Female Heart Attack

Female Heart Attack Symptoms are Different

Awareness that female heart attack symptoms are often different from those in men has received a lot of press lately, but it’s worth taking a few moments here to review the specifics and what to be concerned about. My goal here is to make it so easy for you to remember female heart attack symptoms, that whether you are male or female you will recognize the need for emergency medical care when symptoms begin.

Then of course, thinking as a doctor with a holistic medicine practice, I’d like to lead you pretty quickly to thinking about what you can do at any time of life for heart attack prevention. Just like learning CPR has great value (but you hope to never have to use it), I’d like you to learn heart attack symptoms while working mostly on prevention. And of course prevention starts with understanding what causes a heart attack, and working with your doctor to change those risk factors.

Heart attack or Angina?

To understand the difference between male and female heart attack symptoms, I’d like to help you first understand the difference between a heart attack and angina. Angina pectoris (or angina for short) is the term that’s used to describe the chest pain or discomfort from the heart muscle not getting enough oxygen. A heart attack (or myocardial infarction) happens when the heart muscle loses oxygen long enough to have loss or death of some tissue. Both of these are the result of coronary heart disease (CHD), which is the condition of blockage or partial blockage of the arteries which supply the heart muscle.

That brings us to the first important difference between women and men in this topic. While the first sign of CHD in men is likely to be a heart attack, angina is more likely to be the first sign of heart disease in women.

Heart Attack Symptoms

What would you expect to be the symptoms of a heart attack?Actually only a small percentage of heart attacks are the very intense sudden events of crushing mid-chest pain (in men or women); rather, most start more slowly, but still typically are an unusual and very bothersome discomfort in the center of the chest. It will last more than a few minutes, or may go away then come back. Other symptoms may include pain in either or both arms, pain in the back, neck, jaw or stomach, nausea, feeling light headed, a cold sweat, and shortness of breath.

For women, a heart attack is more likely to include some of the less classic symptoms such as nausea, abdominal pain, shortness of breath, and pain in the neck, shoulder or jaw. So female heart attack symptoms may not immediately make you think of the heart unless you are aware of the differences. 

How does Angina Feel?

Recalling that angina is more likely to be the first sign of CHD in women, let’s take a look at how angina may first show up. Angina of course can present as chest discomfort just as it can in men. But women who are older and who have diabetes are especially likely to have a new onset of symptoms of fatigue and shortness of breath as the first indicators of heart disease. Other angina symptoms in women can be a sleep disturbance, anxiety or indigestion.

Be Aware

Why am I going into all this detail? I want to use this opportunity to drive home a point. Heart disease is the leading killer of women in the US, while at the same time many women ignore symptoms of heart attacks or angina, and doctors and hospitals are less likely to think “heart attack” in women than in men. Because symptoms are often overlooked by women and their doctors, it’s important to raise awareness. The fear of breast cancer is ever present for many women, and yes that’s important to address, but please give your heart the attention it deserves.

The bottom line? A heart attack usually presents with chest pain or discomfort that lasts more than a few minutes, either in women or men. But more so than in males, female heart attack symptoms are likely to not be the classic ones you think of. So especially if you have risk factors for heart disease (older age, smoking, low HDL or high LDL cholesterol, overweight, sedentary, diabetes, or hypertension), the new onset of any of the less common symptoms described above warrants an urgent call for medical care.

So remember the symptoms, and don’t be afraid to use 911 for emergencies if in doubt. And start now with steps for heart attack prevention. 

To your health and wellness,


Robert Pendergrast, MD 

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Learn more from the American Heart Association.