Updated on August 13, 2024.
Cardiovascular disease (CVD) is the leading killer of women in America, accounting for over one-third of all deaths. That's more than the combined death rates from breast, ovarian, and cervical cancers. The threat is very real, especially in the years leading up to and following menopause when hormonal changes can open the door to heart disease. Even so, many women may not feel that heart disease or heart attacks are the greatest health risks they face.
Here's what everyone should know about heart attack symptoms and signs of early cardiac troubles in women, along with risk factors for cardiovascular disease. Understanding these symptoms and risks can significantly increase one’s chances of survival in the face of heart disease or heart attack.
Heart attack signs can be subtle—and may appear weeks in advance
Studies on cardiac events in women reveal that many women may experience prodromal (or early) symptoms of cardiac distress in the days, weeks, or even months leading up to a heart attack. Unfortunately, many of these signs may be dismissed as nothing out of the ordinary, by both women and their healthcare providers (HCPs). The most common early warning signs include:
Unusual fatigue: Fatigue is a common complaint and one that may indicate that you're fighting a virus, experiencing a side effect to medication, or simply missing out on sleep. But unusual or extreme fatigue may also be an early heart attack symptom or a warning sign of heart disease.
Research has shown that unusual fatigue is the leading early symptom of heart attack in women, occurring in as many as 71 percent of cases in the days or weeks prior to heart attacks.
Sleep disturbances: Although it's not unusual to feel tired due to a lack of sleep or a particularly demanding stretch of time, you should take special notice of any unusual or prolonged disturbance in your sleep patterns.
Shortness of breath: Having trouble catching your breath during normal daily activities may also be an early heart attack sign or symptom of cardiac distress in women.
Other symptoms that often occur in the month or so leading up to a heart attack in women include indigestion, anxiety, having a racing heart, or feelings of weakness or heaviness in the arms.
How do you know if your symptoms are serious? Getting into the habit of noting your typical aches and pains and your normal reactions to foods and activities may help you recognize when something is truly amiss. Also, remember that if you have risk factors for heart disease, you should be especially vigilant about monitoring how you feel, particularly if any of your usual symptoms are also some of these common early heart attack signs.
If you experience worrisome or unusual changes in your energy level, comfort, or sleep habits, you should discuss your concerns with an HCP. This is especially important if you have heart disease risk factors, such as high blood pressure, high cholesterol, obesity, diabetes, a smoking habit, or a sedentary lifestyle.
Acute symptoms of heart attack in women
Although chest pain is considered to be one of the classic signs of a heart attack in both women and men, the sudden, violent chest convulsions often portrayed on TV or in movies may not be experienced by all women.
Women may also report pain or discomfort in other areas of the body before or during a heart attack. Pressure, tightness, aching, or burning in the upper back, neck, shoulders, and arms, or even in the jaw or throat can be signs of heart distress. Women have also described the discomfort as a sharpness, a fullness, or a tingling.
Shortness of breath, fatigue, stomach pain, cold sweats, dizziness, indigestion, or nausea also may occur during the acute phase of a heart attack.
Learning about the many different acute symptoms of heart attack can help ensure that you seek emergency care when you need it. Keep in mind that not all of these symptoms occur in every attack, and some symptoms may go away and then return.
How to reduce your risk of heart attack
As a woman, after 40, your risk for coronary heart disease (CHD) starts to rise as your body stops producing estrogen naturally and your cholesterol levels increase. Although taking estrogen through menopausal hormone therapy was once thought to protect against CHD, clinical trials have found that it does not offer cardiac protection and may increase the risk of heart disease and ovarian and breast cancers for some people.
So what can you do to protect your heart and reduce your risk of a heart attack? Managing your cholesterol, blood pressure, and weight can greatly reduce your risk.
Start with these seven steps:
Check your blood pressure regularly. If it's high, and you have been prescribed medication, take it exactly as directed, even if you feel fine.
Stop smoking, if you smoke. Ask your HCP for help with quitting tobacco.
Eat a healthful diet. Include plenty of fresh fruits and vegetables, whole grains, and low-fat dairy to get your daily dose of calcium, potassium, and magnesium.
Be wise about fats. Choose healthful unsaturated fats (like those from seafood, nuts, and other plant foods) instead of saturated fats.
Reduce stress levels at home and at work. You might try mindfulness meditation or deep-breathing techniques.
Reduce or eliminate alcohol. Limit your alcohol intake to no more than one glass per day. If you don’t drink, don’t start.
Move more. Get 30 minutes of exercise every day and keep your weight within healthy limits.
Don't ignore how you feel
Research shows that women tend to ignore signs of illness or attribute their symptoms of cardiac distress to something else. At the same time, research also suggests that HCPs are more likely to dismiss or diminish women’s symptoms then men’s.
If you are feeling unusual fatigue or pain and discomfort, don't dismiss it. The fact that warning signs may occur as much as a month before a heart attack gives you valuable time to seek medical care that may save your life.
