Heart attack symptoms: Different for men and women?

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,

The classic thinking has been that there are significant differences in heart attack symptoms experienced by men versus women. However, more recently, experts have questioned this assumption as well as the research methods investigating it. One thing is clear: the most common universal complaint of people who are having a heart attack is chest pain (called angina, which is a particular kind of chest pain due to lack of blood flow to the heart) or chest pressure. While chest pain is the most common sign of a heart attack in both women and men, research shows that women may be more likely than men to experience a heart attack without chest pain. There are a few other associated symptoms that women are more likely to experience as well (more on that in a bit). You also asked about other possible problems that could lead to heaviness or chest pain. The list of conditions that could lead to chest discomfort is pretty long. Only a health care provider will be able to determine the root cause of any chest heaviness — and address it appropriately.   

In the discussion of heart attack symptoms experienced by either sex, it’s good to start with what is commonly reported among both men and women. Other than chest pain, other typical symptoms of a heart attack include:

  • Pain radiating to the back, shoulders, neck and jaw, or to one or both arms
  • Feeling dizzy or faint
  • Clammy or sweaty skin
  • Shortness of breath
  • Weakness and fatigue

Some symptoms (nausea, vomiting, malaise, and feeling under the weather) appear in both, but have been associated more often with women than men. Additionally, one study found that while men and women may experience identical rates of chest pain, women may be more likely to complain of throat or jaw discomfort. Another difference is that women are, on average, ten years older than men when they experience and seek treatment for heart disease.

It’s not entirely clear why women may present with different symptoms than men and it’s not because they suffer fewer heart attacks than men. According to the Women’s Heart Foundation, heart disease continues to be the leading cause of death for both women and men over the age of 40. One of the discrepancies observed is that women are diagnosed and treated for heart attacks less aggressively than men. One possible reason is misdiagnoses. In women, there may a greater chance that angina pain occurs while sleeping, resting, or during times of mental stress which may not lead to a proper diagnosis. In addition, researchers found that a “silent infarct,” or a heart attack with almost no symptoms, have been observed more often in women than in men. Therefore, both women and health care providers may miss them. Finally, women who underestimate their own risk of a heart attack may also be less likely to seek care when they are experiencing one.

Luckily, there are a number of steps to take to decrease the chances of having a heart attack (regardless of your biological sex or your family history of coronary artery disease). Some strategies to reduce heart attack risk include:

  • Not using or quitting the use of tobacco products.
  • Engaging in 30 to 60 minutes of physical activity most days of the week.
  • Controlling your blood sugar (if diabetic).
  • Lowering blood pressure (if hypertensive).
  • Reducing salt, processed and fatty foods, and eating more fresh produce and healthy grains.
  • Finding support for emotional and psychological well-being (especially if depressed, stressed, or anxious).
  • Making an appointment with a health care provider to assess heart disease risk.

All this to say, Reader, what you’ve heard isn’t off base — though both women and men share many of the same symptoms associated with heart attacks, there are some more commonly reported in women than in men. However, knowing about those differences and the factors that may influence them really highlights how crucial it is not to downplay any experience of these types of symptoms (regardless of who you are) and to seek medical attention if and when they do occur.

Here’s to heart health!

Last updated Jun 04, 2015
Originally published Nov 29, 2001

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