Table of ContentsView AllTable of ContentsDifferencesCommon SymptomsWhen to Seek Medical CareBefore a Heart AttackSilent Heart AttacksDisparities
Table of ContentsView All
View All
Table of Contents
Differences
Common Symptoms
When to Seek Medical Care
Before a Heart Attack
Silent Heart Attacks
Disparities
Heart disease is the number one killer of both men and women, but the symptoms and warning signs of a heart attack can differ between the sexes.Whilechest painis the most common symptom of a heart attack for everyone, women more often have additional symptoms that can lead to a delay in seeking care and diagnosis.
Gender disparities in heart attack care also may contribute to worse outcomes for women.
This article discusses the symptoms and warning signs of heart attacks in women and covers what you need to know when it comes to heart attack symptoms.
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Differences in Heart Disease Between the Sexes
When it comes to heart disease, there are manydifferences between the sexes, but it’s not yet clear why women experience additionalheart attack symptomsthan men.
“Sex” vs. “Gender”
Studies have demonstrated the risk factors like smoking, high blood pressure, anddiabetesincrease women’s risk of heart disease more when compared with men.Furthermore, female-specific factors such aspolycystic ovary syndrome (PCOS),premature menopause, and pregnancy complications likehigh blood pressure during pregnancyincrease risk of heart disease.
Other conditions that increase heart disease risk likerheumatoid arthritisare more common in women.
Studies have also suggested that gender and gender roles may have an effect on risk of heart disease. For example, a person’s gender roles and relations, such as caretaking duties and marital relationships have been linked to greater cardiovascular risk.
Overall, women also have heart attacks later in life compared to men. Hormones may play a role, and historicallyestrogenhas been thought to prevent plaque buildup in the arteries. However, replacing estrogen with supplemental hormones after menopause doesn’t lower the risk.
Common Heart Attack Symptoms
Cardiac prodromal symptoms—warning signs of a heart attack—are more common in women than men. These prodromal symptoms include the following:
Warning Signs of Heart Attack in Women and When to Seek Medical Care
Because women more frequently have prodromal symptoms that occur before a heart attack, it’s especially important to know what to watch for and when to seek medical attention. Studies have shown that women delay seeking medical care for heart attacks compared to men, which appears to contribute to the worse survival for heart attacks in women.
In general, any new or worsening chest discomfort or abruptshortness of breathshould prompt you to seek immediate medical attention. Other heart attack symptoms that can happen with or without chest pain also should not be ignored. These include:
People might be tempted to shrug these symptoms off, thinking they are due to a virus, indigestion, or a muscle strain. However if you have these symptoms it’s a good idea to promptly seek medical attention to get your heart checked out.
How Do Women Typically Feel Before a Heart Attack?
In many cases, women experiencing a heart attack don’t have any symptoms until they experience abrupt chest pain or shortness of breath. In one study, approximately 40% of people diagnosed with a heart attack recalled having symptoms, such as chest discomfort, shortness of breath, fatigue, sleep disturbance, or palpitations in the weeks to month leading up to the heart attack.
Some people experience chest pain that comes and goes in the time leading up to a heart attack. They may notice the pain during exertion like exercise, but it goes away with rest. This type of pain is calledangina. It’s usually related to blockages in the coronary arteries that prevent blood flow leading the heart.
Silent Heart Attacks in Women
Not every heart attack causes obvious symptoms. In fact, researchers have found that about 45% of heart attacks are silent, meaning there is no chest discomfort or other symptom that would lead someone to seek medical attention.
Thesesilent heart attacksincrease the risk of having another heart attack, heart failure, or even death.People who have had silent heart attacks often only discover they’ve had one weeks, months, or even years later when undergoing evaluation for either a downstream complication related to the heart attack, or some other unrelated reason.
Disparities in Heart Attack Care for Women
Unfortunately, there are significant disparities in heart disease care for women compared to men. For example, women often delay seeking.However, there are disparities in care from the time to calling 911 to the immediate heart attack treatment to long-term treatment and follow-up.
One study of women calling 9-1-1 with heart attack symptoms showed that ambulances used lights and sirens less than for men.This can appear as less of a sense of urgency. And once they arrive for medical care, women experience delays to receiving proper treatment for heart attack care.Evidence suggests women also receive less aggressive care in terms of the procedures and surgeries that may be offered for treatment ofcomplications.
Even after experiencing a heart attack, women are less likely to receive medications like aspirin and statins toprevent another heart attack.
Summary
Heart attacks are the number one killer for both men and women. Chest pain is the most common symptom of a heart attack in women, but prodromal symptoms are more common in women. These symptoms can make it more challenging to recognize a heart attack as they may be attributed to other conditions. A substantial proportion of heart attacks are silent, meaning there were either no symptoms, or symptoms were not recognized at the time.
Disparities in heart attack recognition and care for women and worse outcomes in women after heart attack make recognizing heart attack symptoms especially important for women.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Heart disease facts.Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMRGuideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. [published correction appears in Circulation. 2021 Nov 30;144(22):e455] [published correction appears in Circulation. 2023 Dec 12;148(24):e281].Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029National Institutes of Health Office of Research on Women’s Health.What Are Sex & Gender?Gauci S, Cartledge S, Redfern J, Gallagher R, Huxley R, Lee CMY, Vassallo A, O’Neil A.Biology, bias, or both? The contribution of sex and gender to the disparity in cardiovascular outcomes between women and men.Curr Atheroscler Rep. 2022 Sep;24(9):701-708. doi:10.1007/s11883-022-01046-2Rajendran A, Minhas AS, Kazzi B, et al.Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women.Atherosclerosis. 2023;384:117269. doi:10.1016/j.atherosclerosis.2023.117269Peters SAE, Muntner P, Woodward M.Sex differences in the prevalence of, and trends in, cardiovascular risk factors, treatment, and control in the United States, 2001 to 2016.Circulation. 2019;139(8):1025-1035. doi:10.1161/CIRCULATIONAHA.118.035550Bugiardini R, Ricci B, Cenko E, Vasiljevic Z, Kedev S, Davidovic G, Zdravkovic M, Miličić D, Dilic M, Manfrini O, Koller A, Badimon L.Delayed care and mortality among women and men with myocardial infarction. J Am Heart Assoc. 2017 Aug 21;6(8):e005968. doi:10.1161/JAHA.117.005968American Heart Association.Warning Signs of a Heart Attack.Sohail H, Ram J, Hulio AA, Ali S, Khan MN, Soomro NA, Asif M, Agha S, Saghir T, Sial JA.Prodromal symptoms in patients presenting with myocardial infarction. Cureus. 2023 Aug 18;15(8):e43732. doi:10.7759/cureus.43732American Heart Association.Angina (chest pain).Zhang ZM, Rautaharju PM, Prineas RJ, et al.Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the atherosclerosis risk in communities (ARIC) study.Circulation. 2016;133(22):2141-2148. doi:10.1161/CIRCULATIONAHA.115.021177Cheng YJ, Jia YH, Yao FJ, Mei WY, Zhai YS, Zhang M, Wu SH.Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021 Jan 5;10(1):e017044. doi:10.1161/JAHA.120.017044Lewis JF, Zeger SL, Li X, et al.Gender differences in the quality of EMS care nationwide for chest pain and out-of-hospital cardiac arrest.Womens Health Issues. 2019;29(2):116-124. doi:10.1016/j.whi.2018.10.007Burgess SN. Understudied, Under-Recognized,Underdiagnosed, and undertreated: Sex-based disparities in cardiovascular medicine.Circ Cardiovasc Interv. 2022;15(2):e011714. doi:10.1161/CIRCINTERVENTIONS.121.011714Vallabhajosyula S, Ya’Qoub L, Singh M, Bell MR, Gulati R, Cheungpasitporn W, Sundaragiri PR, Miller VM, Jaffe AS, Gersh BJ, Holmes DR Jr, Barsness GW.Sex Disparities in the Management and Outcomes of Cardiogenic Shock Complicating Acute Myocardial Infarction in the Young. Circ Heart Fail. 2020 Oct;13(10):e007154. doi:10.1161/CIRCHEARTFAILURE.120.007154American College of Cardiology.Women Are Less Likely to Get Secondary Prevention Medications and Cardiac Rehabilitation.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Heart disease facts.Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMRGuideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. [published correction appears in Circulation. 2021 Nov 30;144(22):e455] [published correction appears in Circulation. 2023 Dec 12;148(24):e281].Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029National Institutes of Health Office of Research on Women’s Health.What Are Sex & Gender?Gauci S, Cartledge S, Redfern J, Gallagher R, Huxley R, Lee CMY, Vassallo A, O’Neil A.Biology, bias, or both? The contribution of sex and gender to the disparity in cardiovascular outcomes between women and men.Curr Atheroscler Rep. 2022 Sep;24(9):701-708. doi:10.1007/s11883-022-01046-2Rajendran A, Minhas AS, Kazzi B, et al.Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women.Atherosclerosis. 2023;384:117269. doi:10.1016/j.atherosclerosis.2023.117269Peters SAE, Muntner P, Woodward M.Sex differences in the prevalence of, and trends in, cardiovascular risk factors, treatment, and control in the United States, 2001 to 2016.Circulation. 2019;139(8):1025-1035. doi:10.1161/CIRCULATIONAHA.118.035550Bugiardini R, Ricci B, Cenko E, Vasiljevic Z, Kedev S, Davidovic G, Zdravkovic M, Miličić D, Dilic M, Manfrini O, Koller A, Badimon L.Delayed care and mortality among women and men with myocardial infarction. J Am Heart Assoc. 2017 Aug 21;6(8):e005968. doi:10.1161/JAHA.117.005968American Heart Association.Warning Signs of a Heart Attack.Sohail H, Ram J, Hulio AA, Ali S, Khan MN, Soomro NA, Asif M, Agha S, Saghir T, Sial JA.Prodromal symptoms in patients presenting with myocardial infarction. Cureus. 2023 Aug 18;15(8):e43732. doi:10.7759/cureus.43732American Heart Association.Angina (chest pain).Zhang ZM, Rautaharju PM, Prineas RJ, et al.Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the atherosclerosis risk in communities (ARIC) study.Circulation. 2016;133(22):2141-2148. doi:10.1161/CIRCULATIONAHA.115.021177Cheng YJ, Jia YH, Yao FJ, Mei WY, Zhai YS, Zhang M, Wu SH.Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021 Jan 5;10(1):e017044. doi:10.1161/JAHA.120.017044Lewis JF, Zeger SL, Li X, et al.Gender differences in the quality of EMS care nationwide for chest pain and out-of-hospital cardiac arrest.Womens Health Issues. 2019;29(2):116-124. doi:10.1016/j.whi.2018.10.007Burgess SN. Understudied, Under-Recognized,Underdiagnosed, and undertreated: Sex-based disparities in cardiovascular medicine.Circ Cardiovasc Interv. 2022;15(2):e011714. doi:10.1161/CIRCINTERVENTIONS.121.011714Vallabhajosyula S, Ya’Qoub L, Singh M, Bell MR, Gulati R, Cheungpasitporn W, Sundaragiri PR, Miller VM, Jaffe AS, Gersh BJ, Holmes DR Jr, Barsness GW.Sex Disparities in the Management and Outcomes of Cardiogenic Shock Complicating Acute Myocardial Infarction in the Young. Circ Heart Fail. 2020 Oct;13(10):e007154. doi:10.1161/CIRCHEARTFAILURE.120.007154American College of Cardiology.Women Are Less Likely to Get Secondary Prevention Medications and Cardiac Rehabilitation.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Heart disease facts.Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMRGuideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. [published correction appears in Circulation. 2021 Nov 30;144(22):e455] [published correction appears in Circulation. 2023 Dec 12;148(24):e281].Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029National Institutes of Health Office of Research on Women’s Health.What Are Sex & Gender?Gauci S, Cartledge S, Redfern J, Gallagher R, Huxley R, Lee CMY, Vassallo A, O’Neil A.Biology, bias, or both? The contribution of sex and gender to the disparity in cardiovascular outcomes between women and men.Curr Atheroscler Rep. 2022 Sep;24(9):701-708. doi:10.1007/s11883-022-01046-2Rajendran A, Minhas AS, Kazzi B, et al.Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women.Atherosclerosis. 2023;384:117269. doi:10.1016/j.atherosclerosis.2023.117269Peters SAE, Muntner P, Woodward M.Sex differences in the prevalence of, and trends in, cardiovascular risk factors, treatment, and control in the United States, 2001 to 2016.Circulation. 2019;139(8):1025-1035. doi:10.1161/CIRCULATIONAHA.118.035550Bugiardini R, Ricci B, Cenko E, Vasiljevic Z, Kedev S, Davidovic G, Zdravkovic M, Miličić D, Dilic M, Manfrini O, Koller A, Badimon L.Delayed care and mortality among women and men with myocardial infarction. J Am Heart Assoc. 2017 Aug 21;6(8):e005968. doi:10.1161/JAHA.117.005968American Heart Association.Warning Signs of a Heart Attack.Sohail H, Ram J, Hulio AA, Ali S, Khan MN, Soomro NA, Asif M, Agha S, Saghir T, Sial JA.Prodromal symptoms in patients presenting with myocardial infarction. Cureus. 2023 Aug 18;15(8):e43732. doi:10.7759/cureus.43732American Heart Association.Angina (chest pain).Zhang ZM, Rautaharju PM, Prineas RJ, et al.Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the atherosclerosis risk in communities (ARIC) study.Circulation. 2016;133(22):2141-2148. doi:10.1161/CIRCULATIONAHA.115.021177Cheng YJ, Jia YH, Yao FJ, Mei WY, Zhai YS, Zhang M, Wu SH.Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021 Jan 5;10(1):e017044. doi:10.1161/JAHA.120.017044Lewis JF, Zeger SL, Li X, et al.Gender differences in the quality of EMS care nationwide for chest pain and out-of-hospital cardiac arrest.Womens Health Issues. 2019;29(2):116-124. doi:10.1016/j.whi.2018.10.007Burgess SN. Understudied, Under-Recognized,Underdiagnosed, and undertreated: Sex-based disparities in cardiovascular medicine.Circ Cardiovasc Interv. 2022;15(2):e011714. doi:10.1161/CIRCINTERVENTIONS.121.011714Vallabhajosyula S, Ya’Qoub L, Singh M, Bell MR, Gulati R, Cheungpasitporn W, Sundaragiri PR, Miller VM, Jaffe AS, Gersh BJ, Holmes DR Jr, Barsness GW.Sex Disparities in the Management and Outcomes of Cardiogenic Shock Complicating Acute Myocardial Infarction in the Young. Circ Heart Fail. 2020 Oct;13(10):e007154. doi:10.1161/CIRCHEARTFAILURE.120.007154American College of Cardiology.Women Are Less Likely to Get Secondary Prevention Medications and Cardiac Rehabilitation.
Centers for Disease Control and Prevention.Heart disease facts.
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMRGuideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. [published correction appears in Circulation. 2021 Nov 30;144(22):e455] [published correction appears in Circulation. 2023 Dec 12;148(24):e281].Circulation. 2021;144(22):e368-e454. doi:10.1161/CIR.0000000000001029
National Institutes of Health Office of Research on Women’s Health.What Are Sex & Gender?
Gauci S, Cartledge S, Redfern J, Gallagher R, Huxley R, Lee CMY, Vassallo A, O’Neil A.Biology, bias, or both? The contribution of sex and gender to the disparity in cardiovascular outcomes between women and men.Curr Atheroscler Rep. 2022 Sep;24(9):701-708. doi:10.1007/s11883-022-01046-2
Rajendran A, Minhas AS, Kazzi B, et al.Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women.Atherosclerosis. 2023;384:117269. doi:10.1016/j.atherosclerosis.2023.117269
Peters SAE, Muntner P, Woodward M.Sex differences in the prevalence of, and trends in, cardiovascular risk factors, treatment, and control in the United States, 2001 to 2016.Circulation. 2019;139(8):1025-1035. doi:10.1161/CIRCULATIONAHA.118.035550
Bugiardini R, Ricci B, Cenko E, Vasiljevic Z, Kedev S, Davidovic G, Zdravkovic M, Miličić D, Dilic M, Manfrini O, Koller A, Badimon L.Delayed care and mortality among women and men with myocardial infarction. J Am Heart Assoc. 2017 Aug 21;6(8):e005968. doi:10.1161/JAHA.117.005968
American Heart Association.Warning Signs of a Heart Attack.
Sohail H, Ram J, Hulio AA, Ali S, Khan MN, Soomro NA, Asif M, Agha S, Saghir T, Sial JA.Prodromal symptoms in patients presenting with myocardial infarction. Cureus. 2023 Aug 18;15(8):e43732. doi:10.7759/cureus.43732
American Heart Association.Angina (chest pain).
Zhang ZM, Rautaharju PM, Prineas RJ, et al.Race and sex differences in the incidence and prognostic significance of silent myocardial infarction in the atherosclerosis risk in communities (ARIC) study.Circulation. 2016;133(22):2141-2148. doi:10.1161/CIRCULATIONAHA.115.021177
Cheng YJ, Jia YH, Yao FJ, Mei WY, Zhai YS, Zhang M, Wu SH.Association between silent myocardial infarction and long-term risk of sudden cardiac death. J Am Heart Assoc. 2021 Jan 5;10(1):e017044. doi:10.1161/JAHA.120.017044
Lewis JF, Zeger SL, Li X, et al.Gender differences in the quality of EMS care nationwide for chest pain and out-of-hospital cardiac arrest.Womens Health Issues. 2019;29(2):116-124. doi:10.1016/j.whi.2018.10.007
Burgess SN. Understudied, Under-Recognized,Underdiagnosed, and undertreated: Sex-based disparities in cardiovascular medicine.Circ Cardiovasc Interv. 2022;15(2):e011714. doi:10.1161/CIRCINTERVENTIONS.121.011714
Vallabhajosyula S, Ya’Qoub L, Singh M, Bell MR, Gulati R, Cheungpasitporn W, Sundaragiri PR, Miller VM, Jaffe AS, Gersh BJ, Holmes DR Jr, Barsness GW.Sex Disparities in the Management and Outcomes of Cardiogenic Shock Complicating Acute Myocardial Infarction in the Young. Circ Heart Fail. 2020 Oct;13(10):e007154. doi:10.1161/CIRCHEARTFAILURE.120.007154
American College of Cardiology.Women Are Less Likely to Get Secondary Prevention Medications and Cardiac Rehabilitation.
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