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Heart Attack Symptoms in Women That Are Hard To Spot

Studies show a clear difference in heart attack symptoms between men and women. Read on for the most common heart attack symptoms in women—it’s not chest pain.

By D Tejaswi
29 Sep 2021

Symptoms of heart attack go beyond chest pain and importantly, symptoms vary between men and women. For Radhika Yadav, 37, a homemaker, everything was going great until she experienced sudden debilitating fatigue. She recalls that it didn’t hurt at all, but when she tried to move, she couldn’t. She felt as if her hands and legs were tied. Yadav was rushed to a hospital where timely intervention saved her life.

Later, Yadav was shocked to know that something as common as fatigue could indicate a heart attack. “While common warning signs of heart attack are pain or discomfort in the chest, lightheadedness, nausea or vomiting, shortness of breath and discomfort in left shoulder or arm, women are more likely to have other symptoms, such as indigestion, dizziness, hot flashes, nausea, confusion and excessive fatigue,” explains Dr Mukesh Goel, cardiac surgeon, senior consultant, Indraprastha Apollo Hospitals, New Delhi.

Both men and women have some common risk factors for heart attacks but some are more dangerous for women. Women’s range of risk factors such as diabetes or high blood pressure go untreated, sometimes because they prioritise their families over themselves. Also, smoking in women causes a downregulation of the estrogen dependent endothelial wall (membrane that lines the inside of the heart). In addition, women with diabetes are at a greater risk for cardiovascular complications than their male counterparts, outlines the study Gender Differences in Coronary Heart Disease.



Dearth of awareness is another major issue when it comes to identifying the symptoms of heart attack in women. British Medical Journal, 2015 notes that the lack of significant chest pain is a fundamental reason why women have far more unrecognised heart attacks than men. The journal says that many clinicians still consider chest pain as the primary symptom of a heart attack.

Not only professionals, but also the general public, are unaware of the uncommon signs of a heart attack in women. “I often encounter women who are taken by surprise when I explain to them that extreme fatigue, hot flashes and dizziness could be signalling a problem in their heart,” says Dr Goel. In a study conducted among 115 individuals, less than 75 percent of people knew that neck pain, nausea or vomiting, back pain, heartburn and jaw pain could be possible signs of heart attack in women, finds a study published in Journal of Cardiopulmonary Rehabilitation and Prevention.

Furthermore, the fact that a woman is exposed to the risks of heart attack even in her 30s and 40s is also often ignored. Sedentary lifestyle, and consumption of foods rich in trans and saturated fats, lack of enough sleep, stress, use of hormonal birth control increases the likelihood of blood clots. Most birth control pills contain estrogen and progestin, which prevent pregnancy by interrupting ovulation. However, an increase in estrogen levels encourages the formation of blood clots.



By learning about symptoms of heart attack in women and what to look for, you can reduce your risk of complications from heart attack and help save others’ lives too.


1. Pain or pressure in lower chest or upper abdomen: During a heart attack, your diaphragm and adjacent accessory nerves can get irritated, causing pain to refer to other areas of your body such as your lower chest or upper abdomen.

2. Fainting or dizziness: The drop in blood pressure and inability of the heart to pump the blood through the brain cells makes you feel dizzy, faint and off balance. “Sometimes, it can be hard to do simple things like walking to the bathroom,” says Dr Goel.

3. Indigestion or gas-like pain: During a heart attack, there could be an accumulation of fluid in the liver and digestive system, also known as edema. This swelling causes you to feel indigestion or gas-like pain.

4. Hot flashes: Some women experience hot flashes that feel like stress-related sweating. During a heart attack, it occurs even when you are at rest. “In such a case, visit a doctor immediately,” suggests Dr Goel.

5. Confusion or impaired thinking: A potential symptom of heart attack is brain fog. “In rare cases, women can become disoriented, dizzy and lose mental alertness during a heart attack,” says Dr Goel. “The reduced performance of heart and blood supply to the brain causes cognitive problems”.




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