A board-certified cardiovascular surgeon who has spent decades operating on diseased hearts had a heart attack of his own – and almost missed it. Dr. Jeremy London, who practices in Savannah, Georgia, initially convinced himself that the sensation he felt while walking upstairs was acid reflux. It went away when he sat down. His cardiologist eventually found a 99% blockage, which became fully obstructed during the procedure. The detail that makes this story land harder than most: London was doing many things right, and yet his standard annual lab work told him nothing was wrong.
That story matters because of what it reveals about the gap between how people picture a heart attack and how one actually arrives. The Hollywood version – sudden, crushing, unmistakable – describes only a portion of real cardiac events. Early warning signs can start hours, days, or even weeks beforehand, and they’re often subtle enough to fly under the radar. London has since gone public with the heart attack warning signs he urges people not to dismiss, specifically focusing on symptoms tied to atherosclerosis, the buildup of cholesterol-based plaque that narrows the arteries over time.
London took to YouTube to explain how healthy and fit people can still suffer a heart attack, highlighting warning signs tied to atherosclerosis – the narrowing of arteries that makes it difficult for blood to flow through them. His message lands in a medical environment where there should be no assumption that an athlete is immune to coronary artery disease, even when traditional cardiovascular risk factors appear well-managed, because excelling in certain aspects of health does not equate to total cardiovascular protection.
The Eight Heart Attack Warning Signs You Shouldn’t Dismiss
1. Chest Discomfort That Doesn’t Fit the Hollywood Script
Most people waiting for a heart attack are waiting for the wrong thing. Severe chest pain that radiates to the arm or the jaw and doesn’t go away warrants an emergency 911 call, but other warning signs can be more subtle, especially in women – it can feel like a tightness in the chest more than true pain. According to the American Heart Association, chest discomfort is the most common heart attack symptom, but it can feel like uncomfortable pressure, squeezing, or fullness rather than the sharp stab most people expect.
The pattern matters as much as the sensation. Some heart attacks occur after a period of “waxing and waning” symptoms – discomfort that comes and goes without lasting long enough to raise alarm bells, making it easy to brush off or attribute to indigestion. If you notice pressure or tightness in your chest during exertion that disappears at rest, that specific pattern – pain with activity, relief with rest – is a classic signal of coronary artery disease and deserves immediate medical evaluation.
2. Shortness of Breath Out of Proportion to the Activity
Exercise intolerance is a common early symptom in patients with coronary artery disease. Narrowed arteries mean the heart receives less oxygen-rich blood, especially when it’s working hard during exercise. As London told TODAY.com, feeling breathless or fatigued out of proportion to the activity – say, climbing a single flight of stairs or taking out the garbage – could indicate a blockage that’s not severe enough to cause chest pain yet.
The CDC notes that shortness of breath can occur alongside chest discomfort or appear on its own – before any chest discomfort at all. If climbing a single flight of stairs now leaves you winded when it didn’t six months ago, that change in your baseline is the signal, not the breathlessness itself. Tell your doctor about any noticeable decline in your exercise capacity, and ask specifically about a cardiac evaluation.
3. Jaw, Neck, or Back Pain With No Obvious Cause
Pain doesn’t always stay where the problem is. The heart shares nerve pathways with other parts of the upper body, which means cardiac distress can surface as discomfort in the jaw, neck, shoulder, or back – far from the chest. The CDC lists jaw, neck, and back pain explicitly among heart attack warning signs, yet these are among the most routinely dismissed because they so closely mimic dental pain, muscle strain, or a stiff neck.
Pain radiating to the back, neck, or jaw can occur particularly in women and is sometimes mistaken for other conditions like acid reflux, muscle strain, or dental problems. If you’re experiencing pain in any of these areas that arrives without a physical explanation – no recent exertion, no obvious injury – and it comes with even mild breathlessness or a general sense of unease, don’t wait to see if it resolves on its own.
4. Unusual Fatigue That Doesn’t Lift With Rest
Some people are exhausted or have fleeting episodes of chest pain in the days leading up to a heart attack. This isn’t ordinary tiredness. The specific quality to watch for is fatigue that feels disproportionate – heaviness that persists even after a full night’s sleep, or a sudden drop in energy levels during activities that previously required no effort.
In the lead-up to his cardiac event, London was experiencing subtle warnings including low energy and fatigue that he dismissed as minor issues, according to LADbible. That detail underscores the problem: fatigue has so many plausible explanations that it becomes one of the easiest warning signs to rationalize away. The Cleveland Clinic notes that a general sense of unwellness and exhaustion can be an early warning sign of a heart attack – particularly when it’s new, unexplained, and worsening over weeks.
5. Nausea, Vomiting, or Indigestion-Like Symptoms
One of the cruelest features of a heart attack is that its symptoms can convincingly mimic a stomach problem. The CDC identifies nausea and vomiting among the official warning signs of a heart attack, and notes that women are more likely to experience them than men. The heart sits close to the stomach and the esophagus, meaning cardiac pain can radiate downward into the abdomen, easily mistaken for food poisoning, a stomach virus, or heartburn.
The distinction to watch for is context: if stomach-type symptoms arrive alongside any chest pressure, jaw discomfort, or sudden fatigue, treat the combination as cardiac until proven otherwise. Seeking help and being wrong is far better than waiting and being right too late.
6. Cold Sweats or Sudden Clammy Skin
Breaking into a cold sweat without exertion or heat exposure is a specific physical signal tied to the body’s stress response during a cardiac event. The CDC lists cold sweats alongside lightheadedness and weakness as heart attack warning signs that can appear suddenly. London’s own experience illustrates this: according to his interview with TODAY.com, he broke into a sweat and didn’t feel well during what should have been a routine walk with his dogs – a symptom he ignored.
Unlike the sweat from a workout, the cold sweat associated with a cardiac event typically appears without any physical reason – at rest, indoors, or during mild activity. It often arrives alongside other symptoms like nausea or chest tightness. On its own, it warrants attention; paired with any other sign from this list, it requires an immediate call to 911.
7. Dizziness, Lightheadedness, or Near-Fainting
Dizziness or lightheadedness may occur without the chest discomfort commonly associated with heart attacks. When the heart is struggling to maintain adequate blood flow – because a coronary artery is significantly narrowed or partially blocked – the brain can be affected first. Reduced cardiac output means reduced blood supply to the head, producing sudden faintness or the sensation that you might pass out.
Ochsner Health’s blog on heart attack warning signs notes that dizziness or lightheadedness can appear among the warning signs that surface days or weeks before a cardiac event. Harvard Health Publishing further confirms that lightheadedness can be a sign of a heart attack or stroke, especially when it occurs alongside chest pain, shortness of breath, nausea, or back and jaw pain. Any episode of sudden, unexplained dizziness – especially in someone who has never experienced it before, or during physical activity – deserves same-day medical evaluation, not a wait-and-see approach.
8. A Sense of Impending Doom or Unexplained Anxiety
This is the warning sign that gets dismissed most often because it sounds the least medical. Early warning signs of a heart attack can start hours, days, or even weeks beforehand, and among the most consistent but underreported is a difficult-to-describe feeling that something is seriously wrong. The Cleveland Clinic notes that a general sense of unwellness and a sense of impending doom can be early warning signs of a heart attack.
Cardiologists take this symptom seriously because it reflects the body’s autonomic response – an internal alarm that activates before conscious awareness catches up. Patients who have survived heart attacks frequently describe this feeling in retrospect as the moment they “knew” something wasn’t right but couldn’t explain why. If you feel an inexplicable, persistent sense that something is seriously wrong with your body – not anxiety with a known cause, but a nameless wrongness – trust it enough to seek evaluation.
Why “Healthy” People Need to Pay Particular Attention
There should be no assumption that an athlete is immune to coronary artery disease, even when traditional cardiovascular risk factors appear well-managed. Excelling in certain aspects of health does not equate to total cardiovascular protection, a 2025 analysis published in the European Heart Journal found. Plaque can accumulate in the arteries over decades with no symptoms at all until a blockage reaches a critical threshold.
Atherosclerosis starts early in life and progresses silently. By the time symptoms occur, it’s advanced and a serious problem. This is precisely why the eight signs above carry such weight: they represent the window before that critical threshold is crossed. The American Heart Association now recommends cholesterol screening starting at age 30 rather than 40, reflecting growing evidence that arterial disease begins building far earlier than most people assume.
The data on who actually has heart attacks reinforces this. According to the CDC, more than 800,000 Americans have a heart attack each year – about one every 40 seconds. And a significant portion go unrecognized: the American Heart Association estimates that roughly 1 in 5 heart attacks are silent – meaning the person never knew it happened. Women face a compounding problem: according to Brown University Health, women are more likely than men to present with atypical symptoms including shortness of breath, weakness, and fatigue, making their events even harder to recognize in real time.
One of the most striking findings in recent cardiac research is how often the body does try to warn people. Multiple clinical studies confirm that between 40% and nearly 60% of heart attack patients had early warning symptoms in the weeks before the event – symptoms they frequently attributed to other causes or simply ignored. The Mayo Clinic notes that many people have warning symptoms that appear hours, days, or weeks in advance, including chest pressure that comes and goes without fully resolving.
For more on the cardiovascular habits and risk factors linked to serious cardiac events, this piece on heart attack and stroke risk factors covers what a major study of 9 million adults found about the patterns that precede nearly all first cardiac events.
Read More: Heart Attack Symptoms Women Often Miss – And Why It Can Be Fatal
What to Do the Moment Something Feels Wrong
Recognizing these warning signs is step one. Acting on them quickly is what determines outcomes. The moment you experience two or more of these symptoms together – or even one that is new, unexplained, and persisting – call 911. Don’t drive yourself to the hospital, don’t wait for a second episode, and don’t let a friend or family member talk you out of going.
London’s own experience makes the strongest possible case for this urgency. “I absolutely knew better, but didn’t do better – even in a scenario that I knew was very dangerous,” he told TODAY.com. A man with 25 years of cardiovascular surgery experience rationalized his symptoms for days. If it can happen to him, it can happen to anyone.
Beyond the immediate response, the eight warning signs above point toward something else: the value of a proactive cardiovascular workup before symptoms ever appear. Standard annual labs often miss early arterial disease. Ask your doctor specifically about coronary artery calcium scoring – a low-radiation CT scan that can detect plaque buildup years before a blockage becomes dangerous – particularly if you’re over 40, have a family history of heart disease, or consider yourself “healthy” in the way London once did.
Disclaimer: The author is not a licensed medical professional. The information provided is for general informational and educational purposes only and is based on research from publicly available, reputable sources. It is not intended to constitute, and should not be relied upon as, medical advice, diagnosis, or treatment. Always consult a licensed physician or other qualified healthcare provider regarding any medical condition, symptoms, or medications. Do not disregard, avoid, or delay seeking professional medical advice or treatment because of information contained herein.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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