Heart attack symptoms in women can differ from the classic warning signs portrayed in men. Women may notice symptoms such as shortness of breath, nausea or overwhelming fatigue, sometimes without even experiencing chest pain at all. Because these symptoms can be subtle or unexpected, they’re easier to dismiss or misinterpret and many women delay seeking appropriate care as a result, increasing the risk of serious complications or death.
Understanding how heart attack symptoms can present in women, along with risk factors that increase the likelihood of heart disease, is important to ensure you seek treatment quickly and take steps to reduce and prevent future heart problems.
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What Is a Heart Attack?
A heart attack is a severe cardiac condition in which there is a sudden problem with or interruption of blood flow to the heart.
“There are arteries that lay on top of the muscle of the heart, and they supply blood flow to the heart muscle so that it can pump appropriately,” says Dr. Kate Elfrey, a board-certified cardiologist with The Heart Center at Mercy in Baltimore, Maryland. “When you have a buildup of plaque and cholesterol that becomes severe to the point where it has obstructed the artery, that’s when you’ll have a heart attack.”
The most common cause of heart attacks is a blockage in one or more of the major arteries feeding the heart. The plaque buildup will block the artery, preventing that area of the heart muscle to not get adequate blood flow, which ultimately leads to pain, discomfort and other symptoms that come with a heart attack.
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Heart Attacks in Women
Heart disease is the primary cause of heart attacks and the leading cause of death for women in the United States. Heart disease was responsible for about 1 in every 5 female deaths in the U.S., according to 2023 data from the Centers for Disease Control and Prevention.
Despite its prevalence, awareness is limited. A survey from the American Heart Association found that only about half of women surveyed recognize that heart disease is the No. 1 killer in the U.S., with significant disparities in awareness among Black and Latino women.
Heart disease is often preventable, but gaps in awareness and understanding mean many women are still at risk of experiencing a heart attack.
“About 80% of all heart disease can be prevented,” Elfrey says.
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Common Heart Attack Symptoms
Common signs and symptoms of a heart attack include:
— Chest pain or discomfort
— Pain or discomfort that radiates to the jaw area, arm, back or stomach
— Shortness of breath
— Sweating
— Dizziness or lightheadedness
— Nausea or vomiting
“The hallmark signs and symptoms (are) like what we see in the movies,” Elfrey says, describing crushing chest pain in which someone clutches their chest or makes a fist and holds onto their chest.
Someone experiencing a heart attack may describe the feeling as an elephant sitting on their chest. The pain can feel like an excruciating, severe squeezing sensation, explains Dr. Daniel Hermann, an interventional and structural cardiologist and director of structural cardiology at Memorial Hermann Memorial City Medical Center in Houston.
Silent Heart Attack Symptoms in Women
Signs of a heart attack in women can be more subtle than heart attack symptoms in men. These symptoms may include:
— Discomfort in the upper belly or lower chest, often mistaken for indigestion
— Gastrointestinal symptoms, such as nausea or vomiting
— Shortness of breath, at rest or with exertion
— Extreme or unusual fatigue
These signs can be more prominent in women than the classic chest-clenching pain. For women, their chest pain may be less prominent or completely absent at times, Hermann says.
Dr. Supreeti Behuria, co-director of preventive cardiology at Northwell’s Staten Island University Hospital in New York, explains, “The most common symptom of a heart attack in women is still chest pain, but it often presents as discomfort, pressure or tightness rather than the classic ‘elephant sitting on my chest’ sensation that is more commonly described by men.”
Behuria adds that women are also more likely to experience shortness of breath — both at rest and with exertion — along with overwhelming fatigue, gastrointestinal symptoms, dizziness, lightheadedness or even fainting. “So-called ‘silent’ heart attacks can present with these same symptoms, but they are typically milder in intensity, which can make them easier to overlook or dismiss,” she says.
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When to Go to the ER for Heart Attack Symptoms
If you have a sudden or acute onset of heart attack symptoms, including severe chest pain, profuse sweating and extreme dizziness, call 911 right away.
“The faster you can get to the hospital so that we can see if you really are having a heart attack is very important,” Elfrey says. In a sudden severe cardiac event, she explains, there’s a limited window — about an hour and a half — from when you begin experiencing symptoms to the time doctors can treat the heart attack in order to preserve heart function.
Because women’s heart attack signs are often more subtle, it can be harder to recognize a serious cardiac event and when emergency care is needed.
If you live an active lifestyle and notice unusual changes, that’s a big warning sign. For example, Elfrey says, if you go out for a one-mile walk every day and notice you’re more fatigued or can’t walk up a hill you typically can without taking a break, that change could signal a heart problem.
What often prompts women to seek emergency care? Behuria says women frequently present with shortness of breath along with varying degrees of chest pain, pressure or discomfort, which may not always be severe or immediately recognized as heart-related.
Ultimately, if you aren’t feeling quite right — like feeling short of breath walking to the bathroom — the sooner you can get to the hospital the better.
“The most important thing is to listen to your body,” Elfrey says. “Don’t take anything for granted. Don’t say, ‘It’s probably just stress,’ or ‘It’s probably just indigestion.’ Don’t take the risk when it comes to the heart.”
Risk Factors for Heart Attack in Women
There’s no evidence that shows that one risk factor leads to a higher risk of heart attack in men or women, Elfrey says.
Risk factors for heart attack in men and women include:
— Family history of premature heart disease. If you have a loved one that had a heart attack at an early age — in their 40s or 50s — that’s a major risk factor.
— Obesity
— Diabetes
— Living a sedentary lifestyle
— Smoking
— Stress
These risk factors can increase the buildup of plaque or fatty material in your arteries, which can lead to a heart attack.
Stress is often ignored as a risk factor, Elfrey says. Whether it’s work-related stress or family issues, this creates physical stress on our body.
The body goes into that “fight-or-flight mode,” and cortisol levels rise so that we’re able to sustain and function at a higher level of breath, Elfrey says.
Though cortisol secretion is necessary to cope with stress in the short term, prolonged and/or excessive secretion of the hormone can promote inflammation inside the body. Increased inflammation due to stress can trigger premature plaque building in the heart arteries, which contributes to the heart attack process, Elfrey says.
She also points out that, though risk factors don’t necessarily differ from men to women, women often assume the caretaker role in the household. This can increase emotional strain, causing many women to internalize these demands and overlook proper self-care to manage stress levels.
“In women, we need to pay close attention to how stress is affecting our bodies,” she says.
Preventing a Heart Attack
No matter your family history, there are several ways to keep heart disease at bay.
“We see a lot of people that are concerned because of family history, and they feel like they’ve been dealt a bad hand,” Hermann says. “You have a lot of power to modify your risk profile.”
Some of the best ways to prevent a heart attack and heart disease are to:
— Maintain a good relationship with your doctor.
— Ask about heart disease screening.
— Control known risk factors.
— Eat a heart-healthy diet.
— Increase your physical activity levels.
— Avoid smoking.
— Manage stress levels.
Maintaining a good relationship with your doctor
Heart disease can be prevented. The key is building a great relationship with your physician and being able to listen to your body and ask questions, Elfrey says.
Ask about heart disease screening
Elfrey sees many patients who aren’t having any symptoms but just want to come in and have a risk assessment.
“They want to go over their risk factor profile, and that’s what saves lives,” she says.
There’s a simple noninvasive test that you can do, called a coronary calcium score, that looks for calcium buildup in your heart and heart arteries. It identifies how much risk you have of having a coronary heart problem.
The test is a noncontrast CT scan that essentially takes an X-ray of your heart and heart arteries.
“We’ve found so many people that are completely asymptomatic that are walking around with a very high plaque burden and not knowing anything about it,” Hermann says. “It’s important to discuss with your physician whether it’s appropriate to have it or not.”
Control known risk factors
If you have known risk factors for heart attacks, such as high blood pressure, high cholesterol or diabetes, it’s crucial to keep these factors in check. Your health care provider can help identify your risk factors and how to best control them.
Eat a heart-healthy diet
Eating a balanced diet that promotes heart health can help reduce your risk of cardiovascular disease. Look to follow an eating plan that emphasizes heart-healthy foods, such as vegetables, fruits, whole grains, lean poultry and fish.
Increase your physical activity levels
Men and women benefit from being more physically active, losing excess weight and following a heart-healthy diet. Adults should aim for at least 150 minutes of moderate-intensity physical activity — such as biking, swimming or a brisk walk — and two days of muscle-strengthening activity per week, according to the Physical Activity Guidelines for Americans from the U.S. Department of Health and Human Services.
Avoid smoking
Smoking increases the risk of having a heart attack far greater for women than men. Avoiding certain behaviors that are known to lead to heart disease — such as smoking — can decrease your risk, Hermann says.
Manage stress levels
We are all affected by stress differently, but it’s important to recognize stress as a major risk factor so that you can learn how to manage those symptoms.
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Heart Attack Symptoms in Women: Subtle Signs You Can’t Ignore originally appeared on usnews.com