Heart attacks are often stereotyped as something that happens to older men, not women. But heart disease is the leading cause of death for women in the United States.1 Yet only about half (56%) of women know this.1
Plus, the way women experience a heart attack can feel different from men. While both men and women may have chest pain during a heart attack, women tend to have symptoms in addition to chest pain.
Researchers found that when women have a heart attack, they’re more likely to experience 3 or more related symptoms compared to men.2 These symptoms may include jaw pain, neck pain, back pain, and shortness of breath, and can make it hard for women to tell if they’re having a heart attack.
Women are also more likely than men to think their heart attack symptoms are caused by anxiety and stress.2 Oftentimes, this misunderstanding — combined with a wider range of symptoms — can cause women to wait longer to get treated.
“Several studies have shown that women wait longer to get treatment for a heart attack than men,” says Mingsum Lee, MD, a clinical cardiologist at Kaiser Permanente’s Los Angeles Medical Center.
So, it’s important to learn these symptoms of a heart attack and know when to seek care.
Heart attack warning signs for women
1. Chest pain
The most common heart attack symptom for women (and men) is chest pain. “About 90% of women and men have chest pain when they’re having a heart attack,” says Dr. Lee.
This chest pain and discomfort usually happens after stress — the stress can either be physical, like exercise, or emotional stress. The pain is usually strong, comes on gradually, and increases in intensity over several minutes.
“Typically, the pain feels very deep and it’s hard to localize or pinpoint,” says Dr. Lee. “People generally use terms like ‘pressure,’ ‘squeezing,’ ‘heaviness,’ or ‘tightness’ to describe the sensation in their chest.”
2. Arm, back, neck, or jaw pain
“Sometimes chest pain can radiate or travel through your arm, neck, jaw, or your back,” says Dr. Lee. The pain may gradually get more intense over several minutes.
Since most people expect pain to be in their chest during a heart attack, these symptoms can be very confusing. This is especially true because it may be difficult to pinpoint where the pain started.
3. Stomach pain
Nausea and stomach pain may also be heart attack warning signs for women. “Sometimes people come in late for care because they think they’re having heartburn or acid reflux,” says Dr. Lee. Heartburn or reflux comes from inflammation in the esophagus, which is right next to the heart. This can make it hard to tell if it’s discomfort from eating certain foods or a heart attack. “Generally speaking, heartburn can be triggered by certain spicy food, citrus, and alcohol,” she explains. And acid reflux feels worse when you lie down.
4. Shortness of breath
You might be having a heart attack if you suddenly have shortness of breath for no apparent reason. It may feel like you have to stop and catch your breath while doing an ordinary task. “For example, if you can normally do grocery shopping with no problem, but suddenly you can’t catch your breath while you’re walking down the grocery aisle and you have to stop to rest, that’s a warning sign,” says Dr. Lee.
Sudden sweating plus chest pain is another related heart attack symptom for women. You may feel like you’re having a cold sweat or feel clammy while also feeling some chest pain.
Similarly, chest pain with sudden fatigue and exhaustion may be a sign that you’re having a heart attack. You may feel overly tired for no reason — and the fatigue comes out of nowhere. Your regular activities suddenly become too difficult because you’re extremely tired.
Don’t hesitate to call 911
You might not have all of these heart attack warning signs. But if you’re having any of these symptoms, call 911 immediately. Don’t wait.
In her work, Dr. Lee has seen both younger and older women put off going to the doctor — even when they’re feeling heart attack symptoms. “Young women are often focused on being the caretaker for their children or elderly parents, and they don’t come into the hospital because there’s no one else to take care of their children or parents,” she says.
On the flip side, Dr. Lee has seen older women who are widowed and live alone not want to bother their children or friends. “These women may be having chest pain, but they don’t want to bother people. So they sit at home and hope the symptoms go away,” she says. Sometimes, they don’t drive and are too embarrassed to ask for help.
“I think a lot of times women are used to being the caregivers, so when they themselves need help they aren’t used to asking for it,” Dr. Lee says. This could be another reason why women wait so long to get care for heart attacks.
But it’s important to listen to your body and prioritize your health.
Bottom line: If you’re not sure if you’re having a heart attack, come into the hospital to get checked out. “The earlier you come in for medical care,” Dr. Lee says, “the earlier we can start therapy and the less damage there will be to the heart.”
Risk factors for heart attack in women
In addition to knowing key heart attack symptoms, it’s also important to know if you have risk factors for heart disease. “Many women aren’t aware that they’re at risk for heart attack,” explains Dr. Lee. “So when they start having symptoms, they don’t even consider that it’s a warning sign.”
Common risk factors for women include:
- Certain medical conditions. Women are at higher risk for heart disease if they have diabetes, high blood pressure, or an inflammatory disease like rheumatoid arthritis or lupus.
- Pregnancy complications. Women who had pregnancy complications like gestational diabetes, gestational hypertension, or preeclampsia are at higher risk for heart attack later in life.
- Smoking. Research shows that smoking can increase the risk of heart attack for young people by sevenfold.3 And female smokers are 25% more likely to have heart disease than male smokers.3
- Lifestyle choices. Poor diet, overuse of alcohol, and physical inactivity all increase a woman’s risk for heart attack.
- Menopause. Lower levels of estrogen after menopause can increase the risk of heart attack for women.
Understanding your risk factors and knowing common heart attack symptoms are important first steps in taking care of your heart.