Heart attack symptoms — Different for men and women?

Originally Published: November 30, 2001 - Last Updated / Reviewed On: September 16, 2011
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Dear Alice,

I've heard that the symptoms for heart attack differ for men and women. Could you please send me info on these differences? Also could you give me some possible diagnosis for a feeling of heaviness in the chest?

Dear Reader,

You are correct: While the symptoms for a heart attack can be similar in men and women, many differences also exist. Most of the earlier studies on heart disease focused almost exclusively on men. Lately, researchers have been including women in their studies, or focusing exclusively on women and heart disease. Although a lot more research on women and heart disease still needs to be conducted, it is clear that symptoms of a heart attack in women can include:

  • Chest pain or pressure (a feeling of heaviness) that lasts for more than a few minutes and does not go away when you rest or sit down. This is the most common symptom in men also and must not be ignored. People who experience this symptom need to seek immediate emergency medical attention. While this symptom does not always indicate that a person is having a heart attack, this is a symptom that needs to be fully evaluated. This is not a universal symptom, however — women are more likely than men to experience NO chest pain during the course of a heart attack, so women should especially be on the look out for the other "flu–like" symptoms below.
  • Pain that spreads to the back, shoulders, neck, jaw, or arms
  • Feeling dizzy or faint
  • Clammy or sweaty skin
  • Nausea or vomiting
  • Shortness of breath
  • Weakness or fatigue

Because these symptoms are less likely to be recognized as signs of a heart attack, women are less likely to seek treatment in a timely manner, often resulting in more damage to the heart. Research has also shown that women may often receive different treatment for their heart disease. Women are less likely than men to get full diagnostic work-ups for chest pain, are less likely to receive life-saving treatments for heart disease (such as beta-blockers), are more likely than men to be prescribed medications that can complicate heart disease, and are more likely than men to die from a first heart attack. Yet, only 24 percent of participants in medical heart attack studies are women!

These disparities lead to a misperception on the part of women and/or their health care providers that heart disease is something only men have to worry about. This, in turn, sometimes leads women and their providers to skip screenings and ignore symptoms. For more information on heart disease myths and differences between men and women, check out the Women's Heart Foundation. According to their research, 62% percent of heart failurerelated deaths every year are women. Unfortunately, four out of five women surveyed do not know that heart disease is the leading cause of death for both men and women over 40 years of age.

As far as prevention is concerned, the good news is that women's bodies are typically responsive to lifestyle changes in preventing heart disease, often more responsive than men's bodies. Quitting smoking, eating a diet that is low in salt, low in cholesterol, and low in saturated fat, and regular cardiovascular exercise (30—60 minutes per day of at least moderate activity most days of the week) can significantly reduce a woman's risk for heart disease, even when she has a family history of heart disease. Stress and depression also disproportionately affect women and can also be risk factors for heart attacks, so paying attention to your emotional and psychological well–being is important in maintaining heart health. To learn more about the ways in which women can reduce their risk of heart attack, go to the National Coalition for Women with Heart Disease Web site. Another resource is the National Institutes of Health (NIH) publication, Healthy Heart Handbook for Women.

Here's to happy hearts,

Alice