This allows the blood to flow to the heart again, and minimises the amount of damage caused by the initial blockage. 

When should you consult a medical specialist

If you have sudden onset chest pain that isn’t resolving within a few minutes then you should seek medical help urgently. If you think that you are experiencing a heart attack then it is advisable to seek urgent medical help. This is because if it is detected early there are various treatments available that can help to reduce the damage done to the heart. If in doubt, give the doctors a shout! 


Heart attacks occur when there is a continuous blockage to the blood supply of the cardiac muscles. This can cause a variety of symptoms, the most classic one being sudden, sharp, central chest pain. If you think you are experiencing a heart attack then seek medical attention urgently, as there are various treatments available.


  1. Small Rise in Heart Attack Protein Linked to Increased Risk of Early Death in All Age Groups. Accessed 1 Nov. 2022.
  2. ‘Acute Coronary Syndromes’. NICE, Accessed 2 Nov. 2022.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Bazegha Qamar

Bachelor of Medicine, Bachelor of Surgery - MBBS, Medicine, University of Leicester

I am a medically trained doctor, currently working part time in hospital in various medical specialities. I have been working for 3 years, with a year of experience in teaching whilst also working in a busy psychiatric hospital. I have a keen interest in medical education, for both colleagues and also the general public.

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