Pre heart attack symptoms: Don’t ignore ‘soft’ symptoms We come across cases of sudden cardiac death quite often. And, upon enquiring from the family, we find that preceding symptoms in the last 24 hours are common. Most heart attacks, to begin with, are often not painful but recognizable enough in that the condition may present as pressure or discomfort or burning pain in the chest, feeling of fullness in the center of the chest, which may come and go, also called ‘stuttering’ chest pain and increase with activity and relieved with rest. There may also be unexplained exhaustion/fatigue, or unexplained breathlessness or anxiety or nausea. Eventually these symptoms increase in intensity and frequency and present as the classical chest pain of heart attack, unless the patient has diabetes. People often ignore such symptoms. At times, they are in denial about the true cause of such symptoms: “I am too young to have a heart attack”, “All my blood tests are normal”, “My treadmill test is negative”, “I am only a casual smoker” etc. Most are unaware that these ‘soft’ symptoms are important enough to be evaluated by a cardiologist/physician. ‘Soft’ symptoms are early warning symptoms that appear before the actual ‘typical’ presentation of the impending disease and often provide a clue to the diagnosis. Hence, if you suspect that you are experiencing early symptoms of a heart attack or pre heart attack symptoms, it is important to get yourself evaluated. Timely consultation with a doctor and treatment at this stage can avert the onset of disease in many cases, which may be potentially life-threatening in some cases. Just as a ‘smoke detector’ detects smoke, an indicator of fire, such ‘soft’ symptoms should be taken note of as they are warning signs of an oncoming heart attack.