Chest Pain and Other Signs

Women don’t always get the same classic heart attack symptoms as men, such as crushing chest pain that radiates down one arm. Those heart attack symptoms can certainly happen to women, but many experience vague or even “silent” symptoms that they may miss.

These six heart attack symptoms are common in women:

1. Chest pain or discomfort. Chest pain is the most common heart attack symptom, but some women may experience it differently than men. It may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. It’s usually “truly uncomfortable” during a heart attack, says cardiologist Rita Redberg, MD, director of Women’s Cardiovascular Services at the University of California, San Francisco. “It feels like a vise being tightened.”
2. Pain in your arm(s), back, neck, or jaw. This type of pain is more common in women than in men. It may confuse women who expect their pain to be focused on their chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may wax and wane before becoming intense. If you’re asleep, it may wake you up. You should report any “not typical or unexplained” symptoms in any part of your body above your waist to your doctor or other health care provider, says cardiologist C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles.
3. Stomach pain. Sometimes people mistake stomach pain that signals a heart attack with heartburn, the flu, or a stomach ulcer. Other times, women experience severe abdominal pressure that feels like an elephant sitting on your stomach, says cardiologist Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York.
4. Shortness of breath, nausea, or lightheadedness. If you’re having trouble breathing for no apparent reason, you could be having a heart attack, especially if you’re also having one or more other symptoms. “It can feel like you have run a marathon, but you didn’t make a move,” Goldberg says.
5. Sweating. Breaking out in a nervous, cold sweat is common among women who are having a heart attack. It will feel more like stress-related sweating than perspiration from exercising or spending time outside in the heat. “Get it checked out” if you don’t typically sweat like that and there is no other reason for it, such as heat or hot flashes, Bairey Merz says.
6. Fatigue. Some women who have heart attacks feel extremely tired, even if they’ve been sitting still for a while or haven’t moved much. “Patients often complain of a tiredness in the chest,” Goldberg says. “They say that they can’t do simple activities, like walk to the bathroom.”

Not everyone gets all of those symptoms. If you have chest discomfort, especially if you also have one or more of the other signs, call 911 immediately.

• Don’t delay getting help. “Women generally wait longer than men before going to the emergency room,” says Rita F. Redberg, MD, MSc, FACC, director of Women’s Cardiovascular Services for the UCSF Division of Cardiology in San Francisco. Even if you think your symptoms aren’t that bad or will pass, the stakes are too high.
• Don’t drive yourself to the hospital. You need an ambulance. If you drive, you could have a wreck on the way and possibly hurt yourself or someone else.
• Don’t have a friend or relative drive you, either. You may not get there fast enough.
• Don’t dismiss what you feel. “Don’t worry about feeling silly if you’re wrong,” Goldberg says. You have to get it checked out right away.

“People don’t want to spend hours in an emergency room if it isn’t a heart attack,” Bairey Merz says. “But women are actually good at deciding what is typical for themselves and when to seek health care.”