Five subtle signs of heart attacks in women

Heart disease is the leading cause of death in women in the U.S. While heart disease affects men and women in equal numbers, symptoms of heart disease can differ between the sexes. In the case of heart attacks, men tend to experience the classic heart attack symptoms of chest pain, increased sweating, and shortness of breath, while women are more likely to experience symptoms that tend to be a little vaguer.

Here are subtle but serious symptoms of a heart attack that should prompt patients to seek immediate medical attention in the closest emergency department, since early intervention can reperfuse heart tissue before it dies and can prevent lethal heart attack complications like heart failure and fatal cardiac arrhythmias.

1. Nausea & vomiting

Heart attacks most commonly happen when a blood clot lodges in a coronary artery that’s already narrowed from age-related changes or plaque deposits. When this happens, the area of the heart that receives oxygen-rich blood from that artery is suddenly deprived of oxygen, and the heart tissue begins to die. This causes a phenomenon called cardiogenic vomiting, where patients experience nausea and vomiting induced by the toxins released as injured cardiomyocytes, the cells that comprise heart tissue, begin to die.

Patients experiencing nausea and vomiting, especially when accompanied by other symptoms like chest pressure, shortness of breath, or dizziness, should seek immediate medical attention to rule out a heart attack.

2. Lightheadedness

Often the symptoms women experience from a heart attack don’t happen in their chest; they happen as organs in other parts of their bodies are affected.

Women who are having a heart attack often experience lightheadedness or dizziness because the heart is not able to provide the brain with an adequate amount of oxygenated blood.

Postmenopausal women are at an increased risk of heart attacks because they have lower levels of heart-protective estrogen compared to premenopausal women. Women with age-related heart disease risk or other risk factors for heart disease, including diabetes, high blood pressure, obesity, high cholesterol, or tobacco use, should consider lightheadedness or dizziness a serious symptom that requires immediate medical attention.

3. Fatigue

Fatigue is a vague but important symptom of heart disease. Studies have shown that women who have a heart attack can develop unusual fatigue up to four weeks before the heart attack happens.

If you’re suddenly fatigued by everyday activities that you used to do with ease, like climbing a flight of stairs or carrying groceries, or walking around the block, remember that fatigue can be a symptom that your heart isn’t getting enough oxygen.

Women with sudden and unusual fatigue, especially if they have other risk factors of heart disease, should seek immediate medical attention that includes a comprehensive cardiac evaluation.

4. Increased anxiety

When the heart is weakened by a lack of oxygen, the body responds by releasing adrenaline, a stimulant meant to make the heart contract more effectively. Adrenaline also causes a rapid heartbeat, palpitations, rapid breathing, and heightened anxiety, which is why patients who are having a heart attack sometimes feel suddenly anxious.

Also, shortly before a catastrophic event like a massive heart attack, some patients experience what’s called an “impending sense of doom,” which can feel like heightened anxiety or even a panic attack, as the subconscious senses that something dangerous is about to happen.

Patients experiencing these sudden symptoms, especially if they have other risk factors for heart disease, should seek medical care to rule out a cardiac cause of their symptoms.

5. Shortness of breath

Your lungs and your heart work together closely to make sure your body’s cardiopulmonary system supplies the body with all the oxygenated blood it needs to function properly.

If your heart is weakened by a lack of blood flow from a blocked coronary artery, it’s unable to contract with enough strength to send a sufficient amount of blood to the lungs. When this happens, patients often feel shortness of breath because their heart and their lungs are not getting enough oxygen.

Patients who experience shortness of breath -- especially when they’re not exerting themselves, or when they’re doing everyday activities that didn’t make them short of breath before -- should undergo a thorough cardiac evaluation to make sure they’re not experiencing symptoms of a heart attack. At GoHealth Urgent Care, we offer electrocardiograms (ECG or EKG) at all our locations, which is a test that analyzes the electrical activity of your heart. This test can reveal abnormal heart rhythm, if your heart is getting enough oxygen, or if your heart is enlarged.

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We’re here 7 days a week to care for you. However, if you believe you are experiencing symptoms of a heart attack, please call 911.

Written by Sarah Thebarge, Physician Assistant