Am I Having a Heart Attack? Signs of a Heart Attack in Women

Unusually breathless? Extremely exhausted? Ladies, recognizing these early warning signs of a heart attack can help you protect your heart. It’s normal to feel anxious, but it’ll help to stay calm.

Here are the 10 early warning signs of a heart attack that women should look out for ⁽²⁾:

1. Chest pain: The pain may be like a sensation of pressure/ heaviness/ tightness/ crushing/dull pain or radiating to the left arm or left jaw

2. Pain in the arm, shoulder, back, neck, abdomen, jaw, tooth, hand, often on the left side

3. Nausea, vomiting, or even an upset stomach

4. Unusual fatigue

5. Shortness of breath

6. Ache, discomfort, weakness, or tingling in the arm or hand

7. Dizziness

8. Prolonged sleep difficulties

9. Excessive or cold sweats

10. Anxiety

Some women may complain of racing, fluttering or pounding heartbeats.

Statistical context: According to the U.S. Centers for Disease Control and Prevention, heart disease remains the leading cause of death for women, and large surveys show that public awareness is imperfect — by 2019 only about 44 percent of women recognized heart disease as their leading cause of death. ^(9,10)

These findings emphasize the need to better understand female cardiac health and how ischemic heart disease in women often presents differently, making awareness vital for early intervention.

Medbound Times spoke to Dr. Bhavesh Joshi, Cardiac Emergency Care, Lilavati Hospital, Mumbai, who said, “Women are often overworked with domestic and professional responsibilities, so heart attack symptoms, being subtle in women, are often underplayed. Also, symptoms — such as breathlessness, unusual fatigue, nausea, or jaw/back pain — may be mistaken for non-cardiac issues.”

Dr. Bhavesh Joshi adds, “If you suspect a heart attack, the most important steps are:

1. Call emergency medical services immediately. Early hospital care saves lives.

2. Stop all activity.

3. Sit or lie down in a comfortable position with loosened clothes.

4. You can chew one tablet of acetylsalicylic acid (325 mg) (also known as ASA or by the brand name Aspirin) while awaiting help, if you have no risk factors for it.

5. You can take nitroglycerin as directed, if prescribed.

6. Do not attempt home remedies or take multiple medicines without medical supervision."

Mortality difference: Research has also shown that short-term mortality after an acute myocardial infarction can be higher in women than in men; for example, one analysis reported 30-day mortality of about 9.6 percent for women compared with 5.3 percent for men. ⁽¹¹⁾

Women reporting arm pain or discomfort and unusual fatigue during initial IHD evaluation are more likely to have a cardiac event at any point in the next 90 days⁽⁸⁾, so it’s important you stay informed and alert! 

Heart disease can be preventable. Take care of your heart!

FAQs:

What are the Risk factors for Heart Disease?

The known risk factors are⁽¹⁾:

1. High blood pressure

2. Diabetes

3. Smoking

4. Insufficient physical activity

5. Unhealthy diet

6. Stress 

7. Excess abdominal fat⁽⁴⁾.

What can I do to Prevent Heart Disease?

1.  Meet your healthcare professional who can evaluate your risk for heart disease, and advise/prescribe you as needed.

2.  Your heart risk declines rapidly if you quit smoking⁽⁶⁾. 

3.  Exercise regularly.

4.  Adopt a healthy diet.

5.  Maintain favorable levels of blood lipids, blood sugar, and blood pressure⁽⁴⁾.

6.  Sleep about 7-8 hours a night⁽⁷⁾.

7. Maintain a healthy body mass index (BMI) with a lower fat percentage and higher muscle mass.

What’s a heart-healthy diet?

Your diet should be a balance of fruits, vegetables, legumes, whole grains, fiber, lean protein like fish, and be low on processed foods, trans-fats, salt, sugar, and alcohol⁽⁴⁾.

How much should I exercise?

You should exercise at least 3 days a week. Perform either 150 minutes of light to moderate aerobic exercise (like walking) or 75 minutes of vigorous aerobic activity spread over at least 3 days, every week. It's important to note these guidelines have been further modified for specific groups, such as pregnant women, children, and people with disabilities etc., by the U.S. Department of Health and Human Service ⁽⁵⁾.

Listening to your body could save your life — because women’s hearts don’t always “shout,” they often whisper. Raising awareness about women’s heart attack symptoms and silent heart attack in women ensures more women recognize warning signs early and seek care. Prioritizing female cardiac health awareness is key to reducing deaths from ischemic heart disease in women worldwide.

REFERENCES:

1. Maas, A. A., Cenko, E., Vaccarino, V., Göttgens, I., et al. (2025, August 21). Changing clinical perspectives on sex and healthcare disparities in ischaemic heart disease. The Lancet Regional Health – Europe, Article 56.

2. Clapauch, R., Mecenas, A. S., Maranhão, P. A., & Bouskela, E. (2009). Microcirculatory function in postmenopausal women: Role of aging, hormonal exposure and metabolic syndrome. Microvascular Research, 78(3), 405–412.

3. Geraghty, L., Figtree, G. A., Schutte, A. E., Patel, S., Woodward, M., & Arnott, C. (2021). Cardiovascular disease in women: From pathophysiology to novel and emerging risk factors. Heart, Lung and Circulation, 30(1), 9–17.

4. Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A heart-healthy diet for cardiovascular disease prevention: Where are we now? Vascular Health and Risk Management, 19, 237–253.

5. U.S. Department of Health and Human Services. (2018). Physical activity guidelines for Americans (2nd ed.). U.S. Department of Health and Human Services.

6. Dobson, A. J., Alexander, H. M., Heller, R. F., & Lloyd, D. M. (1991). How soon after quitting smoking does risk of heart attack decline? Journal of Clinical Epidemiology, 44(11), 1247–1253.

7. Gottlieb, D. J., Redline, S., Nieto, F. J., Baldwin, C. M., Newman, A. B., Resnick, H. E., & Punjabi, N. M. (2006). Association of usual sleep duration with hypertension: The Sleep Heart Health Study. Sleep, 29(8), 1009–1014.

8. Jurgens, C. Y., Lee, C. S., Aycock, D. M., Masterson Creber, R., Denfeld, Q. E., DeVon, H. A.,Evers, L. R., Jung, M., Pucciarelli, G., Streur, M. M., & Konstam, M. A. (2022). State of the science: The relevance of symptoms in cardiovascular disease and research: A scientific statement from the American Heart Association. Circulation, 146(12), e173–e184.

9. Centers for Disease Control and Prevention. “Heart Disease Facts.” Centers for Disease Control and Prevention. Last modified February 7, 2024. https://www.cdc.gov/heartdisease/facts.htm.

10. Mosca, Lori, Rita M. Benjamin, et al. “Tracking Women’s Awareness of Heart Disease: An American Heart Association National Study.” Circulation 143, no. 24 (2021): e882–e894. https://doi.org/10.1161/CIR.0000000000000969.

11. Gupta, Aakriti, et al. “Sex Differences in Short-Term and Long-Term Mortality after Acute Myocardial Infarction in the United States.” Journal of the American Heart Association 7, no. 13 (2018): e008326. https://doi.org/10.1161/JAHA.117.008326.

_MSM