Heart Attack Symptoms in Women

By Tom Iarocci, MD. May 7th 2016

Heart disease is the leading cause of death in women in the United States, and the Centers for Disease Control and Prevention reports that one in every four female deaths is caused by heart disease.

The heart attack, known to doctors as the myocardial infarction, or MI, was once mainly thought of as a man’s condition, but that misconception is starting to clear up. Women are just as likely to have heart disease as men. 

Recognizing a Heart Attack

The symptoms of a heart attack may not be crystal clear. If you cut your hand, chances are you could close your eyes and describe exactly where the cut is, which finger and maybe even whether it was just a scrape or something more. Unfortunately, symptoms of a heart attack aren’t always so straightforward. While plenty of people’s symptoms include the classic “elephant-standing-on-your-chest” pain as seen on TV, it’s also true that many do not. Understanding all of the symptoms of a heart attack is extremely important.

Symptoms of a Heart Attack Include:

  • Angina: pain, discomfort, pressure or tightness in the middle of the chest that lasts for more than a few minutes or goes away and then comes back; sometimes mistaken for heartburn
  • Pain or discomfort in upper body including arms, left shoulder, back, neck, jaw or stomach
  • Difficulty breathing or shortness of breath
  • Cold sweat or sweating
  • Feeling of indigestion, choking or heartburn
  • Nausea or vomiting
  • Feeling dizzy, light-headed or extremely weak
  • Feeling anxious
  • Rapid or irregular heart beats

A Woman’s Heart Attack

If you are a woman, recognizing a heart attack may have its own set of hurdles and obstacles. A recent study in women who were hospitalized for a heart attack found that they tended to be slightly less likely to have reported chest pain/discomfort than men. Instead, they may report what doctors call vague or less-typical symptoms, including the following:

  • Upper back pain, shoulder pain
  • Jaw pain or pain spreading to the jaw
  • Pressure in the center of the chest
  • Some sweating
  • Light-headedness or dizziness
  • Unusual fatigue, like they just ran a marathon

It’s also important to keep in mind that doctors cannot necessarily tell from your symptoms, alone, whether or not there is a cardiac problem. They work based on the level of suspicion, folding in the results from further tests and evaluation. That’s why knowing your risk factors and having a healthy (but not to the point of obsessing) suspicion that it could happen to you is so important.

In considering the list of heart attack symptoms, consider the following:

  • You can definitely have a heart attack without chest pain.
  • Chest pain/pressure/discomfort is often present, but not always.
  • Women are more likely than men to have so-called atypical symptoms (and no chest pain) such as upset stomach, nausea and shortness of breath.
  • Not having chest pain can make it harder for both you and your doctor to recognize a heart attack.

Next Steps

In men and women alike, the importance of awareness, recognition and prompt action cannot be overemphasized. If you are a woman, first know that a heart attack could happen to you, and then make the appropriate diet and lifestyle changes to minimize your risk.

  1. If you are a smoker, quit. Smoking is a major risk factor for heart disease.
  2. If you are obese, establish a healthy diet and lose weight. Being overweight or obese or having a poor diet are all risk factors.
  3. If you sit at a desk all day, look for ways to move your body, perhaps by taking the stairs instead of the elevator or taking a walk around the office parking lot at lunch. Physical inactivity can put you at a higher risk for heart disease.
  4. If you take medications (e.g. blood pressure, high cholesterol, etc.), work with your doctor to make sure your control is good and levels are where they should be.
  5. If you have chest pain or other symptoms of heart attack that last longer than 5 minutes, don’t ignore it. Seek emergency care to rule out a heart attack.

Doctors who deal with heart attacks have a saying that “time is myocardium,” meaning that if you recognize a heart attack early and take immediate action, you can minimize the loss of heart muscle, improving your odds of survival and of doing better in life after surviving a heart attack.

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