A Woman’s Heart Attack: Why and How It Is Different than a Man’s Heart Attack

Heart disease is the number one killer of women in the United States, killing one out of every four women each year. Why is heart disease so deadly in women? One of the reasons is that “typical” heart attack symptoms—crushing chest pain that radiates to the left arm—do not describe what many women feel during their heart attacks. Consequently, women ignore or downplay their heart attack symptoms until it is too late.

What is a heart attack?

A heart attack (or myocardial infarction) occurs when the blood supply is cut off from or severely reduced to part of the heart. It is caused by a blockage in one of the coronary arteries. This blockage could be caused by a blood clot or by plaque, cholesterol, and fat buildup in the arteries (usually a combination of both). Heart cells starved of blood die rather quickly if blood flow is not restored. If too much heart tissue dies, heart function can be permanently altered or the person could die from the heart attack.

Symptoms of a heart attack

“Typical” cardiac chest pain (angina)

Most descriptions of heart attack symptoms were gleaned from asking men about their heart attack symptoms. As such, these symptoms apply most often to men, though they can also apply to women.

The “typical” symptoms of heart attack are:

  • Discomfort just behind the breastbone (often described as “crushing” or “squeezing”)
  • Brought on by exertion or emotional stress (but may occur at rest)
  • The pain may radiate or extend to the shoulder, jaw or inner aspect of the arm
  • Shortness of breath
  • Nausea
  • Sweating
  • Extreme fatigue

How is a woman’s heart attack different?

Women may experience “typical” symptoms of heart attack, but they also need to be aware of other symptoms of heart attack and take them seriously.

Symptoms of heart attack for commonly experienced by women:

  • Discomfort just behind the breastbone (described as “heaviness,” “tightness,” “pressure”)
  • Chest pain is not necessary for a woman to be having a heart attack
  • Induced by rest, sleep, and emotional stress, in addition to or instead of physical exertion
  • The pain may radiate or extend to the shoulder, jaw or inner aspect of the arm
  • Shortness of breath (perhaps without chest pain)
  • Nausea
  • Sweating (often a cold sweat)
  • Extreme fatigue
  • Inability to sleep, which is unusual or particularly severe
  • Skin becomes pale, clammy
  • Dizziness/lightheadedness/feeling faint

While men generally exhibit the typical symptoms of chest pressure and pain, women generally exhibit symptoms that are not well-known, leading them to delay seeking treatment. Women who are having a heart attack often feel pain in areas outside the chest, including the jaw, neck, abdomen, legs, and arms. Severe fatigue, sweating, or shortness of breath can also be present, leading women to feel as if they just ran a marathon even though they are standing still. Many women who have had heart attacks also mistake the chest pain for heartburn, indigestion, or a stomach ulcer.

What should a woman do if they experience these symptoms?

Call 9-1-1 immediately! If you or someone you know are experiencing these symptoms, don’t delay. Do not wait it out; do not see how you feel in fifteen minutes. Do not drive yourself to the hospital, as the ambulance will be able to get to you faster than you can get to the hospital, and you may cause an accident on the way. If you live in a rural area without prompt, reliable ambulance service, call 9-1-1 and tell them your symptoms. They may be able to arrange alternate transportation (i.e. helicopter).

Think a helicopter is too much fuss for what is probably indigestion? That is the type of thinking that kills thousands of women each year.

Resources for Women About Heart Attacks

Recognizing a Heart Attack

Heart Attack Infographic – From the American Heart Association, this infographic gives the 5 common warning signs of a heart attack.  Can be printed for posting.

WomenHeart Graphic – Another graphic that shows what a heart attack feels like to a woman.

Healthy Heart Quiz – Asks the question “Can you recognize a heart attack?” followed by a quiz to determine how much you know.

Heart Attack Symptoms in Women – There are differences in symptoms between men and women.

Heart Attack Animation – An interactive explanation of what happens during a heart attack.

Coronary Artery Disease in Women – A YouTube video that outlines how to recognize and treat CAD in women.

Living with Heart Disease

Preventing Another Heart Attack – Identifies those risks that you can control and those you cannot change.  Good presentation on modifying behaviors that you can control.

Lower the Risk of Another Heart Attack – Outlines 5 ways to decrease your chance of a second heart attack.

Empowering Women to Take Charge of their Heart Health – A YouTube video that tells stories of women who have survived heart attacks and heart disease.

Thrive 2016 – How to thrive with heart disease.

FDA Heart Health for Women – In multiple languages, this site from the US Food and Drug Administration outlines 4 steps for managing heart health.

Heart Health and Stroke – From the Office on Women’s Health at the Department of Health and Human Services, lots of good information about risk and signs of both heart attack and stroke.

CDC Information on Women and Heart Disease – From the Centers for Disease Control and Prevention, this site outlines facts about women and heart disease.

Support Groups

American Heart Association Support Network – Sponsored by the AHA, this network shares stories and resources for both heart attack and stroke.

Healtheo360 Support Groups – The Heart Disease Support Group is an open access group.  Scroll down to the bottom of the page to request to join the WomenHeart AFib Virtual Support Network.

WomenHeart National Hospital Alliance – For organizations that want to make a difference in your community.

WomenHeart State Specific Support Networks – With an interactive map, you can find support networks in your state.

Inspire Online Community – Read stories from others and post your own story to this online community for women with heart disease.

SisterMatch – A peer-to-peer support opportunity for women living with heart disease.

Latest Advancements and Research

Advancing Women’s Heart Health – Published in Women’s Health Issues May 2016, this article outlines the highlights from the first policy and science summit on women’s cardiovascular health.

National Heart, Lung and Blood Institute – Assessing Cardiovascular Risk and clinical practice guidelines based on a review conducted by the Risk Assessment Work Group.

The Gender Gap in Cardiovascular Disease – From Seconds Count, an interesting look at the gender gap that still exists in cardiovascular disease.

Heart Disease and Monitoring Mobile Apps – From Healthline, a comprehensive list of free and low-cost mobile apps to help with monitoring heart health.


References
http://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20046167
http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_women_heart.htm
https://www.goredforwomen.org/about-heart-disease/facts_about_heart_disease_in_women-sub-category/statistics-at-a-glance/

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As Seen On: American College of Cardiology, U.S.News, JAMA, Circulation Research, The Lancet