Chest pain isn't the only sign of a heart attack. Here are 7 symptoms all women should know.
Heart disease is the number one cause of death for women in the US, accounting for about one in five women's deaths in 2019, according to the Centers for Disease Control and Prevention (CDC). That year alone, 301,280 women died from heart disease.
Heart attacks (aka myocardial infarctions) are one-way heart disease can show up. But heart trouble can easily be confused with other ailments, such as indigestion. About 80% of people experiencing a heart attack have reported chest pain—it's the most common sign of heart attacks, per a February 2018 study published in the journal BMJ Open.
Heart Attack Symptoms To Be Aware Of: On their own, many heart attack symptoms in women can be due to less serious conditions. For example, they may signal a anemia (low red blood cell count), a panic attack, lack of sleep, or dehydration. But if you experience several of the following symptoms at once, especially with chest pain, call a healthcare provider right away.
Tingling Down One or Both Arms or Legs: While this often means you've got a pinched nerve or arthritis in your neck, "it's important to rule out heart problems first," said Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center in New York City. See a healthcare provider if you notice any tingling in your extremities.
Digestive Symptoms: You could have more than just a bug if your upset stomach comes along with other heart-related symptoms, such as shortness of breath, a cold sweat, or lightheadedness, per the American Heart Association (AHA). Nausea can be a symptom of a heart attack for both men and women, but women have nausea in 34% of cases, compared to only 22% of cases in men, per an August 2019 paper published in the Journal of the American Heart Association.
Other digestive symptoms that could signal a heart attack are indigestion, heartburn, and vomiting, per the Office on Women's Health. You may also experience burning or stabbing pain in the upper-middle area of the stomach, per the August 2019 paper.
Indigestion associated with a heart attack typically doesn't start shortly after a meal. If you don't usually have stomach issues, and if you're also experiencing other symptoms, call a healthcare provider.
Shortness of Breath/Racing Heart: It may be difficult to differentiate between a panic attack and a heart attack, since they can both present with shortness of breath and a racing heart. Other signs of a panic attack include trembling, intense terror, and an overwhelming sense of doom, per the National Institute of Mental Health (NIMH).
Shortness of breath can be a sign that something is wrong if it occurs while you're resting or doing light physical activities, per the National Library of Medicine MedlinePlus resource. When it's a heart attack symptom, it typically occurs during or before chest discomfort, per a March 2014 paper published in the journal Circulation. It may also be your only symptom.
Jaw Pain: Yor can get jaw pain if the heart attack pain radiates (spreads) to the jaw, per MedlinePlus. The pain can also radiate to the neck, back, arm, or shoulder, per the CDC.
The pain can occur intermittently and get worse when you exert yourself. You may feel discomfort in the jaw, neck, back, arm, or shoulder too, per MedlinePlus.
Dizziness/Lightheadedness: Feeling faint or lightheaded for no apparent reason could mean that not enough blood is getting to the heart. These signs may signal a heart attack if accompanied by pressure or pain in the lower chest or upper abdomen, upper back pressure, or extreme tiredness, per the American Heart Association (AHA). Women are more likely to experience lightheadedness during a heart attack than men, per the CDC.
Lightheadedness is mentioned along with cold sweat and nausea as an additional sign of a heart attack in a March 2014 article published in the journal Circulation. Other warning signs listed are chest discomfort, discomfort in other upper areas of the body (arms, back, neck, jaw, or stomach), and shortness of breath.
If you're feeling dizzy or lightheaded, remember that these symptoms are very common and can be due to many conditions, such as dehydration, motion sickness, or getting up too quickly, per MedlinePlus. Pay attention to your body and see a healthcare provider if you experience additional heart attack symptoms.
Discomfort or Burning in the Chest: Women often describe a heart attack as tightness, heaviness, or pressure in the chest. It may feel like someone is squeezing your heart, per MedlinePlus. Your pain may feel sharp (or stabbing), crushing, or burning, per the August 2019 paper. This symptom may be mistaken for heartburn.
The pain can radiate to the arm or jaw and lasts for more than 10 minutes. It's considered a "typical" presentation of a heart attack, per the August 2019 paper.
Extreme Fatigue: If you're unable to walk a block comfortably or if you feel like you have to stop and rest while going about your daily activities, it could be a sign that blood is not getting to the heart fast enough. Unusual tiredness and weakness are both symptoms more common in women, per the CDC.
People also describe fatigue with terms such as sleepiness, exhaustion, lack of energy, and cognitive change (mental fog), per an October 2017 paper published in the Journal of Clinical Nursing. Their arms might feel weak or heavy, and they may feel irritable or demoralized because of the fatigue. The feeling can be overwhelming.
Almost half of women research participants reported fatigue during a heart attack, per the October 2017 paper. Fatigue is also the most common prodromal symptom of a heart attack in women—a warning signal that a heart attack is coming. About 71% of women experienced prodromal fatigue.
Unexplained fatigue is a common sign of numerous conditions, including depression, thyroid issues, anemia (low red blood cell count), or chronic pain, per MedlinePlus. Certain medications, alcohol, and drugs can cause tiredness as well. It's worth seeing your healthcare provider if you experience overwhelming fatigue, but the tiredness is unlikely to come from a heart attack—unless you experience other symptoms on this list, such as chest pain.
Causes and Risk Factors for Heart Attack: Heart attacks happen "when the flow of blood that brings oxygen to a part of your heart muscle suddenly becomes blocked," per the National Heart, Lung, and Blood Institute (NHLBI). If your heart doesn't get enough oxygen, part of the heart muscle begins to die, so prompt care is essential.
The flow of blood most often gets blocked when plaque (fatty deposit) builds up in the vessels that carry blood from the heart to other body parts, per the NHLBI. An area of the plaque can break open, causing a blood clot, and block the blood flow. This happens because of coronary artery disease—the most common type of heart disease. Other heart and blood vessel conditions can cause heart attacks too, through different mechanisms.
There's no sure way to prevent a heart attack, and some risk factors such as older age and family history are unchangeable. But you can reduce your risk by eating heart-healthy foods, being active, not smoking, learning to manage your stress, and keeping a healthy weight, per the NHLBI.
Until Next time Stay Safe, Stay Healthy and Stay Careful out there
James A Vito, D.M.D.