Recognizing Heart Disease in Women


Signs of a heart attack in women may be subtle, and they may not even include chest pain. Learn the crucial symptoms that women need to watch for.

We’ve all seen the way a heart attack is depicted in the movies — with a lot of chest-clutching and popping eyes, followed by a person dropping motionless to the ground.

However, not all heart attacks are like that, especially when it comes to heart disease in women. In real life, the signs of a heart attack in women can differ significantly from the stereotypical heart attack.

The most frequent warning sign of heart disease is fatigue, says Sohah N. Iqbal, MD, a general and interventional cardiologist at New York University Langone Medical Center in New York City. “This is usually our body’s way of saying ‘I don’t feel like I normally do.’ The most frequent acute sign of a heart attack is shortness of breath.”

Chest pain (angina) — including pressure, tightness, or squeezing — happens in only 35 to 45 percent of women having a heart attack.

“Surprisingly, women present with chest pain more often than men do,” says Philip D. Ragno, MD, president of Island Cardiac Specialists in Garden City, N.Y. and director of cardiovascular health and wellness at Winthrop University Hospital in Mineola, N.Y. “However, their chest pain is much more likely to be sharp or burning rather than pressure-like. Women may have pain in their back, neck, or jaw. Pain is often felt at rest or comes on during the night.”

Pain also can occur in one or both arms, the upper back, or stomach.

Other Signs of a Heart Attack in Women

In addition to fatigue, shortness of breath, and chest pain, there are a number of other possible signs of a heart attack in women to be aware of:

  • Nausea or vomiting
  • Breaking out in a cold sweat
  • Dizziness or lightheadedness
  • Inability to sleep
  • Pale or clammy skin
  • Anxiety

Women should also be aware that even if these symptoms come and go, they could still be signs of a heart attack.

Why Heart Attack Symptoms Differ Between Women and Men

No one knows for sure why heart attack symptoms often present differently in men and women, but there are a few theories. “Studies have shown that men and women perceive pain differently, and this may help explain why women exhibit different signs of heart disease and heart attack than men,” says JoAnne Foody, MD, American College of Cardiology spokesperson and director of the Cardiovascular Wellness Center at Brigham and Women’s Hospital in Boston.

Another idea revolves around hormonal differences in women, which can cause more small-vessel narrowing and could contribute to different symptoms.

Depression is another possible culprit. Not only is depression a significant factor for heart disease, but it can also alter heart disease symptoms — and depression affects women twice as much as men.

What to Do in Case of a Heart Attack

If you think you’re experiencing signs of a heart attack, you should immediately call 911 and get medical attention. You can also chew two 325 mg aspirin tablets while awaiting the ambulance. Then, alert a neighbor or family member to stay with you until help arrives.

“Remember there is little harm in a false alarm, yet if you are truly having a heart attack, your cardiologist only has a six-hour window to open that artery and limit the damage. So the worst thing that you can do is sit at home and ‘wait it out,'” says Dr. Rango.


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