Recent studies found that a heart attack in women can happen without arterial blockage. This means many cases of heart attacks are dismissed and left untreated, leading to complications and eventually, death.
Contrary to popular belief, women are just as susceptible to heart attacks as men. In fact, signs of impending heart attack in women are much more subtle and less dramatic, making this condition more dangerous to women.
People are generally aware of this common warning sign of a heart attack: a stabbing pain in the chest. But this isn’t the only symptom of a heart attack—especially so in women.
It’s important then that we are familiar with all of the warning signs. Not being familiar with them makes women less likely to seek medical attention and treatment.
The four main signs of heart attack in women
If you exhibit any of the four main signs of heart attack listed below, you should call your area’s emergency hotline or go to the emergency room right away. They may be subtle signs, but could be deadly if left alone.
1. Unusual fatigue
Most mums are busy, so they feel tired most of the time. However, if you’re experiencing unnatural tiredness, you may have to get a checkup. What do we mean by unnatural tiredness?
- You are suddenly more tired than you usually are after a typical exercise routine.
- Even without much exertion, you may experience fatigue or a “heavy” chest. These may be simple activities like fixing your bed or walking to the toilet.
- You are tired, but you wake up at odd hours during the night.
2. Cold sweat, shortness of breath, nausea
As a person ages, lack of exercise and gradual weight gain can cause shortness of breath. During menopause, women commonly complain of hot flashes. However, it could be a heart attack if it’s shortness of breath with or without chest discomfort, like having ran a marathon, but you haven’t even moved at all.
- Sudden sweating or shortness of breath without exertion
- Breathlessness that continues to worsen over time after exertion
- Worsening shortness of breath when lying down that improves when sitting up
- Random “stress” sweat (cold, clammy feeling) when you’re not actually stressed
- Sweating or shortness of breath accompanied by other symptoms such as chest pain or fatigue
3. Pain in multiple areas
The human body is a complex interconnected mass of systems. Quite often, a problem in one area can cause problems elsewhere in the body.
In this case, pain or discomfort in one or both arms, back, neck, stomach, or jaw may be a signal of a heart condition. It’s even more telling if the origin of the pain is hard to pinpoint (no specific muscle or joint that hurts).
If the pain or discomfort begins, persists, and worsens when you exert yourself and disappears when you stop, you should get a check up.
If you feel pain that resembles indigestion or reflux and a doctor ignores it, get a second opinion.
4. Chest pain
This can be uncomfortable pressure, squeezing, or a fullness or pain in the center of your chest. It lasts more than a few minutes. At times, it goes away and comes back.
As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are more likely than men to experience other common symptoms. In particular, these are shortness of breath, nausea/vomiting and back or jaw pain.
The difference between heart attack in women and men
The difference in heart attack symptoms between men and women is further highlighted by a study from the Cedars-Sinai Medical Center in Los Angeles, California. According to the study, the symptoms that are unique to women are:
1. Women experience heart attacks without blocked arteries
According to the Cedars-Sinai study, around 8% of women (or 26 out of 340 participants) have scars on their hearts (an indication of heart attack) despite complaints of chest pain with no blocked arteries.
Around a third of these 26 women were never diagnosed with a heart attack before, despite their heart muscle damage. A year later, doctors found two of them had new heart scarring and were confined for chest pain. But they were never diagnosed with a heart attack.
2. Heart attack without chest pressure
“Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure,” says Nieca Goldberg, MD, medical director at the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center and an American Heart Association volunteer.
“Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue,” Dr. Goldberg says.
3. Upper back pressure
There are also some cases where women describe upper back pressure, like a rope slowly squeezing around your body, according to Dr. Goldberg.
“This study proves that women need to be taken seriously when they complain of chest pain, even if they don’t have the typical symptoms we see in men,” first author Dr. Janet Wei says in the Cedars-Sinai news release.
“Too often, these women are told they don’t have a heart problem and they are sent home, instead of receiving appropriate medical care,” Dr. Wei adds.
Prevention of heart attack in women
Heart disease is something we can prevent. Dr. Goldberg suggests the following ways we can avoid a heart attack in women:
- Schedule an appointment with your healthcare provider to learn your personal risk for heart disease.
- Quit smoking. A year after quitting smoking, you can cut your risk of coronary heart disease by 50%.
- Adopt an exercise routine. Walking 30 minutes a day can lower the risk of heart attack and stroke.
- When necessary, change the family diet with the help of some healthy cooking tips. There are plenty of smart alternatives, healthy snacking suggestions, and better meal preparation methods to improve your family’s diet. For example, when preparing poultry, use the leaner light meat (breasts) instead of the fattier dark meat (legs and thighs). We know chicken skin is tasty, but for your health’s sake, it’s better to avoid it altogether.
What to tell your doctor
Women often notice signs of a heart attack weeks or months before the heart attack happens. So the sooner you report these signs, the better chances you have at preventing a heart attack.
When you see your doctor, tell them the following:
- Show them a list of your symptoms and when they occur.
- Inform them of any related family history.
- Talk about stresses, triggers, or situations that might contribute to the problem.
Listen to your doctor. If they say it’s not a heart attack, get a second opinion to be sure. Doctors may overlook these symptoms of heart attack in women.
First aid for heart attack in women
If you’re having a heart attack alone, follow the steps in the list below. If you have company, have them help you do the following:
- Sit down, rest, and try to keep calm.
- Loosen any tight clothing (unbutton shirts, take off belts and shoes, take off bra).
- If you’re taking any medicine for a known heart condition, take it.
- Within three minutes of taking medication or resting, if the pain does not go away promptly, call for emergency medical help.
DO NOT do these things!
There are also some things people should not do when someone is having a heart attack. If someone near you is having a heart attack, always keep these in mind:
1. Do NOT leave the person alone except to call for help, if necessary.
2. Do NOT allow the person to deny the symptoms and convince you not to call for emergency help.
3. Do NOT wait to see if the symptoms go away.
4. Do NOT give the person anything by mouth unless a heart medicine (such as nitroglycerin) has been prescribed.
Know if you are at risk
Before menopause, female hormones give women some measure of protection from coronary heart disease. However, the risk increases with each year after menopause.
It’s very important that a woman over the age of 40 should get a checkup from a doctor. Identifying and managing conditions like high blood pressure or high cholesterol can lower the risk of future heart attack in women.
It also helps to know whether you have a family medical history of heart disease, as this significantly increases your risk.
Don’t ignore signs of heart attack in women
Goldberg says she has seen many women who merely take an aspirin when they have a heart attack and never call for help.
Often, women see these signs as symptoms of other less life-threatening conditions like acid reflux, flu, or normal ageing.
A study that looked into differences in heart attack symptoms between men and women also found that some women who don’t experience the conventional symptoms of a heart attack don’t receive proper care.
This can result in complications like arrhythmia (abnormal heartbeat), heart failure, heart rupture, or death.
The study’s results found that more women who sought medical care for their symptoms before hospitalization were dismissed as having symptoms that were not heart-related, compared to men.
So it’s important for women to never ignore symptoms and seek medical help as soon as they can.
In an emergency, you can call the following hotlines in Singapore:
- EMS, Ambulance and Fire Rescue: Tel. 995
- Emergency Police: Tel. 999
- Non-Emergency Ambulance (Private): Tel. 1777
For a more extensive list of hotlines in Singapore, you can go to our previous post: Useful Emergency Numbers.