How heart attack symptoms differ in women

Today is National Wear Red Day; a day recognized to raise awareness around heart disease in women.

Many women have questions about heart attack symptoms and how they differ from men. According to Dr. Azmey Matarieh, a cardiologist with Advocate Heart Institute in Elgin, Ill., a common misconception is that heart attack symptoms for men and women will always be different. In reality, men and women often share similar symptoms.

“What we find is that the most common symptom in both men and women is pain or pressure in the chest,” Dr. Matarieh says. “In women, the pain may not be as severe like the typical ‘elephant on the chest’ feeling and may actually be unrelated to chest pain.”

Since chest pain or pressure may not always be the prominent symptom, women need to be aware of other symptoms unique to them. Prior to having a heart attack, women may experience symptoms such as fatigue, sleep disturbance, shortness of breath and indigestion. During a heart attack, they may also experience pain in the arm, shoulder or neck as well as lightheadedness or dizziness, Dr. Matarieh explains.

“The symptoms that women develop can be something unusual or different to them, and therefore, should be addressed,” he says.

Most heart attacks are caused by major vessel obstruction, but women are more likely to develop microvascular disease (small vessel disease) as well. In this condition, small arteries in the heart become narrowed and can lead to a heart attack. Men and women share the same heart disease risk factors, such as high blood pressure, diabetes and high cholesterol. Smoking, obesity and lifestyle also have a significant impact on women’s heart health.

Common in women, extreme stress and depression may lead to a condition known as Takotsubo Cardiomyopathy or stress-induced cardiomyopathy. “Patients will appear like they are having a heart attack, but we don’t find blockages of the arteries,” Dr. Matarieh says. “Most patients’ hearts return to normal function after medical treatment.”

Aspirin therapy for heart attack prevention
According to Dr. Matarieh, daily aspirin therapy can be beneficial for preventing a heart attack in both men and women.

“Taking aspirin thins the blood by acting on factors in the blood that prevent blood clots from forming,” he explains. “As a result, we have to take into consideration bleeding risk and cardiovascular risk and determine if aspirin will have the greatest benefit.”

Like any medication, aspirin can have side effects, particularly bleeding in the stomach, bowel and even brain. “The most important thing to consider when taking aspirin is whether the benefit is greater than the risk,” Dr. Matarieh says. “I take all risk factors and medical history into consideration when recommending aspirin to my patients.”

If you’re concerned about your risk of heart disease or heart attack, Dr. Matarieh recommends consulting with your physician on how to decrease those risk factors and if medication is appropriate treatment.

Do you know your risk for heart disease? Take our heart risk assessment here. If you are at high risk, see one of Advocate Heart Institute’s cardiologists within 24 hours.