Heart disease—specifically coronary artery disease, or CAD—is the leading cause of death for women in the United States. This is also true for men, yet women may not receive a diagnosis or treatment for heart disease as quickly as men. Women also tend to seek emergency care for heart-related symptoms later than men. One big reason: Heart disease symptoms in women—especially signs of a heart attack—are typically different and subtler than in men, leading to a delay in evaluation and diagnosis. Instead of the heart attack victim clutching their chest in pain—as most often portrayed in TV and movies—women are more likely to experience unusual fatigue, breathlessness, or neck and jaw pain. Here’s what women need to watch for so they can protect their health. Heart disease symptoms in women Coronary artery disease is the most common reason for a heart attack. CAD is when the arteries supplying your heart—the coronary arteries—become filled with fatty plaque, which slows blood flow to your heart muscle. With time, a complete blockage can occur, starving your heart muscle of vital oxygen and causing a heart attack. Many men and women think of a heart attack as marked by severe, crushing pain and pressure in the middle of the chest, like an elephant is sitting on top of you. Not always for women. Some women have no chest pain at all; others feel discomfort, pressure or tightness rather than extreme pain. Signs of heart disease in women and impending heart attack can last for a month or more. For women, these signs of heart attack and heart disease are much more common: Neck, jaw (especially left lower jaw), shoulder (especially left), upper back or abdominal discomfort—particularly if your discomfort begins or worsens on exertion and stops with rest Unusual, extreme fatigue that comes on suddenly Shortness of breath, especially sudden onset with no exertion, as well as breathlessness that worsens when lying down and improves when sitting up Pain in one or both arms (as compared to men, who usually only have left arm pain) Nausea or vomiting (often with no other cardiac symptoms) Sensations of fullness, indigestion, or choking (which may feel like heartburn) Sweating, especially sudden sweating without exertion and cold, clammy sweat for no apparent reason Lightheadedness, dizziness, extreme weakness Rapid or irregular heartbeats If you experience pain or pressure in your chest plus any of these symptoms—especially if these last more than five minutes—seek emergency medical care. Call 911. Or, if the pain leaves and then returns, also seek help. If you are in the emergency room, be sure to tell the healthcare professionals who treat you all your symptoms, including unusual sudden fatigue, which is often the chief symptom of heart attack for women. Heart disease risk factors for women Knowing your risk factors can help you keep an eye out for signs and symptoms of heart disease, and also lead the way to preventing future heart attacks. Some risk factors for women are the same as for men: high cholesterol, high blood pressure, and obesity. But other risk factors are more specific to women or are more likely to raise the risk of heart disease in women. These include: Diabetes High blood pressure or diabetes during pregnancy Inflammatory conditions like rheumatoid arthritis or lupus Menopause (especially being postmenopausal) Smoking Stress and depression Take action to protect your heart and your life If you have concerns about signs, symptoms, and risk factors for heart disease, see your healthcare provider for testing and evaluation. If caught early, you can reverse the course of your heart disease. And of course, if you have signs of a heart attack, do not delay seeking immediate, emergency help.