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Thanks to depictions in movies and TV shows, it’s almost expected for someone experiencing a heart attack to clutch their arm or chest, buckle at the knees, and fall to the ground. This sequence is what’s known as the “Hollywood heart attack” because it’s visually theatrical and tells audiences exactly what they need to know without saying a word: that character is having a heart attack.

The only problem is that heart attacks don’t always present as dramatically as that. And when it comes to heart attacks in women, the symptoms aren’t as obvious.

Heart attacks in women can lead to similar symptoms as they do in men, but there are often some differences. Women still experience the most common symptom, onset chest pain, but not always as severely as men do. Some women may even experience a heart attack without experiencing chest pain at all.

To help clarify what a heart attack can feel like for women and to help you recognize the signs more quickly, let’s evaluate the signs and symptoms of a heart attack in women.

(For signs of heart attacks in men, check out our recent article: What Are the Warning Signs of a Heart Attack in Men?)

Signs of a Heart Attack in Women

In most cases, a woman experiencing a heart attack will feel a combination of symptoms, even weeks before the event actually occurs. While it is possible to only suffer one of the following symptoms during a heart attack or leading up to the event, it’s more common for women to experience any combination of:

Onset Chest Pain

Pain in the chest is one of the first and most common symptoms of a heart attack in women. It tends to begin as a mild discomfort anywhere in the chest, not just on the left side. Whether you are at rest or active when the pain starts, it often begins with an uncomfortable or mildly painful sensation in the chest that causes a feeling of ache, pressure, or tightness.

However, some women report never feeling chest pain prior to their attack.

Why can heart attacks cause chest pain in women? A heart attack occurs when a blockage prevents blood from reaching the heart muscle. Your heart requires oxygen from the blood to stay alive. Once that supply is cut off, the affected heart tissue begins to die and causes pain.

Think of it like your muscles during strenuous exercise—when you exert yourself to the point where your muscles aren’t receiving enough oxygen, they will tighten, cramp, and spasm. A heart attack is similar, but instead of your heart not getting enough oxygen, your heart is not receiving any oxygen at all, leading to severe, life-threatening complications.

Women’s hearts and blood vessels tend to be smaller than those of men, which is one reason chest pain can progress differently than it would in a man. Plus, women are more likely to experience blockages in their smaller arteries, which causes sensations that are unique to women.

Pain in the Upper Body

Pain in the upper body, especially the back, neck, and jaw, is a common symptom of a heart attack in a woman. Arm pain is also a possibility, although it’s not always the same as the left arm pain that men often experience.

For many women, the upper body pain comes and goes before intensifying.

Why can heart attacks cause arm pain in women? The painful sensations you may feel in your upper body during a heart attack are due to something called “referred pain.”

The nervous system is a highly complex structure with nerve channels all over the body. When pain occurs in a particular area, receptors will send pain signals along a specific neural pathway to the brain’s sensory cortex, letting the patient know, “There is a problem here.”

However, each organ does not have its own pathway to the brain—it must send pain signals along the pathways of other, more sensitive areas of the body to reach the sensory cortex. If the sensory cortex receives a signal from the heart via the same pathway that serves the back, neck, jaw, or arms, the brain will likely interpret the pain as coming from those areas, which is what can cause you to experience that kind of pain during a heart attack.

Men can experience intense referred pain in the left arm and throughout the upper body. Women’s pain is more diffused and generalized—left arm pain is possible, but it’s not a common symptom in women.

Stomach Pain and Flu-Like Symptoms

While men can experience stomach pain or flu-like symptoms during a heart attack, it is far more common for women to experience these sensations. Many women report that it feels like an elephant is sitting on their stomach because the pressure is so intense in that area. Combine that pain with the feeling of nausea, fatigue, and excessive sweating, and the pain can sometimes be mistaken for indigestion, a bad stomach virus, or the flu.

Why can heart attacks cause stomach pain and flu-like symptoms in women? Stomach pain can sometimes be caused by the same referred pain that affects a woman’s upper body during a heart attack.

It can also be caused by:

  • Chemical changes in the stomach as a reaction to slowed blood circulation
  • Fluid buildup in the stomach and liver, leading to abdominal swelling and pain

Since women’s heart attacks often progress differently than men’s, it could explain their tendency to experience stomach pain more commonly than men. The attack’s slower progression may give the stomach more time to undergo those chemical changes or give organs more time to retain fluids, both of which can lead to intense stomach pain.

Difficulty Breathing

When a woman experiences a heart attack, she may have shortness of breath for no apparent reason. There are several reasons a woman can experience shortness of breath—such as too much physical exertion, an asthma flareup, a viral infection, or even a panic attack—but it can be a sign of a heart attack when it’s accompanied by chest pain or pressure, upper body pain, fatigue, excessive sweating, and even lightheadedness.

Why can heart attacks cause breathing difficulties in women? There are three main reasons for shorter breathing during a heart attack:

  • Your body goes into survival mode and does everything it can to get more oxygen into the body and to the heart, including breathing as short and fast as possible.
  • Blood flow blockage can cause a buildup of fluid in the lungs, making deeper breathing impossible to achieve.
  • Increased chest pressure can hinder your ability to draw a deeper breath.

Both men and women are likely to experience similar breathing difficulties during a heart attack.

Additional Symptoms of Heart Attacks in Women

Female heart attack patients tend to experience the symptoms mentioned above, as well as additional symptoms like:

  • Dizziness
  • Excessive coughing or wheezing
  • Excessive sweating or cold sweats
  • Inability to sleep well leading up to the heart attack
  • Increased anxiety
  • Physical weakness
  • Unexplainable fatigue

What to Do When Experiencing Heart Attack Symptoms?

  • If you or someone nearby is experiencing complications that seem like symptoms of a heart attack, call 911 ASAP.
  • Do not try to drive yourself to the hospital if you are the one experiencing symptoms, and do not opt to drive someone else experiencing symptoms, either—EMTs are more equipped to handle such an emergency and can provide life-saving care in transit to the hospital.
  • Do not try to “wait it out.” Heart attack warning signs cannot be ignored or downplayed, and every minute matters following the onset of symptoms. Seeking medical care during a heart attack is a matter of life and death.

Middle Georgia Heart is dedicated to your heart health and supporting your heart so that you reduce your risk of experiencing symptoms of a heart attack.

Our heart doctors understand the severity of heart attacks, and we know the ways to lower your risk of experiencing one altogether. To best protect your heart and overall health, schedule an appointment with our heart specialists today: 478-207-5224

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