In Women, Heart Attacks Don’t Look Like Heart Attacks

Author: Catherine Dao, M.D.
Specialty: Cardiology

For women in the United States, heart disease is the leading cause of death across all ages and races. More than cancer. More than stroke. More than accidents. In fact, nearly 1 in 3 women will succumb to the disease – that’s almost one death per minute.

Why is this so high? While the prevalence of risk factors, such as obesity, high blood pressure and high cholesterol, undoubtedly contribute to this sobering statistic, so does the simple fact that many of the symptoms that we typically associate with heart attack are based on how it presents in men. For many women, a heart attack just doesn’t seem like a heart attack.

So, what, exactly, does a heart attack look like in woman and can it be prevented?

Heart Attack Symptoms in Women

Many women don’t experience the crushing chest pain commonly associated with heart attack. More commonly, it’s felt as a pressure or discomfort in the chest that may not even be severe enough to cause alarm. In fact, some women may not report feeling chest pain at all. To complicate things further, many of the symptoms that are typical of heart attack in women are really, really common.

So, what should you be looking for? Any combination of the following symptoms:

Pressure or tightness in the chest
Shortness of breath
Discomfort in the neck, jaw, shoulder, upper back or abdomen
Nausea or vomiting
Sweating
Fatigue
Dizzy- or lightheadedness

See? Like I said, a lot of these symptoms are really common. Unfortunately, because these symptoms are so common, a lot of women downplay symptoms or don’t seek medical attention until heart damage has already been done – if they seek it at all.

Know Your Risks

While some risk factors are common to heart disease in general, others play more significant role in women. It’s also important to note that heart disease can affect women at any age, particularly if risk factors are present or if they have a family history of heart disease. In addition to high blood pressure, high cholesterol and obesity, here are some risk factors that are specific to or increase risk within women:

Diabetes – Adults with diabetes are 2-4 times more likely to die from heart disease, with women on the higher end of this statistic.

Mental Health & Stress – While stress is a well-known factor in heart disease, mental health conditions like depression and anxiety also affect heart health due to the impact that they have on one’s ability to lead a healthy lifestyle. Learn more about mental health and managing stress.

Smoking – Smoking increases a woman’s risk for heart disease more than it does among men.

Menopause – Lowered levels of estrogen increases the risk of coronary microvascular disease (buildup or damage within smaller blood vessels), which may also account for the chest discomfort rather than pain experienced within women.

Pregnancy – Complications women may experience during pregnancy, such as diabetes or high blood pressure, increase their risk for developing these conditions after pregnancy. Diabetes and blood pressure well-known heart disease risk factors.

Reduce Your Risk

While some things, like menopause or family history, can’t be helped, other risk factors can be mitigated or eliminated by leading a healthy lifestyle. Things you can do to reduce your risk for heart disease include:

Get 150 minutes of moderate exercise each week.
Maintain a healthy weight.
Quit smoking.
Eat a diet rich in whole grains, fruits and vegetables, and lean meats.
Avoid saturated or trans fats, sugars and salts.

Even with lifestyle modifications, heart disease and heart attacks may be unavoidable. Talk to your doctor about what else can be done to reduce or manage your risk factors. More, importantly, pay attention to your body. If something doesn’t feel quite right, seek medical attention immediately. When your life is on the line, it’s better to be safe than sorry.

If you’d like to learn more about the heart and vascular program at Washington Hospital, visit the hospital website.

Posted January, 2019