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Heart attacks do not necessarily announce themselves with sudden, intense chest discomfort. The genuine danger lies in how people often overlook, misunderstand, or ignore subtle warning signals, wasting critical moments that could be vital for medical intervention. This cautionary message comes from leading cardiologists at Medcare Hospitals in Dubai and Sharjah, who are emphasising this fact as World Heart Day approaches on September 29, educating the public about cardiovascular disease risk factors and effective prevention strategies.
Cardiovascular disease (CVD) stands as the world’s primary cause of mortality. Throughout the UAE, this represents 40% of all deaths 1. Healthcare professionals across the UAE are noticing this increase largely driven by prevalent risk factors including obesity, diabetes, hypertension, and elevated cholesterol. So many young patients come in with such aggressive cardiac diseases. Young people in their 30s and 40s today are showing the same level of artery damage that doctors used to see only in patients over 70.
The Gulf RACE (Registry of Acute Coronary Events) study revealed that nearly one in three severe heart attack patients in the Middle East reached the hospital more than 12 hours after their symptoms began. The research examined 3,197 patients with STEMI (ST-elevation myocardial infarction), a severe type of heart attack caused by a complete blockage of a coronary artery, across 65 centres in six Arab countries and found that 929 patients (30%) reached the hospital after this critical window. 2
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Jan Niclas Strickling, Specialist Interventional Cardiologist at Medcare Hospital Al Safa, warned that heart attack symptoms can be mild or confusing for patients, and sometimes initial tests don’t flag them as urgent. “Heart attack symptoms, particularly in the early stages, can be subtle and are very often mistaken for indigestion or reflux.”
He shared the case of a 44-year-old UAE resident, named Godfrey, who experienced days of chest discomfort that he thought were due to indigestion and eventually ended up in the emergency room of the hospital after a sudden cardiac arrest. Diagnosing a 99% blockage in one of the main arteries of his heart, doctors proceeded within minutes to restart his heart and restore blood flow.
“This case is a classic example and an important reminder that heart attack symptoms can closely mimic common digestive complaints, and that timely evaluation can be the difference between life and death. The warning signs may come before the crisis, but too many people dismiss them, delay seeking care, and lose the opportunity for timely intervention,” warned Dr. Strickling.
“I had a history of elevated cholesterol and took medication for approximately two to three months. I noticed some chest discomfort over several days, which I dismissed as stress-related or a digestive issue. When the intermittent chest pain persisted for three days, something I initially thought might be acid reflux, I decided to have this checked at a nearby clinic. My tests, including an ECG and troponin screening, came back normal,” said Godfrey.
“The day after my clinic visit, I was scheduled for a treadmill stress test, but I suddenly developed severe chest pain at rest and immediately headed to Medcare Hospital Al Safa’s emergency room. When the intense pain occurred that day, I understood that something was genuinely wrong. I am deeply grateful for how quickly the medical team at the hospital responded. Now that I have had time to reflect, I recognise that I should have sought emergency care immediately when the pain first started, rather than trying to wait through it,” he remarked.
“Godfrey’s ECG report on admission showed changes suggestive of reduced blood flow to the heart, and he was diagnosed with an NSTEMI (non-ST-elevation myocardial infarction), a type of heart attack that occurs when blood flow to part of the heart muscle is reduced, usually due to a partial or complete blockage in a coronary artery. While still in the emergency room, Godfrey suddenly became unresponsive and experienced ventricular fibrillation (VF), a life-threatening heart rhythm that prevents the heart from pumping blood effectively. The medical team immediately initiated CPR, and two defibrillator shocks were required to restore a normal rhythm. He was then rushed to the Cath-Lab, where we urgently opened the blocked coronary artery,” explained Dr. Strickling.
Dr. Mohammed Albialy Sulieman, Consultant Interventional Cardiologist at Medcare Hospital Sharjah, highlighted another factor that can complicate a cardiac arrest beyond diagnosis or timing, depending on the patients’ underlying health conditions.
He cited the case of a 70-year-old Arab man with narrowed blood vessels outside the heart, along with severe peripheral vascular disease (PVD), chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and high cholesterol.
“The patient arrived at the hospital with respiratory distress, which resulted in an insufficient supply of oxygen to tissues and cells that led to his cardiac arrest. The prompt attention and CPR procedure at the hospital helped us save the patient’s life, achieving the return of spontaneous circulation (ROSC),” said Dr. Sulieman.
“But treating his heart attack was only half the battle. His years of vascular disease had blocked off the usual access points to reach his heart, so we had to find another way in before we could even begin the procedure,” he added.
According to Dr. Sulieman, cases like this show that it is not just the heart attack itself that determines how difficult a resuscitation will be. “We got the blockage cleared, and he went on to recover well, with his heart function improving steadily at follow-up.”
Dr. Rupesh Singh, Specialist Cardiologist at Medcare Hospital Sharjah, said that a clear diagnosis doesn’t guarantee safe passage to treatment because a cardiac arrest can strike at any point in life. “Awareness, preventive measures and a healthy lifestyle are crucial.”
He recalled the case of a 45-year-old Asian patient who was brought to the emergency department by his friends in a private vehicle after developing sudden, severe upper abdominal pain along with heavy sweating. “The patient had already been diagnosed at a nearby clinic with an acute inferior STEMI, a heart attack affecting the lower wall of the heart. Despite this early, accurate diagnosis, the patient suddenly became unresponsive and collapsed inside the vehicle while being driven to the hospital.”
“The patient’s heart stopped twice in a short time, once before arriving and again right before his procedure. An imaging test revealed that a blood clot had completely blocked a major heart artery. We successfully cleared it, restoring normal blood flow. The patient spent two days in the ICU before being discharged and has since returned to work,” Dr. Singh explained.
The three experts observed that these cases highlight the major risk of misreading heart attack warning signs. Heart attack symptoms can be subtle and are often mistaken for indigestion, reflux, or fatigue. Persistent or recurrent chest discomfort, especially with breathlessness, sweating, or pain radiating to the arm, warrants urgent evaluation, even if the earlier tests come back normal. The warning signs may come before the crisis, but too many people dismiss them and lose the chance for timely intervention.