#37

Heart Attack Warning Signals

By Lord Dr Paul Martin (HonDSc), WKA World Vice President

What You Need to Know

Heart attacks rarely happen “out of the blue.” In many cases, the body gives us warning signals days, weeks, or even months in advance. The challenge is that these signals can be subtle, easy to dismiss, or mistaken for something less serious. Understanding them—and acting quickly—can make the difference between life and death (NHS, 2023).

Why Early Recognition Matters

In the UK, someone is admitted to hospital with a heart attack every five minutes (British Heart Foundation, 2024). A heart attack occurs when blood flow to part of the heart muscle is blocked, often by a clot in a coronary artery. Without oxygen, heart tissue begins to die within minutes. The sooner treatment is received, the better the chances of survival and recovery (NHS, 2023). Recognising early warning signals empowers us to act swiftly and seek medical care before irreversible damage occurs (Mayo Clinic, 2023).

Classic Warning Signals

The most well-known signs of a heart attack are dramatic, but they don’t always look like they do in movies. Still, it’s important to recognise these classic symptoms (NHS, 2023; BHF, 2024):

• Chest pain or pressure
• Pain radiating to the arm, shoulder, or back
• Shortness of breath
• Cold sweats
• Nausea or lightheadedness

Subtle and Less Recognized Signals

Not every heart attack shouts its arrival. Some whisper. These quieter signs are particularly common in women, older adults, and people with diabetes (BHF, 2024; NHS, 2023): fatigue, disturbed sleep, indigestion-like discomfort, jaw/neck pain, or a general sense of unease.

Gender Differences in Symptoms

Research shows men often present with chest pain, while women may report shortness of breath, nausea, and fatigue without chest discomfort (NHS, 2023).

What to Do if You Notice the Signals

1. Call 999 immediately (NHS, 2023).
2. Chew aspirin if advised (BHF, 2024).
3. Stay calm and still.
4. Never dismiss the symptoms.

Prevention: Lowering Your Risk

• Maintain a healthy weight.
• Control blood pressure, cholesterol, and blood sugar.
• Quit smoking.
• Manage stress.
• Get regular check-ups (WHO, 2023).

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Heart Attacks in Martial Arts and Sports

While martial arts are widely celebrated for improving cardiovascular fitness, strength, and resilience, the intense training and competitive stress can also reveal underlying heart problems. Sudden cardiac events in sport, though rare, are a recognised medical concern.

• Sudden cardiac arrest is the leading cause of death in young athletes worldwide, often linked to undiagnosed heart conditions such as hypertrophic cardiomyopathy or arrhythmias (Corrado et al., 2005).
• In martial arts, the risk is heightened by high-intensity bursts of exertion, rapid weight changes for competition, and sometimes dehydration, which can all place strain on the heart (Thompson et al., 2007).
• Even well-conditioned athletes may not be immune. Cases have been reported of fighters collapsing during training or competition due to undetected heart disease or exercise-induced arrhythmias (Maron & Zipes, 2005).
• For older practitioners—particularly those returning to training after years of inactivity—the risk is greater if cardiovascular screening and gradual conditioning are ignored (Pelliccia et al., 2021).

Practical Guidance for Martial Artists

1. Know your limits — build intensity gradually, especially after illness or inactivity.
2. Get screened — ECG or echocardiogram screening can detect hidden risks.
3. Stay hydrated and avoid extreme weight cuts.
4. Pay attention to subtle symptoms — unexplained fatigue, dizziness, or chest discomfort should never be dismissed as “just part of training.”
5. Ensure AEDs (defibrillators) are available at gyms, dojos, and competition venues. Early defibrillation is the most effective response to sudden cardiac arrest.

By recognising that martial artists are athletes with unique physical demands, the community can foster not only discipline and resilience but also a culture of safety and awareness.

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The Takeaway

A heart attack doesn’t always look like a dramatic collapse. Sometimes it feels like discomfort, fatigue, or a sense of unease. For martial artists, these warning signs are even more critical: ignoring them in the pursuit of toughness or discipline can carry deadly consequences. By combining awareness with prevention, martial arts can remain what it is meant to be — a lifelong path to health, strength, and personal growth.

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References

1. NHS. Heart Attack. London: NHS; 2023. Available at: https://www.nhs.uk/conditions/heart-attack [Accessed 6 September 2025].
2. British Heart Foundation. Heart Attack Symptoms. London: BHF; 2024. Available at: https://www.bhf.org.uk/informationsupport/conditions/heart-attack-symptoms [Accessed 6 September 2025].
3. Mayo Clinic Staff. Heart Attack: Symptoms and Causes. Rochester, MN: Mayo Clinic; 2023. Available at: https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106 [Accessed 6 September 2025].
4. World Health Organization. Cardiovascular Diseases (CVDs) Fact Sheet. Geneva: WHO; 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) [Accessed 6 September 2025].
5. Corrado D, Basso C, Schiavon M, Thiene G. Screening for hypertrophic cardiomyopathy in young athletes. New England Journal of Medicine. 2005;352(4):364–366.
6. Maron BJ, Zipes DP. 36th Bethesda Conference: Eligibility recommendations for competitive athletes with cardiovascular abnormalities. Journal of the American College of Cardiology. 2005;45(8):1312–1375.
7. Thompson PD, Franklin BA, Balady GJ, et al. Exercise and acute cardiovascular events: Placing the risks into perspective. Circulation. 2007;115(17):2358–2368.
8. Pelliccia A, Sharma S, Gati S, et al. 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease. European Heart Journal. 2021;42(1):17–96.