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.
“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
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:womens-heart-attack-graphic

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)
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.