Signs of Heart Attack in Women
By Megan Meier, BSN, RN
Heart attack, or myocardial infarction, results from a blocked cardiac artery, or a blood vessel that supplies blood in the heart. Up to 70% of women have chest tightness or pressure, but 30% of women have different symptoms (1). Signs of heart attack, or myocardial infarction, in women can appear differently than in men. Heart disease in men most of the time forms in the larger coronary arteries, or the blood vessels that supply blood to the heart. Heart disease in women mostly forms in the smaller arteries that branch out from the coronary arteries, often called microvascular disease (2, 3)
Because of the blockages of the smaller arteries, the symptoms can appear more subtle (1), such as:
Extreme and Unusual Fatigue
Refer to your baseline energy level. If your usual activities of daily living such as walking, making the bed, and brushing your teeth wear you out, particularly if accompanied by a “heavy chest”, is a serious problem (1).
Shortness of Breath
This can be with or without chest discomfort (4). Becoming short of breath when you previously weren’t with usual activities can be indicative of a cardiac problem (1).
Neck, Jaw, Arm, and/or Back Pain
This is particularly serious if the origin is hard to pinpoint (1). If any pain in the neck, jaw, arm, and/or back cannot be explained, don’t dismiss the symptom(s).
Sudden or Excessive Sweating
This is not sweating associated with menopause. Sweating accompanied with nausea, chest pain, and/or shortness of breath are symptoms of a cardiac problem (1).
Upset Stomach (4)
This can imitate severe indigestion and cause nausea and/or vomiting (5). Uncomfortable Pressure or Pain in the Center of Your Chest
Even if this comes and goes, it can be a sign of a serious cardiac problem (4). If you are feeling chest pressure and/or tightness, especially if accompanied by any of the above symptoms, go to the emergency room immediately (1).
Too often, these symptoms are misdiagnosed or neglected entirely. If something doesn’t feel right, don’t delay getting help. Your health care provider will listen to your symptoms and record your blood pressure and pulse. They will order blood tests to see if there is any damage to your heart. They may use an electrocardiogram (EKG) to measure the electrical activity of your heart, or an echocardiogram, an ultrasound of the heart while pumping blood to assess its function. Don’t ignore any problematic symptoms, take the steps to intervene to find the source of the problem (1).
References
1. Heart Attack Symptoms Women Shouldn’t Ignore [Internet]. Cleveland Clinic. Available from: https://health.clevelandclinic.org/women-dont-ignore-3-subtle-heart attack-symptoms
2. American Heart Association. Angina in Women Can Be Different Than Men [Internet]. www.heart.org. 2015. Available from: https://www.heart.org/en/health topics/heart-attack/angina-chest-pain/angina-in-women-can-be-different-than-men
3. Expanding the possibilities of treatment options for patients with coronary microvascular disease - Mayo Clinic [Internet]. Mayoclinic.org. 2025. Available from: https://www.mayoclinic.org/medical-professionals/cardiovascular
diseases/news/expanding-the-possibilities-of-treatment-options-for-patients-with coronary-microvascular-disease/mac-20581614. (Source for comparative figure)
4. American Heart Association. Heart attack symptoms in women [Internet]. www.heart.org. 2024. Available from: https://www.heart.org/en/health-topics/heart attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women
5. Mayo Clinic. Heartburn or Heart attack: When to Worry [Internet]. Mayo Clinic. 2023. Available from: https://www.mayoclinic.org/diseases-conditions/heartburn/in depth/heartburn-gerd/art-20046483
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