Male Pre Heart Attack Symptoms

What symptoms do men present before having a heart attack? Perhaps you’ve heard that the symptoms of a heart attack can vary between men and women and may be uncertain about whether to take particular symptoms seriously. However, the modern world is awash with confusing information. As an example, the American Heart Association state on its website that “symptoms vary between men and women."1 On the other hand, their British counterparts at the British Heart Foundation state that “It’s a common misconception that men and women experience different symptoms when having a heart attack."

Since this article deals with heart attack symptoms in men, this difference in opinion can be very unsettling to the reader. However, such differences in scientific opinion are not quite as uncommon as one might be tempted to think, but that is a subject well outside the scope of this article. Those interested in why such differences exist in science can read up on the “Duhem-Quine Thesis."3 Nonetheless, whether the reader just wants clear information or whether the reader has been confused by contradictory information, this article will make every attempt to un-muddy the waters so to speak, and to present a clear and concise picture of the heart attack symptoms that are common to men.

Does your body warn you before a heart attack?

Thankfully, the human body can give warning signs of a previously unknown heart condition or heart disease which in turn could be a precursor for a heart attack. However, it is important to understand that this is not always the case. In some cases, people either do not present any symptoms people with diabetes being a high-risk group in this case or present symptoms which might not be thought of as being caused by a heart condition, such as indigestion and muscle pain. This is commonly called a silent heart attack, or an unrecognised heart attack, which is what David Morrow, director of the Harvard Affiliated Brigham and Women's Hospital, prefers to call it.4 We shall return to this later when discussing atypical heart attack symptoms.

What do you feel when you’re having a pre-heart attack?

When blood flow is restricted to the heart – called myocardial ischaemia5 symptoms you could feel are pain, aching, or discomfort in your chest; discomfort or pain in your jaw, neck, or back; pain or discomfort in your arms, and shortness of breath.6 Also, if you have diabetes, silent myocardial ischaemia may be a risk.7 Myocardial Ischaemia, if left untreated, could lead to a much more serious condition which is the death of a critical heart muscle. The medical term for this is myocardial infarction8 or a heart attack as it is more commonly known.

What are 3 warning signs of a Heart Attack in males?

When talking about warning signs, women tend to be more aware of heart attack signals than men9 which is why it is in the interest of men to pay attention. In addition, while the symptoms discussed here are quite general, some readers might be concerned about whether racial or cultural differences are relevant in trying to interpret warning signs of a heart attack. A study by Greenslade et al in 2012 confirmed that there were differences across different races and cultures in how symptoms of suspected acute coronary syndrome10 (which means you probably have coronary heart disease) showed up in patients, but that it was limited in its value in helping to diagnose acute coronary syndrome.11 This does not mean that you should ignore any atypical symptoms; please seek medical help when presented with symptoms. With the above caveat out of the way, listed below are three warning signs of a probable heart attack to watch out for in men. This will be done by contrasting how the same signals showed up in a recent study between men and women.  

The study referenced below was commissioned by the British Heart Foundation and published in the journal of the American Heart Association. The study which was conducted in Edinburgh showed that of the 756 women and 1185 men that participated in the study, the most common symptom of a heart attack was chest pain, with 92% of women and 91% of men reporting chest pain as the most common symptom. Another common symptom for men was pain radiating in the left arm with the study reporting the symptom in 36% of the women that participated, and 31% in the men. Another symptom demonstrated by the study that could warn men of a heart attack was nausea, with the study reporting the symptom in 34% of women and 22% of men.12 In summary, according to this study, three major warning signs of a heart attack in men were chest pain, pain radiating to the left hand, and nausea. It should be noted that pain is not always limited to the left arm but can be felt in both arms.13

Table 1 Data Extracted from Edinburgh study

Chest pain92%91%
Radiating pain in the left arm36%31%
Pain radiating to the back31%17%
Pain radiating to the neck/jaw28%20
Palpitation of the heart11%7%

Other general warning signs and atypical symptoms

You may also feel shortness of breath, fatigue, weakness, dizziness,14 or back pain, burning pain, epigastric pain, and even indigestion, which are sometimes described as atypical symptoms.15 What men need to consider is that symptoms once thought of as being atypical symptoms, or symptoms that tend to show up in women can also show up in men. As the Edinburgh study shows, in every symptom category, although these symptoms were reported in women in higher numbers, men also presented the same symptoms.

How long can a man have symptoms before a Heart Attack?

The question of how long a man can have heart attack symptoms before the onset of a heart attack is a complex one. Remember the silent/unrecognised heart attack or silent myocardial infarction that was mentioned above? Not everyone presents symptoms of an impending heart attack. Nevertheless, studies show that before a sudden cardiac arrest, there are often warning signs but most people ignore them.16 In addition, silent myocardial infarction increases the risk of heart failure17 which could be fatal. As such, the earlier the intervention, the more likely the potential for a positive outcome as a 2018 study suggests.18 Therefore, act19 as soon as your body signals the need for medical attention.


In summary, the most common warning sign of a heart attack for men is chest pain. This is true regardless of race and culture. Pain can also radiate to the arms, neck, jaw, and back. Nausea, once thought of as atypical, can also warn men of an impending heart attack. The lesson is to seek medical help as early as possible; don’t dismiss anything and don’t wait! 


  1. Warning Signs of a Heart Attack [Internet]. American Heart Association; Available from:
  2. Heart Attack Symptoms [Internet]. British Heart Foundation; Available from:
  3. Duhem-Quine Thesis [Internet]. Stanford Encyclopedia of Philosophy; Available from:
  4. The Danger of Silent Heart Attacks [Internet]. Harvard Health Publishing; Available from:|A569760968&v=2.1&it=r
  5. Law J, Martin E, editors. Concise medical dictionary [Internet]. 10th ed. Oxford: Oxford University Press; 2020. Available from:
  6. Patel A, Fang J, Gillespie C, Odom E, Luncheon C, Ayala C. Awareness of Heart Attack Signs and Calling 911 Among U.S. Adults. Journal of the American College of Cardiology. 2018;71(7):808–9.
  7. Regitz-Zagrosek, V. Sex and gender differences in symptoms of Myocardial Ischaemia. European Heart Journal. 2011;32:3064–6.
  8. Law J, Martin E. Concise medical dictionary [Internet]. 10th ed. Oxford: Oxford University Press; 2020. Available from:
  9. Han CH, Kim H, Lee S, Jae HC. Knowledge and Poor Understanding Factors of Stroke and Heart Attack Symptoms. International Journal of Environmental Research and Public Health. 2019;16(3665).
  10. Law J, Martin E. Concise medical dictionary [Internet]. 10th ed. Oxford: Oxford University Press; 2020. Available from: https://www-oxfordreference
  11. Greenslade JH, Cullen L, Parsonage W, Reid CM, Body R. Examining the Signs and Symptoms Experienced by Individuals With Suspected Acute Coronary Syndrome in the Asia-Pacific Region: A Prospective Observational Study. Annals of Emergency Medicine. 2012;6(6).
  12. Ferry A. V, Anand A, Strachan F. E, Mooney L, Stewart S. D, Marshall L, et al. Presenting symptoms in men and women diagnosed with myocardial infarction using sex-specific criteria. Journal of the American Heart Association. :1–14.
  13. Ornato J. P, Hand M. M. Warning Signs of a Heart Attack. Circulation. 2014;393–5.
  14. The Dangers of Silent Heart Attacks. Harvard Heart Letter [Internet]. 2019; Available from:|A569760968&v=2.1&it=r
  15. Greenslade J. H, Cullen L, Parsonage W, Reid C. M, Body R. Examining the Signs and Symptoms Experienced by Individuals With Suspected Acute Coronary Syndrome in the Asia-Pacific Region: A Prospective Observational Study. Annals of Emergency Medicine. 2012;6(6):777–85.
  16. Eloi M, Uy-Evando A, Dumas F, Karam N, Reinier K, Teodorescu C, et al. Warning Symptoms Are Associated With Survival From Sudden Cardiac Arrest. Annals of Internal Medicine. 2016;164(1):23–9.
  17. Soliman Elsayed Z. Silent Myocardial Infarction and the Risk of Heart Failure: Current Evidence and Gaps in Knowledge. Trends in Cardiovascular Medicine. 2019;29:239–44.
  18. Qureshi WT, Zhang ZM, Chang PP, Rosamond WD, Kitzman DW, Wagenknecht LE, et al. Silent Myocardial Infarction and the Long-Term Risk of Heart Failure: The Aric Study. Journal of the American College of Cardiology. 2018;71(1):1–8.
  19. Ornato JP, Hand MM. Warning Signs of a Heart Attack. Circulation. 2014;393–5.
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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