ER Doctors Share The Most Common Heart Attack Signs In Women

At one time, heart disease was believed to largely only happen to men, which meant women weren’t included in health studies on the topic.

While this has changed ― and it’s now known that heart disease is the leading cause of death for women (and men) in the United States ― research is still catching up. This means heart health outcomes are worse for women than they are for men.

Heart disease is an umbrella term for many cardiovascular conditions, including coronary artery disease, which can lead to emergent episodes like heart attacks ― which are also understudied in women.

“In medical school, when we learn about heart attacks, we learn about something called typical chest pain, and that is … right behind the center of your chest, and it’s crushing chest pain that usually goes down your left arm and it goes up to your jaw,” said Dr. Jennah Morgan, an emergency medicine physician at the Ohio State University’s Wexner Medical Center.

Generally, someone experiencing this type of pain walks into a hospital while gripping their chest and sweating, Morgan added. However, heart attacks don’t present this way in everyone — especially women.

“Between both men and women, chest pain is still the most common sign,” said Dr. Bernice Fokum, an emergency medicine physician at the University of Chicago Medicine.

However, chest pain can feel different for men and women, according to Morgan. “In men, it usually is the ‘elephant on my chest,’ this deep, intense pressure pain,” Morgan said. “For women, it might be achiness, it might be a little discomfort, it might be a little squeeze, a little tightness, but it may not be the crushing chest pain that we’ve been taught to look for.”

It is also customary for women to have vague symptoms, Fokum said, “which is a bit overwhelming as clinicians because it might be something that you want to write off as, ‘oh, that’s just somebody having some acid reflux’ or, ‘that’s just somebody who slept weird and they’re having some shoulder pain.’”

Clinicians aren’t the only people who may write the vague symptoms off — women may, too, which may delay care and lead to serious health consequences.

Both Fokum and Morgan said the atypical signs of a heart attack in women include shortness of breath, nausea, indigestion, acid reflux, discomfort right below the rib cage, unexplained fatigue, neck pain and back pain.

These vague symptoms could be signs of many issues other than heart attacks, however, including the flu, a bad night’s sleep and food poisoning, which is both good and bad news.

While you don’t need to panic the next time you have nausea or have unexplained tiredness, you should also take symptoms seriously if they feel off.

“People know their body,” Fokum said. If you routinely get indigestion after eating spicy food or know your neck pain is from a certain pillow, you likely don’t need to worry much about those symptoms.

If you’re having a “gnawing, really uncomfortable sensation not precipitated by things that normally” occur, perhaps accompanied by shortness of breath, you may want to speak with your primary care doctor, Fokum said.

“Or if it is persistent and you are really concerned … it really might make sense for you to either call the paramedics or go to the emergency department.”

Women with heart attack risk factors or a family history of heart disease should pay close attention if they have any of the vague symptoms mentioned above, both doctors told HuffPost.

“Think big picture,” Morgan said. “If you have a family history of heart conditions, if you already have predisposing factors” — for example, high blood pressure, diabetes, high cholesterol, kidney disease or a combination of several conditions — it may make it more likely that “something concerning is happening,” she said.

“I would say have a low threshold if you don’t feel well” and also have those risk factors, Morgan said.

If you have a personal history of heart disease or heart attacks, you should also take all signs seriously, according to Fokum. The same is true if you’re in your 50s, 60s or 70s, when heart attacks are more common.

But that doesn’t mean younger people should ignore these symptoms. Heart attacks are happening in younger women more often, research shows.

Just as many women are unaware of some of the vague signs of a heart attack, the same knowledge gap exists for some medical professionals. Meaning, your nausea (that’s actually a heart attack) or back pain (that’s actually a heart attack) could be dismissed at the hospital.

Only you know what is normal for your body and what’s not, Fokum said. If you notice that you’re very fatigued or feeling unexplained pain, respectfully let your medical care team know at the hospital.

“That may increase the number of tests I do or increase the interventions that I recommend,” Fokum said.

You could even tell your care team that you suspect you’re having a heart attack. There can be “a lot of bias whenever we, as clinicians, talk to women and assess women’s symptoms and determine what kind of intervention [is needed],” she added. “For a multitude of reasons, there are less lifesaving cardiac interventions that are done for women than men across the board. It is the reality of the situation.”

Research shows that women with symptoms of a heart attack are less likely than men to receive aspirin, which can be protective during a heart attack, and less likely to receive other medical interventions, too, according to Fokum.

“So, somebody being an advocate for themselves in these settings is going to be really paramount in pushing them towards having a higher likelihood of getting the interventions that they need,” she said.

If your doctor runs tests and it turns out you aren’t having a heart attack, that’s OK. “We certainly have a lot of people who come in and it ends up not being a heart attack. Sometimes it is just simply acid reflux,” Fokum said.

There is no reason to be embarrassed if you go in for testing because of a serious concern and it turns out you’re not experiencing what you think.

Not everyone can afford to just go to the emergency department when a concerning symptom like unexplained fatigue or nausea occurs.

If you suspect you are having a heart attack, it’s crucial that you go to the hospital, but “if you have a question, you have hesitation, I think it’s OK to call [your local emergency department] because if something is really concerning, the person on the other end will say, ‘get here now’ … I think that message will be clear,” Morgan said.

“If you are concerned and you’re worried about costs, I would say it’s still always better [to go to the hospital]. You can worry about costs later and save your life,” Morgan said. “But if you’re more inclined to say, ‘no, I’m not coming,’ I would at the very least call an emergency department and speak to a healthcare provider, and they can at least give you some support.”

With heart disease being the leading cause of death in the U.S. for women, and increased heart attacks in younger women, it’s important to do what you can to lower your risk.

Exercising is one way to do this, Morgan said. It’s recommended that adults get at least 150 minutes of moderate exercise (such as walking, gardening or dancing) each week, or 75 minutes of vigorous exercise (such as running, singles tennis or swimming).

“Then also just eating a high-fiber diet, a diet that is high in vegetables and fruits. But of course, with fruits, you have to make sure that if you have diabetes, that you’re looking at sugar control as well,” Morgan said. “If you already have a diagnosis and you’re already prescribed medication, do your best to stick to your medication regimen,” especially if it’s medication for high cholesterol, high blood pressure, diabetes and more.

It’s also important to know your numbers for blood pressure, cholesterol and blood sugar, which can all be gathered through a routine blood test.

Controlling stress is also important for your health. “Stress is horrible for your body. It raises your cortisol levels. It raises your blood pressure. It just really puts everything out of whack,” Fokum said.

While it’s not easy to stay stress-free during busy days and tough economic times, it is important to try. Meditation, socialization, church, therapy and time in nature can all help lower stress. Find a method that works for you.

Heart attack symptoms in women aren’t taken as seriously as those in men, which leads to fewer medical interventions and deadly outcomes. If you notice any concerning health symptoms in yourself or in a loved one, go to a doctor immediately and do what you can to get the treatment you deserve.