Most heart attacks start slowly and build up gradually over a few minutes. Heart attacks can be anticipated as mild discomfort or pain, including pressure,tightness, fullness or radiating pain to the neck, jaw, or arm, and is usually associated with shortness of breath, nausea, sweating and paleness. People with diabetes and women may not have the typical symptoms of chest discomfort and may have only a few of the associated features (such as shortness of breath or nausea)