What are the first signs of a heart attack in women?
For a majority of people, the signs and symptoms of heart attack are quite apparent (unmistakable) or evident (clear) – they get the picture of some heavy object sitting on their chest – squeezing the chest with a great deal of pressure – but in women, the signs and symptoms can be somewhat subtler and bewildering. Let us understand the easily mistakable and somewhat confusing signs of a heart attack in women.
When somebody experiences a heart attack – the first thing comes to their mind is chest pain – it is quite obvious though. A squeezing, pressurizing and intense chest pain – which can be compared to a heavy object sitting on the chest. In simple terms this is what the typical heart attack sign in men and women would be like – but, according to experts from American Heart Association, women can experience a heart attack without experiencing chest pain. It looks quite amazing, but it is a fact. In this context, let us understand the early warning signs of a heart attack in women – and how are they different from those in men.
Signs and symptoms of a heart attack in women
Chest Pain: Is it different in women?
Chest pain is also one of the most common symptoms of a heart attack in women as in men. But, one important distinction, as far as chest pain associated with a heart attack in women is that it is not always the prominent symptom or not always severe or not even majorly noticeable symptom in women.
The reason for this is that the majority of women describe their chest pain as just pressure or tightness. Another confusing aspect here is that a woman can have a heart attack without having chest pain. This is just startling, but it is a fact.
Pressure or pain in the lower chest or upper abdomen
Upper abdominal discomfort or lower chest discomfort associated with heartburn like symptoms (burning sensation in the chest), nausea and vomiting sensation is often mistaken for abdominal issues like acid reflux by the majority of women. Some women treat it as their normal ageing process. But these symptoms in women are indicative of problems with the heart (heart attack).
Some women, apart from these symptoms, also have flu-like symptoms, which they consider not so threatening and thus tend to ignore them.
Many women experience extreme fatigue that rather builds up several weeks before a heart attack and also just before a heart attack. They feel exhausted by doing simple activities which they normally do routinely at home.
Upper back pain and pressure
Some women feel upper back pressure – which they feel like someone tied a rope around them: squeezing back pressure. When this happens, being a woman, you should look for other symptoms like dizziness, fainting and light-headedness.
Weakness, anxiety, dizziness, light-headedness and fainting are some of the other symptoms associated with heart trouble in women.
Sweating: Women experiencing heart attack burst out in cold sweat. They feel nervous and the sweating looks more like stress-related rather than perspiration from exercising or doing physical activities outside in sun. If a woman doesn’t have any other reason for sweating such as hot flashes or heat (as seen during menopause), they must see a cardiologist immediately.
Shortness of breath: Women who experience heart attack feel short of breath to an extent that they have run a marathon – which means, they experience shortness of breath to a great extent.
Why the symptoms of heart attack are different in women?
Chest pain is not prominent and as noticeable as in men because women may have blockages in the smaller arteries that supply blood to the heart (coronary microvascular disease or small vessel heart disease) in addition to the main artery. Women experience heart attack symptoms while resting and during sleep as well – which is common in women when compared to men. Furthermore, heart attack symptoms in women can be triggered by emotional stress as well.
Though the signs associated with a heart attack in women seem to be subtle, the consequences can be drastic, if a woman doesn’t get medical care immediately following a heart attack. For this reason, women tend to appear more often in the emergency rooms after heart damage has occurred following a heart attack. As the heart attack symptoms in women differ from those in men, they are less often diagnosed with heart disease.
Majority of women tend to ignore warning signs and symptoms of heart attack assuming those to be due to less serious health conditions including acid reflux, common cold and flu. This is yet another reason for the delay in the diagnosis of heart disease in women.
Remember! There is no hard and fast rule of thumb that the above signs and symptoms (as discussed in the signs and symptoms of a heart attack in women) are always common in all women. While this may be correct to an extent, it is important to understand that any sudden and unexplained complaints above the waistline should always be taken seriously – even if it is a case with women.
Dr. Sanjeev Kumar
MBBS, DLO, MD (General Medicine), DM (Cardiology)
Consultant Interventional Cardiologist
Department of Cardiology