How The Signs of A Woman’s Heart Attack Differ From A Man’s

Did you know that cardiac arrest, not breast cancer, is the #1 killer in women? In fact, according to The Heart Foundation, heart disease is more deadly for women than all forms of cancer combined. An estimated 43 million women in the U.S. are affected by heart disease. And yet, only 1 in 5 American women believe that heart disease is their greatest health threat.

Since the symptoms of heart disease can be quite different in women and men, and are often misunderstood, I offer this blog to help both sexes understand what to look for, what it might mean, and when to seek medical help.

Signs that a woman may be having a heart attack

The warning signs of a woman in cardiac arrest can be much more subtle than those for a man. For instance, women don’t always get the same classic heart attack symptoms as men, such as crushing chest pain that radiates down one arm. Those heart attack symptoms can certainly happen to women, but many experience vague or even “silent” symptoms that they may miss.


Margaret Andersen, MD

I’ve listed below the most common symptoms of a heart attack in a woman. If you have any of these signs, call 911 and get to a hospital right away.

  • A feeling of fatigue. I’ve had many patients tell me over the years that they’re extremely tired all the time, even if they’re just sitting still. They may be unable to do simple activities, like walk to the bathroom. I’ve also had women who exercise regularly tell me that they can’t get on the treadmill; they feel like they just can’t do it. This signals to me that this is something I should investigate because it may be a sign of heart disease.
  • Abdominal discomfort or gastric pain rather than actual chest pain.
  • Chest pain or discomfort. Chest pain is the most common heart attack symptom, but some women may experience it differently than men. It may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. Many women report that it feels like a vise being tightened.
  • Pain in one or both arms, back, neck or jaw. This type of pain is more common in women than in men and may catch some women by surprise who expect their pain to be in their chest and left arm. The pain can be gradual or sudden, and it may come and go before becoming intense. If you’re asleep, it may wake you up.
  • Stomach pain. Sometimes when women feel moderate stomach pain (that could signal a heart attack), they mistake it for heartburn, the flu or a stomach ulcer. In other cases, the abdominal pressure can be severe, feeling like an elephant sitting on their stomach
  • Shortness of breath, nausea or lightheadedness. If you’re having trouble breathing for no apparent reason, you could be having a heart attack, especially if you’re also having one or more other symptoms. These particular symptoms are more common in women than men.
  • Breaking out in a nervous, cold sweat. It will feel more like stress-related sweating than perspiration from exercising or spending time outside in the heat. Seek medical attention immediately if there is no other reason for it, such as a hot day or menopausal hot flashes.

Not everyone experiences all of these symptoms. But if you are having chest discomfort, especially if you also have one or more of the other signs above, call 911 immediately.

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

The most important thing to remember is: don’t delay getting help.

Women generally wait longer than men before going to the emergency room. Even if you think your symptoms aren’t that bad or will pass, the stakes are too high to ignore them.

  • Don’t drive yourself to the hospital. Call an ambulance. If you drive yourself, you could have a wreck on the way and possibly hurt yourself or someone else.
  • Don’t have a friend or relative drive you, either. You may not get there fast enough.
  • Don’t ignore what you feel. Don’t worry about feeling silly if you’re wrong. What if you’re right?
  • Don’t just take an aspirin. Many of my female patients take an aspirin if they are feeling any of these symptoms and never call 911. Sadly, that could prove fatal.
  • Watch this video from The American Heart Association about a woman (actress Elizabeth Banks) having a heart attack. Obviously, I’m asking you to watch it now while you’re not having heart attack symptoms, not during the event. It does a good job of illustrating the signs of cardiac arrest while also portraying how women often ignore them until it’s almost too late.

Risk factors for a heart attack

Several factors increase your chances of a heart attack, particularly in combination:

  • Family history of heart disease
  • Smoking
  • High blood pressure
  • High cholesterol levels
  • Diabetes
  • Obese
  • Stress
  • Lack of exercise
  • Depression

Preventing heart attacks

1) If you smoke, stop. This will immediately cut your chances of a heart attack by a third.

2) Get exercise and eat healthy. The American Heart Association recommends 30 minutes of moderate exercise a day, 5 days a week. It also recommends a diet containing plenty of fruits, vegetables and whole grains to keep your arteries healthy.

3) For some people, a daily aspirin helps prevent heart disease. Consult with your doctor to see if this is right for you.

4) Find positive ways to manage your stress. Yoga, biking, swimming, volunteering or even taking up a craft or hobby are just a few suggestions of healthy ways to relieve stress and avoid a heart attack.

5) Control your blood pressure. Check your BP regularly and contact your doctor if you notice a change.

6) Take your medicine. Certain medications can lower your cholesterol and blood pressure, prevent blood clots, and even lower your chances of a heart attack. They can also ease your symptoms and take stress off your heart. If you have been prescribed medicines for your heart, be sure to take them.

7) Watch your cholesterol. A high LDL or a low HDL can lead to heart problems. Aim to keep your LDL at 100 or lower and your HDL above 60. If you have already had a heart attack or are at high risk for one, shoot for 70 or below. Sometimes diet and exercise aren’t enough to control cholesterol, and your doctor may want to put you on medication to keep yours in check.

8) If you drink alcohol, do so in moderation.  Alcohol can weaken your heart and make it work harder. Research has shown that a small amount can raise your HDL (good) cholesterol level, but too much can make you gain weight or raise your blood pressure. Ask your doctor what’s best for you.

9) See your doctor regularly. Keep up with your appointments, and tell your physician about any heart-related symptoms you may have noticed symptoms. Remember, your doctor is your partner in your healthcare.

Good news: Heart disease is mostly preventable.

Research shows that up to 90% of heart disease can be prevented by changing your diet, exercising more, maintaining a healthy weight and not smoking. While some heart disease risk factors (such as family history) are out of your control, a healthy diet and lifestyle can really make a difference.

Concerned that you might be at risk for heart disease? Please come see us.

At Westchester Health, our #1 goal is to help you stay healthy, and a very important part of your overall health is maintaining the health of your heart. If you’re concerned about your heart, or you would like to be screened for possible heart disease, please call (914) 232-1919 to make an appointment with one of our Westchester Health Internal Medicine specialists. And remember: if you take care of your heart, it will take care of you. Whenever, wherever you need us, we’re here for you.

Margaret Andersen, MD, an internist with Women Caring For Women, an internal medicine practice focused solely on women, part of Westchester Health, member of Westchester Health Physician Partners

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