By Dr. Apurba Kumar Sarma, MCh CVTS | Cardiac Surgeon, Tulip Mediworld Superspeciality Hospital, Guwahati
Quick Takeaways
- Heart attacks do not always cause dramatic chest pain – nausea, jaw pain, back pain, and unusual fatigue are equally real warning signs, especially in Indian patients.
- Women and people living with diabetes frequently experience “silent” or atypical cardiac arrest symptoms that are easy to dismiss as indigestion or exhaustion.
- The first five minutes after symptoms begin are critical – what you do (and what you avoid) directly affects outcomes.
- India records approximately 1.7 million heart attacks every year; rates are rising in Northeast India due to changing diets and lifestyle patterns.
- World-class emergency cardiac care is now available in Guwahati – you no longer need to travel to Delhi or Chennai.
Imagine this: a 52-year-old man in Guwahati wakes up at 3 a.m. with what feels like indigestion. He takes an antacid and tries to go back to sleep. By morning, his family rushes him to hospital – but several critical hours have already passed. This scene happens more often than it should, and in nearly every case, the delay is the most dangerous part.
Heart disease is the leading cause of death in India, responsible for approximately 28% of all deaths nationwide. Across Northeast India – Assam, Manipur, Nagaland, Meghalaya, Tripura, and Arunachal Pradesh – the burden is rising as urban lifestyles bring with them higher rates of hypertension, diabetes, and high cholesterol.
Recognising cardiac arrest symptoms early, and knowing what to do in the first five minutes, can be the difference between full recovery and irreversible heart damage. In this article, I want to walk you through the warning signs that every Indian adult should know – including the ones that are most commonly missed.
The symptoms most people associate with a heart attack – the ones they’ve seen on television – are the classic presentation. They are real and important, and if you experience them, you should treat them as an emergency without hesitation.
Chest pain or pressure is the most common symptom. Patients describe it as a squeezing, tightening, or heavy pressure in the centre or left side of the chest, sometimes radiating outward. It may last several minutes or come and go.
Pain spreading to the left arm, jaw, or neck is another classic indicator. The American Heart Association notes that this referred pain is caused by shared nerve pathways between the heart and these areas of the body.
Shortness of breath, even without significant chest pain, is a serious warning sign. Cold sweats, lightheadedness, or sudden nausea – particularly when they appear together – should also raise immediate concern.
| Classic Cardiac Arrest Symptoms | What It Feels Like |
|---|---|
| Chest pain / pressure | Squeezing, tightening, heavy – not always sharp |
| Left arm or jaw pain | A dull ache that spreads from the chest outward |
| Shortness of breath | Difficulty breathing even at rest |
| Cold sweat | Sudden, unexplained perspiration without physical exertion |
| Nausea or vomiting | Often mistaken for a stomach problem |
| Lightheadedness | Feeling faint or dizzy without obvious cause |
This is one of the questions I hear most often from patients – and it is entirely fair to ask. The two can feel surprisingly similar, which is why so many people wait.
Acidity or gastric reflux typically causes a burning sensation that rises from the stomach toward the throat. It often improves with an antacid within 15–20 minutes. A heart attack, by contrast, tends to produce a pressure or squeezing feeling – not a burn – and it does not respond to antacids. It may also come with sweating, breathlessness, or pain that spreads to your arm or jaw.
A useful rule of thumb: if your discomfort is accompanied by any symptom beyond the stomach area – arm heaviness, jaw ache, unusual sweating, or difficulty breathing – do not treat it as indigestion. Seek medical assessment immediately.
Yes – and this is perhaps the most important thing I can tell you in this article.
Research published by the National Library of Medicine (NCBI) has documented that nearly one-third of heart attacks present without classic chest pain. In Indian patients, I have seen this often enough over 25+ years and 7,000+ surgeries to take it very seriously.
Women are significantly more likely to experience atypical symptoms: unusual fatigue that persists for days, upper back pain, shortness of breath, nausea, or simply a vague sense that something is wrong. These symptoms are frequently attributed to stress or anaemia – and the cardiac cause is missed until it is much more serious.
Patients living with diabetes face a particular risk. Diabetic neuropathy – nerve damage caused by long-term high blood sugar – can blunt the sensation of pain. As a result, a diabetic patient may experience what is called a “silent heart attack,” with minimal or no chest pain, often discovered only during a routine ECG or checkup.
Older adults may also present atypically – with confusion, extreme fatigue, or a sudden drop in blood pressure rather than classic chest pain.
If you or someone you care for is living with diabetes, hypertension, or has a family history of coronary artery disease, the absence of chest pain does not mean the heart is safe. Any cluster of the symptoms above deserves attention.
Time is heart muscle. Every minute that a coronary artery remains blocked, more cardiac tissue is lost. Here is what I recommend:
What to do:
What not to do:
Northeast India is experiencing what cardiologists call an epidemiological shift. Traditional diets high in mustard oil and red meat, combined with rising rates of sedentary work, tobacco use, and undiagnosed diabetes and hypertension, are contributing to increasing rates of coronary artery disease across Assam and the broader region.
The Cardiological Society of India has noted that Indians in general tend to develop coronary artery disease about a decade earlier than Western populations – often in their 40s and 50s rather than 60s and 70s. This makes awareness in younger adults especially critical.
The risk factors most prevalent in Northeast India include:
If you have two or more of these risk factors, a preventive cardiac screening at Tulip Mediworld – including a CT Coronary Angiogram, the first of its kind available in Northeast India – can identify silent disease before a crisis occurs.
If you or a family member experience any of the symptoms described in this article, please do not wait. Tulip Mediworld Superspeciality Hospital on GS Road, Guwahati operates a 24/7 emergency department with full cardiac facilities – including a Cathlab for immediate intervention.
As a cardiac surgeon in Guwahati with over 25 years of experience, I have seen outcomes change dramatically based on how quickly patients arrive. The care you need is here – you do not need to travel to Delhi, Chennai, or Kolkata.
For non-emergency consultations, risk assessments, or if you have a family history of heart disease and want a thorough evaluation, you can book an appointment directly through drapurbasarma.in or call our team at 1800 890 4655.
A heart attack does not always announce itself the way you expect. The pressure in the chest, the pain down the arm, the cold sweat at 3 a.m. that feels like indigestion – these are not symptoms to reason away. They are your body asking for help.
The most important things to remember: know the atypical symptoms, act within the first five minutes, and do not hesitate to come in. If you are in Northeast India, you no longer have to travel hundreds of kilometres to access world-class cardiac care. Experienced, compassionate help is here in Guwahati.
Book a consultation at drapurbasarma.in or call Tulip Mediworld at 1800 890 4655. Your heart – and your family – deserve nothing less.
About the Author
Dr. Apurba Kumar Sarma, MBBS, MS (General Surgery), MCh (CVTS) is a cardiovascular and thoracic surgeon with over 25 years of experience and 7,000+ successful heart surgeries. He is the Founder, Chairman and Managing Director of Tulip Mediworld Superspeciality Hospital, GS Road, Rukmini Gaon, Guwahati, Assam — 781022. He is a Fellow of the Indian Association of Cardiovascular-Thoracic Surgeons and a Life Member of the Indian Medical Association.
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified cardiac surgeon for evaluation and treatment specific to your condition.
