Hi, I’m a cardiac nurse….
And I am here to tell you that you have to look out for other symptoms of a heart attack if you are a woman. Please continue reading, the information in this post could save your life or your loved one’s life.
My Monday through Friday job is a cardiac stress testing and cardiac rehab nurse. I’ve been in this specialty for seven years and I’ve learned a thing or two.
- Women frequently do not have the classic “chest pain” symptom when having a heart attack.
- Women are more likely to put off seeking medical attention because they are too busy taking care of other people first. (Especially the sandwich generation…. when you still have kids at home and also elderly parents that need help.)
- Once a woman does seek medical attention, her symptoms are so vague that her provider may not be immediately cued in on her heart.
- Women who actually go the emergency department have longer wait times than a male complaining of the same symptoms. (Additional wait time: 11 mins for white women, and 15 mins for Black and other ethnic women) (Women and Black, 2022)
Why Won’t I Have Chest Pain?
Great question! But I cannot completely answer that for you. An appointment with your healthcare provider looking at your unique health history and risk factors would be more beneficial to you.
However, as healthcare professionals, we have some reasons as to why women don’t have classic chest pain during a heart attack.
- Women are more likely to suffer from microvascular disease, which is a disease that affects the smaller heart arteries rather than the major arteries.
- Plaque build up in the arteries of the heart may be more diffuse or spread out throughout the arteries, rather than in one or two areas
- The hormone estrogen can be heart protective and may alter how we experience symptoms.
Here are some good articles to read for more information:
National Heart, Lung, and Blood Institute
What is a Heart Attack Exactly?
A heart attack happens when blood flow to the heart muscle is blocked and the heart muscle cannot get oxygen and nutrients. If blood is blocked for long enough, tissue death may occur. Once heart muscle tissue dies, that part of the heart will no longer work properly.
A blockage can happen from an artery spasm in the heart or from plaque buildup that has broken off and a blood clot forms in the artery.
Who is at Risk for Having a Heart Attack?
The following list outlines risk factors for heart disease. If you have any of the following risk factors, you need to speak with your healthcare provider about heart disease prevention.
Non-Modifiable Risk Factors:
- Age: The risk of heart disease increases as we get older– we’ve had more time to build up plaque and acquire other risk factors like high blood pressure
- Gender: Men typically have a higher risk of heart disease at a younger age. However, women’s risk increases and eventually equals or exceeds men’s after menopause.
- Family History: A family history of heart disease, especially if a close relative developed heart disease at an early age. Are you related to someone who has died from “hardening of the arteries”? That is a type of vascular disease that can also affect the heart.
- Genetics: Certain genetic factors can predispose individuals to heart disease. Have you ever hear of plaque makers? Those are people who despite living relatively healthy lifestyles, still have been found to have severe coronary artery disease.
Modifiable Risk Factors:
- Uncontrolled High Blood Pressure (Hypertension)
- Uncontrolled High Cholesterol
- Smoking
- Diabetes
- Obesity
- Physical Inactivity
- Unhealthy Diet
- Excessive Alcohol Consumption
- High Stress Levels
- Untreated Sleep Apnea
- Poor Dental Health
- Depression
- Metabolic Syndrome
- Certain Medications: think of chemotherapy or hormone replacements
- Chronic Inflammation: think about rheumatoid arthritis or other diseases that increase inflammation markers
Symptoms
Finally! What symptoms you need to be aware of if you are possibly having a heart attack or leading up to having one as a woman:
Shortness of breath
I’m talking about shortness of breath this is abnormal for the activity that you are doing. Are you just sitting and feel short of breath? Yeah… that’s not normal! Go get that checked out… like now.
It is also not normal to get short of breath walking around your house. Now… if you are carrying a heavy box…. or load of laundry up and down the stairs, yeah, you will probably get short of breath with that activity. But when you sit and rest, do you recover within a minute or two? Or does the heavy breathing last for several minutes after resting?
If the shortness of breath is lasting for several minutes after resting, call your healthcare provider and get it checked out.
Also, if you are noticing that over the past few weeks or months that you are getting more short of breath with less and less activity, that is not normal. That is not necessarily a normal part of aging.
For example: Two months ago you could walk a mile outside no problems, but this week you begin to notice shortness of breath by the time you step out of your driveway. Say it with me…. That’s not normal!
Back or Jaw Pain
Do you have chronic neck or back pain? As long as you know what your normal pain feels like, any different discomforts need to be taken notice of.
Same if you have a reason for your jaw to hurt. Did you just get a tooth worked on? Then the discomfort is probably from that healing area in your mouth.
I want you to take notice of new back pain… or new unexplainable tooth or jaw pain. You can even go so far as to include any throat tightness or fullness into this heart attack symptom category.
Frequently, women complain of back pain in between the shoulder blades, with no known cause. This discomfort is unrelieved by position changes, heat/ice, or over the counter pain medications. I’m telling you.. that’s not normal.
Feeling of Impending Doom
With the world like it is today, who doesn’t feel like this from time to time?
But all joking aside, if you are having some of these other vague symptoms and also a feeling of something just isn’t right, go get checked out by a healthcare provider. Sooner rather than later.
Unfortunately, I cannot perfectly describe what a feeling of impending doom might feel like to you. The best way I can describe it based on my professional experience working with heart patients is that you will know it if you feel it. It’s a nagging feeling that something bad is going to happen, but you don’t know what or when.
Fatigue
Woof…. I could go for a nap. Like all the time. I’m tired when I wake up, all day, and definitely cannot miss my evening two hour nap. Guess what…. That’s not normal!
Fatigue is a feeling of exhaustion. It is not necessarily a normal sign of aging. If you feel wiped out tired most of the time, make an appointment with your healthcare provider and tell them. It could be abnormalities in your blood, or undiagnosed sleep apnea, or…. you guessed it…. YOUR HEART.
If your heart muscle is starving for oxygen, it’s working overtime trying to meet the demands of the body, making you extra tired all the time.
Light headedness, Dizziness, Nausea, Indigestion, Sweating
I grouped these together because separate, they are quite vague, right? Which is why heart attacks are so hard to pinpoint in women!
Pay attention if you ever have these symptoms and think about what could have caused them. Is there a logical reason for you to be nauseous and light headed? Like for example, has your family been fighting off the stomach flu?
If there is no logical reason for these symptoms, and ESPECIALLY if they are associated with any of the other previously mentioned symptoms, go to the emergency department…. quickly. Don’t wait to shower, or pack a bag of any sort, or wait till your spouse gets off work. Go now.
Better yet, call an ambulance.
Chest Pain
Now wait a second. Isn’t this whole article about how women don’t have classic chest pain symptoms during a heart attack?
True, it is. But some of the lucky ones do have classic chest pain, and I need to educate what that might be for everyone. Now what I hear often from men and women is that, “it wasn’t chest pain, it was pressure” or “it wasn’t chest pain, it was heaviness”.
In the eyes of the healthcare professionals, it’s all the same.
So, be on the lookout for:
Chest pain, pressure, tightness, heaviness or any discomfort at all. This discomfort could start in the back and radiate to the front chest area. Or, this discomfort could start in the chest and radiate up to the neck, or to either arm. Yep, you read that correctly, right or left arm/shoulder.
Final Thoughts
Alright, there ya have it. The information you need to be better informed about your heart health and heart attack symptoms for women. I am so passionate about the heart that it was hard to not go into great detail on every little piece of information in this article. I will get more information out, but it will just take more time.
If you have made it this far into reading, thank you. Please leave a comment if you or someone you know has experienced a heart attack and had symptoms not listed in this article. The more information we can get to people, the better outcomes for all of us.
Or feel free to share your story! Having a heart attack or a close call is very emotionally taxing and it could help to share your experience.
Till next time, Cheyenne ❤️
Disclaimer: The health and wellness advice provided on this platform is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified healthcare provider with any questions you may have regarding your health or a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.
References:
Women and Black adults waited longer in ER for chest pain evaluation. (2022, May 4). American Heart Association. Retrieved from: https://newsroom.heart.org/news/women-and-black-adults-waited-longer-in-er-for-chest-pain-evaluation
