Women’s heart attack symptoms can be more subtle

Women may not experience crushing chest pain with a heart attack. Instead, they could have symptoms similar to flu, heartburn or an ulcer

Heart attack symptoms are often different for women.

Women may not experience the stereotypical crushing chest pain. Instead, they could have symptoms that could be confused with the flu, heartburn or an ulcer.

“It’s critical women understand what a heart attack can feel like for them, so they get immediate medical care. Any delay in seeking treatment can result in more damage to the heart muscle and can be life threatening,” said Li Zhou, M.D., Ph.D., medical director, Norton Heart & Vascular Institute Women’s Heart Program.

In general, heart attack symptoms in women may be more subtle than the symptoms men experience.

Instead of chest pain, women may feel exhaustion, dizziness, nausea, indigestion, difficulty breathing, a cold sweat, pain that travels up the jaw, or stomach pain. This can be accompanied by vomiting, difficulty breathing or a cold sweat.

A heart attack could also be felt as upper back pain. This referred pain happens when pain in one part of the body is felt elsewhere.

Women can still feel chest pain when they are having a heart attack, with pressure or squeezing that can last for more than a few minutes or be intermittent. Almost 1 out of every 3 people who have heart attacks do not feel any chest pain. Heart attacks with no chest pain are more common in women.

If you believe you are having a heart attack, do not wait to get help

Call 911 or have someone take you to the nearest hospital emergency room. After calling 911, you can:

  • Take nitroglycerin, if prescribed by your doctor.
  • Take aspirin, but only if prescribed by your doctor. Aspirin can interact with other medications and should be taken only when advised by a medical professional.

Related: A STEMI is one of the most dangerous forms of heart attack — here’s what you need to know

There are other differences between heart attack symptoms in women and men. While men may feel pain and numbness on the left arm or side of the chest, the pain may appear on the right side for women.

Chest pain in women could also be the result of microvascular disease, rather than a heart attack. This results from damage to smaller blood vessels leading from the heart. Damage to blood vessels is linked to diabetes, high blood pressure or inherited heart diseases (cardiomyopathy).

There are other conditions that cause chest pain and other symptoms that can be easily confused with heart attack symptoms. Some of these conditions are also medical emergencies. If you experience chest pain, seek medical attention.

In general, sharp pain when breathing, sneezing, or coughing is less likely to signal a heart attack. So is a sudden, stabbing chest pain that lasts only a few seconds, pain that lasts for hours or days without other symptoms, or pain that happens with a specific body movement.

Stabbing chest pain accompanied by a feeling of dread and difficulty breathing may be a panic attack, rather than a heart attack. Women have twice as many panic attacks as men.

Panic attack symptoms include a feeling like you’re losing control or might die, a rapid heart rate, shortness of breath, and sharp or stabbing chest pain that lasts only 5 to 10 seconds and is localized to one small area. A panic attack can also be accompanied by hot flashes, chills, trembling or shaking.

Other conditions that can cause chest pain include GERD – acid reflex – or a chest muscle strain.

Weakness in the arms or an inability to raise both arms evenly could be a sign of stroke, rather than a heart attack. Stroke is also an emergency.

Heart attacks during pregnancy or shortly afterward are rare. When they do happen, a common cause is spontaneous coronary artery dissection. Instead of plaque blocking blood from reaching the heart muscle, which happens in a typical heart attack, blood flows under a tear in the coronary artery, blocking blood flow.

Heart disease is the number one cause of death in women in the United States. According to the Centers for Disease Control and Prevention (CDC), more than 267,000 women die each year from heart attacks.

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