Warning Signs of a Heart Attack in Women


Catherine Spader, RN

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You lead a busy life and may feel exhausted after a stressful day at work or managing your hectic schedule. Check in with yourself and ask if your fatigue seems excessive relative to your activity level. Unusual fatigue is also a sign of a heart attack, especially in women.

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How Does a Woman Feel Before or During a Heart Attack?

Warning signs of a heart attack (myocardial infarction) in women are often subtle and easy to dismiss. As a woman, you are less likely than a man to have chest pain. You may have unusual fatigue, weakness, or other symptoms without chest pain.

Up to one month or longer before a heart attack, women are known to have the following warning signs and symptoms:

  • Unusual tiredness with your usual activities, such as working or taking the kids to their activities

  • Tossing and turning at night, waking in the middle of the night, or waking up too early

  • Shortness of breath

  • Indigestion

  • Anxiety, uneasiness, or sense of dread

  • Heart racing or palpitations

  • Heavy or weak feeling in your arms

During a heart attack, women are more likely than men to have these symptoms:

  • Shortness of breath, or feeling like you can’t breathe or take a deep breath

  • Feeling like you might throw up

  • Breaking out in a cold sweat

  • Heavy or weak feeling in the arms

  • General weak feeling, or that you don’t have strength

  • Dizziness or feeling as if you might pass out

  • Fatigue

  • Back or jaw pain

What Should a Woman Do for Warning Signs of a Heart Attack?

A heart attack in a woman younger than 50 years is twice as likely to be fatal than a heart attack in a man. Delaying treatment, even by a few minutes, increases the risk of permanent heart damage and death at any age. Yet studies show that women tend to wait longer than their male counterparts to seek emergency treatment for warning signs of a heart attack, according to the Women’s Heart Foundation.

Here’s what you should do to if you have any heart attack symptoms, even if they don’t seem serious:

  • Call 911. Follow the operator’s instructions until the ambulance arrives. This may include taking an aspirin to help prevent a blood clot in your heart or keep the clot from getting bigger. Be sure to tell the operator if you know you are allergic to aspirin, you have a bleeding disorder, or if you are taking blood-thinning medications. Emergency personnel will treat you as if you are having a heart attack until all your tests (on site and at the hospital) are complete.

  • Be vigilant. At the hospital ER, ask for a full explanation of all your tests and ask questions until you are sure you understand everything. Women may not show signs of a heart attack on electrocardiograms (EKGs) or other tests in the same way a man does. This can make it more difficult for doctors to interpret test results. Because of this, women with negative test results are often admitted to the hospital overnight for observation and more tests. Whether or not you are admitted to the hospital depends on your age, personal and family medical history, what other symptoms you have, and your test results.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Mar 18, 2015

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Medical References

  1. Gender matters: Heart disease risk in women. Harvard Medical School. http://www.health.harvard.edu/newsweek/Gender_matters_Heart_disease_risk_in_women.htm
  2. Women and Heart Attack. National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/actintime/haws/women.htm
  3. What is a Heart Attack? National Heart Lung and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/heartattack/
  4. Heart disease. New York Online Access to Health. http://www.noah-health.org/en/blood/disease/
  5. Gender Differences in Diagnosis and Management of Heart Disease. Women’s Heart Foundation. http://www.womensheart.org/content/HeartDisease/gender_differences.asp
  6. Women and Heart Disease Facts. Women’s Heart Foundation. http://www.womensheart.org/content/HeartDisease/heart_disease_facts.asp

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