Heart Attacks in Women: Symptoms, Risks & Prevention Tips

Lori Sepich smoked for years and sometimes skipped taking her blood pressure medicine. But she never thought she’d have a heart attack. The possibility “just wasn’t registering with me,” said the 64-year-old from Memphis, Tennessee, who suffered two heart attacks 13 years apart.

She’s far from alone. More than 60 million women in the U.S. Live with cardiovascular disease, which includes heart disease as well as stroke, heart failure and atrial fibrillation. And despite the common misconception that heart attacks primarily strike men, women are equally vulnerable.

Overall in the U.S., 1 in 5 women dies of cardiovascular disease each year, with 37,000 of those deaths resulting from heart attacks. Cardiovascular disease is, as Dr. Sharonne Hayes, a cardiologist at the Mayo Clinic in Rochester, Minnesota, states, “the No. 1 killer of women. It will affect you or someone you know.” She emphasizes that “knowing what to do if you have symptoms of a heart attack and taking action if you do, that’s really important.”

Preventing Heart Attacks: A Multifaceted Approach

There are several steps individuals can take to reduce their risk. The American Heart Association’s “Life’s Essential 8” provides a framework for prevention: eating a healthy diet, quitting tobacco use, prioritizing healthy sleep, increasing physical activity, controlling cholesterol, and managing weight, blood sugar, and blood pressure.

Dr. Stacey Rosen, association president, advises regular checkups to discuss these preventive measures, monitor overall health, and address any family history of heart problems. Doctors also suggest discussing risk factors that uniquely or disproportionately affect women.

Women are more susceptible to autoimmune conditions like lupus or rheumatoid arthritis, which cause inflammation that can elevate heart disease risk. They are also more likely to experience depression, a condition linked to inflammation and unhealthy behaviors. A history of high blood pressure or diabetes during pregnancy, miscarriages, or stillbirths are associated with increased cardiovascular risk. Even hormonal changes, such as hot flashes and night sweats during menopause, have been linked to a greater risk of high blood pressure and other cardiovascular factors.

Heart Attacks in Women: Recognizing the Differences

The typical portrayal of a heart attack – a middle-aged man clutching his chest and collapsing – doesn’t reflect the reality for many, particularly women. As Dr. Hayes explains, “it’s not going to probably be one of those Hollywood heart attacks.” Chest pain or discomfort is a common symptom, but it’s far from the only one.

“What’s different about women is that they are more likely than men to have other symptoms as well,” Rosen notes. These can include back pain, shortness of breath, cold sweats, unusual fatigue, nausea, lightheadedness, an anxious feeling, jaw pain, and tingling in the fingers. The exact reasons for these differences aren’t fully understood, but research suggests physiological variations may play a role.

Another key difference is the subtlety of symptoms in women. Hayes often hears patients describe symptoms that “waxed and waned a little bit over time, but I knew something wasn’t right.” This can lead to delays in seeking medical attention.

Immediate Action is Crucial

“If you think that there’s even a chance that you’re having a heart attack, that’s when you call 911,” Rosen advises, emphasizing the importance of erring on the side of caution. She recommends taking an ambulance to the hospital, as emergency medical services are better equipped to handle such situations than urgent care centers or a doctor’s office.

Any delay in receiving appropriate care can have harmful, even fatal, consequences. “If you wait too long,” Rosen warns, “the damage can be more significant.”

Overcoming Denial and Recognizing the Signs

Lori Sepich’s experience highlights the dangers of denial. After being diagnosed with severe, hereditary high blood pressure at age 17, she largely dismissed her heart health. When she experienced her first heart attack in 2005 – on Easter Sunday – she initially ignored the extreme chest pressure, nausea, and radiating arm pain.

“I chose to ignore those signs that day because I was absolutely in shock,” she recalls. “I was scared.” She attended Mass, a family lunch, and even went to work the following day before finally seeking emergency care at her doctor’s urging. She ultimately required six stents and a week-long hospital stay.

She acted more quickly during her second heart attack, promptly receiving another stent after her cardiologist discovered a near-complete blockage in a major artery.

Sepich now manages her blood pressure effectively, has abstained from smoking for over two decades, and exercises regularly. She urges other women to be honest with themselves about their heart health. “I could justify my actions from denial. I could just be like, ‘Oh, it’s not gonna hurt you,’” Sepich said. “Well, it does hurt you. It can kill you.”