What do heart attacks feel like in women?

When a man has a heart attack, it usually looks a lot like the "Hollywood heart attack" on TV and in films.

The man gets sweaty. He may feel pain in/clutch the left side of his chest. The pain may radiate to their jaw or arm. When we see it, we know we have to call 911.

When a woman has a heart attack, the symptoms are more subtle. Throughout my career in cardiology at the University of Chicago Medicine, I continue to see women miss key signs of a current or upcoming heart attack. By educating women on their specific symptoms for a heart attack, I am hopeful they will know when to seek medical attention.

What are the signs of a heart attack for women?

For women, heart attack symptoms typically look a lot different than for men. A woman’s symptoms may include:

• Chest pain
• Nausea
• Vomiting
• Dizziness
• Shortness of breath
• Fatigue
• Stomach pain
• Weakness

Since a woman’s symptoms tend to be more subtle, they may be associated with a non-cardiac condition, including stress and anxiety. Women may not recognize these symptoms as a threat or attribute those symptoms to a possible heart attack. As a result, they are more likely to wait at home, take longer to call 911 and get to the emergency room later than men.

The difference in symptoms may be due to the ways men and women deposit cholesterol in the arteries. 

Why is it that women over the age of 65 have the highest mortality rate from heart attack?

The answer may be surprisingly simple. It’s likely a generational gap. Over the last 20 years, heart attack deaths have decreased across all age groups and sexes, with one exception: women over the age of 65.

Some women of a certain generation can still have the idea that only men have heart attacks. When their symptoms are milder, they don’t think they are having one. There is also evidence that shows disparities in physicians’ interpretations of heart disease symptoms by gender. Women who present with chest pain are more likely than men to be treated for anxiety by healthcare providers because there is a perception that women cannot have heart attacks.

Are women treated differently for heart attacks than male counterparts?

Despite men and women experiencing different heart attack symptoms, treatment of cardiovascular disease is just as effective in both sexes.

When women get the same treatment as men consistently, they benefit from the same mortality reduction. Women do just as well with stents as men; they do just as well with the angioplasty as men. Early, aggressive treatment is equally important.

How to prevent heart attacks in women

The UChicago Medicine cardiology team takes great pride in educating women and primary care doctors on recognizing heart attack symptoms. This includes sharing preventive steps to reduce their risk of cardiovascular disease. Factors that increase heart attack risk for both women and men include:

• Diabetes
• High blood pressure
• High cholesterol
• Smoking
• Family history
• A diet high in saturated fats