Warning signs to stop and get help

Which symptoms during exercise mean you need emergency help?

Chest pain or pressure is the main one. Warning signs often come before exercise-related heart problems¹, so it helps to know them before you need them.

Get emergency help straight away for:

• Sudden chest pain or discomfort that doesn't go away. It can feel like squeezing, pressure, burning or indigestion², or heavy, pressing or tight³. Some people describe it as crushing.
• Pain that spreads to the arm, neck, jaw, stomach or back².
• Difficulty breathing, or feeling faint, sweaty or unwell⁴.
• Being too short of breath to say more than a few words, or having blue lips, or feeling drowsy or confused⁵.
• Signs of a stroke: one side of the face drooping, not being able to lift both arms and keep them there, or slurred or confused speech. Call straight away, even if the signs stop.

Heart attacks look different from person to person. Some people have mild chest pain, pain that comes and goes, or no chest pain at all⁴. Chest pain is the most common sign in women, as in men. Women are more likely to also have shortness of breath, feeling sick, or pain in the back, shoulder, arm, neck or jaw⁶. Unusual tiredness on its own isn't an emergency, but get it checked by a doctor. If it comes with chest discomfort, breathlessness or feeling sick, stop and get urgent help.

At the first sign of any of these, stop what you're doing and sit down. If you think it could be a heart attack, don't wait to be sure³, and don't drive yourself. Ask for an ambulance. Don't push through chest pain or breathlessness; it is not a sign of a good workout.

What should you do if you get chest pain during exercise?

Stop what you're doing, sit down and rest, and get emergency help straight away rather than waiting to see whether it passes. Do this even if you're not sure it's your heart. Chest pain can be a heart attack even when it is mild or comes and goes⁴, so don't decide it was nothing because it eased.

1. Stop and sit down. Rest.
2. Ask for an ambulance straight away. You don't need to be certain it's a heart attack³.
3. Have someone stay with you. Don't drive yourself to hospital.
4. Don't try to work out the cause yourself. Some chest pain happens during an anxiety or panic attack, which can also bring a racing heart, sweating and dizziness³. Don't assume that's the cause; get it checked.

Angina is chest pain or tightness that happens when the heart isn't getting enough blood for what you're asking of it. If your doctor has diagnosed angina, follow the action plan they gave you. The first step is to stop and rest^7,8. Sudden chest pain in someone who hasn't been diagnosed with angina needs emergency care straight away⁷.

When should dizziness or breathlessness worry you?

Some breathlessness is normal when you exercise, because your body needs more oxygen⁵. The less fit you are, the more breathless you feel when you exert yourself⁵, so a new routine can feel hard at first. Breathlessness that is much worse than the effort explains, or that comes with chest pain, is not normal.

Get it checked by a doctor if your breathlessness:

• is worse than usual
• gets worse during normal activities, or when you lie down⁹

If you're more short of breath than usual, a health advice line can give you urgent advice⁹. Being too breathless to say more than a few words is an emergency, as listed above.

Dizziness can have simple causes, such as standing up quickly or dehydration¹⁰. If you feel dizzy, stop and sit down, and stand up slowly afterwards. If it settles, ease off. If it keeps happening, doesn't settle or gets worse, see a doctor. Fainting or collapse, or dizziness with chest pain, sweating or feeling sick, needs emergency help straight away.

When to check with a health professional

If you're starting exercise after a long break, it's always a good idea to see your doctor first.

For an injury or a health condition, see a health professional, such as your doctor or a physio.

Call your local emergency number for chest pain or pressure (or pain spreading to the arm, neck, jaw or back, especially with sweating or feeling sick), severe breathlessness, fainting or collapse, signs of a stroke, a serious injury, or someone who isn't safe.

For anything else, such as a sore muscle or joint, or dizziness that settles, stop or ease off. See a doctor or other health professional if it persists or gets worse.