Heart attack symptoms in women: warning signs to know

Medical disclaimer: This page is general health information for education only. It is not medical advice and is not a substitute for diagnosis or treatment by a qualified health professional. It has not been reviewed by a clinician. In an emergency, call 911 or your local emergency number.

Heart attack symptoms in women: the short answer

If you think you or someone else is having a heart attack, call 911 right away, even if you are not sure. The HHS Office on Women’s Health says to call 911 even when you are unsure.

Do not drive yourself to the hospital, and do not let a friend drive you. Ambulance workers are trained to treat you on the way. Treatments that open clogged arteries work best within the first hour after a heart attack starts.

A heart attack happens when blood flow to the heart suddenly becomes blocked. Without that blood, the heart muscle cannot get oxygen and begins to die. MedlinePlus explains what a heart attack is. The medical name is myocardial infarction.

This page focuses on the warning signs women should know and why they are often missed. It goes deeper than the general warning signs on our heart disease overview. You can find related topics in the health conditions library.

This page does not replace emergency care. It cannot tell you whether your own symptoms are a heart attack.

The most common heart attack symptom in women

Chest pain or discomfort is the most common heart attack symptom in women, just as it is in men.

• Heart attack chest discomfort is usually in the center or left side of the chest.
• The discomfort can feel like pressure, squeezing, fullness, or pain. CDC lists the major heart attack symptoms.
• It can be mild or strong, last more than a few minutes, or go away and come back.
• Women often describe heart attack chest pain as pressure or tightness.
• The more heart attack symptoms you have, the more likely it is a heart attack.

Angina is chest pain in people who have coronary artery disease. Stable angina usually goes away in a few minutes with rest. Heart attack pain does not go away when you rest. NHLBI says to call 911 if you cannot tell angina from a heart attack.

Chest pain has many causes, and this list cannot rule a heart attack in or out.

Other heart attack symptoms women have more often

Women are more likely than men to have heart attack symptoms besides chest pain, such as shortness of breath, nausea, and unusual tiredness.

• Pain in the back, neck, jaw, or throat
• Pain in the shoulder or arm
• Shortness of breath or problems breathing
• Nausea, vomiting, indigestion, or heartburn
• Unusual tiredness and weakness
• Anxiety
• Dizziness or light-headedness

These symptoms can happen together with chest pain or without any chest pain. NHLBI describes heart attack symptoms in women. NHLBI also notes that feeling unusually tired for no reason, sometimes for days, is more common in women.

Compared with men, women tend to have symptoms more often when resting, or even when asleep. Emotional stress can also play a role in triggering heart attack symptoms. Mayo Clinic notes these patterns in women.

No single symptom confirms or rules out a heart attack. Many of these symptoms also come with common, less serious illnesses, so a clinician needs tests to tell the difference.

Silent and atypical heart attacks

A silent heart attack is a heart attack that does not cause obvious symptoms. Silent heart attacks are more common in women than in men.

• Silent heart attacks can happen with no symptoms or very mild symptoms.
• A doctor may find a silent heart attack days, weeks, or months later.
• It may be found on an electrocardiogram (ECG), a test used to diagnose heart problems.
• Silent heart attacks can happen to women younger than 65.
• Silent heart attacks are more likely in women with diabetes.

The Office on Women’s Health describes silent heart attacks in women. Diabetes can change how you sense pain, which makes heart attack symptoms easier to miss. NHLBI adds that silent heart attacks are more common in older adults. Our guide to diabetes covers the condition itself.

Not all heart attacks begin with sudden, crushing chest pain. Symptoms can start slowly, be mild, and come and go over several hours. NHLBI describes how heart attack symptoms vary. Women are more likely than men to have these nontraditional symptoms. NHLBI uses the term atypical heart attack for cases that first hospital tests may miss.

Women are also more likely than men to have heart attacks not caused by coronary artery disease. NHLBI says this makes heart attacks in women harder to diagnose. The Office on Women’s Health gives one example, a coronary spasm, when an artery pinches itself closed. Coronary spasms are rare, but they happen more often in young women.

Only a clinician can confirm a silent heart attack with tests. This page cannot help you work out whether you had one in the past.

Why women may delay care or get a later diagnosis

Women may get emergency care later because they downplay symptoms, mistake them for milder problems, or have signs that early tests miss.

NHLBI and the American Heart Association point to several reasons.

• Many women do not recognize their symptoms as a heart attack.
• Women often blame symptoms on acid reflux, the flu, or normal aging. The American Heart Association describes this pattern.
• Usual first screening tests at the hospital may not detect an early or atypical heart attack.
• Women may be more likely than men to face delays in getting a first electrocardiogram at the hospital. NHLBI explains the diagnosis and treatment gaps women face.

According to NHLBI, women have a higher risk of serious health problems after a heart attack because of them.

If you think you are having a heart attack, get emergency help right away. The Office on Women’s Health advises you not to let anyone tell you that you are overreacting or to wait and see. For general emergency basics, see our first aid guide.

These patterns describe groups of women in research. They do not predict how any single hospital visit will go.

Heart attack risk factors specific to women

Some heart attack risk factors are unique to women, including pregnancy complications, early menopause, and polycystic ovary syndrome.

Heart disease is the leading cause of death for women in the United States. Only about half (56%) of US women recognize that heart disease is their number 1 killer. CDC reports on women and heart disease. According to the Office on Women’s Health, women usually have heart attacks about 10 years later than men. The average age of a first heart attack is 64 for men and 72 for women.

NHLBI says smoking, high blood pressure, high cholesterol, high blood sugar, obesity, and stress raise heart attack risk more in women than in men. Our page on high blood pressure explains that risk factor in more detail.

Pregnancy and reproductive factors that can raise a woman’s risk of coronary heart disease include:

• Preeclampsia and other high blood pressure disorders during pregnancy
• Gestational diabetes, which is diabetes that develops during pregnancy
• Preterm birth or delivering a baby smaller than average
• Early menopause, before age 40
• Polycystic ovary syndrome (PCOS)
• Endometriosis
• A first period before age 11

Autoimmune and inflammatory diseases, depression, and anxiety can also raise risk. NHLBI lists risk factors unique to or more common in women. Heart attacks are not common in pregnancy, but they can happen during and soon after delivery.

Having a risk factor does not mean you will have a heart attack. Having none does not rule one out. This section does not cover how to lower your risk or treat heart disease.

Questions to bring to your appointment

These questions can help you talk with your care team about your personal heart attack risk.

• Based on my health history, how high is my risk of a heart attack?
• Do my pregnancy history or the timing of my menopause change my heart risk?
• Which symptoms mean I should call 911 instead of waiting to see you?
• Could I have had a silent heart attack, and would an ECG show it?
• How do my blood pressure, blood sugar, and cholesterol affect my heart?
• Does the risk score you use account for risk factors specific to women?

These questions are a starting point. They do not replace advice from your own clinician.