Heart Attack Symptoms in Women Can Differ from Men

Heart attack symptoms in women can be subtler than they are in men. In fact, some women may mistake their symptoms as a common illness such as heartburn, muscle pain, or flu. Here’s what you need to know.

The thought of having a heart attack is frightening but can be even more so when you consider that women often mistake symptoms of a heart attack as a less life-threatening condition. According to the American Heart Association, both men and women can experience chest pressure or pain during a heart attack, but women may have a heart attack without chest pain. Furthermore, chest pressure or pain is not always the most prominent symptom in women. In many cases, the heart attack symptoms in women mimic less fatal conditions such as pain or pressure in the upper abdomen or upper back, dizziness, lightheadedness, or extreme fatigue.

The Most Common Heart Attack Symptoms in Women

According to the Mayo Clinic, when women do experience chest pain during a heart attack, they often describe it as a “pressure”, “squeezing”, or “tightness” rather than actual pain. The chest discomfort either lasts several minutes (or longer) or it is a feeling that comes and goes. Other heart attack symptoms in women include:

1. Pain in the left arm (or both arms)
2. Upper back pain
3. Pain in the neck or jaw area
4. Stomach pain or heartburn symptoms
5. Shortness of breath
6. Rapid heartbeat
7. Dizziness or lightheadedness
8. Feeling weak or shaky
9. Sweating
10. Nausea or vomiting
11. Extreme fatigue
12. Sleep disturbances

Also, some studies have shown that women will have “prodromal symptoms” up to four weeks before having a heart attack. Prodromal means that one or more of the heart attack symptoms is experienced prior to actually having an acute myocardial infarction (heart attack). For example, almost half of women report issues with sleep in the weeks leading up to a heart attack including difficulty falling asleep, unrestful sleep, or waking up throughout the night. 

Heart Disease in Women

Heart disease is the most common cause of death for both men and women in the United States. However, women more frequently develop a condition called coronary microvascular disease. This means that in addition to having a blockage in one of the main arteries that supply blood to the heart, there can be a blockage in the smaller blood vessels that branch off of the larger arteries. This is why women may feel chest pressure or tightness as opposed to chest pain.

Causes of Heart Attacks in Women

Having low levels of estrogen can put women at risk of coronary microvascular disease. The American Heart Association notes, “Women may be at risk for coronary microvascular disease (MVD) if they have lower than normal estrogen levels at any point in their adult lives. Low estrogen levels before menopause can raise younger women’s risk for coronary MVD, and can be caused by stress or a functioning problem with the ovaries.”

Other risk factors for heart attack in women include:

• High blood pressure
• Unhealthy cholesterol levels
• History of diabetes
• Lack of regular exercise
• Obesity
• Nicotine or drug use
• Menopause
• Age (being over 55)
• History of endometriosis
• Preeclampsia during pregnancy

Mental Stress and Heart Attacks

Emotional stress really can break the heart! A condition known as “broken heart syndrome” can cause heart muscle failure known as stress cardiomyopathy or Takotusubo cardiomyopathy. Broken heart syndrome occurs in response to physical or emotional stress such as the loss of a loved one or divorce. During broken heart syndrome, a person may not actually be experiencing a full-blown heart attack, but instead the body might be mimicking the symptoms of a heart attack such as shortness of breath, chest pain, low blood pressure, or fainting. But, broken heart syndrome can cause cardiogenic shock or heart failure, and should be treated with the same urgency as a “regular” heart attack.

Furthermore, studies show that anxiety, depression, or other mental stress impacts the cardiovascular health of women more so than men. In fact, chronic stress can increase the risk of heart attack just as much as smoking or overeating. Research shows that people who suffer from chronic anxiety are more likely to suffer from atrial fibrillation (an irregular heart rhythm), heart attack, or sudden heart death.

Heart Attack Prevention

There are several strategies you can incorporate into your lifestyle to help prevent a heart attack:

1. Exercise regularly – aim for 30 minutes per day, at least 3 to 5 days per week
2. Eat a healthy diet.
3. Quit using drugs or nicotine products.
4. Maintain a healthy body mass index.
5. Get 7 to 8 hours of sleep per night.
6. If you have a history of diabetes, high blood pressure, or low estrogen levels, talk to your doctor about options to lower your risk of heart disease.
7. If you suffer from anxiety, depression, or chronic stress, consider talking with a counselor or therapist. (And, know that beginning a regular exercise program can also help eliminate chronic stress!)

What to do if you think you are having a heart attack:

If you think you are having a heart attack, but you are not sure, seek emergency help right away. Call 9-1-1 or have someone drive you to your local emergency room immediately. Don’t disregard and blow off your symptoms. Waiting even a few seconds to get emergency help can be fatal.

While waiting for the paramedics to arrive or while en route to the hospital, take an aspirin (unless you are allergic or your doctor has told you to avoid aspirin). If you are over the age of 50 or have any risk factors for heart disease, you should always have a bottle of 81 mg aspirin readily available in your medicine cabinet in case of emergency.

If you have been prescribed nitroglycerin or other cardiac medication, take it according to your doctor’s direction. But, never take another person’s prescription medication.

References:

[1] American Heart Association

[2] Mayo Clinic

[3] Circulation. 2003 Nov; 108:2619-2623.

[4] John Hopkins Medicine