What a heart attack really feels like - it's much different from what you see on TV

When we think of a heart attack, the image that often comes to mind is straight out of a movie: someone suddenly clutches their chest in pain and collapses as shocked bystanders look on. It’s a scene etched into our collective memory by decades of TV and film.

However, the real experience of a heart attack rarely fits that narrative. In fact, believing in that dramatic version can delay life-saving treatment.

Hollywood’s version has shaped public perception in ways that may be doing more harm than good. The truth is far more complex and subtle.

For Ann Eckhardt, a nursing professor and researcher at The University of Texas at Arlington, this public misunderstanding is not just a matter of health education. It is a deeply personal mission rooted in years of research and a family experience that first sparked her passion for the subject.

Missing the signs of a heart attack

Movies from the 1980s and 1990s cemented an unrealistic idea of heart attacks. The result? Many people don’t recognize the signs when it happens to them.

“We did ourselves a disservice in the 1980s and 1990s with what’s known as ‘The Hollywood Heart Attack,’” Dr. Eckhardt said. “That’s unfortunately not real life. It’s not always intense.”

“Sometimes it’s just discomfort that doesn’t feel quite right, so people tend to wait to see a doctor. The longer you wait, the more likely you are to have negative consequences after your heart attack.”

This tendency to wait, to dismiss symptoms that don’t seem dramatic enough, can cost precious time. And in cardiology, time is muscle.

The longer blood flow to the heart is restricted, the greater the damage. But if people are looking for cinematic signals, they might miss the real ones.

Heart attack symptoms can be subtle

One of the biggest myths is that heart attacks always present with severe, sudden pain. In reality, many symptoms are subtle.

People may experience vague discomfort, pressure, or a strange feeling they can’t quite describe. These symptoms are easier to ignore, especially when life is busy or stressful.

Eckhardt and her team wanted to understand these misconceptions in detail. They explored how people interpret chest pain and whether that interpretation affects how and when they seek care.

The team has identified a dangerous gap between public belief and medical reality.

Rethinking the warning signs

Many people also believe that heart attacks look drastically different in men and women. While that belief was once supported in the medical community, experts are now rethinking the language they use.

“We used to say men have typical symptoms and women have atypical symptoms,” Eckhardt said. “We’re trying very hard to move away from that language now.”

“The most common symptom for men and women is chest-related. We created confusion by saying women are somehow completely different.”

False expectations about heart attacks

Labeling symptoms as typical or atypical can confuse patients. If someone doesn’t feel the expected kind of pain, they may assume it isn’t serious. Worse, they might believe it can’t possibly be a heart attack. That false assurance can delay treatment.

Eckhardt’s team wanted to dig deeper into how people form these ideas. To do that, they created the Chest Pain Conception Questionnaire. The tool is designed to measure what people think heart attack symptoms look like, and where those ideas come from.

Three years into the project, the team made a striking discovery: nearly 75% of respondents had gotten their information about heart attacks from media sources like TV and film. That suggests medical messaging is losing the battle for public attention.

“We often tell people chest pain is a symptom of a heart attack, but what we don’t tell them is what they might actually feel,” Eckhardt said.

“For a lot of people, it’s not pain in the traditional sense. It’s more discomfort, pressure, tightness. They just don’t feel quite right, but they can’t really put their finger on it.”

Vague signs delay treatment

Many heart attack sufferers report a general unease or tightness instead of sharp pain. But because it’s vague, they hesitate to call a doctor or go to the hospital. This indecision can lead to devastating outcomes.

Eckhardt wants medical professionals to change how they talk to patients. Instead of simply asking about chest pain, they should expand the question to include more accurate descriptions.

“The longer you wait, the more likely it is you’ll have irreversible damage to the heart,” Eckhardt said.

“So, if we can determine what people think a heart attack will be like, perhaps we can help the medical community better triage and ask questions. It’s not just ‘Are you having chest pain?’; it’s also ‘Do you have any discomfort, pressure, tightness, squeezing?’”

This approach could help doctors identify patients at risk more effectively. It also makes space for individuals to describe their symptoms without second-guessing themselves.

A lifelong mission

For Eckhardt, this work is not just about data or education. It is deeply personal. Her commitment to the subject began when she was young, shaped by a frightening family event.

“That experience sparked my interest early on,” Eckhardt said. When she was in middle school, her grandfather was rushed to the hospital after a heart attack.

Thankfully, he survived the ordeal thanks to timely bypass surgery and lived for another two decades. That moment planted the seeds of a lifelong commitment to health education and research.

Changing the public perception

Eckhardt and her colleagues know it won’t be easy to re-educate the public. Hollywood images are hard to shake.

However, the team’s research continues, driven by a clear goal: help people recognize real heart attack symptoms, seek help early, and improve outcomes.

Every person who rethinks their idea of what a heart attack feels like could be one life saved. It is not always about pain. Sometimes, it is a quiet, persistent signal that something is wrong.

The study is published in the journal Heart & Lung.

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