Hidden Heart Attack Symptoms in Women

Medically reviewed in February 2022

As a woman, you may feel that a heart attack is not the greatest risk you face. But the threat is very real, especially in the years leading up to and following menopause when hormonal changes can open the door to heart disease. Understanding the heart attack symptoms in women, as well as signs of early cardiac troubles, and your own risk factors for cardiovascular disease can significantly increase your chances of survival.

Cardiovascular disease (CVD) is the leading killer of women in America, accounting for over one-third of all deaths. That's more than the combined death rates from breast, ovarian, and cervical cancers.

Heart Attack Warnings Can Be Subtle
Studies on cardiac events in women reveal that many women may experience prodromal -- or early -- symptoms of cardiac distress in the days, weeks, or even months leading up to a heart attack. Unfortunately, many of these signs may be dismissed as nothing out of the ordinary -- by both women and their doctors. The most common early warning signs include:

  • Unusual fatigue - Fatigue is a common complaint and one that may indicate that you're simply missing out on sleep, fighting a virus, overextending yourself, or experiencing a side effect to medication. But unusual or extreme fatigue may also be an early heart attack symptom or a warning sign of heart disease. In one study, more than 70% of the women surveyed experienced marked fatigue in the days or weeks prior to their heart attacks.
  • Sleep disturbances - Although it's not unusual to feel tired due to a lack of sleep or a particularly demanding week or month, you should take special notice of any unusual or prolonged disturbance in your sleep patterns. One study revealed that almost half of the women who had suffered a heart attack also experienced sleep disturbances in the days or weeks leading up to their attacks.
  • Shortness of breath during normal daily activities, indigestion, and anxiety may also be early heart attack signs or symptoms of cardiac distress in women.

So how do you know if your symptoms are serious? Getting into the habit of noting your typical aches and pains and your normal reactions to foods and activities may help you recognize when something is truly amiss. Also, remember that if you have risk factors for heart disease, you should be especially vigilant about monitoring how you feel -- particularly if any of your usual symptoms are often early heart attack signs. If you experience worrisome or unusual changes in your energy level, comfort, or sleep habits, you should discuss your concerns with your healthcare provider, especially if you have heart disease risk factors, such as high blood pressure, high cholesterol, obesity, diabetes, a smoking habit, or a sedentary lifestyle.

Acute Symptoms in Women
Although chest pain is considered to be one of the classic signs of a heart attack in both women and men, the sudden, violent chest convulsions portrayed on TV or in movies may not be experienced by all women.

Fortunately, we now know of several more moderate signals a woman's body sends to alert her that she is having a heart attack.
Severe chest pain may occur during a heart attack, but women also report pain or discomfort in other areas of the body before or during a heart attack. Pressure, tightness, aching, or burning in your upper back, neck, shoulders, and arms, or even in the jaw or throat can be signs of heart distress. Women have also described the discomfort as a sharpness, a fullness, or a tingling.

Shortness of breath, fatigue, stomach pain, cold sweats, dizziness, indigestion, or nausea also may occur during the acute phase of a heart attack.

Learning about the many different acute symptoms of heart attack can help ensure that you seek emergency care when you need it. Keep in mind that not all of these symptoms occur in every attack, and some symptoms may go away and then return.

Reduce Your Risk of Heart Attack
As a woman, after 40, your risk for coronary heart disease (CHD) starts to rise as your body stops producing estrogen naturally and your cholesterol levels increase. Although taking estrogen through hormone replacement therapy was initially thought to protect against CHD, clinical trials have found that it does not offer cardiac protection and may increase the risk of heart disease and ovarian and breast cancers.

So what can you do to protect your heart and reduce your risk of a heart attack? Plenty. Controlling your cholesterol, blood pressure, and weight can greatly reduce your risk.

Start with these seven steps:

  1. Check your blood pressure regularly. If it's high, and you have been prescribed medication, take it exactly as directed, even if you feel fine.
  2. Stop smoking, if you smoke. Ask your doctor for help.
  3. Eat plenty of fresh fruits and vegetables, whole-grains, and low-fat dairy to get your daily dose of calcium, potassium, and magnesium.
  4. Choose healthful unsaturated fats instead of saturated fats.
  5.  Reduce stress levels at home and at work. Try this deep-breathing technique.
  6.  Limit your alcohol intake to no more than one glass per day.
  7.  Get 30 minutes of exercise every day, and keep your weight within healthy limits.

Don't Ignore How You Feel
Research shows that women tend to ignore signs of illness or attribute their symptoms of cardiac distress to something else. If you are feeling unusual fatigue or pain and discomfort, don't dismiss it. The fact that warning signs may occur as much as 1 month before an attack gives you valuable time to seek medical care that may save your life.

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