Heart attack symptoms can be more subtle
“Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure, ” Nieca Goldberg, MD, medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center, told the American Heart Association. “Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.” Even though heart disease is the number-one killer of women in America, women don’t always immediately suspect heart attack when some or all of these symptoms strike. They may mistake them for acid reflux, the flu, or normal aging, according to the AHA.
Women may have a different type of heart disease
Part of the reason heart attack symptoms can present differently in women is because there’s a difference in plaque and blockage patterns between men and women, according to cardiologist C. Noel Bairey Merz, MD, director of the Women’s Heart Center at the Cedars-Sinai Heart Institute. On the center’s website, Dr. Bairey Merz explains that women’s heart disease should be called ischemic heart disease, which indicates a lack of blood flow and oxygen to the heart. (The kind of heart disease that primarily affects men should remain coronary artery disease, which indicates plaque build-up in the arteries near the heart). “Women with ischemic heart disease generally have major arteries that are clear of plaque, but the smaller coronary blood vessels cease to constrict and dilate properly, creating the lack of blood flow and oxygen to the heart,” according to the site. Women can have normal angiograms and stress tests even if they have ischemic heart disease; doctors should pay attention to symptoms like chest pain and shortness of breath instead of just looking at test results, Dr. Bairey Merz says.