Know the symptoms

The first step to surviving a heart attack is to recognize the symptoms of a heart attack. The more of these symptoms you have, the more likely it is you're having a heart attack.1 And women are more likely than men to have more than one symptom of a heart attack. The most common heart attack symptom in women and men is chest pain. However, women are more likely to have at least one of these other heart attack signs.2

Many women say that they felt "off" or that something was "just not right" before their heart attack, but they didn't realize their symptoms could be related to their heart.3 Not all heart attacks feel the same. Some are sudden and intense. Others may start slowly with mild pain or discomfort, which can come and go over several hours, or get worse. New symptoms, or a change in the pattern of existing symptoms, are cause for concern. The only way to be sure is for hospital emergency department staff to examine you as soon as possible. Trust your instincts and remember that you know your body better than anyone. When in doubt, check it out.

Symptom: Unusually heavy pressure on the chest, like there's a ton of weight on you

Most heart attacks involve chest pain or discomfort in the center or left side of the chest. It usually lasts for more than a few minutes or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness, or pain. It may even feel like the worst heartburn or indigestion you’ve ever had. Women may be more likely to use words like “crushing” or “pressing” to describe heart attack chest pain. Some women say it is “discomfort” or a very bad ache.4

Symptom: Sharp upper body pain in the neck, back, and jaw

This symptom can include pain or discomfort in one or both arms, the back, shoulders, neck, jaw, or upper part of stomach (not below the belly button). Pain in the back, neck, or jaw is a more common heart attack symptom for women than it is for men.

Symptom: Severe shortness of breath

This symptom can come on suddenly. It can happen while you are resting or not moving around very much. You may struggle to breathe or take deep breaths. Shortness of breath may start before or at the same time as chest pain or discomfort, or may be the only heart attack symptom you have. If you have trouble breathing for more than a few minutes, this is a medical emergency and you should call 911.

Symptom: Cold sweats, and you know it's not menopause

Unexplained or excessive sweating, or breaking out into a "cold sweat," can be a sign of heart attack.

Symptom: Unusual or unexplained fatigue (tiredness)

Sudden and unusual tiredness or lack of energy is one of the most common symptoms of heart attack in women, and one of the easiest to ignore. It can come on suddenly or be present for days.

Symptom: Unfamiliar dizziness or light-headedness

Unlike in the movies, most heart attacks do not make you pass out right away. Instead, you may suddenly feel dizzy or light-headed.

Symptom: Unexplained nausea (feeling sick to the stomach) or vomiting

Women are much more likely than men to experience nausea, vomiting, or indigestion during their heart attack.5 Women often dismiss these symptoms, or think that nausea, vomiting, or indigestion is normal. Nausea and vomiting may be signs that something is seriously wrong, especially if you have other heart attack symptoms.

Sources

• DeVon, H. A., Rosenfeld, A., Steffen, A. D., & Daya, M. (2014). Sensitivity, specificity, and sex differences in symptoms reported on the 13-Item Acute Coronary Syndrome Checklist. Journal of the American Heart Association, 3(2), e000586.
• Coventry, L.L., Finn, J., Bremner, A.P. (2011). Sex differences in symptom presentation in acute myocardial infarction: A systematic review and meta-analysis. Heart Lung; 40(6): 477-91..
• Lichtman, J.H., Leifheit-Limson, E.C., Watanabe, E., Allen, N.B., Garavalia, B., Garavalia, L.S. et al. (2015). Symptom Recognition and Healthcare Experiences of Young Women with Acute Myocardial Infarction. Circulation: Cardiovascular and Quality Outcomes; 8(2 Suppl 1): S31–S38.
• Kreatsoulas, C., Shannon, H. S., Giacomini, M., Velianou, J. L., & Anand, S. S. (2013). Reconstructing angina: Cardiac symptoms are the same in women and men. JAMA Internal Medicine, 173(9), 829–31.
• Coventry, L.L., Finn, J., Bremner, A.P. (2011). Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis. Heart Lung; 40(6): 477-91.

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