Family Health: Heart attack symptoms can differ for women

When the actor on the screen clutches his chest, cries out in pain and collapses, we’re pretty sure we know what happened – he had a heart attack.

It’s a good guess. Chest pain or pressure is the most common symptom of this serious event, in both men and women. But the dramatic “movie heart attack” symptoms don’t happen for everyone. For women especially, heart attack signs can be much more subtle. This can lead them to put off getting help, believing their discomfort is due to a less serious condition like acid reflux or the flu.

Men can also have heart attack symptoms that don’t seem to raise red flags. But according to the American Heart Association, symptoms such as these happen more often in women:

  • Pain or discomfort in one or both arms, or in the back, neck or jaw.
  • Pressure in the upper back that feels like being squeezed by a rope.
  • Shortness of breath, sometimes without chest pain or discomfort.
  • Nausea, vomiting or stomach pain.
  • Dizziness or fainting.
  • Sweating.
  • Extreme fatigue.

Doctors speculate that women may have different heart attack symptoms because they’re more likely than men to have blockages in the smaller coronary arteries as well as the main vessels. This is called microvascular disease, and the risk for it goes up after menopause, when estrogen levels drop.

In fact, after menopause women surpass men for heart disease risk overall. Certain diseases and conditions, such as diabetes, mental stress and depression, increase these risks more in women than men. And while smoking is one of the biggest factors in heart disease for everyone, it’s even worse for women.

When women put off going to the emergency department, they delay treatment that can minimize the damage from a heart attack. If you have heart attack symptoms, with or without chest pain, don’t hesitate to get emergency help immediately.

An even better plan is to take steps to avoid having a heart attack. Lifestyle changes like getting more exercise, not smoking, eating right and losing weight can put distance between you and heart disease. Some people also benefit from medications to manage blood pressure and cholesterol.

Your best first step is to find out what your risks are – the AHA recommends that both men and women begin regular screening for heart disease risks at age 20. That includes a lab profile to check your cholesterol and triglycerides, a diagnostic EKG, blood pressure and Body Mass Index measurements, and other assessments.


Shawn Lake writes for Community Medical Center.

This article is also published in the Missoulian.