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  • Blog

    Heart Attack Symptoms in Women

    Dr. Mary Williams, RN, DC

    About the author

    Dr. Mary Williams, RN, DC

    Dr. Mary Williams, R.N., D.C is a Doctor of Chiropractic with an extensive background as a Registered Nurse and experienced Core Instructor for the American Heart Association. She has over 30 years of hands-on medical and instructional experience.

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    Signs of heart attack in women include:

    • Pain or pressure in the center of the chest (that lasts more than a minute or two, or comes and goes).
    • Pain in the back, jaw, neck, stomach, or one or both arms.
    • Shortness of breath.
    • Nausea and vomiting.
    • Lightheadedness.
    • Cold sweats.
    • Extreme fatigue.

    Heart attacks feel different for women

    Both men and women can experience intense chest pain. But women may not—and even when they do, they also frequently experience more vague symptoms such as dizziness or lightheadedness, crushing fatigue, pain in different areas of the body such as the arms, jaw, neck, back, or stomach; and nausea or vomiting.

    Warning signs of heart attack in women are more subtle than those found in men—and they mean heart attacks are sometimes mistaken for other ailments, such as the flu. Many women don’t get the help they need in time because they don’t recognize the symptoms until it’s too late.

    Doctors often don’t recognize the signs

    And sometimes health providers don’t recognize them soon enough, either. According to a recent study by the Yale School of Public Health, women’s symptoms are often dismissed or misdiagnosed on the first try—especially younger women’s.

    The researchers interviewed over 2,000 female and 1,000 male patients for the study, within the age range of 18-55, who had been hospitalized for a heart attack. Almost 30% of the women interviewed had seen a doctor for their symptoms at least once before hospitalization, and 53% were not told that those symptoms could be a heart attack.

    The health care system treated the men better—only 22% had seen a doctor prior to their hospitalization, but of those, only about a third were not told that their symptoms could be a heart attack leading to cardiac arrest needing CPR.

    In addition, a recent study by Cedars-Sinai demonstrated that when they have women in their offices complaining of heart attack symptoms, doctors frequently look for causes more typically experienced by men—and send the women home if they don’t see those.

    In the study, female patients with heart attack symptoms were frequently told that they weren’t having a heart attack because they didn’t have coronary artery blockages—a major cause of heart attacks in men. However, 8% of those women were later found to have scars on their hearts that showed a heart attack had happened.

    The picture is clear: even now, doctors frequently don’t recognize the signs of heart attacks in women or correctly identify underlying causes—because those differ from the ones commonly seen in men.

    Why the disparity?

    Up until recently, heart attacks in women hadn’t been extensively studied—and their heart attack symptoms were frequently misdiagnosed.

    In a recent article in the Times, the founder of the Women’s Heart Clinic at the Mayo Clinic discussed how she was taught in the 1980s that women rarely got heart disease.

    In addition, most large studies on heart disease did not include women, either deliberately or because they set limits on study participants by excluding women of childbearing age or those with other pre-existing conditions, which women are more likely to have.

    Because of this underlying education gap, there have been many instances where healthcare professionals have not recognized the symptoms of heart attacks in women—often for weeks or months, until the patient ended up in the hospital with a massive heart attack that could have been prevented.

    Add to that a disturbing trend in medicine where women’s symptoms tend to be taken less seriously overall—across a wide variety of ailments.

    This may be because women’s symptoms for a variety of health problems tend to be different from those found in men—and men’s symptoms are often what’s taught in medical schools.

    Women’s symptoms for a variety of health issues can present as more complex and less clear-cut than men’s, resulting in their complaints being dismissed as a product of anxiety or mental stress.

    Statistics about women and heart attacks

    • Heart disease is the leading cause of death for women in the United States—approximately 1 in 4 women will die of heart disease.
    • Heart attacks aren’t just a male disease. Both men and women die of heart attacks at about the same rate in the United States. 
    • Approximately two-thirds of women who die of coronary heart disease have had no previous symptoms.
    • Women are 50% more likely than men to get an incorrect initial diagnosis of heart attack symptoms.
    • Women across all age groups are more likely to die in a hospital after being admitted for heart attack. Women under 50 are twice as likely as men to die in a hospital setting.

    What can you do?

    Approximately 80% of the factors that lead to heart attack are preventable. Steps you can take to reduce your risk include:

    • Stop smoking. If you quit, you immediately slash your risk of coronary heart disease by 50%.
    • Talk to your doctor. Discuss your concerns and go over your risk factors for heart disease—including lifestyle issues, cholesterol levels, and family history.
    • Add in exercise. Exercise can help reduce your risk of heart attack and other ailments as well—including stroke. And you don’t have to run a marathon to get health benefits. Just half an hour of walking can make a difference.
    • Change your diet. Adopting a heart-healthy diet can also do a lot to reduce your cholesterol levels. Substituting in lean meats, low-fat dairy, skinless poultry, and vegetables for processed foods can go a long way toward reducing your risk.
    • Consider cholesterol-lowering drugs. If you try diet and lifestyle modifications and your cholesterol levels are still high, you may want to discuss different cholesterol-lowering drugs with your doctor.

    Knowing the symptoms of heart attacks in women can help you recognize when things are wrong for you—and give you the confidence to trust your gut that something really is wrong. The sooner you get help, the more likely you are to survive a heart attack.


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