Heart attack symptoms in women are not what you’d expect

When you think of a heart attack, the image that probably comes to mind is a person clutching their chest or experiencing numbness in their left arm. Whether you intended it or not, that conjured image was probably a guy.

For a while, heart problems were considered a man’s disease. And for good reason – heart disease is the leading cause of death in American men. But that doesn’t mean women are immune to heart problems.

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We now know that heart attacks are a danger for both men and women. In truth, one in five women die of heart disease. Older women are especially vulnerable. O National Institute of Health (NIH) reports that women suffer more heart attacks at older ages than men. Menopause is likely to blame, as the drop in estrogen increases belly fat, high blood pressure, and other factors that increase a person’s risk of clogged arteries.

“Misdiagnosis and undertreatment are critical pieces to why more women die from heart disease than from all cancers combined,” he says. Suzanne Steinbaum, MD, a cardiologist specializing in menopausal women’s health. “If there are risk factors and a woman is postmenopausal, she should be evaluated for evidence of plaque in the arteries.”

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The issue is that the hallmark symptoms we associate with heart attacks, such as chest pain, occur more in men than in women. A now well-cited 2003 NIH study found that only 30% of 515 women surveyed had some sort of chest discomfort while they suffered a heart attack.

Heart attack symptoms for women can be distressingly more vague and subtle. But as troublesome as heart attacks are for women, they are also one of the most preventable. Recognizing early warning signs it can help you stop an impending heart attack.

extreme fatigue

Extreme and unexplained tiredness is one of the most reported heart attack symptoms among women. This is because your heart is under great stress as it tries to pump blood to a blocked area.

In the NIH study, 70% of women reported a wave of fatigue that comes on a month or two before the actual attack. Fatigue must be so damaging that it affects your day-to-day activities.

“For some, it’s so severe that they can’t make the bed without resting while folding the sheets. It interferes with your normal activities.” Jean C. McSweeney, PhDa professor at the University of Arkansas for Medical Sciences in Little Rock, said NBC News.

sleep disorders

If you’re suddenly having trouble sleeping at night, this could be your body warning you about high blood pressure. High blood pressure is one of the main risk factors for a heart attack. Blood pressure normally decreases during sleep but when you have trouble sleeping, it stays elevated. a 2023 to study in Clinical Cardiology found that insomnia and less than 5 hours of sleep are associated with an increased risk of heart attack years later.

When you wake up, your spikes in heart rate and blood pressure causing cardiac stress while your heart works harder to get you moving.

Back, neck or jaw pain

When an artery is clogged and blood flow is blocked, people can feel immense pressure or tightness in their chest. Women, more than men, are more likely to feel the painful pressure in other places, such as the upper back, neck, jaw, and shoulder blades. “If it happens in times of stress, it should be taken seriously. One of my patients said that her shoulder hurt every time she walked. She thought it was her bag, but her shoulder was throbbing even when she wasn’t holding the bag.” Radha Kachhy, MDsaid a cardiologist DukeHealth.

The uncomfortable pressure can start out gradual or intense and can even come and go before becoming impossible to ignore.


Heart failure can cause abdominal swelling, which can feel like indigestion. About 40 percent of women report indigestion one month before the cardiac event.

Other telltale signs that are often overlooked are nausea, lack of appetite and vomiting. Vomiting because of heart problems is called cardiogenic vomiting. When the heart is badly injured or unable to receive oxygen-rich blood, heart tissue begins to die. Dying heart cells release toxins that stimulate the nerves responsible for vomiting, giving you that sick feeling in your stomach.

“Heart attacks are more commonly missed in women and often manifest as nausea and vomiting in women more than men,” said Jeffrey Ko, MD, assistant clinical professor of health sciences. UC Davis Health. “If you are a woman over 50, with other contributing factors such as diabetes or obesity, and experiencing these symptoms, it is advisable to go to the nearest Emergency Room.”

Flu-like symptoms

Past experience says that waking up with chills, sweat and dizziness means you’re coming down with the flu. However, for women, flu-like symptoms can indicate an upcoming heart attack.

Julia Allen shared her story about a heart attack she had at age 44 women’s health . Initially, she mistook it for the flu. “I felt an immediate and extreme feeling (almost like someone slamming a door in your face) of flu-like symptoms. Keep in mind that all of my flu symptoms were EXTREME. I felt tired, weak, dizzy and nauseous.”

Liz Johnson – then 39 years old – told the American Heart Association how his flu symptoms were interfering with his ability to teach. She later went to the emergency room, where it was discovered that she was having a heart attack. The flu-like symptoms that Liz experienced are common in people with spontaneous coronary artery dissection (SCAD). This is when there is a tear in the artery wall, letting blood pool between the layers of the artery wall. The resulting bulge in the wall blocks blood flow and damages the heart muscle. SCAD can happen at any age, but it is most common among women in their 30s and 50s.


Anxiety is a way of life for most Americans in today’s society. More than 40 million adults have an anxiety disorder. But if you notice unusual bouts of stress or feelings of “impending doom,” take a minute to breathe. Your anxiety may be trying to tell you something.

Thirty-five percent of women in the NIH study reported feelings of anxiety during their heart attack. And unlike a panic attack, the feeling of anxiety doesn’t go away. It may even increase in intensity over time. Anxiety arising from an upcoming heart attack will also be accompanied by other physical symptoms.

heart attack symptoms

heart attack symptoms

Image: Terese Condella/SheKnows

A version of this article was originally published in December 2016.

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Heart attack symptoms in women are not what you’d expect

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