You don’t need extreme chest pain to signal a heart attack is looming.
In fact, many guys don’t experience classic symptoms, like gripping or pressing pain in the chest that radiates down the arm, shortness of breath, or sweating, says Steven Nissen, M.D., chairman of cardiovascular medicine at the Cleveland Clinic.
Heart attacks occur when a blocked artery stops the flow of oxygen-rich blood to your heart. But the symptoms it produces can vary, depending on things like your age, fitness level, where the blockage occurs, and severity of your heart attack.
Take these 6 men. They all suffered heart attacks, yet their symptoms may shock you. Keep reading for their stories.
“I felt winded doing normal stuff.”
Name: Kalun Lee, 45, Washington, D.C.
Date of heart attack: March 15, 2010
Lee always walked the three-quarters of a mile to his job as an attorney at a state agency in Boston. One spring morning, he felt a bit out of breath and thought he must be coming down with a cold.
Later that night, he felt more winded than usual climbing the three flights of stairs to his apartment. That seemed strange, but since the 39-year-old had a clean physical exam the week before, he shrugged it off.
After dinner, though, he sat on the couch to watch TV and send emails. That’s when the chest pain began, along with the feeling he was going to throw up.
“I knew something was very wrong,” Lee says.
Even though he didn’t fit the picture of heart disease—he was young, fit, at a healthy weight, and didn’t smoke, drink, or do drugs—the chest pain prompted him to Google symptoms of a heart attack.
He saw enough overlap between the symptoms listed online and his current condition to decide to head to the hospital just in case.
By the time he arrived, he was pale, breathless, and had severe chest pain. An exam, a finger clip to measure his blood oxygen levels, and an electrocardiogram (EKG) all pointed to a heart attack.
Doctors gave him nitroglycerine pills to open up his arteries and whisked him into surgery, where he had a stent put in to unclog them.
“The pain went away nearly immediately,” he says.
“I lost 50 pounds and lowered my cholesterol—so I thought it couldn’t be a heart attack.”
Name: Paul Traynor, 44, Wilmette, Ill.
Date of heart attack: May 31, 2015
Traynor, a suburban Chicago filmmaker and actor, transformed his life at age 40: He quit drinking and smoking, went vegetarian, started practicing yoga, and lost 50 pounds. His high triglycerides and cholesterol levels went back to normal.
So when he woke one Sunday morning with triceps and neck pain, he figured he did one too many rounds of chaturanga. He also experienced growing fatigue and a feeling of overall dread, which, he figured, came thanks to a new baby, new puppy, and huge work project.
But those symptoms are actually indicative of a heart attack: The nerves that connect your heart to your brain don’t send specific pain signals the way your skin or other organs do, so the resulting pain is harder to pinpoint, says Dr. Nissen. That’s why you can feel it elsewhere, from your stomach to your neck to your arms.
And fatigue can serve as a signal that your heart can’t keep up with the demands placed on it. This also can trigger anxiety or a sense of doom, similar to what Traynor felt.
Still, Traynor didn’t think much about it until he started feeling “a little bit belchy, a little bit clammy, and a little bit dizzy” when walking the dog later that evening. It got bad enough that he stopped and searched for “heart attack symptoms” on his phone.
But every entry listed chest pain or tightness, which Traynor didn’t have. His wife, though, insisted she drive him to the hospital.
During a test called a cardiac catheterization—in which doctors inserted a thin, flexible tube through a blood vessel in his groin—they discovered a portion of his right coronary artery was completely blocked. They inserted another tube with a stent to open in, a procedure called percutaneous coronary intervention, or angioplasty.
It was successful: He recovered well, and only sustained slight damage to his heart.
But after a couple of months, the high of surviving the heart attack gave way to fear and a crippling bout of sadness. In fact, heart-attack survivors have about triple the risk of depression as the general population, according to the American Heart Association.
He realized quickly that he couldn’t cope with that alone any more than he could’ve inserted his own stent. He spoke with his doctor, who prescribed therapy and antidepressants to improve his mood and sense of wellbeing.
“I thought I had the flu.”
Name: Tom Ivany, 28, Youngstown, Ohio
Date of heart attack: May 25, 2013
High cholesterol runs in Ivany’s family: In fact, their genetic predisposition to it—his mom had quadruple bypass surgery at 37—was the focus of a PBS documentary on the topic.
That happened when Ivany was 16. At that point, doctors tested his cholesterol too, and found he had the same condition. He did everything by the book after that, controlling his levels with statin medications, diet, and exercise.
But 9 years later, the then 25-year-old Ivany started feeling woozy and chilled while shopping with his wife. He assumed he had the flu, but when it persisted and he threw up, his wife Haley convinced him to head to the hospital.
An EKG quickly revealed he was, in fact, having a massive heart attack.
Two stents opened his nearly blocked arteries. When the first one went in, “it was like they lifted a million pounds off my chest,” he says. He’d felt tired and run down for a while, but blamed it on work stress.
Because Ivany was fit and healthy otherwise, he sustained no lasting damage to his heart.
He now takes a newly approved PCSK9 inhibitor called Repatha, which better helps people with genetically high cholesterol who don’t respond well to traditional meds like statins. He can play rugby and do CrossFit without any problem.
Still, the experience left him with one mental scar—he’s now conflicted about having children.
“It scares me,” he says. “I went through this at such a young age and I don’t know if it would be fair to pass this on.”
“For a few months prior, I felt a weird burning in my chest.”
Name: Steve VandenBerg, 52, San Juan Capistrano, Calif.
Date of heart attack: Nov. 22, 2012
Running the Dana Point Turkey Trot 10K race—an annual family tradition—VandenBerg remembers high-fiving his daughter when she passed him at the midway turnaround. The 48-year-old’s next memory doesn’t surface until three days later, when he awoke in the hospital.
VandenBerg didn’t remember feeling anything out of the ordinary that day of the race, but looking back, he does recall experiencing a mild burning in his chest during early-morning runs for a few months beforehand. He attributed this to a chest cold, since it went away once he warmed up.
His wife filled in the blanks at his bedside: VandenBerg—who exercised regularly and took a low-dose statin to keep his high cholesterol in check—collapsed around mile 4. A firefighter running by him rushed over to administer CPR.
Damage sustained during a heart attack can cause an arrhythmia, a life-threatening electrical problem that messes with your heart’s rhythm, Dr. Nissen says. That’s exactly what happened to Vandenberg.
Within 10 minutes, paramedics used an automated external defibrillator (AED) to shock his heart back into beating normally before rushing him to the ER.
There, he received two stents to open up his blocked arteries, and underwent hypothermic therapy—which uses cold temperatures and a medically induced coma to slow the body’s systems to reduce heart and brain damage.
Now, in addition to a statin, he also takes a baby aspirin to fight clots and a beta blocker to control blood pressure. Doctors also implanted a defibrillator that will shock or jump-start his heart as needed.
And he still runs the Turkey Trot every year, after undergoing a stress echocardiogram to make sure no new blockages have emerged.
“The following year the race was actually on my birthday—I turned 50, and my goal was to run the 10K in 50 minutes,” VandenBerg says. “And I did that. That day was when I finally felt normal again.”