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5 heart attack symptoms in women that should be talked about more

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The warning signs of a heart attack most women are missing

We can blame it on everything we've seen on TV, but as women, most of us make the mistake of assuming that heart attacks only happen to men. But you might be shocked to learn that heart disease remains the leading cause of death for both men and women in the U.S.

According to the CDC, heart disease fatalities affect men and women equally. And even worse, almost two-thirds of the women who die suddenly from heart disease don't experience any previous symptoms. This "silent killer" is responsible for roughly one in four female deaths.

More: 5 heart attack symptoms that are different in women

According to Dr. William Daniel, leading cardiologist and chief medical officer of software provider Emerge Clinical Solutions, heart disease is even more dangerous to women because symptoms of a heart attack are often different for women than men. Worse, most women don’t know the symptoms or attribute warning signs to stress or general fatigue. Knowing the signs of an attack, says Dr. Daniel, is the first major step toward preventing heart attacks from being America’s No. 1 killer in women.

1. More subtle than chest pain

Chest pain may seem like an obvious symptom of heart attack, but in reality symptoms are much more subtle and easy to ignore. We’ve all seen Hollywood heart attacks involving dramatic chest-clutching and sudden collapse, but for women, symptoms can be anything from discomfort that feels like bad indigestion to pain in the arm to breathlessness. Before you learn about the symptoms, it’s important to erase assumptions that a heart attack is always a chest-pounding, keeling-over movie melodrama.

More: 8 foods that just might trigger a migraine

2. It may be more than fatigue

Everyone feels a little tired now and then. But even though we learn to write off fatigue as a sign of not sleeping enough, fighting a cold, overexertion or a reaction to a new medicine, feeling drowsy nonstop could mean something bigger. Unusual or extreme fatigue shouldn’t be ignored, says Dr. Daniel. It may be an early warning sign of heart disease or an impending heart attack. One recent study by the National Institutes of Health (NIH) found that more than 70 percent of women surveyed experienced marked fatigue in the days or weeks prior to their heart attacks.

3. Pay attention to chronic sleep problems

Everyone experiences problems sleeping now and then because of stress, but chronic trouble sleeping might be caused by more than everyday exertion. If you’ve noticed unusual or prolonged disturbances in your regular sleep patterns, it’s smart to visit your doctor. The NIH study showed almost half of women who recently had a heart attack had sleep disturbances or unexplained insomnia in the days or weeks before the attack.

More: Why young women are at a higher risk for strokes

4. Check your skin tone

Some women may take on a gray pallor before or while having a heart attack. If your complexion is suddenly dull, call a doctor before you dial the esthetician. Cold and clammy skin or appearing severely ill can be another sign.

5. You may feel like you have the flu

We’ve all been through the flu, but many women write off heart attacks as just that. Women may experience shortness of breath for no obvious reason, unusual upper-back pressure, dizziness, lightheadedness, nausea, vomiting or fainting.

More: Chronic fatigue syndrome is so much more than exhaustion

Prevention and treatment

Even though signs of heart attack can be subtle in women, the good news is that heart disease is preventable. To better understand your body and risks, schedule an appointment with your health care provider to discuss your history. Try to move around a little more every day as well, since even walking 30 minutes a day can lower the risk of heart attack. If you think you might be having a heart attack, dial 911, sit or lie down, and chew an uncoated aspirin immediately. Even if it turns out not to be a heart attack, it’s better to be prepared. Once a heart attack starts, every minute counts.

The bottom line, says Dr. Daniel: Don’t ignore how you feel. If you know something isn’t right, you can’t expect symptoms to just go away. Even though women often put themselves last after taking care of others, it’s important to pay attention to your body’s signals and trust your instincts. Women may experience warning signs up to a month before an attack, which means they have a valuable internal warning system when something isn’t right. The true trick to preventing a heart attack is taking preventative measures like exercising and eating well, but most of all, listening to your body.

Originally published Feb. 2013. Updated May 2016.

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