You might assume that if you ever have a heart attack, you’ll just know it. Like in the movies, you’ll clutch your chest, call 911 and head to the hospital right away.
But that’s not always the case — especially if you’re a woman.
Cardiovascular disease is the leading killer of women in the United States, causing 1 in 3 deaths each year, according to the American Heart Association (AHA). What’s worse, many women experience signs and symptoms of a heart attack that are outside of the clutching-your-chest norm. And those are harder to recognize.
A nationwide survey by the Cleveland Clinic found that about half of respondents didn’t know that atypical symptoms such as pain in the back and jaw, dramatic fatigue and nausea could be signs of a heart attack in women.
“Some heart attacks are sudden and intense, but many times symptoms begin and then become more pronounced over time,” says Suzanne Steinbaum, DO. She’s a cardiologist in New York City. She’s also a volunteer medical expert for the AHA’s Go Red for Women movement.
Women may also brush off their symptoms as acid reflux, the flu or normal aging, Dr. Steinbaum says.
That’s why it’s important to know exactly what symptoms to watch out for so that you can take quick action. Because that can save your heart — and your life.
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Heart attack symptom #1: Chest discomfort
This is the most common symptom people report. More than 85% of women and men experience chest pain when having a heart attack. These findings were reported in a 2018 study in Circulation.
It can feel like uncomfortable pressure, tightness or pain that lasts more than a few minutes. “The overwhelming comment I hear from patients is that their chest pain feels more like pressure than pain. It has been classically described as being like an elephant sitting on the chest,” says Dr. Steinbaum.
But chest pain isn’t the only telltale sign to watch for. The AHA notes that women may feel the discomfort lower in their chest than men do, including down in their upper abdomen. (That’s why some mistakenly think it’s acid reflux.)
In the study, women were more likely to have a cluster of 3 or more symptoms, too. These could be heart palpitations or added pain or discomfort in the jaw, neck, arms or in between the shoulder blades.
Unfortunately, women were also more likely to think that their problem was related to stress or anxiety.
Sure, life can be hectic. But chest pain isn’t normal. Dr. Steinbaum notes that in some people the pain can come on gradually. So don’t rule out chest pain just because it doesn’t fit these parameters. Call 911.
Heart attack symptom #2: Shortness of breath
It’s one thing if you set out on a hard run and feel out of breath (especially if there are hills). It’s another if you’re walking up the stairs — which you do routinely — and suddenly can’t make it up without stopping because you’re winded. Or you can’t walk to your car without gasping for air, when normally you would have been just fine.
“Exercise not only is by far the best medicine — it’s the barometer for knowing exactly how you feel,” says Dr. Steinbaum.
If a routine movement is suddenly too challenging, you can’t catch your breath during it or you experience chest discomfort, those may all be signs that something is wrong with your heart, she says.
Related reading: Can you pass this heart health quiz?
Heart attack symptom #3: Nausea or vomiting
Riding in the back seat, having the stomach flu, eating something that shouldn’t have passed the smell test. All of these things can trigger nausea or vomiting. But feeling queasy can also point to a heart attack. “Women may dismiss these types of symptoms, as they can be caused by issues not linked to a heart attack,” says Dr. Steinbaum.
If you don’t know why you’re vomiting or struck with a bout of nausea, contact your health care team right away. As Dr. Steinbaum says: “Don’t die of doubt.”
